3218 claims processor jobs found

Title: Claims Processor 1                             Department: Claims Union: OPEIU 29                                               Grade: 16 Position Summary The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers’ Compensation, or disability.  May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned....

Title:   Claims Processor 2   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   17 Position Type:   Non-Exempt   Hours per Week:   40 Position   Summary The Claims Processor 2 provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key   Duties   and   Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries....

Title: Claims Processor 3                             Department: Claims Union: OPEIU 29                                               Grade: 18 Position Summary: Responsible for independently processing all types of health claims on an assigned Plan(s), and for assuming primary or back-up customer service responsibilities as necessary. General Duties: Independently process all types of health claims in accordance with assigned Plan(s). Perform customer service responsibilities for providers and members as needed. Generate correspondence and form letters. Maintain current knowledge of assigned Plan(s) and effectively apply this knowledge in the payment of claims. Assist other processors with claims as needed to minimize backlog. Perform other related duties and special projects as assigned. Minimum Qualifications: High school diploma or general education degree (GED); two years related experience processing all types of group health and/or dental...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   This is a six-month temporary work assignment. Successful candidates may have conversion opportunities into a full-time position depending on performance and position availability. Temporary Subrogation Claim Support Processor - AAA The Auto Club Group Reports to: Claim Manager or above What you will do: Provide daily support to the Claim department by completing well defined clerical tasks that require a general understanding of the Claims process, business Provide daily support to the Claim department by completing well defined clerical tasks that require a general understanding of the Claims process, business context and the Claims department organization and workflow.  Day-to-day routine tasks include: Research and proper routing of mail, data...

Job Description Gap Claims Representative Build the future with us Are you driven by delivering exceptional service and supporting clients with accuracy, empathy, and professionalism? Are you eager to contribute to a company that helps its clients feel confident and secure about their future? As a Gap Claims Representative , you will play a key role in reviewing documentation, resolving GAP claims, and ensuring a seamless and positive customer experience. This position is a great opportunity to showcase your attention to detail, communication skills, and ability to thrive in a fast‑paced environment. Here, people and their development are at the heart of our priorities, fostering an environment that encourages collaboration and innovation. What you’ll accomplish with us As a Gap Claims Representative , you’ll be at the core of our mission. Here are the main responsibilities: Answer incoming calls from the queue and resolve GAP claims in accordance with...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Processes and delivers incoming and outgoing mail per established procedures and deadlines. Enters data and check information into designated computer systems. Maintains confidentiality at all times. Performs all duties in a safe...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Processes and delivers incoming and outgoing mail per established procedures and deadlines. Enters data and check information into designated computer systems. Maintains confidentiality at all times. Performs all duties in a safe...

The Litigation Processor is responsible for providing clerical support to the General Claims Legal Department by reviewing, analyzing, and processing incoming complaints directed to the Company. Essential Duties and Responsibilities: Provide support to staff attorneys in processing complaints. Provide support to the PIP Litigation team in processing PIP arbitration demands. Provide support as needed to FNOL (First Notice of Loss) Dept in taking claims. Receive, analyze, and process complaints, determine type of lawsuit, and prepare investigation file accordingly.  Assign trail adjuster, submit complaint to staff attorney for review. Process various types of legal letters to defense firms and insureds. Maintain Legal Exchange (electronic billing site) by creating matters, closing matter and processing attorney invoices for payment. Periodic telephone communications with insureds, plaintiff counsel and defense firms regarding the status of legal pleadings....

The Cross Family of Agencies welcomes you. We need your talent and expertise. Personal Lines Processor A Personal Lines Processor is primarily responsible for processing documents related to personal lines insurance and providing administrative support to the Producers and Account Managers. Standard duties of a Personal Lines Processor include but are not limited to : Understanding and following the Cross Basic Procedure Manual. Understanding and following the Personal Lines Workflow Manual. Auditing transaction to ensure that the correct Action Codes are being used. Following up and completing open suspense’s daily. Running the download reports daily. Processing the download report which includes reviewing new business, endorsements, renewals, cancellations, and reinstatements for accuracy. Invoicing all types of download transactions. Mailing new business letters to clients. Entering claims acknowledgements as received. Following up on...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Business Process Senior , the candidate(s) selected for this position will play an important role within Property Claims Optimization shaping the future of the Property Telematics, Policy Modernization, and Catastrophe Experiences.  We have an opening for two positions, and they appear to support...

Description USRM Casualty Insights and Solutions (I&S) is seeking an individual to lead and support casualty litigation, with a focus on process enhancements and outcomes. This role will partner closely with claims, staff counsel, and enabling teams to design and implement litigation processes that improve legal accuracy, strengthen decision-making, and deliver measurable results that support accuracy.   *This position may have in-office requirements twice a month depending on candidate location.*     Ideal Experience Extensive casualty litigation experience, including deep knowledge of claims handling, litigation strategy, staff counsel utilization, ALAE spend, and cycle time management. Experience leading and designing litigation processes and legal/claims workflows to improve accuracy, efficiency, and outcomes. Claims leadership experience with demonstrated ability to influence outcomes, lead cross-functional initiatives, and drive...

Position Summary: The Client Manager, Employee Benefits services the employee benefit needs of our clients in a prompt and efficient manner. The Client Manager, Employee Benefits prepares all client presentations, including claim reports and renewal details, as well as preparing client data for marketing efforts to seek alternative coverages and plans. Principal Responsibilities: Manage client service calendar including new client onboarding, processing and negotiating renewals for all lines of coverage, compliance alerts and updates, 5500 filings, plan documentation (SPDs, SBCs, Wrap Documents, certificates of insurance, policies, etc.), and Open Enrollment preparation and execution. Prepare and present executive summaries for clients, including claim experience, benchmarking, rate renewals and exhibits, plan design alternatives, contribution modeling, and renewal recommendations. Manage all policy activity aspects of assigned accounts Present risks to the insurance...

The Claims Consultant is considered an expert in managing insurance claims on an individual and portfolio level for our clients. The Claims Consultant must have technical knowledge and experience in insurance claims handling and risk mitigation techniques. The ability to develop relationships and effectively communicate with a diverse range of clients, carriers and colleagues is a key success factor in this role. Strategic vision coupled with tactical execution of risk mitigation plans that drive favorable client Cost of Risk results is also critical to the overall success of this position. PRIMARY RESPONSIBILITIES: Process submissions within the claims process lifecycle for agencies and insureds assigning to the appropriate claim’s firm. Respond to requests from agencies and insureds for help in understanding a specific claim. Handle requests from claims adjusters for assistance in gathering additional data or documentation around a specific claim. Work with adjusters,...

Customer Service Rep I Full-time Shift: 8:00 am to 8:00 pm  (Shift bidding process based on seniority) Grand Rapids, MI Assessment required -  Customer Service Rep   Analyzes, evaluates, resolves and primarily responds to low complexity level membership issues under various product lines. Primarily conducts low complexity internal and external research to determine and request the data needed to handle inquiries regarding membership.  Analyze and service various product lines in the area (i.e., Facility, Professional). Provide responses by telephone, check-off letters, and/or automated letters. Follow department/corporate reporting requirements (i.e., PCRS, ICS, Special Surveys and Manual counts).  Organize work to meet Nati45onal/Corporate/Department Production and Quality Standards.  Reroute misdirected inquiries.  Primarily evaluates membership issues/inquiries and price/adjudicates low complexity claims/inquiries.  Interact with others inside and outside the...

Manages a group of associates who have underwriting responsibility for all middle market lines, responsibly growing strategy, talent, and business. This position will be located in our Denver, CO office under a hybrid work model. What You’ll Do: As an Underwriting Manager - Commercial Lines, you will oversee and guide the implementation and successful execution of our business strategy and uphold continuous improvement through leadership focused on process, problem solving, performance, partnering, purpose and people. In addition, you will: Manage the day-to-day underwriting operations while providing technical guidance to a team of underwriters. Recommend and implement changes to improve productivity, growth, profitability, and quality, as well as monitor effectiveness of these policies and procedures. Interpret underwriting guidelines for larger or more complex files. Handle difficult underwriting inquiries through direct personal action. Coordinate and...

Unlock your potential by joining an integrated team of accounting professionals in Treasury Services and learn the dynamic world of investments and banking. This position can be filled as an Associate Financial Analyst or Financial Analyst based on the selected candidate’s qualifications and experience. This position offers career growth opportunities for the right candidate. This position will be located at our Office in Stevens Point, WI in a hybrid work model and is not a fully remote opportunity. For this position, Sentry does not offer employment to holders of F-1, J-1, and H-1 Visas. What You’ll Do As a member of our Treasury Services team, you will play an integral role to the continued success of our team by: Daily banking, cash positioning, wire transfers, and bank reconciliations Completing the accounting, processing, and reconciliations for various integrated systems for investments and banking Validating daily trading wires and...

Why Arbella? At Arbella, we’re focused on people. We work hard to attract and retain the best. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive, industry-leading salaries and benefits packages. We invest in our employees and encourage them to grow so that we, too, can grow as a company. Other perks include: • On-site gym and fitness classes and one-on-one personal training • On-site nurse, nutritional counseling, and mental health resources • Full-service cafeterias • Free shuttle service to Quincy Adams T Station • Tuition assistance programs • Opportunities to get involved: Arbella Activities Committee, Diversity and Inclusion Council, and more • A company committed to community: volunteer opportunities, employee-led community efforts, and the Arbella Insurance Foundation • Robust training, mentorship, and professional/personal...

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Job Description Great American's Equine Mortality Division is one of the world's leading providers of equine mortality insurance and related coverages. The division is staffed with experts in all breeds and disciplines such as racing, showing, cutting, dressage,...

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...

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...