Claims Representative Jobs in New York

Vanguard is currently in need of a Liability Field Adjuster to adjust claims in New York City and the surrounding boroughs. This contractor will manage all aspects of assigned liability claims in a variety of business classes, and effectively determine and communicate the extent of liability or damage associated with each claim. The incumbent will assist in fulfilling Vanguard's obligation to policyholders and maintaining our client's claims processing functions, including evaluating potential coverage issues, liability and evaluation of damages, risk transfer opportunities, litigation and settlement matters within the limits of assigned authority levels and in compliance with applicable legal and regulatory requirements. Specific responsibilities include: Conducting investigations through field visits and phone contact; obtaining contracts, job files, and appraisals; conducting insured, witness, and claimant interviews and/or statements; complete site inspections; scope, measure and write estimates, and use other fact-finding methods to evaluate liability, damages, and proper coverage. Using knowledge of property and construction, and/or knowledge of the specific industry or business affected, personally conducting property inspections and photographing claim sites as necessary to depict and substantiate losses or damage, or lack thereof. Investigating insurance claims in a variety of settings including, but not limited to retail establishments, office buildings, residences, condominiums, apartments, hotels, corporate facilities, governmental facilities, schools, clinics, or hospitals; assess loss or damage resulting from various events including, but not limited to, inclement or catastrophic weather, construction defect, and fire. Conducting thorough interviews or other methods to obtain necessary information from the claimant and experts such as architects, engineers, builders, construction workers, police officers, health care practitioners, accountants, and others to assess the extent of the loss fully and accurately. Appling a thorough understanding of insurance policies and policy interpretation to properly conduct an investigation, establish appropriate loss estimates based on all relevant information and findings, provide coverage recommendations, and draft cover letters, if requested by the client. Using Xactimate to produce accurate estimates. Requirements of Contractor Bachelor's degree is preferred. A High School Diploma or equivalency is required. A minimum of three years of liability claims adjusting experience Must have an active license in the state of New York. Must be proficient in Microsoft Office (including but not limited to Word, Excel, and Outlook) Must have a basic knowledge of casualty claims law and jurisdictional issues Experience with building estimates through Xactimate required. Must be able to draft coverage letters Proficient written and oral communication skills Effective time management and organization skills Ability to interpret policies Commitment to confidentiality and ability to discretely handle sensitive information Strong customer service skills Detail-oriented, and the ability to research, investigate and problem solve.

The Company At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $1.6B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, our Home Office is based in Central New York, with Regional Office locations including Boston, NYC, Atlanta, Dallas, Columbus, Richmond, and Chicago. This is a hybrid position with a minimum of 8 days/month spent in-office in New Hartford, NY; Buffalo, NY; or Charlotte, NC. What you will do You'll be responsible for investigating, evaluating, negotiating, and resolving workers' compensation claims in primarily New York jurisdictions, as well as Connecticut, Massachusetts, New Hampshire, Rhode Island, and Vermont. In this role, low to moderate complexity lost time claims will be adjusted, and there will be some exposure to litigated files. Skills in communication, customer service, detail orientation, and analysis will be used to work with all parties involved and resolve claims in an accurate, fair, and timely manner. Key responsibilities * Perform all the duties and responsibilities of a Claims Specialist I. * Investigate, evaluate, negotiate and resolve low to moderate complexity lost time claims. * Operate more independently and resolve claim files within a higher authority limit. * Ability to interpret coverage, evaluate damages and negotiate settlements with limited supervisor intervention. * Handle less complex litigated files; on occasion may be required to attend mediation or trials. Direct defense counsel in the resolution of claim. * Consult with Supervisor on more complex coverage and technical matters. * Provide technical support for less experienced specialists as needed. * Perform other tasks as assigned. What you need * Four year degree or equivalent experience preferred. * 2-4 years of insurance claims experience preferred with workers' compensation experience. * Proof of licensing required. Licensing Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment. Salary Range: $54,700 - $73,000 The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications. Benefits We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following: * Medical and Prescription Drug Benefit * Dental Benefit * Vision Benefit * Life Insurance and Disability Benefits * 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results) * Health Savings Account (HSA) * Flexible Spending Accounts * Tuition Assistance, Training, and Professional Designations * Company-Paid Family Leave * Adoption/Surrogacy Assistance Benefit * Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance * Student Loan Refinancing Services * Care.com Membership with Back-up Care, Senior Solutions * Business Travel Accident Insurance * Matching Gifts program * Paid Volunteer Day * Employee Referral Award Program * Wellness programs Additional Information This position is a full time salaried, exempt (non overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy. #LI-HL1

Everest is a leading global reinsurance and insurance provider, operating for nearly 50 years through subsidiaries in the Europe, Bermuda, Canada, Singapore, US, and other territories. Our strengths include extensive product and distribution capabilities, a strong balance sheet, and an innovative culture. Throughout our history, Everest has maintained its discipline and focuses on creating long-term value through underwriting excellence and strong risk and capital management. But the most critical asset in this organization is our people. Everest is a growth company offering Property, Casualty, and specialty products among others, through its various operating subsidiaries located in key markets around the world. Everest has been a global leader in reinsurance with a broad footprint, deep client relationships, underwriting excellence, responsive service, and customized solutions. Our insurance arm draws upon impressive global resources and financial strength to tailor each policy to meet the individual needs of our customers. Everest has an opportunity for an experienced claims professional or attorney to join our Casualty Claims team. This individual will handle mainstream and moderately complex auto, general liability and excess liability and umbrella claims of all varieties. Responsibilities include but not limited to: * Reviewing and analyzing complex coverage issues and preparation of coverage position letters. * Investigating, analyzing and evaluating liability and damages. * Managing and directing outside counsel. * Preparing case summary reports related to matters of significant reserve and trial activity. * Setting timely and appropriate case reserves. * Developing and executing claim strategies as well as resolution strategies. * Negotiating and resolving cases. * Attending trials, mediations and settlement conferences. * Working with underwriters to support policy construction and drafting, reporting claim trends, data analysis, and risk assessments. * Extensive communication with insureds, brokers, reinsurers, actuaries, and underwriters. * Attending client meetings and industry functions to support retention and development of client relationships and business. * Performing similar work-related duties as assigned. Qualifications, Education & Experience: * Strong analytical and organizational skills. * Excellent verbal and written communication skills. * Strong negotiation and investigation skills. * Ability to think strategically. * Ability to influence others and resolve complex, disputed claims. * In-depth knowledge of the litigation, arbitration, and trial process. * Currently holds or readily can obtain all required adjuster licenses. * Ability to identify and use relevant data and metrics to best manage claims. * Collaborative mind-set and willingness to work with people outside immediate reporting hierarchy to improve processes and generate optimal departmental efficiency. * Ability and willingness to present to senior management and to others in other group settings. * Knowledge of the insurance industry, claims process and legal and regulatory environment. * 3-5 years of claims handling experience or legal experience. * B.A. or B.S. required; JD helpful but not required. Our Culture At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture. * Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Diversity, Equity and Inclusion. * Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together. All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve. For NY & CA only: The base salary range for this position is $90,000-$130,000 annually. The offered rate of compensation will be based on individual education, experience, qualifications and work location. #LI-Hybrid #LI-VP1 Type: Regular Time Type: Full time Primary Location: Warren, NJ Additional Locations: Boston, MA, Chicago, IL - South Riverside, Hartford, CT, Houston, TX, Los Angeles, CA, New York, NY, San Francisco, CA Everest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy), sexual orientation, gender identity or expression, national origin or ancestry, citizenship, genetics, physical or mental disability, age, marital status, civil union status, family or parental status, veteran status, or any other characteristic protected by law. As part of this commitment, Everest will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Everest Benefits at *********************************. Everest U.S. Privacy Notice | Everest (everestglobal.com)

We are seeking a Complex Cyber Claims Specialist to join our team of dedicated professionals in the insurance industry. As a Complex Cyber Claims Specialist, you will be responsible for handling complex cyber claims for our clients. The ideal candidate for this position will have several years of cyber claims handling experience (JD preferred but not required). Responsibilities: Investigate and evaluate complex cyber claims to determine coverage and liability. Analyze legal and technical issues related to cyber claims. Work with attorneys, experts, and other professionals to resolve complex claims. Develop and maintain strong relationships with clients, brokers, and underwriters. Provide guidance and support to other claims professionals. Ensure compliance with company policies and procedures. Monitor trends and developments in the cyber insurance industry. Requirements: Several years of cyber claims handling experience, (JD is preferred but not required). Strong analytical and problem-solving skills. Excellent communication and interpersonal skills. Ability to work independently and as part of a team. Familiarity with insurance policies and coverage. Knowledge of cyber risk and related legal issues. Strong attention to detail and organizational skills. Ability to handle multiple tasks and priorities. Benefits: We offer a competitive salary dependent upon experience, a bonus anywhere from 10-20%, flexible work schedule, and great benefits including medical, dental, vision, life insurance, and 401(k) retirement plan. The work week is 35 hours. If you are looking for an exciting opportunity to join a leading international insurance carrier and work with a team of dedicated professionals, we encourage you to apply for this position.

Litigation Adjuster - Construction Specialist Hybrid Work Schedule Buffalo, NY Merchants Insurance Group, is a leading Property and Casualty Insurer in the Northeast, and is looking for a Litigation Adjuster - Construction Specialist to join our growing Claims Legal Team in our Corporate Headquarters located in Buffalo, New York. The Litigation Adjuster - Construction Specialist will become part of a dedicated team focusing on New York Labor Law, construction defect and/or third-party property damage claims. This position interacts extensively with internal colleagues as well as policyholders, agents, attorneys and a multitude of claim-related service providers. Merchants Insurance Group, rated A- (Excellent) with a positive outlook by the A.M. Best Company, is proud to be one of Buffalo Business First's Best Places to Work in Western New York (2023, 2024), a Fast Track company (2019-2024), and a Top Private Company (2019-2024). Merchants has been granted Ward's 50 designation as a top-performing property-casualty insurance company for four consecutive years. In October 2024, Newsweek and Statista included Merchants Insurance Group on their first-ever America's Most Reliable Companies list, which highlights organizations that other companies can feel confident doing business with in 2025. Of 1,500 B2B companies evaluated, Merchants was one of only 300 companies to make the list. Merchants offers its colleagues a Hybrid work schedule. The Hybrid work schedule requires 8 full days per month in the office, with the option to work the remaining days at home or in the office. This exciting Hybrid Work benefit offers colleagues a flexible work schedule with the ability to remain connected with their Merchants team and colleagues. Essential Duties and Responsibilities include, but are not limited to: Cultivating relationships with claims and other internal staff, policyholders, attorneys, agents and a variety of service providers and experts all while working towards achieving the most optimal outcomes for Merchants and our policyholders. Providing a high level of customer service while managing a portfolio of complex and high exposure litigated claims involving complex liability and damage issues. Evaluating coverage by interpreting/applying policy language to claim facts and preparing appropriate and timely coverage position letters. Conducting and directing timely and quality claim investigation, evaluation and equitable settlement of all assigned claims. Ensuring timely and accurate reserves consistent with established reserving philosophy and practices. Negotiating fair and equitable settlements directly with attorneys. Identifying risk transfer opportunities through trade contracts and/or applicable law. Qualifications & Skills: Qualified candidates will have a 4 year degree or equivalent work related experience. A minimum of 3 years' experience handling New York Labor Law, construction defect and/or third-party property damage claims. Candidates with a JD and insurance defense experience looking for a new career path are encouraged to apply. Ability to oversee and manage defense counsel, select and retain appropriate experts and develop appropriate resolution strategies. Professional designations or working towards industry specific designations are a plus. Exceptional organization, negotiation, verbal and written communication skills are required. Merchants Insurance Group Pay information: Merchants Insurance Group offers a competitive pay scale. The actual compensation will be determined based upon experience and other factors permitted by law. The pay range for this position is $68,400 - $100,000. Merchants Insurance Group Benefits: Welcoming and positive work environment. Colleague Appreciation events. Flexible work arrangements, including flex scheduling and summer hours. Hybrid work schedule. The Hybrid work schedule will require 8 full days per month in the office, with the option to work the remaining days per month at home or in the office. Competitive pay scale. Generous paid time off package. Full Benefits: Health, Dental, Vision, Life Insurance, Short Term Disability, 401(k) employer match amount is 100% up to 6% of your annual contributions. You are immediately 100% vested in the employer match dollars. Company bonus program. Tuition Reimbursement. And many more exciting company benefits!! EOE

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℠. Summary This position is responsible for the adjustment of commercial claims. This includes claim evaluation and coverage review, contact with insured/claimants (and agents as necessary), claim investigation, coverage evaluation, negotiation, and settlement of first and third-party commercial claims. Essential Functions •Claim investigation: Initial and final coverage confirmation, review, investigate, and actively bring claims to a conclusion, process claims utilizing a high degree of judgment. •Initiative: Appropriate diary and claim management to ensure prompt, accurate, and appropriate claim resolution. •Service: timely and responsive communication with insureds, agents, claimants, attorneys, independent insurance adjusters, and carriers regarding the status of the claim. •Coverage and Damage Analysis: Appropriately analyze coverage and accurate claim damage and injury valuation using expert resources as needed. •Reserves, Negotiation, and Settlement: Maintain accurate and timely reserves that reflect the ultimate probable value of the claim. Accurately and timely resolve claims using appropriate negotiation and influencing skills. •Leadership of the organization: At the direction of Claims Management, provide mentorship to Claim Adjusters, assist in organization training efforts, and participate in regular file audits and data reviews. Knowledge, Skills, and Abilities •High-school degree or equivalent, college degree or coursework preferred. •NY State Adjusters license a plus, but not required. Ability to obtain state licensing as needed within 9 months of hire. •Minimum of 2-3 years exposure to commercial claims adjusting and claim resolution. •Knowledge of various state regulations as they apply to benefits administration and claim adjudication. •Strong written and verbal communication skills. •The ability to succeed and excel in a collaborative and team-based environment. •Strong time management and desk management skills. •Knowledge of and ability to operate efficiently in a Windows-based environment using Excel, Word, and Outlook as well as company claim administration software. •Ability to work independently and to carry 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. $70,000 - $90,000/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. 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. 20200 McNeil & Company, Inc.

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top liability insurers in the industry as a Complex Claims Specialist! Please note that this position is hybrid and requires a minimum of two (2) days in office per week. Position can be based in the following office locations: New York (Manhattan or White Plains) (preferred) Atlanta, GA Chicago, IL Scottsdale, AZ West Hartford, CT About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals working together to manage their claims directly with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox's strong brand built on a long history of outstanding claims handling. The Role: The primary role of Complex Claims Specialist is to independently analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our clients and their brokers, and to proactively drive early resolution of claims arising from our General Liability products. The Complex Claims Specialist will manage a full pending of General Liability Claims, as well as provide thought leadership in multiple forums within and outside of the company. The Complex Claims Specialist actively engages in business development, product innovation, and market/customer insight and develops strong working relationships with underwriting leadership. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service. Key Responsibilities: Strategize and maximize early settlement opportunities for General Liability Claims Draft and Review coverage analyses Monitoring litigation and managing local defense counsel Continually assessing exposures and adequacy of claim reserves Drive employee engagement by exhibiting passion about the company, values and our customers Take lead in managing high exposure claims on team Attend mediations and/or settlement conferences where appropriate Assists in preparing & presenting quarterly reserving packs Actively participate in the Claims/UW/Actuarial feedback loop Keep senior claims management adequately and appropriately informed of key issues Liaising directly on daily basis with insureds, counsel and brokers Maintaining timely and accurate file documentation/information in our claims management systems Personal Specification: JD from an ABA-accredited law school preferred with Bar admission in good standing if applicable Or minimum of 8-10 years of professional experience in General Liability with an insurance carrier or litigation experience in General Liability Minimum Associates Degree or equivalent work experience; however Bachelor's Degree Preferred New York Labor Law (NYLL) experience highly preferred Risk Transfer practice Litigation and mediation experience Ability to analyze liability and potential damages exposure Experience monitoring outside counsel Experience negotiating allocation issues Experience drafting or reviewing litigation budgets Experience recommending or setting reserves Experience handling large volume of claims or litigation matters Ability to manage case load independently and meet time lines Excellent verbal and written communication skills Strong ability to establish rapport and build relationships with clients Team-oriented, with ability to excel in a collaborative environment Leadership and people management skills Active insurance adjuster's license issued by NY or current residential/DHS location or ability to secure within 45 days What Hiscox USA Offers Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA 401(k) with competitive company matching 24 Paid time off days, plus 2 Hiscox days, 10 paid holidays and 1 paid floating holiday, with ability to purchase up to 5 additional PTO days annually Paid parental leave 4-week paid sabbatical after 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership/fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing 2023 Gold level recipient of Cigna's Healthy Workforce Designation - best-in-class health and wellness Dynamic, creative and value-driven culture Modern and open office spaces, complimentary fruit and drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force over 425 employees mostly operating out of 6 major cities - New York, Atlanta, Chicago, Los Angeles, Scottsdale and West Hartford. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. About Hiscox As an international specialist insurer we are far removed from the world of mass market insurance products. Instead, we are selective and focus on our key niche areas of expertise and strength - all of which are underpinned by a culture that encourages us to challenge convention and always look for a better way of doing things. We insure the unique and the interesting. And we search for the same when it comes to talented people. Hiscox is full of smart, reliable human beings that look out for customers and each other. We believe in doing the right thing, making good decisions and rebuilding holistically when things go wrong. Everyone is encouraged to think creatively, challenge the status quo and look for solutions. Scratch beneath the surface and you will find a business that is solid, but slightly contrary. We like to do things differently and constantly seek to evolve. We might have been around for a long time (our roots go back to 1901,) but we are young in many ways, ambitious and going places. Some people might say insurance is dull, but life at Hiscox is anything but. If that sounds good to you, get in touch. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance). Salary range: $100k - $120k #LI-AJ1 Work with amazing people and be part of a unique culture

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℠. Summary This position is responsible for the adjustment of commercial claims. This includes claim evaluation and coverage review, contact with insured/claimants (and agents as necessary), claim investigation, coverage evaluation, negotiation, and settlement of first and third-party commercial claims. Essential Functions •Claim investigation: Initial and final coverage confirmation, review, investigate, and actively bring claims to a conclusion, process claims utilizing a high degree of judgment. •Initiative: Appropriate diary and claim management to ensure prompt, accurate, and appropriate claim resolution. •Service: timely and responsive communication with insureds, agents, claimants, attorneys, independent insurance adjusters, and carriers regarding the status of the claim. •Coverage and Damage Analysis: Appropriately analyze coverage and accurate claim damage and injury valuation using expert resources as needed. •Reserves, Negotiation, and Settlement: Maintain accurate and timely reserves that reflect the ultimate probable value of the claim. Accurately and timely resolve claims using appropriate negotiation and influencing skills. •Leadership of the organization: At the direction of Claims Management, provide mentorship to Claim Adjusters, assist in organization training efforts, and participate in regular file audits and data reviews. Knowledge, Skills, and Abilities •High-school degree or equivalent, college degree or coursework preferred. •NY State Adjusters license a plus, but not required. Ability to obtain state licensing as needed within 9 months of hire. •Minimum of 2-3 years exposure to commercial claims adjusting and claim resolution. •Knowledge of various state regulations as they apply to benefits administration and claim adjudication. •Strong written and verbal communication skills. •The ability to succeed and excel in a collaborative and team-based environment. •Strong time management and desk management skills. •Knowledge of and ability to operate efficiently in a Windows-based environment using Excel, Word, and Outlook as well as company claim administration software. •Ability to work independently and to carry 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. $70,000 - $90,000/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. 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. 20200 McNeil & Company, Inc.

Award Winning Toyota of Clifton Park has an immediate opening for a Licensed Body Shop Adjustor. Our shop is staffed by an amazing group of qualified and long standing technicians. Our body shop is extremely busy and we need additional help! Apply today if you have a history of success in the Collision Center repair field and want to work for an award winning dealership in the Capital District! Benefits Medical and Dental 401K Plan Paid time off and vacation Growth opportunities Paid Training Family owned and operated Long term job security Responsibilities Understand, keep up-to-date with and comply with federal, state and local regulations that affect Body Shop operations such as hazardous waste disposal. Right-to-Know and environmental updates Write and manage all estimates in the body shop from beginning to end Establish and maintain good working relationships with several insurance adjusters Present self as a role model by demonstrating leadership and commitment to the customer, dealership, and manufacturer Take the initiative to exceed customer satisfaction, even if it requires overcoming obstacles Perform multiple tasks simultaneously Prioritize work to ensure that deadlines are met Other responsibilities as assigned by dealership General Manager Qualifications Must have adjuster license High school diploma or the equivalent Proven track record of successful estimator positions Excellent communication, supervisory and managerial skills Working knowledge of body repair methods Proficient knowledge of dealership's computer systems Must have valid in-state driver's license and have and maintain an acceptable, safe driving record, and safe driving habits in order to drive both customer vehicles and a demonstrator vehicle Must be a team player with impeccable honesty and integrity Maintain a high level of professional personal appearance and conduct We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

SourceProSearch is seeking a Claims Specialist with 1-2 years of experience to work in our New York office. The ideal candidate should be comfortable with technology and platforms. This position requires at least 2 days per week in the office. Job Responsibilities: Format documents and communications for clients. Liaise between third-party vendors and the firm. Review documents (release/document verification) for production to defense counsel for quality control. Calendaring and entry of case info into the database. Perform intake and initial filtering of client inquiries. Preparation of submissions involving large volumes of individual claims. Run and analyze client data reports. Organize documents and communications with clients. Ensure that case documents accurately reflect a client's individual information. Keep track of communications or developments relating to client cases and deadlines that may be applicable to individual clients. Prepare and send client communications. Communicate with clients telephonically, on occasion. Work with attorneys to plan data gathering and settlement update workflows. Analyze and summarize client inquiries to identify trends and patterns requiring further action. Assist with the development of processes and technological systems for addressing large volumes of client interactions. Skills/Requirements: Proficient in the use of Microsoft Word and Excel. Familiarity with Filesite preferred. Familiarity with client management systems or databases preferred. Strong technical skills and ability to quickly learn new litigation support software. Strong written and oral communication skills and strong interpersonal skills. Must possess great attention to detail. Must possess analytical and critical thinking skills. Strong organizational and time-management skills. Ability to work independently while understanding the importance of teamwork. Ability to manage workload consisting of multiple tasks. The work shift for this position is 9:30 am-5:30 pm, five days a week, but the applicant must be willing and available to work overtime, both evening and weekends, when necessary. ****************************

Setting: A minimum of 2 days onsite (usually Wednesday and Friday), though this may vary. Schedule: Monday –Friday 8: 30 am-5: 30 pm (1 hour lunch) Contract Length: Long Term/Ongoing, potential for Direct Hire As a Claims Specialist, you will oversee claims processed by external vendors, resolve provider appeals/disputes, and drive process improvements. You’ll conduct root cause analysis to identify areas for provider education and system enhancements. Your key tasks will include investigating claims, managing claim reports, improving workflows, and ensuring accurate reimbursement configurations. You’ll also handle refunds, validate pricing outcomes, and collaborate with internal teams, providers, and vendors. Additionally, you'll contribute to special projects and ensure compliance with regulations and SLAs. Key Responsibilities Include: Review and resolve provider claims, appeals, and disputes. Analyze claims and medical data to improve processes and workflows. Collaborate with providers, members, and vendors to ensure smooth claim processing. Validate DRG grouping and (re)pricing outcomes. Manage refund checks, identify trends, and propose process enhancements. Produce routine reports to ensure vendor productivity and compliance. Participate in special projects and continuous process improvements. QUALIFICATIONS: Education: Bachelor's degree. Certified Professional Coder (a plus) Experience: - Eight or more years of insurance experience within a healthcare or managed care setting (preferred) - Claims adjudication experience - Knowledge of MLTC/ Medicaid/Medicaid benefit - Knowledge of Member (Subscriber) enrollment & billing - Knowledge of Utilization Authorizations - Knowledge of Provider Contracting - Knowledge of CPTs, ICD 9/ICD 10, HCPC, DRG, Revenue, RBRVS - Proficiency in MS Excel, Word, PowerPoint, and experience using a claims processing system or comparable database software

WHO WE ARE Domiciled in Bermuda, with offices in London, Miami, New York and Dubai, Relm Insurance Ltd. (“Relm”) is the first IIGB (Innovative Insurer General Business) insurer regulated by the Bermuda Monetary Authority (“BMA”). Since inception, Relm has remained focused on its Vision of “Making Innovation Resilient” by providing insurance to companies pioneering new technology frontiers in over 35 countries around the world. Relm's dynamic global team has executed market-leading insurance solutions for companies operating in web3, AI, financial technology, biotech and other important emerging sectors. WHAT WE ARE LOOKING FOR At Relm Insurance Ltd, our Mission is “To contribute to the building of the future by creating solutions for complex risks in innovative markets.” As we continue leading the way in emerging industries, we're looking for a C to join our team and play a key role in this mission. At Relm, we believe in fostering a diverse and inclusive culture, where everyone is empowered to bring their unique perspectives and ideas. Our core values of Accountability, Collaboration, Curiosity & Creativity, and Courage & Optimism are central to who we are, and we strive to bring these values to life every day. We bring these values to life every day - whether by collaborating on innovative solutions, tackling challenges with optimism, or pushing boundaries with creativity and courage. WHAT YOU WILL DO: Manage High-Exposure and Complex Claims: Handle claims across Financial Lines (D&O, E&O, Cyber, Crime, Tech Liability) with high financial impact, ensuring efficient resolution while mitigating company exposure. Conduct Coverage Analysis: Review and interpret policy language, assess coverage applicability, and provide coverage determinations in alignment with legal and regulatory requirements. Litigation and Dispute Management: Oversee litigation strategies, work closely with external defense counsel, and participate in mediation, arbitration, and settlement negotiations. Regulatory and Compliance Oversight: Ensure claims handling practices comply with state, federal, and international regulations, particularly in emerging sectors such as blockchain and digital assets. Collaborate with Underwriting and Risk Teams: Provide insights on claims trends, risk assessments, and policy wording recommendations to enhance underwriting strategies and product development. Work with External Partners: Liaise with brokers, third-party administrators (TPAs), coverage counsel, and forensic investigators to facilitate claims investigations and resolutions. Lead Claims Investigations: Conduct in-depth claim assessments, including gathering evidence, interviewing key parties, and analyzing loss data to make well-informed claims decisions. Develop and Implement Claims Strategies: Establish proactive claims-handling strategies to optimize financial outcomes and improve policyholder experiences. Provide Thought Leadership on Emerging Risks: Stay ahead of market trends, regulatory developments, and industry best practices, particularly in financial lines and blockchain-related risks. Deliver Reports and Stakeholder Communications: Prepare detailed claim summaries, risk analyses, and reports for senior management, reinsurers, and regulatory bodies, ensuring transparency and strategic alignment. Requirements WHAT YOU BRING TO THE TABLE: Bachelor's degree in Law, Business, Finance, Risk Management, or a related field required; Juris Doctor (JD) or advanced degree preferred. 2-5 years of experience handling complex financial lines claims, including D&O, E&O, Cyber, Crime, and Technology Liability in an insurance, legal, or risk management setting. Strong knowledge of insurance policy language, coverage analysis, and claims resolution strategies, particularly within financial and professional liability lines. Experience managing high-exposure, litigated claims, including oversight of outside counsel, mediation, and settlement negotiations. Familiarity with regulatory frameworks such as SEC regulations, GDPR, CCPA, AML/KYC compliance, and evolving digital asset insurance requirements. Prior experience in blockchain, fintech, or emerging technology-related risks is highly desirable. Proven ability to work with third-party administrators (TPAs), brokers, reinsurers, and risk management professionals to drive optimal claims outcomes. Strong analytical, negotiation, and communication skills, with the ability to articulate complex coverage issues and claims strategies to internal and external stakeholders. Adjuster license in all 50 states strongly preferred; ability to obtain additional state licenses as required. The annual salary for this role is structured within a range of USD$140,000 to USD$160,000, depending on experience and qualifications. Benefits WHY YOU'LL LOVE WORKING WITH US: At Relm, we are not just another insurance company - we're a team of innovators, creators, and collaborators who are redefining what's possible in the industry. We value each individual's unique skills and experiences and offer a workplace where creativity, innovation and diversity are at the heart of everything we do. We are deeply committed to fostering an inclusive culture where every team member feels valued, supported, and empowered to do their best work. At Relm, you will have the opportunity to grow in your career, play a role in an industry transformation,and contribute to a team that celebrates creativity, collaboration, and innovation. WHAT WE OFFER: Generous Paid Time Off (PTO): You'll receive 28 days of Paid Time Off (PTO) annually, giving you the flexibility to take care of personal matters, vacation, or sick days. Full Health Coverage: The company fully covers your medical, dental, vision, life, and disability insurance to ensure you and your family are well taken care of. 401K Program with Company Match: Plan for your future with access to the company's 401K program, including a 5% company match. Professional Development & Mentorship: We invest in your growth through professional development opportunities, training, and mentorship programs, helping you advance in your career. Wellness Stipend: Take care of yourself with a monthly wellness stipend to support your health and well-being. Commuting & Travel Reimbursement: We offer a commuting reimbursement to help with transportation costs, including parking, making your daily commute easier. Wellness Benefits: Stay healthy and active with access to gym memberships, exercise classes, and other wellness perks that promote a balanced lifestyle. Your Voice Matters: Work in an environment where your opinions and ideas are valued and play a crucial role in driving the success of our team. Endless Growth Opportunities: Enjoy a multitude of career growth opportunities, ensuring that you have the resources to thrive and advance within the company. At Relm, you won't just join a company - you'll be part of a team that's shaping the future. If you're ready to make an impact, we'd love to hear from you.

Job Type: Full-time or Part-time (days only) MUST HAVE HOSPITAL BILLING EXPERIENCE. Are you a seasoned professional with a minimum of 2 years of hospital in-patient and out-patient claims follow-up experience? Join our team as an Insurance Claims Follow-up Specialist, where you'll leverage your expertise in medical collections, denial processing, appeal submission, and EOB review to resolve unpaid claims effectively. KEY RESPONSIBILITIES: The ideal candidate will excel in: Insurance billing, follow-up, and verification processes. Reviewing correspondence, including refund requests and medical necessity documentation. Conducting detailed follow-ups with insurance providers. Investigating accounts requiring additional action and resolving unpaid claims. Responding to claim denials and verifying reimbursements based on payer contracts. SALARY AND BENEFITS: Up to $24.00 per hour (based on experience). Flexible work settings (in-office, hybrid, or remote). Medical/Dental/Vision health insurance offered Paid Vacation/Sick/Holiday Time 401K

Are you Interested in becoming an Independent Claims Adjuster? The storm season is in at an all-time HIGH this past year and it is predicted that the next 5 years to be as Active as this year was, that means TONS of work as ADJUSTERS, and Adjusters are needed “Everywhere” to help with the winter storm season. As a top firm that trains, licenses and staff's adjusters for the upcoming storm season. Insurance companies send Jet Adjusters claims and our Adjusters write estimates so the carrier can pay the claim. Adjusters make either 37.50 to 62.25/per hour or from $500 to $1000 per claim (Average). The average Adjuster can process 2-5 claims a day during storm season. Travel to the storm area, cash in and go home. A sixfigure income potential/year and up. Start working right away and make what you are worth this year while helping others put their lives back together! Visit -******************************* - or call Charles or Mike for details. ************. Must be 18 years and older, valid driver's license, and a good working vehicle, energetic with a positive attitude a must. Basic computer skills and strong customer service skills.

Claims Specialist - Insurance Brokerage - Base Salary to 130k/year - Hewlett, NY Our client, a sixth-generation insurance brokerage firm, has an immediate need for a Claims Specialist to join their team. They provide a comprehensive range of both commercial and personal insurance products and risk management solutions. Responsibilities: Report Commercial Lines and Personal Lines claims to carrier. Help gather and review Loss data on largest clients, to help prepare for Claims reviews. Work hand in hand with Claims department to ensure that all claims information is accurate in EPIC, especially on larger accounts. Follow up on status of claims (includes calling and/or emailing insurance adjusters). Guiding Insured through the claims process. Keep organized log of follow ups. Qualifications: 3+ years of claims experience working at a retail agency. EPIC agency management experience. Compensation: Base salary to 130k/year Full benefits package including Medical, Dental, Vision, 401k with company match, PTO/Sick days. All paid national holidays including all Jewish holidays. Hybrid, 3 days in office and 2 remote. **TO APPLY** Click Here for QUICK APPLY - Hassle Free & Easy #BPCINS321 #INDALL

Our client, a sixth-generation insurance brokerage firm, has an immediate need for a Claims Specialist to join their team. They provide a comprehensive range of both commercial and personal insurance products and risk management solutions. Responsibilities: Report Commercial Lines and Personal Lines claims to carrier. Help gather and review Loss data on largest clients, to help prepare for Claims reviews. Work hand in hand with Claims department to ensure that all claims information is accurate in EPIC, especially on larger accounts. Follow up on status of claims (includes calling and/or emailing insurance adjusters). Guiding Insured through the claims process. Keep organized log of follow ups. Qualifications: 3+ years of claims experience working at a retail agency. EPIC agency management experience. Compensation: Base salary to 130k/year Full benefits package including Medical, Dental, Vision, 401k with company match, PTO/Sick days. All paid national holidays including all Jewish holidays. Hybrid, 3 days in office and 2 remote. #INDALL

Position Description: The Claims Processing Specialist is responsible for reviewing and processing all claims from the billing system and the clearinghouse. Responsible for working exception and rejection reports to ensure claims get cleared and processed to the payer in a timely manner. $22.28-$23.34 Requirements Responsibilities: · Printing daily HCFA batches and ensuring all claims are mailed on a daily basis. · Attach necessary paperwork for secondary, school claims, and commercial claims as needed. · Basic knowledge of insurance and insurance payer guidelines. · Reviews & completes BLING Follow Up Dashboard for exceptions pertaining to subscriber, demographic, provider, and referring provider issues (BDOC, BDATA, BPINS, BREF). · Works claims to clear edits, scrub for errors or rejections and ensure claims get processed to payer for payment. · Ensures accounts are processed and submitted to payers. · Identifies billing issues within Raintree Billing System and the clearinghouse; escalates as necessary and resolves issues to ensure clean claims are submitted. · Maintains a working knowledge of HIPAA, OSHA, Risk Management and compliance regulations. · Practices confidentiality in accordance with Company policies and all laws and regulations. · Attends Company meetings as required. · Other duties as assigned by RCO Management. Benefits Qualifications: · At least one year of Revenue Cycle experience required. · Knowledge and understanding of processes for varous payer groups and functions within the department. · Must demonstrate consistency in meeting productivity goals. · Proficient in Raintree Navigation. · Bachelor's degree preferred · Basic computer proficiency is required · Behaves in a manner consistent with Professional's mission, vision and values. · Ability to work independently and follow-through and handle multiple tasks and/or special projects simultaneously. Working Conditions: · Works in an office/home environment. · He or she may spend long amounts of time sitting down. · May be required to walk up and down the stairs. · May be required to work evenings and/o weekends as job duites require.

Our Company PharMerica Step Into a Rewarding Role as a Claims Specialist with PharMerica! Are you ready to make a real impact in a growing organization? Join our PharMerica team as a Claims Specialist, where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly matters-delivering exceptional care and service. Part -Time Role Schedule: Friday: 9a-7p, Saturday: 9a-6:30p Why Join PharMerica? Focused on Service Excellence: Our mission is to provide top-quality care and outstanding customer service to hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers across the nation. Career Growth: We're in high growth mode, offering plenty of opportunities for those looking to advance their careers. What You'll Do: As a dynamic Claims Specialist, you will: Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need. Be a vital part of a team that's dedicated to enhancing patient care through meticulous claims management and customer service. What We Offer: DailyPay Flexible Schedules Competitive Pay with Shift Differentials Health, Dental, Vision, and Life Insurance Company-Paid Disability Insurance Tuition Assistance & Reimbursement Employee Discount Program 401k Plan Paid Time Off Non-Retail, Closed-Door Environment Responsibilities The Claims Specialist - 3rd Party: Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes Works as a team to identify, document, communicate and resolve payer/billing trends and issues Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans Prepares and maintains reports and records for processing Performs other tasks as assigned Qualifications Education/Learning Experience: Required: High School Diploma or GED Desired: Associate's or Bachelor's Degree Work Experience: Required: Customer Service Desired: Up to one year of related experience. Pharmacy Technician experience Skills/Knowledge: Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office Suite Desired: Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters Licenses/Certifications: Desired: Pharmacy technician, but not required About our Line of Business PharMerica is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica is one of the nation's largest pharmacy companies. PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about PharMerica, please visit ******************* Follow us on Facebook, Twitter, and LinkedIn. Additional Job Information This is an excellent opportunity to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing. Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference. Salary Range USD $18.00 - $19.00 / Hour

Pay Range: $17.50 - $19.62Responsible for contacting customers with delinquent consumer and residential mortgage accounts. Researches, maintains and processes account transactions. Recommends foreclosure, repossession and or accounts for legal. Works with internal and external customers, and branch personnel to resolve problems or answer questions that may arise. Researches lost or mis-posted payments for customer accounts. Reviews collateral prior to any actions the Bank may take. Reviews with supervisor and/or department manager any problem accounts. Prepares reports and maintain appropriate files as needed. Education and Experience: High School Diploma or GED Customer service experience preferred Skills and Abilities: Good communication skills. PC skills with proficiency in word and excel. Ability to negotiate Unique Job Characteristics and Requirements: Some evening hours required. Tasks Performed: 80% Contact past due consumer and residential mortgage customer accounts for payment. 10% Recommend accounts for foreclosure, repossession and legal. Research accounts for lost or misapplied payments. Review problem accounts with supervisors and/or department manager as required. Ensure timely procedures are met to exercise the Bank's rights. 5% Prepare reports and maintain appropriate files as needed. 5% Other duties as assigned. Physical Requirements: Communicate effectively with internal and/or external customers Stationary 75% of time or greater Move Objects to Maximum 10 lbs Benefits for Full-Time Employees: Generous Paid Time Off: At least 22 days annually, prorated in the year of hire. Parental Leave: Six weeks of paid leave at 100% of your salary. Comprehensive Medical Coverage: Includes employer contributions to HSA for High Deductible Health Plan participants. Dental and Vision Coverage: Ensuring your overall health and well-being. Flexible Spending Accounts: For healthcare and dependent care expenses. Employer-Paid Disability Coverage: Both short-term and long-term, with an option to purchase additional long-term coverage. Life Insurance: Employer-paid basic life insurance, with an option to purchase supplemental coverage. Voluntary Benefits: Including hospital, accident, and critical illness coverage. Retirement Plans: Benefit from a 401(k) plan with employer matching, an optional Roth 401(k), and a pension plan to help secure your future. Adoption Assistance: Supporting your growing family. Tuition Reimbursement: Invest in your education and career growth. Employee Assistance Program (EAP): Access to support and resources. Financial and Banking Services: Various benefits and financial planning assistance. Benefits for Part-Time Employees Working 20+ Hours/Week: Medical Coverage: Includes employer contributions to HSA for High Deductible Health Plan participants. Generous Parental Leave: Six weeks of paid leave at 100% of your salary. Benefits for All Part-Time Employees: Retirement Plans: Benefit from a 401(k) plan with employer matching, an optional Roth 401(k), and a pension plan for employees who work at least 1,000 hours in a calendar year, all designed to help secure your future Paid Sick and Safe Leave: For your health and safety. Employee Assistance Program (EAP): Access to support and resources. Financial and Banking Services: Various benefits and financial planning assistance. Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or assume sponsorship of an employment Visa at this time.