Claim Processor jobs at MetLife - 281 jobs

Long Term Disability Claims Specialist II 3 30 26
Metlife, Inc. 4.4
Claim processor job at MetLife
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The LTD Claims Specialist II evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the LTD Claims Specialist II is required to exercise independent judgment, critical thinking skills, exemplary customer service skills as well as effective inventory management skills. Location: Fully Virtual Key Responsibilities: * Virtual roles predominately work from a home office with periodic visits to the assigned office as needed for team events, meetings, training, business continuity, etc. * Effectively manages with minimal oversight an assigned caseload of moderately complex claims which consists of pending, ongoing/active reviews. The LTD CS will be evaluated for increases in their authority levels as they become more experienced in their decision-making and demonstrate consistency in meeting all key performance indicators * Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations. * Develop actions plans and identify return to work potential * Provides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other information that may be pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skills * Interacts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations * Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available * Collaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants as needed to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions. * Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed * Proficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, and Rehab Return to Work benefits, and other non-routine payments * Provides timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determination. * Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas. Essential Business Experience and Technical Skills: Required: * High school diploma * Prior experience with independent judgement and decision making while relying on the available facts * Be able to demonstrate the use of critical thinking and analysis when reviewing the information * Creative problem-solving abilities and the ability to think outside the box * Excellent interpersonal and communication skills in both verbal and written form * Excellent customer service skills proven through internal and external customer interactions * Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively * Organizational and time management skills * Minimum 1 year LTD/IDI Insurance Claims experience Preferred: * Bachelor's degree Business Category Operations - Claims Travel Not applicable At MetLife, we're leading the global transformation of an industry we've long defined. United in purpose, diverse in perspective, we're dedicated to making a difference in the lives of our customers. The expected salary range for this position is $41,600 - $62,500. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms. Benefits We Offer Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more! About MetLife Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East. Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible. Join us! MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics"). If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities. $41,600 - $62,500
$41.6k-62.5k yearly 4d ago

Looking for a job?

Let Zippia find it for you.

Injury Examiner
USAA 4.7
Colorado Springs, CO jobs
Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Injury Examiner, you will be responsible to adjust complex bodily injury claims, UM/UIM, and small business claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy. This role is remote eligible in the continental U.S. with occasional business travel. However, individuals residing within a 60-mile radius of a USAA office will be expected to work on-site three days per week. What you'll do: Adjusts complex auto bodily injury claims with significant injuries (e.g. traumatic brain injury, disfigurement, fatality) and UM/UIM, and small business claims, as well as some auto physical damage associated with those claims. Identifies, confirms, and makes coverage decisions on complex claims. Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes. Prioritizes and manages assigned claims workload to keep members and other involved parties informed and provides timely claims status updates. Collaborates and supports team members to resolve issues and identifies appropriate matters for escalation. Partners and/or directs vendors and internal business partners to facilitate timely claims resolution. Serves as a resource for team members on complex claims. Delivers a best-in-class member service experience by setting appropriate expectations and providing proactive communication. Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed. Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. What you have: High School Diploma or General Equivalency Diploma. 4 years auto claims and injury adjusting experience. Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations. Advanced negotiation, investigation, communication, and conflict resolution skills. Demonstrated strong time-management and decision-making skills. Proven investigatory, prioritizing, multi-tasking, and problem-solving skills. Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims. Ability to exercise sound financial judgment and discretion in handling insurance claims. Advanced knowledge of coverage evaluation, loss assessment, and loss reserving. Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts. What sets you apart: 2 or more years of high-value catastrophic injury experience (e.g. traumatic brain injury, disfigurement, fatality) to include UM/UIM coverage College Degree (Bachelor's or higher). Insurance Designation. Compensation range: The salary range for this position is: $85,040 - $162,550. USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.). Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
$43k-59k yearly est. Auto-Apply 1d ago
Claims Examiner
Securian 3.7
Macon, GA jobs
** At Securian Financial, the internal title is Customer Benefit Payments Sr Rep** The Claims team is looking for a highly motivated, energized and positive individual. We work in a fast-paced, ever-changing environment where claim information needs to be processed efficiently and accurately. We take pride in providing high standards of performance to our customers and strive to exceed those standards. If you enjoy assisting people in their time of need, being customer focused and working in a team-oriented environment, then joining our team may be right move for you. Responsibilities include but not limited to: Serves department dedicated to issuing timely, accurate benefit payments to customers and channel partners. Tasks include payment processing, data entry, records management, fraud prevention, and loss or eligibility investigations. Provides effective, customer-centric, and compliant communication to internal and external resources, clients, and partners. Adjudicates payments in compliance with regulatory requirements and applicable law, engaging legal, medical, and investigative resources as necessary. Maintains accurate and complete payment record to improve the customer experience, quality review/audit process, and protect our company in the event of litigation and regulatory investigations. Makes critical risk assessments on behalf of Securian Financial and its clients. May manage or serve as subject matter expert for special projects. Ensures payment practices are efficient and in keeping with our organization's values and the highest ethical standards. Qualifications: Strong analytical skills and attention to detail Good judgment/decision-making skills and organizational skills Strong written and verbal communication skills Willingness to maintain a positive and compassionate attitude in a high volume setting Ability to work independently within a team environment Desire to provide world-class customer service Preferred qualifications: Experience on claims processing systems Financial institution background Demonstrated proficiency with Microsoft Word and Outlook Telephone customer service experience #LI-Hybrid This role requires 2 days onsite a month and for moments that matter. The estimated base pay range for this job is: $18.27 - $31.73 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information on base pay and incentive pay (if applicable) can be discussed with a member of the Securian Financial Talent Acquisition team. Be you. With us. At Securian Financial, we understand that attracting top talent means offering more than just a job - it means providing a rewarding and fulfilling career. As a valued member of our high-performing team, we want you to connect with your work, your relationships and your community. Enjoy our comprehensive range of benefits designed to enhance your professional growth, well-being and work-life balance, including the advantages listed here: Paid time off: We want you to take time off for what matters most to you. Our PTO program provides flexibility for associates to take meaningful time away from work to relax, recharge and spend time doing what's important to them. And Securian Financial rewards associates for their service by providing additional PTO the longer you stay at Securian. Leave programs: Securian's flexible leave programs allow time off from work for parental leave, caregiver leave for family members, bereavement and military leave. Holidays: Securian provides nine company paid holidays. Company-funded pension plan and a 401(k) retirement plan: Share in the success of our company. Securian's 401(k) company contribution is tied to our performance up to 10 percent of eligible earnings, with a target of 5 percent. The amount is based on company results compared to goals related to earnings, sales and service. Health insurance: From the first day of employment, associates and their eligible family members - including spouses, domestic partners and children - are eligible for medical, dental and vision coverage. Volunteer time: We know the importance of community. Through company-sponsored events, volunteer paid time off, a dollar-for-dollar matching gift program and more, we encourage you to support organizations important to you. Associate Resource Groups: Build connections, be yourself and develop meaningful relationships at work through associate-led ARGs. Dedicated groups focus on a variety of interests and affinities, including: Mental Wellness and Disability Pride at Securian Financial Securian Young Professionals Network Securian Multicultural Network Securian Women and Allies Network Servicemember Associate Resource Group For more information regarding Securian's benefits, please review our Benefits page. This information is not intended to explain all the provisions of coverage available under these plans. In all cases, the plan document dictates coverage and provisions. Securian Financial Group, Inc. does not discriminate based on race, color, religion, national origin, sex, gender, gender identity, sexual orientation, age, marital or familial status, pregnancy, disability, genetic information, political affiliation, veteran status, status in regard to public assistance or any other protected status. If you are a job seeker with a disability and require an accommodation to apply for one of our jobs, please contact us by email at , by telephone (voice), or 711 (Relay/TTY). To view our privacy statement click here To view our legal statement click here
$18.3-31.7 hourly 4d ago
Claims Examiner
Securian 3.7
Saint Paul, MN jobs
** At Securian Financial, the internal title is Customer Benefit Payments Sr Rep** The Claims team is looking for a highly motivated, energized and positive individual. We work in a fast-paced, ever-changing environment where claim information needs to be processed efficiently and accurately. We take pride in providing high standards of performance to our customers and strive to exceed those standards. If you enjoy assisting people in their time of need, being customer focused and working in a team-oriented environment, then joining our team may be right move for you. Responsibilities include but not limited to: Serves department dedicated to issuing timely, accurate benefit payments to customers and channel partners. Tasks include payment processing, data entry, records management, fraud prevention, and loss or eligibility investigations. Provides effective, customer-centric, and compliant communication to internal and external resources, clients, and partners. Adjudicates payments in compliance with regulatory requirements and applicable law, engaging legal, medical, and investigative resources as necessary. Maintains accurate and complete payment record to improve the customer experience, quality review/audit process, and protect our company in the event of litigation and regulatory investigations. Makes critical risk assessments on behalf of Securian Financial and its clients. May manage or serve as subject matter expert for special projects. Ensures payment practices are efficient and in keeping with our organization's values and the highest ethical standards. Qualifications: Strong analytical skills and attention to detail Good judgment/decision-making skills and organizational skills Strong written and verbal communication skills Willingness to maintain a positive and compassionate attitude in a high volume setting Ability to work independently within a team environment Desire to provide world-class customer service Preferred qualifications: Experience on claims processing systems Financial institution background Demonstrated proficiency with Microsoft Word and Outlook Telephone customer service experience #LI-Hybrid This role requires 2 days onsite a month and for moments that matter. The estimated base pay range for this job is: $18.27 - $31.73 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information on base pay and incentive pay (if applicable) can be discussed with a member of the Securian Financial Talent Acquisition team. Be you. With us. At Securian Financial, we understand that attracting top talent means offering more than just a job - it means providing a rewarding and fulfilling career. As a valued member of our high-performing team, we want you to connect with your work, your relationships and your community. Enjoy our comprehensive range of benefits designed to enhance your professional growth, well-being and work-life balance, including the advantages listed here: Paid time off: We want you to take time off for what matters most to you. Our PTO program provides flexibility for associates to take meaningful time away from work to relax, recharge and spend time doing what's important to them. And Securian Financial rewards associates for their service by providing additional PTO the longer you stay at Securian. Leave programs: Securian's flexible leave programs allow time off from work for parental leave, caregiver leave for family members, bereavement and military leave. Holidays: Securian provides nine company paid holidays. Company-funded pension plan and a 401(k) retirement plan: Share in the success of our company. Securian's 401(k) company contribution is tied to our performance up to 10 percent of eligible earnings, with a target of 5 percent. The amount is based on company results compared to goals related to earnings, sales and service. Health insurance: From the first day of employment, associates and their eligible family members - including spouses, domestic partners and children - are eligible for medical, dental and vision coverage. Volunteer time: We know the importance of community. Through company-sponsored events, volunteer paid time off, a dollar-for-dollar matching gift program and more, we encourage you to support organizations important to you. Associate Resource Groups: Build connections, be yourself and develop meaningful relationships at work through associate-led ARGs. Dedicated groups focus on a variety of interests and affinities, including: Mental Wellness and Disability Pride at Securian Financial Securian Young Professionals Network Securian Multicultural Network Securian Women and Allies Network Servicemember Associate Resource Group For more information regarding Securian's benefits, please review our Benefits page. This information is not intended to explain all the provisions of coverage available under these plans. In all cases, the plan document dictates coverage and provisions. Securian Financial Group, Inc. does not discriminate based on race, color, religion, national origin, sex, gender, gender identity, sexual orientation, age, marital or familial status, pregnancy, disability, genetic information, political affiliation, veteran status, status in regard to public assistance or any other protected status. If you are a job seeker with a disability and require an accommodation to apply for one of our jobs, please contact us by email at , by telephone (voice), or 711 (Relay/TTY). To view our privacy statement click here To view our legal statement click here
$18.3-31.7 hourly 4d ago
Processor
United Mortgage Lending LLC 3.5
Troy, MI jobs
Full job description United Mortgage Lending LLC is looking for a detail-oriented and motivated Mortgage Loan Processor to join our team. In this role you will process mortgage applications, ensure and analyze all loan documentation, and ensuring that all loan documents are accurate and compliant with applicable regulations. Key Responsibilities: Review loan approvals and gather necessary documentation while maintaining strong communication with the borrowers Ensure compliance with Federal lending regulations Clear loan conditions and communicate effectively with the sales team Provide excellent customer service throughout the loan process Job Requirements: Minimum 2 years of experience in Wholesale Mortgage processing Manage a pipeline of 30-50 loans. Experience with Salesforce, Lending Pad and UWM portal Knowledge of Conventional, Jumbo, FHA, and VA processing Strong verbal and written communication skills Education: High school diploma or GED Languages: English required; Spanish a plus Benefits: Health, dental, and vision insurance 401(k) Job Type: Full-time Pay: $60,000.00 - $80,000.00 per year Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance Experience: Loan processing: 2 years (Preferred) wholesale mortgage: 1 year (Preferred) Ability to Commute: Troy, MI (Required) Work Location: In person
$28k-34k yearly est. 1d ago
CDP Processor II
Renasant Bank 4.3
Lawrenceville, GA jobs
Job ID 2025-14810 The CDP Processor II will process and have final responsibility for preparing Consumer and Commercial loan documents for retail branches and to promote uniformity of loan documents through a platform automation system in a centralized location. RENASANT BANK IS AN EQUAL OPPORTUNITY EMPLOYER Responsibilities Analyze Consumer, HELOC, and Commercial loan applications for completeness Proficient use of loan processing software and other bank software (LaserPro, DecisionPro, nCino, IBS, ISView, Word and Excel) Proficient knowledge of loan documentation, loan policy, compliance, and loan procedures Prepare HELOC Disclosure packages and HELOC loans Effectively communicate with lending personnel to ask questions and get additional information when necessary Maintain general proficiency to complete and review loan documents for accuracy before sending to lending location Advanced knowledge of Consumer and Commercial Extensions, Admin Renewals, Modifications, Change in Terms, Release/Substitute Collateral, and Subordination process Perform other related duties as assigned Qualifications High school diploma or equivalent required Minimum of 2 years of experience in banking - commercial and consumer loan experience required Minimum of 1 year of experience in LaserPro preferred Advanced understanding of Consumer, HELOC, and Commercial applications and loan documentation to prefect the banks lien Proficient verbal and written communication skills Proficient computer and 10-key skills Excellent work ethic Physical Demands The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand or sit; kneel, stoop, or squat; use hands or fingers to handle or feel objects, tools or controls; reach with hands and arms, and talk or hear. The employee is occasionally required to walk. The employee must occasionally lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, peripheral vision, depth perception and the ability to focus. Work Environment The Bank's professional working environment requires employees to communicate effectively, both verbally and in writing. Employees must demonstrate strong interpersonal skills when working closely with internal business partners and external clients. Employees may be exposed to confidential and propriety information within the working environment, therefore, must uphold confidentiality at all times. Due to the possibility of being exposed to high risk situations (i.e. robbery), detailed instructions and procedures are required to be followed at all times to safeguard the Bank's employees, customers, and assets. The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements. The principal duties and responsibilities enumerated are all essential job functions except for those that begin with the word "May". This is intended to describe the normal level of work required by the person performing the work. The principle duties outlined are the essential responsibilities and duties. Other duties may be assigned as needs arise. Job requirements and/or processes may be modified to reasonably accommodate persons with a disability as required by law. This description is not intended as a contract and is subject to change. Any written contractual agreements supersede this job description.
$25k-29k yearly est. 5d ago
Equity Processor II
Navy Federal Credit Union 4.7
Pensacola, FL jobs
To process equity loans and ensure compliance in accordance with applicable federal/state laws, as well as Navy Federal's policies, procedures, NCUA and Federal Home Loan Bank guidelines and regulations. To provide information to members regarding equity loan requirements, products and related services. Process equity loan applications according to established guidelines and requirements. Coordinate final loan application changes, revisions and corrections with other equity staff, closing agents and settlement attorneys to ensure accurate and efficient processing of equity loans. Record, track and monitor documentation issues and productivity. Perform moderately complex/varied tasks with moderate scope and analysis. Responsibilities Act in the capacity of a Loan Officer on applications status and communicate with member regarding outstanding documentation issues Analyze, research and resolve problems and discrepancies related to member accounts/loans Analyze/evaluate status of title, determine exceptions for acceptability and take corrective action or obtain additional documentation if required Communicate outstanding documentation requirements and set appropriate deadlines for submission Coordinate schedule of settlement with member and settlement agent/notary public Counsel current and prospective members about Navy Federal's products and services Examine preliminary title work, status reports , hazard and flood insurance policies to determine if property condition/insurance is within acceptable levels Identify circumstances in which additional documentation may be required - Moderately complex/Varied Prepare loan disclosures required by Federal/state laws (e.g. Good Faith Estimate, Truth-In-Lending) Process equity applications according to established laws, requirements and guidelines Relay loan status to member and other member approved parties (e.g. real estate agent, settlement agent) Review approved equity loans for completeness, accuracy and additional information required to close loan Verify "intent to proceed" by member prior to collecting required fees, requesting appraisal and ordering title work Enter applications into online application system Prepare/submit final applications and member appeals for decision Resolve escalated member issues and problems Respond to inquiries and resolve any issues concerning the processing of applications Submit applications for decision according to applicable terms and conditions Perform other duties as assigned Qualifications Experience in managing multiple priorities independently and/or in a team environment to achieve goals Working knowledge of mortgage/equity loan processing, closing and documentation requirements and regulations Working knowledge of Navy Federal mortgage and equity applications, products and services Effective organizational, planning and time management skills Effective skill exercising initiative and using good judgment to make sound decisions Effective skill following, interpreting and applying relevant data/instructions to guidelines, procedures, practices and regulations Effective skill maintaining accuracy with attention to detail and meeting deadlines Effective skill performing mathematical calculations and working accurately with numbers Effective verbal and written communication skills Effective word processing and spreadsheet software skills Hours: Available Monday - Friday, 8:00AM - 4:30PM Location: 5510 Heritage Oaks Drive, Pensacola, FL 32526 About Us Navy Federal provides much more than a job. We provide a meaningful career experience, including a culture that is energized, engaged and committed; and fierce appreciation for our teams, who are rewarded with highly competitive pay and generous benefits and perks. Our approach to careers is simple yet powerful: Make our mission your passion.* Fortune 100 Best Companies to Work For 2025* Yello and WayUp Top 100 Internship Programs* Computerworld Best Places to Work in IT* Newsweek Most Loved Workplaces* 2025 PEOPLE Companies That Care* Newsweek Most Trustworthy Companies in America* Military Times 2025 Best for Vets Employers* Best Companies for Latinos to Work for 2024* Forbes 2025 America's Best Large Employers* Forbes 2025 America's Best Employers for New Grads* Forbes 2025 America's Best Employers for Tech Workers* 2025 RippleMatch Campus Forward Award Winner for Overall Excellence* Military.com Top Military Spouse Employers 2025* 2025 Handshake Early Talent AwardFrom Fortune . 2025 Fortune Media IP Limited. All rights reserved. Used under license. Fortune and Fortune Media IP Limited are not affiliated with, and do not endorse products or services of, Navy Federal Credit Union.Equal Employment Opportunity: All qualified applicants will receive consideration for employment without regard to age, race, sex, color, religion, national origin, disability, veteran status, pregnancy, sexual orientation, genetic information, gender identity or any other basis protected by applicable law.Disclaimers: Navy Federal reserves the right to fill this role at a higher/lower grade level based on business need. An assessment may be required to compete for this position. Job postings are subject to close early or extend out longer than the anticipated closing date at the hiring team's discretion based on qualified applicant volume. Navy Federal Credit Union assesses market data to establish salary ranges that enable us to remain competitive. You are paid within the salary range, based on your experience, location and market position. For additional details regarding compensation and benefits, review the Benefits page of the Navy Federal Career Site.Protect Yourself from Job Scams: Navy Federal Credit Union jobs are posted on our career site, jobs.navyfederal.org and reputable job boards (e.g., LinkedIn, Indeed). We do not post jobs on social media marketplaces, messaging apps or unverified websites. We will never ask candidates for payment, bank details or personal financial information during the hiring process.Bank Secrecy Act: Remains cognizant of and adheres to Navy Federal policies and procedures, and regulations pertaining to the Bank Secrecy Act.
$26k-33k yearly est. 5d ago
Claims Examiner Trainee
Berkshire Hathaway 4.8
San Diego, CA jobs
WHAT WE'RE LOOKING FORAre you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers' Compensation Claims Adjuster. Upon successful completion of the Claims Training program, the Claims Examiner Trainee will be responsible for management of a caseload of workers compensation claims from inception to resolution. Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations. This individual will continue to build on claims knowledge and claims will increase in number and complexity. RESPONSIBILITIES Completes classroom training introducing workers' compensation claims handling strategies, medical terminology, and legal concepts. Learns skills such as investigative and persuasive communication, negotiation, decision-making, and strategic planning. Learns to review and interpret medical records. Conducts and directs the investigation of reported claims to determine coverage, compensability and severity and to gather all other relevant information, including making three-point contact telephone calls. Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines. Develops and updates a plan of action for the successful resolution of each claim. Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently. Reduces fraud through early identification and escalation. Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers. Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims. Ensures that the actions of all other professionals involved in managing a claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim. WHAT YOU'D BRING TO THE ROLE Minimum of High School Diploma or equivalent certificate required; Bachelor's degree from four-year college or university is preferred Ability to communicate effectively verbally and in writing; Spanish Fluency ability preferred Exceptional interpersonal and customer service skills Ability to manage and prioritize multiple assignments in a fast-paced environment Strong organization skills to ensure tasks are completed within hard deadlines Basic mathematical skills to calculate monetary reserves Knowledge of Microsoft Word, Powerpoint, Excel, Outlook WHY YOU SHOULD APPLY Unparalleled financial strength and stability Fantastic growth and advancement opportunities WFH Hybrid schedule Free gym in building Generous Paid Time Off and Holidays Excellent Benefits (Medical, Dental, Vision, 401k, etc) Health and Wellness Reimbursement Tuition Assistance Reimbursement Discounts across companies such as GEICO, See's Candies, etc. In accordance with the California Equal Pay Act, the starting hourly wage for this job is $30.2885. This hourly wage is what the employer reasonably expects to pay for the position based on potential employee qualifications, operational needs and other considerations consistent with applicable law. The pay scale applies only to this position and only if it is filled in California. The pay scale may be different for other positions or in other locations.
$30.3 hourly Auto-Apply 11d ago
Claims Examiner Trainee
Berkshire Hathaway 4.8
Walnut Creek, CA jobs
WHAT WE'RE LOOKING FORAre you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Are you a Spanish speaker looking to apply those skills in a professional environment? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers' Compensation Claims Adjuster. Upon successful completion of the Claims Training program, the Claims Adjuster Trainee will be responsible for management of a caseload of workers compensation claims from inception to resolution. Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations. This individual will continue to build on claims knowledge and claims will increase in number and complexity. RESPONSIBILITIES Completes classroom training introducing workers' compensation claims handling strategies, medical terminology, and legal concepts. Learns skills such as investigative and persuasive communication, negotiation, decision-making, and strategic planning. Learns to review and interpret medical records. Conducts and directs the investigation of reported claims to determine coverage, compensability and severity and to gather all other relevant information, including making three-point contact telephone calls. Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines. Develops and updates a plan of action for the successful resolution of each claim. Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently. Reduces fraud through early identification and escalation. Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers. Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims. Ensures that the actions of all other professionals involved in managing a claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim. WHAT YOU'D BRING TO THE ROLE Minimum of High School Diploma or equivalent certificate required; Bachelor's degree from four-year college or university is preferred Ability to communicate effectively verbally and in writing; Spanish Fluency ability preferred Exceptional interpersonal and customer service skills Ability to manage and prioritize multiple assignments in a fast-paced environment Strong organization skills to ensure tasks are completed within hard deadlines Basic mathematical skills to calculate monetary reserves To perform this job successfully, an individual should be proficient in the Microsoft Office Suite of applications and be proficient, or able to become proficient, on applicable databases, systems, and vendor software programs. WHY YOU SHOULD APPLY Unparalleled financial strength and stability Fantastic growth and advancement opportunities WFH Hybrid schedule Free gym in building Generous Paid Time Off and Holidays Excellent Benefits (Medical, Dental, Vision, 401k, etc) Health and Wellness Reimbursement Tuition Assistance Reimbursement Discounts across companies such as GEICO, See's Candies, etc. In accordance with the California Equal Pay Act, the starting hourly wage for this job is $32.6924. This hourly wage is what the employer reasonably expects to pay for the position based on potential employee qualifications, operational needs and other considerations consistent with applicable law. The pay scale applies only to this position and only if it is filled in California. The pay scale may be different for other positions or in other locations.
$32.7 hourly Auto-Apply 60d+ ago
Claims Examiner, Commercial Insurance
Arch Capital Group Ltd. 4.7
Hartford, CT jobs
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing medium-high severity commercial liability claims in jurisdictions throughout the United States. Responsibilities * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures * Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary * Investigate claims and review the insureds' materials, pleadings, and other relevant documents * Identify and review each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Demonstrated ability to take part in active strategic discussions * Demonstrated ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 10% * Hybrid schedule, 3 days a week in office Education * Bachelor's degree required. * Minimum of 3 years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims * Proper & active adjuster licensing in all applicable states #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $95,000 - $150,000/year based on experience level * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
$95k-150k yearly Auto-Apply 2d ago
Quality Assurance Claims Processor
Pennymac 4.7
Moorpark, CA jobs
PENNYMAC Pennymac (NYSE: PFSI) is a specialty financial services firm with a comprehensive mortgage platform and integrated business focused on the production and servicing of U. S. mortgage loans and the management of investments related to the U. S. mortgage market. At Pennymac, our people are the foundation of our success and at the heart of our dynamic work culture. Together, we work towards a unified goal of helping millions of Americans achieve aspirations of homeownership through the complete mortgage journey. A Typical Day The Quality Assurance (QA) Claims Processor will perform QA reviews in accordance with established procedures and complying with investor requirements and federal and state regulations. As the QA Processor, you will be responsible for reviewing the default timeline to verify that reported actions occurred as required by the applicable investor and insurer servicing guidelines. The QA Claims Processor will: Reconcile servicing expenses/corporate advances as required by MI, investor, insurer and internal guidelines including: foreclosure fees and costs, eviction requirements, property inspections and preservation, HOAs, taxes, hazard insurance and expenses during the default process Ensure reviews are performed in a timely manner in accordance with established procedures and investor guidelines Maintain and update various databases to meet departmental and QA requirements Assist in identifying error trends noted during the QA evaluation Achieve key metrics associated with the process and meet departmental monthly goals Perform other related duties as required and assigned Demonstrate behaviors which are aligned with the organization's desired culture and values What You'll Bring Mortgage default-related experience preferred Demonstrated aptitude for data, reporting, data reconciliation desired Familiarity with FHA, VA, USDA, MI and GSE Insurer servicing guidelines Must have experience with auditing and/or filing claims for FHA, VA and/or USDA adhering to the Investor/Insurer's guidelines Must be highly proficient in Excel and Word Why You Should Join As one of the top mortgage lenders in the country, Pennymac has helped over 4 million lifetime homeowners achieve and sustain their aspirations of home. Our vision is to be the most trusted partner for home. Together, 4,000 Pennymac team members across the country are guided by our core values: to be Accountable, Reliable and Ethical in all that we do. Pennymac is committed to conducting a business that makes positive contributions and promotes long-term sustainable growth and to fostering an equitable and inclusive environment, where all employees and customers feel valued, respected and supported. Benefits That Bring It Home: Whether you're looking for flexible benefits for today, setting up short-term goals for tomorrow, or planning for long-term success and retirement, Pennymac's benefits have you covered. Some key benefits include: Comprehensive Medical, Dental, and Vision Paid Time Off Programs including vacation, holidays, illness, and parental leave Wellness Programs, Employee Recognition Programs, and onsite gyms and cafe style dining (select locations) Retirement benefits, life insurance, 401k match, and tuition reimbursement Philanthropy Programs including matching gifts, volunteer grants, charitable grants and corporate sponsorships To learn more about our benefits visit: ********************* page. link/benefits For residents with state required benefit information, additional information can be found at: ************ pennymac. com/additional-benefits-information Compensation: Individual salary may vary based on multiple factors including specific role, geographic location / market data, and skills and experience as defined below: Lower in range - Building skills and experience in the role Mid-range - Experience and skills align with proficiency in the role Higher in range - Experience and skills add value above typical requirements of the role Some roles may be eligible for performance-based compensation and/or stock-based incentives awarded to employees based on company and individual performance. Salary $39,000 - $55,000 Work Model OFFICE
$39k-55k yearly Auto-Apply 14d ago
Claims Examiner
Arch Capital Group Ltd. 4.7
Hartford, CT jobs
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary The Claims Division is seeking a team member to join the Shared Services Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of commercial first and third party low complexity claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence. Responsibilities: * Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level * Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution * Review and analyze supporting damage documentation * Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions * Establish appropriate loss and expense reserves with documented rationale * Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines Experience & Qualifications * Hands-on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint, and Word * Knowledge of ImageRight preferred * Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions * Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines * Ability to work well independently and in a team environment * Texas Claim Adjuster license preferred, but not required for posting. Upon employment candidate would be required to obtain Texas Claim Adjuster license within six months of hire date. Education * Bachelor's degree preferred * 3-5 years' experience handling the process of commercial insurance claims #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $71,900 - $97,110/year * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.
$71.9k-97.1k yearly Auto-Apply 2d ago
Claims Examiner II
SWBC 3.0
San Antonio, TX jobs
SWBC is seeking a talented individual to review and evaluate incoming claims for payment or denial and acts as a liaison for the carrier and the financial institution. Why you'll love this role: This role allows you to help those who are dealing with difficult circumstances in their lives. Your help gives them a sense of relief in times of need. You will also have a team who is supportive and there to help at any time. Essential duties include the following: Adjudicates routine to moderately complicated Payment Protection claims and determines if benefits are payable or not; ensures claims are adjudicated within the customer service level standards established by the company with adherence to Prompt Payment of Claims Regulation respective to each state. Prepares letters and requests any information needed to make a determination on claims from insurance carrier, family, claimant, physicians, employers, and others. Submits all claims determined contestable to carriers for review and final determination. Calculates the benefit amount and ensures claims are not being overpaid or underpaid according to the provisions within the specific insurance certificate/policy form that describes the terms and conditions of the applicable coverage. Assists claimants or financial institutions via phone to answer questions, and documents such within the claim file. Maintains carrier guidance and administrative files, required logs to comply with carrier requirements, reviews and evaluates instructions provided by carriers and assists management with proper implementation. Completes request for refund form and submits to Premium Processing; verifies monthly outstanding loan balances for active and inactive financial institutions; and ensures that open accounts loan balances are verified every 6 months and closed accounts are verified each month; provides back-up assistance to the claims processor position for establishment and set-up of new claims. Serious candidates will possess the minimum qualifications: High School Diploma or equivalency. Some college course work in medical terminology or related field preferred. Minimum one (1) year of claims processing or related experience. Able to type at least 40 WPM accurately and know 10 key by touch. Working knowledge of word processing and spreadsheets preferably in Microsoft Word and Excel. Excellent organizational and interpersonal skills. Able to draft business letters. Able to read and understand medical records. Able to prioritize job duties and be detail oriented. Able to lift up to 10-20 lbs. of claim storage boxes. Able to move (push/pull) up to 50 lbs. of files and documents. Able to bend, stoop, and stand to perform filing duties. SWBC offers*: Competitive overall compensation package Work/Life balance Employee engagement activities and recognition awards Years of Service awards Career enhancement and growth opportunities Leadership Academy and Mentor Program Continuing education and career certifications Variety of healthcare coverage options Traditional and Roth 401(k) retirement plans Lucrative Wellness Program *Based upon employee eligibility Additional Information: SWBC is a Substance-Free Workplace and requires pre-employment drug testing. Please note, SWBC does not hire tobacco users as allowed by law. To learn more about SWBC, visit our website at ************* If interested, please click the appropriate apply button.
$30k-44k yearly est. Auto-Apply 59d ago
Claims Examiner, Commercial Insurance
Arch Capital Group Ltd. 4.7
Garden City, MI jobs
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing medium-high severity commercial liability claims in jurisdictions throughout the United States. Responsibilities * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures * Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary * Investigate claims and review the insureds' materials, pleadings, and other relevant documents * Identify and review each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Demonstrated ability to take part in active strategic discussions * Demonstrated ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 10% * Hybrid schedule, 3 days a week in office Education * Bachelor's degree required. * Minimum of 3 years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims * Proper & active adjuster licensing in all applicable states #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $95,000 - $150,000/year based on experience level * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
$39k-52k yearly est. Auto-Apply 2d ago
Claims Examiner I
Americo Financial Life and Annuity 4.7
Kansas City, MO jobs
We are currently looking for a Claims Examiner to join our team! The Claims Examiner processes the notification of death claims, ensures state regulations are being maintained in the follow up process, reviews and adjudicates claims, and provides assistance to the beneficiaries through calls and written correspondence. Job Responsibilities Review and process death claims Create payments and letters to settle claims Correspond with claimants via phone, letter, and email Follow all state regulations, being mindful of Unfair Claim Practice regulations Provide excellent, prompt customer service to beneficiaries and other callers Reconcile suspense items, returned mail, and other items in workflow according to service level agreements Job Qualifications Good understanding or ability to learn in house systems (Workflow/Imaging System, Life Insurance Policy Administration systems, Microsoft Office applications) Knowledge of life and disability insurance Well organized, detail oriented, uses time efficiently Able to work independently and think critically Excellent written and verbal communication Able to operate effectively in a fast-paced environment while maintaining a professional image and positive attitude Previous life insurance claims experience Education Qualifications Four year degree from an accredited college or university, or relevant industry experience About Us Americo: We're in this for life! The roots of the Americo family of companies date back more than 100 years. Americo is a life insurance and annuity company providing innovative products to our customers. At Americo, it's the people who make things work, so we hope you join us! What you'll love about working at Americo: Compensation: Our competitive pay and robust bonus program, offered to all associates, will make you feel valued. Learning and development: We prepare you for success with a comprehensive, paid training program. Additionally, our Talent Development team creates various development opportunities for associates at every stage of their careers. Work-life balance: We value work-life balance with our generous paid time off; you begin accruing hours every month, and they increase with tenure. All new hires earn over three weeks of paid time off annually, plus 11 paid company holidays! We also support new mothers with a maternity leave program, along with paid STD and LTD. Health and well-being: We commit to your health and well-being and are proud to offer comprehensive health and life insurance options, including FSA or HSA accounts and subsidies to support your health and fitness goals through vendor partnerships at The Y, Orange Theory, WW, and more. Future planning: Americo offers a 401(k) with a company match. We also have tuition reimbursement programs to further your education. Giving back: We support several local organizations, such as Ronald McDonald House, Hope Lodge, the American Red Cross, Harvesters, and many more. Our associates volunteer their time and donate money alongside the company to make a difference in our community. The fun stuff: Americo participates in the Kansas City Corporate Challenge, a great way to connect with coworkers. Additionally, we host events like a Royals Party at the K, a legendary Holiday Party, and in-office events with local vendors to allow associates to step away from work and enjoy each other's company. Bustling environment: Our newly renovated offices are conveniently located in downtown Kansas City, within walking distance of your favorite restaurants and attractions. Plus, you'll receive complimentary paid parking near our Americo offices - downtown parking is a premium, but we've got you covered. #AMERICO
$36k-61k yearly est. 5d ago
Claims Examiner I
Americo Financial Life and Annuity 4.7
Kansas City, MO jobs
We are currently looking for a Claims Examiner to join our team! The Claims Examiner processes the notification of death claims, ensures state regulations are being maintained in the follow up process, reviews and adjudicates claims, and provides assistance to the beneficiaries through calls and written correspondence. Job Responsibilities Review and process death claims Create payments and letters to settle claims Correspond with claimants via phone, letter, and email Follow all state regulations, being mindful of Unfair Claim Practice regulations Provide excellent, prompt customer service to beneficiaries and other callers Reconcile suspense items, returned mail, and other items in workflow according to service level agreements Job Qualifications Good understanding or ability to learn in house systems (Workflow/Imaging System, Life Insurance Policy Administration systems, Microsoft Office applications) Knowledge of life and disability insurance Well organized, detail oriented, uses time efficiently Able to work independently and think critically Excellent written and verbal communication Able to operate effectively in a fast-paced environment while maintaining a professional image and positive attitude Previous life insurance claims experience Education Qualifications Four year degree from an accredited college or university, or relevant industry experience About Us Americo: We re in this for life! The roots of the Americo family of companies date back more than 100 years. Americo is a life insurance and annuity company providing innovative products to our customers. At Americo, it s the people who make things work, so we hope you join us! What you ll love about working at Americo: Compensation: Our competitive pay and robust bonus program, offered to all associates, will make you feel valued. Learning and development: We prepare you for success with a comprehensive, paid training program. Additionally, our Talent Development team creates various development opportunities for associates at every stage of their careers. Work-life balance: We value work-life balance with our generous paid time off; you begin accruing hours every month, and they increase with tenure. All new hires earn over three weeks of paid time off annually, plus 11 paid company holidays! We also support new mothers with a maternity leave program, along with paid STD and LTD. Health and well-being: We commit to your health and well-being and are proud to offer comprehensive health and life insurance options, including FSA or HSA accounts and subsidies to support your health and fitness goals through vendor partnerships at The Y, Orange Theory, WW, and more. Future planning: Americo offers a 401(k) with a company match. We also have tuition reimbursement programs to further your education. Giving back: We support several local organizations, such as Ronald McDonald House, Hope Lodge, the American Red Cross, Harvesters, and many more. Our associates volunteer their time and donate money alongside the company to make a difference in our community. The fun stuff: Americo participates in the Kansas City Corporate Challenge, a great way to connect with coworkers. Additionally, we host events like a Royals Party at the K, a legendary Holiday Party, and in-office events with local vendors to allow associates to step away from work and enjoy each other s company. Bustling environment: Our newly renovated offices are conveniently located in downtown Kansas City, within walking distance of your favorite restaurants and attractions. Plus, you ll receive complimentary paid parking near our Americo offices downtown parking is a premium, but we ve got you covered. #AMERICO
$36k-61k yearly est. 60d+ ago
Claims Examiner, Commercial Insurance
Arch Capital Group Ltd. 4.7
Chicago, IL jobs
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing medium-high severity commercial liability claims in jurisdictions throughout the United States. Responsibilities * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures * Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary * Investigate claims and review the insureds' materials, pleadings, and other relevant documents * Identify and review each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Demonstrated ability to take part in active strategic discussions * Demonstrated ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 10% * Hybrid schedule, 3 days a week in office Education * Bachelor's degree required. * Minimum of 3 years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims * Proper & active adjuster licensing in all applicable states #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $95,000 - $150,000/year based on experience level * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
$39k-50k yearly est. Auto-Apply 2d ago
Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
Stout Risius Ross 4.1
Chicago, IL jobs
At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include: Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support. Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team. What You Bring Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You'll Thrive Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions. Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment. Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. ***************************************** The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - *****************************************.
$40k-50k yearly est. Auto-Apply 13d ago
Insurance Claims Specialist
Mid Florida Finance 4.1
Lakeland, FL jobs
Mid Florida Financing is looking for an Insurance Specialist to join our team in Lakeland, FL. This position will provide insurance coverage to our new and existing clients. We are looking for someone who is self-motivated, organized, and has the ability to work independently. Benefits: 401(k) Dental insurance Flexible schedule Health insurance Paid time off Vision insurance Responsibilities: Provides exceptional customer service while investigating policy coverage, liability and damages in a timely manner Gathers information and documents claim file to comply with company guidelines and state compliance and regulations Negotiates timely and appropriate settlements with insurance companies Manages pending claims to meet company quality criteria Recognizes recovery opportunities in regards salvage vehicles Performs other related duties as assigned or required. Assists internal and external customers with problems or questions regarding claims by phone or through written correspondence while providing a high level of customer service. Job Type: Full-time Pay: $16.00 per hour Expected hours: 40 per week Schedule: Monday to Friday Work Location: In person We are an equal opportunity employer.
$16 hourly Auto-Apply 60d+ ago
Long Term Disability Claims Specialist I 3 30 26 NY NC CT PR
Metlife, Inc. 4.4
Claim processor job at MetLife
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The LTD Claims Specialist I evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the LTD Claims Specialist is required to exercise critical thinking skills, exemplary customer service skills as well as effective inventory management skills with oversight and expected progression to a LTD Claims Specialist II role. Job Location: Virtual, but must be commutable to the following offices: * Oriskany, NY * Bloomfield, CT * Cary, NC * San Juan, PR Employees are required to come into the office for 2 weeks after initial training. After training, employees are to report to the office 1x a month. Key Responsibilities: * Virtual roles predominately work from a home office with periodic visits to the assigned office as needed for team events, meetings, training, business continuity, etc. * Effectively manages some level of oversight an assigned caseload which consists of pending, ongoing/active reviews. The LTD CS will be evaluated for increases in their authority levels as they become more experienced in their decision-making and demonstrate consistency in meeting all key performance indicators * Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations. * Develop actions plans and identify return to work potential * Provides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other information that may be pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skills * Interacts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations * Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available * Collaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants as needed to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions. * Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed * Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas. Essential Business Experience and Technical Skills: Required: * New hires should live a commutable distance from the site the role is posted in * High School Diploma * Minimum 2 years of experience in external customer service or related experience * Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning * Creative problem-solving abilities and the ability to think outside the box * Excellent interpersonal and communication skills in both verbal and written form * Excellent customer service skills proven through internal and external customer interactions * Organizational and time management skills Preferred: * Bachelor's degree Business Category Operations - Claims At MetLife, we're leading the global transformation of an industry we've long defined. United in purpose, diverse in perspective, we're dedicated to making a difference in the lives of our customers. The expected salary range for this position is $41,600 - $60,500. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms. Benefits We Offer Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more! About MetLife Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East. Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible. Join us! MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics"). If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities. $41,600 - $60,500
$41.6k-60.5k yearly 4d ago

Learn more about MetLife jobs

Overview
Reviews

View all jobs

Most in demand jobs

Zippia Careers
Business and Financial Industry
Claim Processor Jobs
MetLife Jobs
MetLife Claim Processor Jobs

Updated January 19, 2026

Claim Processor jobs at MetLife - 281 jobs

Long Term Disability Claims Specialist II 3 30 26

Injury Examiner

Claims Examiner

Claims Examiner

Processor

CDP Processor II

Equity Processor II

Claims Examiner Trainee

Claims Examiner Trainee

Claims Examiner, Commercial Insurance

Quality Assurance Claims Processor

Claims Examiner

Claims Examiner II

Claims Examiner, Commercial Insurance

Claims Examiner I

Claims Examiner I

Claims Examiner, Commercial Insurance

Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations

Insurance Claims Specialist

Long Term Disability Claims Specialist I 3 30 26 NY NC CT PR

Learn more about MetLife jobs

Most common jobs at MetLife

Most in demand jobs