Claims Analyst Jobs Near Me

- 502 Jobs

Claim Specialist - Property Field Inspection
State Farm Careers 4.4
Remote Claims Analyst Job
Being good neighbors - helping people, investing in our communities, and making the world a better place - is who we are at State Farm. It is at the core of how we operate and the reason for our success. Come join a #1 team and do some good! Grow Your Skills, Grow Your Potential Responsibilities Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-related claims for homeowners, commercial properties, and large losses. We are looking for an experienced and highly skilled professional to contribute to our dynamic team. You will be the first point of contact to meet with our insureds, explain coverage, estimate damages, and help them through the claims process while providing Remarkable service. Key Responsibilities: Conduct on-site inspections and assessments of property damages for both residential and commercial claims Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently May occasionally require interacting with parties who express strong emotions or concerns about ongoing inspections or claim resolutions Provide exceptional customer service throughout the claims process, addressing inquiries and concerns promptly and professionally Gather necessary evidence, document findings, and prepare detailed reports to support the claims handling process Investigate and adjust both personal and commercial property claims with exposures up to $500,000 Evaluate coverage and policy terms to determine the validity of claims and ensure compliance with local regulations Negotiate and settle claims within the authorized limits, considering policy provisions, industry standards, and company guidelines Where you'll work: This position is located in Birmingham North, AL. Competitive candidates should reside within one of the listed zip codes and will service this same territory: 35004 35060 35068 35071 35091 35094 35116 35117 35120 35126 35173 35206 35207 35210 35212 35214 35215 35217 35222 35234 35235. This is a Remote-Field position in which you will work from home and utilize a mobile office/vehicle for in-person appointments. Although the primary work location is in the field, with a commutable distance from home, there will be opportunities for virtual work to be completed at home. Additionally, there may be occasions where you will be required to travel outside your assigned area to assist in other territories. Hours of operation are continually evaluated and may change based on business need. Successful candidates are able and willing to work flexible schedules and may be asked to work overtime and/or irregular hours. Qualifications Competitive candidates must demonstrate: Experience as a Property Field Inspection Claim Specialist in the insurance industry, specifically in property claims Strong knowledge of property insurance policies, coverage and claim handling practices Knowledge of both residential and commercial building construction Familiarity with local regulations and compliance requirements in your assigned territory Excellent communication and interpersonal skills to effectively interact with clients, agents, and other stakeholders Proven effective communication skills to handle difficult/emotional conversations with a customer-minded focus Proven ability to assess damages, estimate repair costs, and negotiate settlements Detail-oriented with strong organizational and analytical skills Proficient in using claims management software and other relevant tools Physical agility to allow for: frequent lifting, carrying and climbing a ladder; ability to navigate roofs at various heights for inspection of both residential and commercial structures; ability to crawl in tight spaces May be required to complete Rope and Harness Safety Training. A valid driver's license is required Preferred: Bachelor's Degree in a related field or equivalent work experience Experience in handling complex or high-value claims Construction background Water mitigation inspection experience Xactimate, XactContents Additional Details: Employees must successfully complete all required training, including applicable licensing exam(s) and background checks required of various state(s). State Farm recently implemented new pre-employment assessments. Candidates that have previously taken an assessment may be asked to participate in additional testing Our Benefits Because work-life balance is a priority at State Farm, compensation is based on our standard 38:45-hour work week! Potential starting salary range: $59,059.65 - $90,000.00 annually. Starting salary will be based on skills, background, and experience High end of the range limited to applicants with significant relevant experience Potential yearly incentive pay up to 15% of base salary At State Farm, we offer more than just a paycheck. Check out our suite of benefits designed to give you the flexibility you need to take care of you and your family! Get Paid! On top of our competitive pay, you are eligible for an annual raise and bonus. Stay Well! Focus on you and your family's health with our robust health and wellbeing programs. State Farm pays most of your healthcare premium, and we offer multiple healthcare plan options, including a high deductible plan. All medical plans provide 100% coverage for in-network preventative care, AND you and your family have access to vision, dental, telemedicine, 24/7 mental health professionals, and much more! Develop and Grow! Take advantage of educational benefits like industry leading training programs, top-notch tuition assistance programs, employee resource groups, and mentoring. Plan Ahead! Plan for those big moments in life with benefits like fertility/IVF/adoption assistance, college coaching, national discount programs, interactive monthly financial workshops, free financial coaching, and more. You can also start a savings account or consider financing through our State Farm Federal Credit Union! Take a Little “You” Time! You will have access to our generous time off policies designed so you can plan around holidays, family events, volunteering, or just to take a relaxing day off. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! Give Back! We offer several ways to give back through our Matching Gift Program, Good Neighbor Grant Program, and the Employee Assistance Fund. Finish Strong! Plan for retirement using free financial advisors and a 401(k) plan with company contributions of up to 7% of your salary. Visit our State Farm Careers page for more information on our benefits, locations, and the hiring process of joining the State Farm team! PandoLogic. Category:Insurance, Keywords:Insurance Examiner, Location:Birmingham, AL-35242
$59.1k-90k yearly 4d ago
Insurance Analyst
Insight Global
Remote Claims Analyst Job
Our large life insurance client is hiring for a premium analyst to join their team. This person will be responsible for posting premiums for the company as well as handling any trouble shooting, issue resolution, and research (including talking to brokers, policy holders etc). They will be working heavily in excel, with data entry, data manipulation, reporting and analysis. They will be responsible for meeting month end financial goals. This is a very analytical position, and a strong candidate will be someone who is comfortable working in a high volume environment. This is a Hybrid work model with 3 days in office and 2 days work from home. Equipment will be provided for the WFH days. Excel skills (knowledge of vlookups/data sorts/pivot tables/formulas) Customer service experience 2+ years of experience working with AP/AR/billing, insurance processing, or payment processing
$54k-95k yearly est. 13d ago
Claim Rep, Workers Compensation Trainee
The Travelers Companies, Inc. 4.4
Remote Claims Analyst Job
Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $48,700.00 - $80,400.00 Target Openings 3 What Is the Opportunity? Travelers' Claim Organization is at the heart of our business. By providing assurance to our customers during life's rainy days, the Travelers Workers Compensation Claim team is committed to partnering with our business insurance customers to help their injured employees return to work as soon as medically appropriate. As a Workers Compensation Claim Professional Trainee, you will handle all aspects of a workers compensation claims. In this role, you will learn how to help our customers and their injured employees when they are injured at work. You will develop the technical skills needed for quality claim handling including investigating, evaluating, negotiating, and resolving claims on losses of lesser value and complexity and provide claim handling throughout the claim life cycle. As part of the hiring process, this position will require the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. This is a hybrid work arrangement requiring three days in the office with two days work from home. What Will You Do? Complete virtual, classroom, and on-the-job training which includes the overall instruction, exposure, and preparation for employees. Completion of an internal training program is required to progress to next level position. The training may require travel. Handle all aspects of a Workers Compensation claim including completing investigations, setting accurate reserves, and making various claim-related decisions under direct supervision. As a trainee, you may also be exposed to claims that could involve litigation, settlement negotiations, Medicare set asides and offsets. Communicate and apprise all parties regarding claim status which may include our business customers, injured employees, medical providers, and legal counsel. Investigate, develop, and evaluate action plans for claim resolution. Assess coverage and determine if a claim is compensable under Workers Compensation including evaluating claims for potential fraud. Achieve a positive result by returning an injured party to work when appropriate. This may include coordinating medical treatment in collaboration with internal or external resources. Effectively prioritize and manage a Workers Compensation claim inventory, including filing and diary systems, document plans of action and complete time-sensitive required letters and state forms. Participate in Telephonic and/or onsite File Reviews. Acquire and maintain relevant Insurance License(s) to comply with state and Travelers' requirements within three months of starting the job. Perform other duties as assigned. What Will Our Ideal Candidate Have? Bachelor's Degree or a minimum of 2 years of work or customer service-related experience. Ability to work in a high volume, fast paced environment managing multiple priorities while facing ambiguity. Able to review information from multiple sources and use analytical thinking and problem-solving skills to accurately achieve optimal claim outcomes and determine appropriate next steps. Ability to own and manage all assigned tasks. Provide excellent customer experience by communicating effectively, verbally and written. Able to work independently and in a team environment. Strong attention to detail. What is a Must Have? High School Diploma or GED One year of customer service experience OR Bachelor's Degree. What Is in It for You? Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ********************************************************* 0
$48.7k-80.4k yearly 33d ago
Claims Specialist I - Provider Claims
Inland Empire Health Plan 4.7
Remote Claims Analyst Job
We are seeking a detail-oriented and knowledgeable Claims Specialist I to join our team. Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Claims Specialist I - Provider Claims is responsible for evaluating professional, high dollar and outpatient/inpatient institutional claims while determining coverage and payment levels. Responsible for evaluating and resolving provider disputes & appeals, issuing resolution letters, and processing adjustment requests timely and accurately in accordance with standard procedures that ensure compliance with regulatory guidelines. Additional responsibilities include payment adjustment projects and complex claims as assigned. *Candidate will report to the Supervisor, Provider Claims Resolution and Recovery. * *This position is fully remote. Candidates must reside in California. No out of state candidates will be reviewed.* *Duties* * *Review and process provider dispute resolutions according to state and federal designated timeframes.* * *Research reported issues; adjust claims and determine the root cause of the dispute.* * *Draft written responses to providers in a professional manner within required timelines.* * *Independently review and price complex edits related to all claim types to determine the appropriate handling for each including payment or denial. * * *Complete the required number of weekly reviews deemed appropriate for this position. * * *Respond to provider inquiries regarding disputes that have been submitted.* * *Maintain, track, and prioritize assigned caseload through IEHP's provider dispute database to ensure timely completion. * * *Maintain knowledge of claims procedures and all appropriate reference materials; participate in ongoing training as needed.* * *Communicate with a variety of people, both verbally and in writing, to perform research, gather information related to the case that is under review. * * *Recommend opportunities for improvement identified through the trending and analysis of all incoming PDRs.* * *Coordinate with other departments as necessary to facilitate resolution of claim related issues. Identify and report claim related billing issues to various departments for provider education.* * *Any other duties as required to ensure Health Plan operations are successful.* *Requirements* Minimum of four (4) years of experience evaluating and processing institutional and professional medical claims. Proficiency in the following areas: Medical claims system, ICD-10 and CPT coding, reviewing medical authorizations, Provider contract rate interpretation, medical benefit coverage determination. Prior experience handling provider disputes, appeals and claim adjustments. *Experience preferably in HMO or Managed Care setting. Medicare and/or Medi-Cal experience, as well as managed care or government payer environment is helpful. * *Education Requirement* High School Diploma or GED required. *Skills* Strong analytical and problem-solving skills. Microsoft Office, Advanced Microsoft Excel. Written communication skills. Ability to analyze data and interpret regulatory requirements. Excellent communication and interpersonal skills, strong organizational skills, and skilled in data entry required. Typing a minimum of 45 wpm. Excellent oral and written communication skills. Billing experience will not be considered as actual claims processing or adjudicating experience. Job Type: Full-time Pay: $53,872.00 - $68,681.60 per year Benefits: * 401(k) * 401(k) matching * Dental insurance * Employee assistance program * Flexible spending account * Health insurance * Life insurance * On-site gym * Paid time off * Retirement plan * Tuition reimbursement * Vision insurance Schedule: * 8 hour shift * Day shift * Monday to Friday * No weekends Experience: * Medicare and Medi-Cal Claims processing: 4 years (Required) Work Location: Remote
$53.9k-68.7k yearly 6d ago
CAT Claims Representative
Auto-Owners Insurance 4.3
Claims Analyst Job In Columbus, OH
Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated claims professional to join our team. This is a remote field position. The position requires the following, but is not limited to: Frequent travel up to 21 days at a time and is required upon short notice to location of catastrophe, which would most likely be out of state. Can meet the physical demands required for the position including carrying and climbing a ladder. Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses. Familiar with insurance coverage by studying insurance policies, endorsements and forms. Work towards the resolution of claims, possibly attending arbitrations, mediations, depositions or trials as necessary. Ensure that claims payments are issued in a timely and accurate manner. Desired Skills & Experience Bachelor's degree or equivalent experience Minimum of 2 years claims handling experience or comparable experience Field claims experience with multi-line property and casualty claims and wind/hail Proficient with Xactimate software Above-average communication skills (written and verbal) Ability to resolve complex issues Organize and interpret data Ability to handle multiple assignments Possess a valid driver's license Benefits Competitive salary, matching 401(k) retirement plans, fully funded pension plan, bonus programs, paid holidays, vacation days, personal days, paid sick leave and a comprehensive health care plan. Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. *Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
$31k-40k yearly est. 48d ago
REMOTE - Medical Claims Examiner
Insurance Relief
Remote Claims Analyst Job
Medical Claims Examiner - Remote - Fresno, CA *100% Remote for Central Valley candidates* Candidates are required to attend occasional trainings/meetings in Fresno, CA The Company: A well-respected insurance company in California with over 25 years in the business is looking to add a Medical Claims Examiner! This company is dedicated to helping clients, providing excellent customer service, and truly investing in their employees. What's in it for you? $18.00 - $20.00/hour depending on experience Remote position + few weeks of training in the office What we need from you: Experience - 1-2+ years reviewing and processing medical, dental, and vision claims Education - High school diploma required, college degree preferred Software - You are proficient with data entry, Microsoft Office, Outlook, carrier websites, and other software systems as needed for the position Comprehensive knowledge - You have data entry coding and medical claims processing experience What you will be doing: Comprehensive understanding of employee benefits for medical, dental, and vision plans. Compares data on claim application with policy file and other company records to ascertain completeness and validity of claim Refers most questionable claims to investigator or to claim adjuster for investigation and settlement Corresponds with agents and claimants to correct errors or omissions on claim forms and to investigate questionable entries Examines claim adjusters' reports or similar claims/precedents to determine the extent of coverage and liability Contacts doctors, lawyers, or others involved to resolve claim/coverage questions Perform other duties and responsibilities as assigned by management APPLY NOW! Why Insurance Relief™? As a businessperson in the insurance industry, it is an advantage to partner with a staffing expert and ally who understands your unique skills and needs. With vast experience in the insurance arena, Insurance Relief™ works with brokers, carriers, and third-party administrators to locate and place the best people for positions ranging from entry-level to senior management. We invest the time to truly understand what you want to accomplish and then do our best to find meaningful opportunities. Insurance Relief™ provides ample opportunities for you to put your skills to work so if this position is not quite the fit for you please give us a call to hear about all of the other opportunities we have available.
$18-20 hourly 8d ago
Claims Supervisor
Brentwood Services Administrators, Inc.
Remote Claims Analyst Job
Job Title: WC Claims Supervisor Department/ Agency: Claims / Brentwood Services Remote / Agency Office: Remote opportunity FLSA Status: Exempt Full/Part-time: Full-Time About Us: For more than 30 years, Brentwood Services has focused on simplifying risk management by offering a customized comprehensive suite of claims administrative solutions. Our refreshing process caters to our clients' needs and ultimately improves their financial performance. Brentwood's success is measured by our achievements in reducing the overall cost of claims incurred by our clients and producing a positive outcome for those impacted by claims. We are a people business. Brentwood maintains a collaborative and creative work environment, which values diversity, fosters growth and encourages new ideas. Passionate employees are our heartbeat. The Brentwood team is resourceful, experienced and committed to service excellence. Job Summary: is responsible for the investigation, adjustment, and supervision of assigned claims. This role involves supervising adjusters, managing high-exposure and litigated files ensuring compliance with company policies and state regulations. The supervisor will also be responsible for training and mentoring staff, as well as maintaining strong relationships with clients, claimants, and attorneys. This position may serve as an advanced training role with potential for promotion to a management position. Essential Duties and Responsibilities include the following. Other duties may be assigned : Review, assign and provide supervision of all claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws. Investigate, evaluate and adjust assigned claims in accordance with established claim handling standards and laws. Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels. Provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist designated claim staff in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Direct handling of designated litigated and complex claims. Provide education, training and assist in the development of claim staff. Review and maintain personal diary on claim system. Supervision of all claim activity for specified accounts. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Performs other duties as assigned. Additional Responsibilities: Prepares performance evaluations on subordinate staff Mentors less experience co-workers to develop their understanding of procedures, state laws, and help others improve their claims handling ability Analyzes and resolves client issues independently. Attends educational seminars and networking opportunities when available. Attends marketing calls to present information about the claim process. Other duties may be assigned Qualifications High school Diploma or equivalent is required 10+ years prior experience handling worker's claims/ or an equivalent combination of training, education and experience. 3 years supervisory experience State Adjuster licensing required; (Multiple jurisdictions will be involved, will be required to have a license that will reciprocate to other states.) Strong organization skills, attention to detail and the ability to multi-task and prioritize work are required. Analytical thinking skills are needed to properly evaluate complex claims A strong attention to detail is necessary as claims adjusters must carefully review documents and policies Good verbal and written communication skills, as well as interpersonal skills are required, experience with negotiations, knowledge of litigation process is preferred. Ability to listen well and negotiate with constituents is needed. Ability to speak a second language is an asset Basic computer skills or the ability to quickly learn new software are required A strong work ethic and time management skills is needed, to efficiently handle a caseload ranging from minor to complex claims Ability to establish and maintain good rapport with clients and claimants is needed. Ability to calculate figures is required Physical Demand While performing the duties of this job, the employee is regularly required to sit; stand; use hands to finger, handle, or feel; and talk or hear. The employee is occasionally required to walk; reach with hands and arms; and stoop, kneel, crouch, or crawl. Specific vision abilities required by this job include close vision. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This description is not meant to be all-inclusive and may be modified from time to time at the discretion of management.
$49k-86k yearly est. 12d ago
Claims Coordinator
Keystone Insurers Group 3.9
Remote Claims Analyst Job
About Us Keystone started in 1983 when four independent insurance agencies teamed up to pool their experience and expertise. Today, that passion and spirit that started Keystone continues. Growing to over 300 independent agency partners, Keystone provides its agents with a community of like-minded agencies, industry expertise, and access to specialized products for their clients. For insurance carriers who want to develop relationships with independent agencies, Keystone offers a network of quality independent agencies and an innovative approach that aims to tap new markets and develop new products. For individuals, families, and businesses that are looking for insurance coverage and financial services, Keystone offers a consultative approach to help independent agents develop the right coverage for their clients' needs, with specialized pricing and coverage from insurance carriers. Our Risk Management Division works with agents and their clients to improve their risk profiles, with specializations in Workplace and Fleet Safety, Human Resources, and Claims Management. The Risk Management Division is seeking new team members to help fuel our growth and provide superior service to our valued clients. Claims Coordinator Position Summary: The Claims Coordinator provides support to clients and the internal claims team with new claims intake, claims reporting, and ensures client information is accurate in the CRM. The Claims Coordinator works as a liaison between the client base and Keystone internal stakeholders to help ensure quality services are delivered. Responsibilities: New Claims Intake - Carrier filing, set up in Salesforce, and assign a Claims Consultant Loss Run Coordination - Monthly requests to Agents/Clients, review for accuracy/missing data against claims of open/closed files in Salesforce, and email notifications to Claims Consultant Assist in new client on-boarding process WC Panel Management - Request new client physician panels, update, review, and save to client folder, email client postings, client panel renewal updates WC Policy Renewal Information - Update Salesforce and track data Claims Fax Distribution - Distribute to the team Claims Medical Bill Processing - Send billing to Carrier and save/document into claims folders Perform other duties as assigned by the Director of Claims Qualifications: High School Diploma Any claims experience within the insurance industry highly desired Strong computer skills; proficiency with Microsoft Office Strong interpersonal skills Exceptional verbal and written communication skills Organizational and time management skills Strong attention to detail and quality Ability to be flexible and adapt to the dynamic nature of the position Ability to foster and maintain relationships Hours: Monday-Friday, 8:00am-5:00pm EST Office Location: 7562 State Route 30, Irwin, PA 15642 (Remote Work Options Available) Benefits: Competitive Salary Health Insurance Plans (PPO, HSA, Copay Options) Dental Insurance Vision Insurance Company Paid Disability Insurance Supplemental Insurance including Critical Illness, Accident, Legal, Pet Insurance 401(k) with Safe Harbor Match Paid Time Off Paid Holidays No Solicitation Notification to Agencies: Please note that Keystone Agency Partners and our Partner Agencies do not accept unsolicited resumes or calls from third-party recruiters or employment agencies. In the absence of a signed Master Service Agreement and approval from HR to submit resumes for a specific requisition, Keystone Agency Partners will not consider or approve payment to any third parties for hires made.
$30k-37k yearly est. 4d ago
Auto, BI Claims Examiner III
Tristar Insurance 4.0
Remote Claims Analyst Job
Job Details Experienced Philadelphia Office - Philadelphia, PA Fully Remote Full Time High School Diploma or GED $65000.00 - $77500.00 Salary/year None Day InsuranceAuto, BI Claims Examiner III . Must have a NY Adjuster's license. Please navigate all the way to the end of the application to sign it. POSITION SUMMARY: Responsible for the prompt review of policy information including all relevant endorsements and vehicle schedules to determine coverage for loss/damage/injury. Conduct and efficient claim examination and investigation leading to the final resolution of liability claims, including matters in litigation. Frequent contact and interaction with involved parties including claimants and their legal representatives will be required. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client. DUTIES AND RESPONSIBILITIES: Review, process and conclude assigned claims including investigation and evaluation complex Commercial Auto property and casualty claims with a total incurred of $25,000. Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion. Maintain an ongoing diary. Continually assess exposure and evaluate for accurate reserves and settlement recommendation. Prepare Loss Reports providing thorough analysis of liability and damages. Where applicable, determine if subrogation and/or risk transfer exists and initiate recovery efforts at the direction of the client. Document all correspondence, reports, discussions and decisions in the claim file record. Provide outstanding service to the client. Assist Supervisors and Claim Department with requested tasks or special projects. Other duties as assigned. EQUIPMENT OPERATED/USED: Computer, 10-key, printer, copier, fax/scanner machine and other office equipment. SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire Qualifications QUALIFICATIONS REQUIRED: Education/Experience: High school diploma or GED required; Bachelor's degree in related field (preferred) and a minimum of five (5) years commercial auto casualty related experience; or equivalent combination of advanced education and experience. Knowledge, Skills and Abilities: At least 5 years of commercial automobile liability claims experience required. Knowledge of claims handling concepts, practices and techniques, including but not limited to coverage issues and product line knowledge. Demonstrated verbal and written communications skills. Demonstrated advanced analytical, decision making and negotiation skills. Computer proficiency. Ability to communicate effectively and clearly, both orally and in writing. Ability to manage relationships in a fast paced environment, while demonstrating problem solving and decision making skills to work with customers. Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions with a minimal amount of supervision. Excellent customer service skills. An understanding of the litigation process and case valuation in multiple jurisdictions. Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense. An ability to handle assigned claims following company guidelines and industry best practices with a minimal amount of supervision. Time management skills, organizational skills and ability to prioritize issues and tasks. Ability to effectively operate computer equipment and applications. Independence, flexibility and creativity. Other Qualifications: Valid New York adjuster license. Here are some of the benefits you can enjoy in this role: Medical, Dental, Vision, Disability & Life Insurance 401(k) plan Paid time off Paid holidays Mental and Physical Requirements: MENTAL AND PHYSICAL REQUIREMENTS 1. MENTAL EFFORT a. Reasoning development: Follow one- or two-step instructions; routine, repetitive task. Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables. Follow written, verbal, or diagrammatic instructions; several concrete variables. Solve practical problems; variety of variables with limited standardization; interpret instructions. <
$65k-77.5k yearly 37d ago
Medical Credentialing Analyst - REMOTE
Fasttrack Staffing Solutions, LLC
Remote Claims Analyst Job
We are hiring for Medical Credentialing Analysts for an 8 week contract. 8am-5pm, 40 hours/week - One weekend day + 4 weekdays This contract is starting ASAP and can be be remote or on-site in Gainesville Position Summary: Acts as liaison between the Medical Staff Office and hospital credentialed providers and stakeholders. Performs the credentialing function for the hospital by compiling and analyzing all credentialing and provider enrollment supporting information to assure that all Medical Staff and Allied Health Professionals providing medical care or treatment of patients throughout the hospital system are continually credentialed and/or privileged in accordance with all statutory and accreditation requirements. Performs provider enrollment with state/government payers and maintains enrollment record data in group practices billing database to assure accurate reimbursement for services. Minimum Education and Experience Requirements: Bachelors degree or minimum of four years equivalent combination of education and experience which includes advanced administrative experience and independent project task management required. Proficient organizational skills and ability to set priorities as well as manage demands effectively. Must be detail-oriented and able to work independently on each credentialing/provider enrollment project as assigned. Proficiency in a paperless computer environment and understanding of provider data integrity standards (credentialing software, MS Office suite, Adobe Professional, document scanning/storage, web based application and tools, etc.). Knowledge of credentialing privileging, accreditation standards, provider billing and enrollment with federal and state programs is preferred. This is a drug-free workplace. All applicants must be willing to submit to a drug test and background check.
$38k-60k yearly est. 12d ago
Medical Imaging Analyst
Medpace 4.5
Remote Claims Analyst Job
Our imaging services are growing rapidly, and we are currently seeking a full-time, office-based Medical Imaging Analyst to join our team. If you want an exciting career where you use your previous expertise and can develop and grow your career even further, then this is the opportunity for you. Responsibilities * Perform quality assurance checks on medical imaging data collected during medical and device clinical trials to ensure protocol specific requirements are met; * Perform established image processing techniques (converting imaging formats, contouring, performing preliminary measurements of lesions and volumes) across multiple modalities (including but not limited to MRI, CT, US, ECHO, DXA, etc.) using proprietary software as well as other third party software; * Assist in developing imaging protocols to obtain required study metrics based on clinical trial protocols; * Write (in English) technical documents related to the study required imaging procedure * Compile and maintain project-specific status reports and project timelines associated with imaging studies; and * Perform project specific tasks in compliance with Good Clinical Practices (GCP), regulatory requirements (21CFR Part 11), applicable departmental and companywide SOPs, and project specific protocols Qualifications * Bachelor's Degree in biomedical engineering, biomedical sciences (or similar field), with knowledge of medical imaging from experience performing, reviewing, and/or analyzing medical images in either a research or clinical setting. * 1-3 years of experience in clinical research or imaging related field, with at least 2 years of experience in an imaging center * Experience working with clinical trials or within the pharmaceutical environment is preferred TRAVEL: Minimal Compensation Your compensation will be based on your skills and experience. Medpace offers the following benefits for eligible positions: medical, dental, vision, 401(k), vacation policy, sick days, paid holidays, work from home flexibility, short-term disability, long-term disability, health savings and flexible savings accounts, life and AD&D insurance, and pet insurance. For more details, please discuss with your recruiter. Medpace Overview Medpace is a full-service clinical contract research organization (CRO). We provide Phase I-IV clinical development services to the biotechnology, pharmaceutical and medical device industries. Our mission is to accelerate the global development of safe and effective medical therapeutics through its scientific and disciplined approach. We leverage local regulatory and therapeutic expertise across all major areas including oncology, cardiology, metabolic disease, endocrinology, central nervous system, anti-viral and anti-infective. Headquartered in Cincinnati, Ohio, employing more than 5,000 people across 40+ countries. Why Medpace? People. Purpose. Passion. Make a Difference Tomorrow. Join Us Today. The work we've done over the past 30+ years has positively impacted the lives of countless patients and families who face hundreds of diseases across all key therapeutic areas. The work we do today will improve the lives of people living with illness and disease in the future. Cincinnati Perks * Cincinnati Campus Overview * Flexible work environment * Competitive PTO packages, starting at 20+ days * Competitive compensation and benefits package * Company-sponsored employee appreciation events * Employee health and wellness initiatives * Community involvement with local nonprofit organizations * Discounts on local sports games, fitness gyms and attractions * Modern, ecofriendly campus with an on-site fitness center * Structured career paths with opportunities for professional growth * Discounted tuition for UC online programs Awards * Named a Top Workplace in 2024 by The Cincinnati Enquirer * Recognized by Forbes as one of America's Most Successful Midsize Companies in 2021, 2022, 2023 and 2024 * Continually recognized with CRO Leadership Awards from Life Science Leader magazine based on expertise, quality, capabilities, reliability, and compatibility What to Expect Next A Medpace team member will review your qualifications and, if interested, you will be contacted with details for next steps. EO/AA Employer M/F/Disability/Vets
$35k-51k yearly est. 60d+ ago
Viral - Content Claiming Specialist
Create Music Group 3.7
Remote Claims Analyst Job
Create Music Group is currently looking for self-described viral internet culture enthusiasts to join our Viral Department. Viral Content Claiming Specialist perform administrative tasks such as YouTube copyright claiming and asset onboarding, as well as scope out trending memes and social media videos on a daily basis. This position requires a regular workload of data entry/administration in order to carry out the most basic functions of our department but there are plenty of opportunities for more creative and ambitious pursuits if you are so inclined. This is a full time position which may be done remotely, however our office is located in Hollywood, California, and we are currently only looking for job candidates who are located in California. In the future, you may be encouraged to come into our office for meetings or company functions, so it is best if you are located in the Los Angeles/Southern California area. Through our Viral team, we collaborate with some of the most prominent viral talent from the TikTok and meme world including Supa Hot Fire (Deshawn Raw), Welven Da Great (Deez Nuts), Verbalase, KWEY B, Hoodnews, presidentofugly1, 10k Caash, dimetrees, Zackass, Supreme Patty, The Man with the Hardest Name in Africa, ViralSnare, Adin Ross, and more. YouTube monetization provides an alternative consulting and revenue-generating resource for our clients to grow their audience and earnings. We have helped our clients monetize and collected millions in previously unclaimed revenue for content creators, artists and labels. REQUIREMENTS: 1-3 years work experience Excellent communication skills, both written and verbal Internet culture and social media platforms, especially YouTube Conducting basic level research Organizing large amounts of data efficiently Proficiency with Mac OSX, Microsoft Office, and Google Apps PLUSES: Strong understanding of the online video market (YouTube, Instagram, TikTok) Bilingual - any language, although Spanish, Mandarin, and Russian is preferred RESPONSIBILITIES: We work directly with our clients and their team to help them break down the data and find potential opportunities to build their career. Daily responsibilities include but are not limited to the following. Watching YouTube videos for several hours daily Content claiming Uploading and defining intellectual assets Administrative metadata tasks Researching potential clients Staying on top of accounts for current client roster As this is a remote position, you are required to have your own computer and reliable internet connection. This position may require you to download a great deal of video files (files which may be deleted once onboarding tasks are completed) so please make sure that you have a computer that is up to the task. Laptops are preferable if you would like to come into our office to work (snacks, soft drinks, and Starbucks coffee are provided at our physical office). BENEFITS: Paid company holidays, paid time off, and health benefits (medical, dental, vision, and supplementary policies) are included. TO APPLY: Send us your resume and cover letter (in one file). After you apply, you will be redirected to take our Culture Index survey here. Otherwise, copy and paste the link to your web browser: ********************************************************* Info.php?cfilter=1&COMPANY_CODE=cYEX5Omste Applications without a cover letter and Culture Index survey will not be considered. OPTIONAL: Link relevant social media campaigns and/or writing samples from your portfolio.
$45k-75k yearly est. 43d ago
Liability Claims Manager (3 Openings)
Safety National
Remote Claims Analyst Job
At Safety National, we don't just offer jobs - we build careers with purpose! Since 1942, we've been an industry leader, valuing integrity, teamwork, and stability while providing competitive rewards, top-tier benefits, career growth opportunities, and flexible work options that promote balance. With tuition reimbursement, wellness perks, and a strong community impact, we invest in your success-both personally and professionally. Ready to grow with us? Apply today! Follow this link to view all of our available careers and apply: ******************************************** This opportunity is in the Claims department. Our Claims department oversees both high-exposure workers' compensation and liability claims. As an unbundled carrier, we work actively with third-party administrators (TPAs) and self-administered accounts to assist in guiding claims to a successful resolution. As an excess and large deductible carrier, the high exposure claims we handle keep our group challenged, but the uniqueness provides plenty of growth opportunities. Role Description: As a Liability Claims Manager, you will take ownership of assigned claims from initial assignment through closure. You will play a critical role in evaluating coverage, determining exposure, and developing resolution strategies for a variety of liability lines, including Automobile Liability, General Liability, Employers Liability, Public Entity, Cyber, Excess, Umbrella, and Construction Liability. You will proactively manage litigation, oversee third-party administrators (TPAs), and work closely with internal business partners to communicate claim exposures and business trends. Your expertise will help drive cost-effective resolutions while maintaining compliance with internal policies and industry best practices. This position is based in our St. Louis, MO home office and allows for remote work with periodic home office visits. Qualifications: Education: Bachelor's Degree from an accredited college or university required. JD preferred. Required Qualifications: 5 or more years of experience handling complex liability claims, including Automobile Liability, General Liability, Employers Liability, Public Entity, Cyber, Excess, Umbrella, and/or Construction Liability claims. Strong knowledge of litigation processes, including mediation, settlement negotiations, and trials. Proven ability to analyze coverage issues and draft reservation of rights and coverage letters. Excellent written and verbal communication skills, with the ability to interact effectively with internal stakeholders and external partners. Must be presently authorized to work in the U.S. without a requirement for work authorization sponsorship by our company for this position now or in the future. This position allows for a hybrid work schedule which includes a minimum of 3 days per week in our St. Louis Corporate Office, located at 1832 Schuetz Rd. Saint Louis, MO. All employees are required to submit work-from-home requests and follow our Work From Home policy, which will be provided to all candidates selected to interview. Preferred Qualifications: Experience managing claims across multiple jurisdictions with an insurance carrier or Third-Party Administrator (TPA) preferred. Strong organizational and analytical skills with the ability to manage a high-volume workload. Proficiency in Microsoft Excel, Word, and Outlook. AIC, SCLA, or CLCS designation preferred. Protect the confidentiality, integrity and availability of information and technology assets against unauthorized disclosure, destruction and/or alteration, in accordance with Safety National policies, standards, and procedures. Safety National is a leading specialty insurance and reinsurance provider. Our culture is built upon relationships, which allow us to demonstrate our expertise gained through our rich 80-year history. As a wholly-owned subsidiary of Tokio Marine, Inc., we appreciate the benefits and support provided by our affiliation with one of the top 10 insurance companies in the world. Total Rewards That Put Employees First In our vision to be First with Co-Workers, compensation that includes base salary, holiday bonus, and incentive awards is only a small portion of the comprehensive total rewards package we offer. Our total rewards approach recognizes and rewards the time, talents, efforts, and results of our valued employees. Highlights of our exceptional benefits include generous health, dental, and vision coverage, health savings accounts, a 401(k)-retirement savings match and an annual profit-sharing contribution. We proudly offer family forming benefits for adoption, fertility, and surrogacy, generous paid time off and paid holidays, paid parental and caregiver leave, a hybrid work environment, and company-paid life insurance and disability. To support employees in their career journeys, we provide professional growth and development opportunities in addition to employee recognition and well-being programs. Apply today to learn more. Safety National is committed to fair, transparent pay and we strive to provide competitive, market-based compensation. In our vision to be First with Co-Workers, compensation is only one piece of the comprehensive total rewards package we offer. The target base salary range for this position is $86,000 to $112,000. Compensation for the successful candidate will consider the candidate's particular combination of knowledge, skills, competencies, experience and geographic location. #LI-Hybrid
$86k-112k yearly 27d ago
W/C Insurance Claims Specialist 2
Arizona Department of Administration 4.3
Remote Claims Analyst Job
INDUSTRIAL COMMISSION Are you ready to work for an exceptional state agency that works to protect the life, health, safety, and welfare of the employees in the State of Arizona? Apply with us! The Industrial Commission of Arizona (ICA) is committed to the highest standards of compliance, demonstrating leadership in all areas, and teaching and working with employers and employees to make them successful. A thriving workforce in Arizona is what we strive for and work towards each day. W/C INSURANCE CLAIMS SPECIALIST 2 Job Location: Address: Claims Division/Compliance Section 800 W. Washington Street, Phoenix, AZ 85007 Posting Details: Salary: 17.60 Grade: 17 Closing Date: Open Until Filled Job Summary: This position is responsible to audit incoming claims documents for compliance with applicable workers compensation claims management laws, statutes, and case laws. This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures. The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State's Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance. Job Duties: Essential Duties and Responsibilities include but are not limited to: ● This position will critically analyze submitted forms for compliance and issue appropriate awards when indicated. ● Audit insurance carriers, self-insured employers and third-party administrators adjusting workers' compensation claims. ● Reviews all notices, attached medical and/or documentation to verify it supports current change of status and/or calculation of wage and awards. After analysis, specialist will issue correct corresponding award, notification, or document. ● Answer incoming phone calls from injured workers, attorneys, interested parties, claim adjusters, medical providers, and the general public. ● Matches documents lacking information to existing Commission claims files by researching information in Claims database and for creating a new claim file for documents received when there is no existing claim file. ● Provides backup assistance to data entry, error resolution, insurance or combine/delete, as requested and ● Participates in Arizona Management System (AMS) and daily Huddle board. ● Attends staff meetings, seminars, conferences, training classes. Knowledge, Skills & Abilities (KSAs): Knowledge in ● Basic knowledge or ability to learn of applicable workers compensation claims management laws, statutes, and case laws. ● Basic Medical terminology. ● Microsoft Office Suite; Outlook, Word, Excel, Google Office Suite, Gmail, Sheets and Docs ● Basic English ● Basic Mathematics ● The insurance industry claims adjusting standards and practices. ● Skill in: ● Communicating verbally and in writing to resolve disputes with interested parties. ● Basic analysis of insurance, medical and legal documents. ● Reviewing and interpreting Arizona Workers' Compensation laws, rules, procedures, and court decisions ● Critical thinking ● Time Management ● Initiative and attention to detail ● Customer service ● Organizing and planning ● Basic Business process acumen, management skills including workflows and information management. ● Ability to: ● Interpret medical records to determine physical limitations for injured workers. ● Manage heavy workload with high level of accuracy and production. ● Learn computer systems and applications. ● Work well within a diverse and inclusive office environment. ● Process documents in a timely manner and within established productivity standard. ● Prioritizes work within established time frames. ● Manage time effectively and meet deadlines. ● Adapt to changing circumstances. ● Demonstrate initiative and attention to detail. ● Exercise discretion and judgment. ● Works well under pressure. ● Perform job responsibilities incorporating lean management and principles of the Arizona Management System. ● Produce high quality, nearly error-free output. Selective Preference(s): The ideal candidate for this position will have: Claims adjusting license, certification (WCCA, WCCP, CPCU) or designation relating to workers' compensation. Pre-Employment Requirements: All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify). Benefits: The Arizona Department of Administration offers a comprehensive benefits package to include: Sick leave Vacation with 10 paid holidays per year Health and dental insurance Retirement plan Life insurance and long-term disability insurance Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion. For a complete list of benefits provided by The State of Arizona, please visit our benefits page Retirement: You will be eligible to participate in the state employee health/disability insurance plan, and you are required to participate in the Arizona State Retirement System (ASRS). ASRS participation may begin immediately or upon your 27th week of employment. Contributions are matched by the employer. Contact Us: If you have any questions please feel free to call ************ or email ************ for assistance.
$39k-45k yearly est. 60d+ ago
Health Claims Stop Loss Specialist
Virginpulse 4.1
Remote Claims Analyst Job
Now is the time to join us! We're Personify Health. We're the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we're shaping a healthier, more engaged future. Responsibilities Who are you? The Stop Loss Specialist is responsible for supporting the coordination and filing of specifications, advance funding, and plan year-end closeouts. The incumbent is expected to communicate professionally and respectfully with peers, supervisors, subordinates, markets, customers, and the public. Courtesy and professionalism are key components of success in this role. In this role you will wear many hats, but your knowledge will be essential in the following: Prepare Stop Loss claims and applicable documents to determine Stop Loss filing eligibility applicable to the Excess Loss Policy. Files submissions of spec claimants (running reports, gathering necessary documents and email correspondence), processing all submissions within established internal timeframes. Coordinate Advanced Funding Requests, with the client and the Stop Loss carrier. Maintains database of all specific reimbursement requests. Creates initial Specific File for each claimant, files all submissions in our EDOCS platform. Coordinates the release of Over Specific, System Hold “on hold” claims. Acts as the liaison between the PBM's and internal clients, as it pertains to our Stop Loss claimants. Keeps immediate supervisor apprised of open or disputed items. Contributes to daily workflow with regular and punctual attendance. Performs related or other assigned duties as required or directed. Monitors all reinsurance requests to ensure receipt of reimbursement. Generates weekly outstanding reimbursement report and follows up with the Stop Loss carrier. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Qualifications What you bring to the Personify Health team: In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including: High school diploma or general education degree (GED) required. Knowledge of medical terminology, CPT, HCPCS and ICD-10 codes a plus. Knowledge of insurance database system a plus. Ability to read, analyze, and interpret common financial reports and legal documents. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Experience with claims/call center health insurance environment a plus. Experience in self-funded plan administrations a plus. You also take pride in offering the following Core Skills, Competencies, and Characteristics: Must be computer literate and knowledgeable in Windows and Microsoft Office environment, including Word, Excel and Outlook. Strong written and verbal communication skills. Proficient in Word, Excel, and outlook. Ability to organize, prioritize, and multitask in a fast-paced/deadline driven environment. Demonstrate ability to work independently with excellent judgment. A detail-oriented, analytical, financially minded approach. Capacity to think creatively and strategically. Claims processing experience or medical background a plus. Ability to interact in a professional manner with coworkers, clients. No candidate will meet every single desired qualification. If your experience looks a little different from what we've identified and you think you can bring value to the role, we'd love to learn more about you! Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice. In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $17.00 to $22.00 per hour. Note that compensation may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits. We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing. #WeAreHiring #PersonifyHealth #Hybrid Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to **************************. All of our legitimate openings can be found on the Personify Health Career Site. Application Deadline: Open until position is filled.
$17-22 hourly 7h ago
Sr. Professional Liability Medical Claims Manager *Remote*
Providence Health & Services 4.2
Remote Claims Analyst Job
Providence caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Sr. Professional Liability Medical Claims Manager who will: Investigate, evaluate, and manage professional, general, and other liability claims under the PSJH Insurance Program: * Communicate with patients, claimants, caregivers, providers, leadership * Review and analyze medical records, interview witnesses, assist with the discovery process and communicate with facility risk manager regarding evaluation and investigation * Be responsible for writing insurance policy coverage letters * Analyze insurance policy documents to address coverage * Set appropriate indemnity and expense reserves * Select appropriate medical experts for case review * Develop a plan of action for assigned claims and update the claims file following all material changes in status * Review and approve statements for services and take proper steps to pay vendors * Inform Senior Manager Operations of large or complex claims and claims with potential for media exposure * Report claims with potential excess exposure to excess insurers * Ensure compliance with relevant claims reporting procedures and required regulations * Work with defense attorneys specializing in defense of medical negligence claims * Have direct responsibility to foster teamwork, operational excellence, and effective communication within the claims team, including other Claims Managers, Claims Reps and Claims Specialists Maintain complete documentation for each matter: * Develop and document for each claim or lawsuit a plan of action for resolution by settlement, trial, or other means * Maintain the electronic file including all material communication, correspondence, analysis, expert opinions, interview summaries and all other material documents in accordance with the Claims Policies and Procedures Manual Coordinate with facility leadership, risk managers, defense counsel and others: * Select defense counsel when appropriate from approved counsel list * Coordinate and consult with risk management on disclosure conversations with patients and families * Obtain authority for settlement or trial in accordance with policies and procedures or facilitate claims roundtables * Assist in Regional CEO Conferences with Senior Manager Operations * Facilitate and participate in case reviews with Risk Managers upon request Resolve claims in accordance with policies and regulations: * Negotiate settlements * Monitor trials and advise on disclosure and early resolution opportunities * Report to relevant federal, state, and local regulatory agencies as required * Close files in accordance with internal policies and procedures and facilitate appropriate reporting to NPDB and state agencies * Participate in department and claims team projects as assigned to develop and improve procedures, policies; to improve efficiency of department work; and to assist the SVP Chief Risk Officer and Senior Manager Operations as needed Provide Input to Reduce Risk: * Provide feedback and recommendations, evaluations, litigation trends, department policies and procedures, system-wide claims and litigation processes, and appropriate System risk management issues * Provide input for quality and patient safety projects, through the Risk & Integrity Services division and Risk, Claims, & Insurance department Providence welcomes 100% remote work for applicants who reside in the following States: * Alaska * Washington * Oregon * Montana * California * Texas Required qualifications for this position include: * Bachelor's Degree in Business Administration, Finance, or another related field of study -OR- a combination of equivalent education and experience * 7+ years of relevant general and professional liability claims processing or management experience * 5+ years of direct supervisory or management experience Preferred qualifications for this position include: * Certified Professional Healthcare Risk Management (CPHRM) * 10+ years of medical malpractice experience * Insurance Carrier Experience * Third Party Professional Negligence Claims Experience * Experience handling Medical Negligence Professional Liability Claims * Experience handling Complex General Liability Claims * Experience Investigating, evaluating, and negotiating medical negligence claims * Experience working with defense attorneys specializing in defense of medical negligence claims * Experience analyzing medical professional and general liability insurance policy documents and addressing coverage * Experience writing medical professional and general liability insurance policy coverage letters * STARS / Riskonnect or similar claims management software experience Salary Range by Location: * AK: Anchorage: Min: $52.19, Max: $82.39 * AK: Kodiak, Seward, Valdez: Min: $54.40, Max: $85.88 * California: Humboldt: Min: $54.40, Max: $85.88 * California: All Northern California - Except Humboldt: Min: $61.04, Max: $96.35 * California: Southern California: Min: $54.40, Max: $85.88 * Montana: Except Great Falls: Min: $42.02, Max: $66.33 * Montana: Great Falls: Min: $39.81, Max: $62.84 * Oregon: Non-Portland Service Area: Min: $48.65, Max: $76.80 * Oregon: Portland Service Area: Min: $52.19, Max: $82.39 * Texas: Min: $39.81, Max: $62.84 * Washington: Western: Min: $54.40, Max: $85.88 * Washington: Southwest - Olympia, Centralia: Min: $52.19, Max: $82.39 * Washington: Clark County: Min: $52.19, Max: $82.39 * Washington: Eastern: Min: $46.44, Max: $73.31 * Washington: Southeastern: Min: $48.65, Max: $76.80 Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
$52.2 hourly 12d ago
Claim Manager - Casualty General Liability (Hybrid or Remote)
Intact Specialty Solutions
Remote Claims Analyst Job
Our employees are at the heart of what we do: helping people, businesses and society prosper in good times and be resilient in bad times. When you join our team, you are bringing this purpose to life alongside a passionate community. Feel empowered to learn and grow while being valued for who you are. At Intact, we commit to supporting you in reaching your goals with tools, opportunities, and flexibility. It's our promise to you. Who we are At Intact Insurance Specialty Solutions, we are experts at what we do in protecting what makes businesses unique. Our deep understanding of the specialty insurance market is the foundation for our customized solutions, backed by targeted risk control and claims services. Our employees are passionate about providing insurance coverage that's aligned to our targeted customer groups. Intact's Global Specialty Lines business spans across more than 20 verticals in four distinct markets: U.S., Canada, UK and Europe. The following opportunity is for our U.S. team. The opportunity We currently have an opportunity for a Claim Manager to join our Property Casualty Liability Claims team based in our Denver, CO, Boston, MA, Canton, MA or Plymouth, MN office or remotely nationwide. This position manages all components of claim handling for a specialty line of business. Develops plans, analyzes results and oversees work of Claims staff. Reviews and provides direction on reserve and settlement authority, where required, on complex, specialized claims and/or high exposure claims. Supports business partner through communication about specific claims, identification of claim trends, input on form development, and marketing support. Monitors claim quality, customer feedback and claim reports of staff to ensure compliance with regulatory requirements, customer satisfaction and achievement of corporate objectives. Independently operates within very broad company guidelines and high authority levels in the settlement of claims. Makes appropriate decisions on coverage and settlement of claims. Some of the Claim Manager responsibilities include but are not limited to: Ensures execution of proper claim handling strategies; including appropriate determination of coverage, liability, and claim resolution. Ensures proper reserving to achieve compliance with corporate policy. Makes decisions on recommendations for claim disposition, including evaluation, negotiation and settlement of claims, on complex claims or those with exposure in excess of staff authority levels. Evaluates claim file quality through appropriate audits. Reviews and analyzes claim reports to identify and address trends. Develops and implements strategies to correct adverse trends. Maintains a strong professional knowledge of competitive, regulatory and legal environments and applies this information effectively. Consults with other company staff and may participate on related projects and committees. Manages assigned staff, including development, goal setting, skill assessment, staff selection, role alignment, and performance appraisals of staff. Provides frequent communication and measurement of goals. Oversees training and personal development programs within the group. Assists in the development and administers operating and salary budgets. Anticipates and meets all customer needs (internal and external). Prepares for and attends claim review meetings with business partners within specialized business units. The expertise you bring Bachelor's degree or equivalent experience required; JD may be required depending upon the needs and requirements of the business unit. Minimum of 7-10 years of specialty claim experience 3-5 years of supervisory/management experience. Our salary ranges are determined by many factors including location, role, experience and skillset of the candidate. The following ranges displayed reflect the target base salary for new hires but your recruiter will share more specific compensation information with you during the hiring process. The typical base salary range for this position is: $119,000 - $158,000, based on the factors aforementioned. For candidates located in San Francisco, CA; Hoboken, NJ; and the New York City metro area, the base salary range is $139,000 -$162,000. In addition to base salary, full time Intact employees are also eligible for bonus potential and a full range of benefits to include: Comprehensive medical, dental and vision insurance with no waiting period Competitive paid time off programs 401(k) savings and annual contributions of up to 12% of annual salary Mental health support programs, life and disability insurance, paid parental leave and a variety of additional voluntary benefits Why choose Intact We live our Values: We are committed to acting with the highest of ethical standards through our five core values: integrity, respect, customer driven, excellence and social responsibility. Our commitment to Diversity: Founded in our values, we see diversity as a strength and aspire to create an environment where everyone can be themselves, grow and succeed. Together, we will stand up for what's right to build an inclusive society. Manage your Time: What you accomplish matters more than hours in the office. We are committed to creating a positive and supportive environment in which you perform your best. Our Time-Off and Flexible Work Arrangement options help foster a healthy work-life balance. Check out our Glassdoor reviews to see why people love working for Intact! Our promise to you Our Values are foundational to our success at Intact. You'll make a difference every day when you live our Values, do your best work, are open to change, and invest in yourself. In return, we promise you support, opportunities and performance-led financial rewards in a flexible work environment where you can: Shape the future: Help us lead an insurance transformation to better protect people, businesses and society. Win as a team: Collaborate with inspiring people to do your best work every day and together, stand up for what is right. Grow with us: Refresh and reinvent your skills, learn from our diverse teams, lift others up, and grow. About Intact At Intact Insurance Specialty Solutions we are experts at what we do. Our deep understanding of the specialty insurance market is the foundation for our customized solutions, backed by targeted risk control and claims services. Our employees are passionate about providing insurance coverage that's aligned to our targeted customer groups. Today, we help protect over a dozen industries with tailored coverages and services. #LI-DNP
$45k-80k yearly est. 3d ago
Sr Claims Manager - Liability
CCSI CC Services
Remote Claims Analyst Job
Experience more with a career at COUNTRY Financial! We're excited you're interested in a career at COUNTRY as we strive toward our vision - to enrich lives in the communities we serve. Our footprint spans coast to coast. But more important than where we operate, is the people who do the work. Apply today to help our organization grow and make a difference for our clients. About the role The Senior Manager for Liability Claims leads a team of 10 Liability Managers. This role is responsible for liability claims results across all states, for identifying and implementing improvements in liability claims handling, for collaborating with internal business partners and for driving team engagement and development.How does this role make an impact?- Collaborates and coordinates to establish and achieve goals for assigned areas. Monitors and measures metrics to improve results, efficiencies and adherence to claims goals, policies and procedures. Assures consistency across claims operations for assigned areas. - Provides guidance and counsel to claims personnel with respect to the investigation, evaluation, negotiation and settlement of all liability claims. - Supervises the development of assigned staff, including succession planning and administering and monitoring employee development to align with corporate and divisional needs. - Manages the implementation and maintenance of disaster recovery plans and activities in assigned areas. Maintains current contact information for all employees in applicable areas and communicates with non-recovery employees during a disaster.Do you have what we're looking for? Typically requires 10+ years of relevant experience or a combination of related experience, education and training, including management experience. - This job operates in a professional office or work from home environment and routinely uses standard office equipment such as computers, phones, scanners and copy machines. - Work may extend beyond normal business hours as business needs dictate. - May be called upon for catastrophic duty. #LI-Hybrid Base Pay Range: $134,400-$184,800 The base pay range represents the typical range of potential salary offers for candidates hired. Factors used to determine your actual salary include your specific skills, qualifications and experience. Incentive Pay: In addition to base salary, this position is eligible for a Short-Term Incentive plan. Why work with us? Our employees and representatives serve nearly one million households with our diverse range of personal and business insurance products as well as retirement and investment services. We build relationships and work together to create a stronger, more secure future for our clients and our communities. We're a big company, yet small enough you can make an impact and won't get lost in the shuffle. You'll have the opportunity to learn and grow throughout your career, either within this role or by exploring other areas of our business. You'll be able to take advantage of our benefits package, which includes insurance benefits (medical, dental, vision, disability, and life), 401(k) with company match. COUNTRY Financial is committed to providing equal opportunity in all areas of employment, and in providing employees with a work environment free of discrimination and harassment. Employment decisions are made without regard to race, color, religion, age, gender, sexual orientation, veteran status, national origin, disability, or any other status protected by applicable laws or regulations. Come join our team at COUNTRY today!
$35k-65k yearly est. 3d ago
Sr Claims Manager - Liability
Country Financial 4.4
Remote Claims Analyst Job
Experience more with a career at COUNTRY Financial! We're excited you're interested in a career at COUNTRY as we strive toward our vision - to enrich lives in the communities we serve. Our footprint spans coast to coast. But more important than where we operate, is the people who do the work. Apply today to help our organization grow and make a difference for our clients. About the role The Senior Manager for Liability Claims leads a team of 10 Liability Managers. This role is responsible for liability claims results across all states, for identifying and implementing improvements in liability claims handling, for collaborating with internal business partners and for driving team engagement and development. How does this role make an impact? * Collaborates and coordinates to establish and achieve goals for assigned areas. Monitors and measures metrics to improve results, efficiencies and adherence to claims goals, policies and procedures. Assures consistency across claims operations for assigned areas. - Provides guidance and counsel to claims personnel with respect to the investigation, evaluation, negotiation and settlement of all liability claims. - Supervises the development of assigned staff, including succession planning and administering and monitoring employee development to align with corporate and divisional needs. - Manages the implementation and maintenance of disaster recovery plans and activities in assigned areas. Maintains current contact information for all employees in applicable areas and communicates with non-recovery employees during a disaster. Do you have what we're looking for? Typically requires 10+ years of relevant experience or a combination of related experience, education and training, including management experience. * This job operates in a professional office or work from home environment and routinely uses standard office equipment such as computers, phones, scanners and copy machines. * Work may extend beyond normal business hours as business needs dictate. * May be called upon for catastrophic duty. #LI-Hybrid Base Pay Range: $134,400-$184,800 The base pay range represents the typical range of potential salary offers for candidates hired. Factors used to determine your actual salary include your specific skills, qualifications and experience. Incentive Pay: In addition to base salary, this position is eligible for a Short-Term Incentive plan. Why work with us? Our employees and representatives serve nearly one million households with our diverse range of personal and business insurance products as well as retirement and investment services. We build relationships and work together to create a stronger, more secure future for our clients and our communities. We're a big company, yet small enough you can make an impact and won't get lost in the shuffle. You'll have the opportunity to learn and grow throughout your career, either within this role or by exploring other areas of our business. You'll be able to take advantage of our benefits package, which includes insurance benefits (medical, dental, vision, disability, and life), 401(k) with company match. COUNTRY Financial is committed to providing equal opportunity in all areas of employment, and in providing employees with a work environment free of discrimination and harassment. Employment decisions are made without regard to race, color, religion, age, gender, sexual orientation, veteran status, national origin, disability, or any other status protected by applicable laws or regulations. Come join our team at COUNTRY today!
$54k-78k yearly est. 6d ago
Auto Liability Claims - REMOTE
Employer-Payroll
Remote Claims Analyst Job
The Claim Representative handles low to mid-range exposure bodily injury and property damage claims under Ryder's self-insured, self-administered liability program. This position investigates and adjusts claims, as well as directs independent adjusters, experts, and other vendors in the claims handling processes ESSENTIAL FUNCTIONS Investigates and adjusts claims, as well as directs independent adjusters, experts, and other vendors in the claim handling processes Interacts, on an on-going basis, with field and operations management, legal counsel, safety managers, customers, insurance carriers, and third party claimants Manages litigation to ensure claims are handled appropriately, according to the applicable jurisdiction Assists Claim Manager in the identification of exposures and recommends solutions Manages indemnity and expense costs properly Interacts with primary and excess insurance carriers, and re-insurers on files meeting reporting thresholds Alerts Claim Manager to changes and proposed changes in laws that could impact Ryder's liability program Updates field operations personnel on claim status Supervises outside vendors and experts retained to assist in the investigation Recommends and sets reserves to ensure the reserves represent the probable ultimate payout based on documented file developments ADDITIONAL RESPONSIBILITIES Performs other duties as assigned EDUCATION Bachelor's degree related field . EXPERIENCE Two (2) years or more experience in physical damage claims SKILLS Demonstrated ability to handle and resolve low-to-mid range liability exposures Requires strong claim technical skills Strong commitment to the principles of customer focus Effective interpersonal skills and ability to communicate clearly in verbal and written communications Strong negotiation skills and ability to deal effectively with insurers KNOWLEDGE Understanding of relevant laws and regulations governing physical damage claims in the U.S.; Understanding of insurance coverage; Comprehensive understanding of relevant laws and regulations LICENSES Licenses preferred TRAVEL 1-10% Job Category Risk Management Compensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. The position may also be eligible to receive an annual bonus, commission, and/or long-term incentive plan based on the level and/or type. Compensation ranges for the position are below: Pay Type: Salaried Minimum Pay Range: $65,000.00 Maximum Pay Range: $72,500.00 Benefits Information: For all Full-time positions only: Ryder offers comprehensive health and welfare benefits, to include medical, prescription, dental, vision, life insurance and disability insurance options, as well as paid time off for vacation, illness, bereavement, family and parental leave, and a tax-advantaged 401(k) retirement savings plan. Ryder is proud to be an Equal Opportunity Employer and Drug Free workplace. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability. Security Notice for Applicants: Ryder will only communicate with an applicant directly from a [@ryder.com] email address and will never conduct an interview online through a chat type forum, messaging app (such as WhatsApp or Telegram), or via an online questionnaire. During an interview, Ryder will never ask for any form of payment or banking details and will never solicit personal information outside of the formal submitted application through ********************** Should you have any questions regarding the application process or to verify the legitimacy of an interview or Ryder representative, please contact Ryder at ***************** or ************. Current Employees: If you are a current employee at Ryder, please click here to log in to Workday to apply using the internal application process. Job Seekers can review the Job Applicant Privacy Policy by clicking here.
$65k-72.5k yearly Easy Apply 17d ago

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