3050 claims processor 1 jobs found

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. Minimum Qualifications High school diploma or GED. Six months of experience processing health and welfare claims. Basic knowledge of benefits...

Job Description Claims Processor L1     Build the future with us Are you driven by delivering exceptional customer service and eager to contribute to a company that helps its clients feel confident and secure about their future? As a Claims Processor L1 , you will play a key role in supporting our contract holders and dealer partners by accurately adjudicating claims and ensuring a smooth, supportive customer experience. This position is a great opportunity to showcase your skills and fully realize your potential within a caring and trustworthy company. 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 Claims Processor L1 , you’ll be at the core of our mission. Here are the main responsibilities: Answer at least 40 inbound calls per day from technicians, customers, and dealer partners Gather all...

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...

Title: Customer Service Claims Processor                                 Department: Customer Service Union: OPEIU 29                                                                               Grade: 17 Position Summary The Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides written, verbal or face-to-face customer service to members by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Resolves customer inquiries and complaints in a timely and accurate manner. Escalates issues as appropriate. Processes routine...

Title: Customer Service Claims Processor                                 Department: Customer Service Union: OPEIU 29                                                                               Grade: 17 Position Summary The Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides written, verbal or face-to-face customer service to members by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Resolves customer inquiries and complaints in a timely and accurate manner. Escalates issues as appropriate....

Title: Claims Processor Department: Claims Bargaining Unit: UFCW 555 Grade: 3 Position Type: Non-exempt Hours per Week: 40 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. Minimum...

- The Core Specialty Actuarial team is looking to grow the team supporting our Actuarial Pricing function. This individual contributor role will primarily be responsible for supporting analytics of ceded reinsurance and capital model during an exciting period of growth. The role will primarily focus on evaluating ceded reinsurance purchases, risk transfer analyses, developing and maintaining appropriate diagnostic tools, and providing actuarial subject matter expertise as needed to key stakeholders. Key Accountabilities/Deliverables: Develop risk analysis models specific to the reinsurance purchase while maintaining consistency between the different lines of business. Perform any risk transfer testing analyses as required. Perform rating agency capital utilization on a company-wide basis, and by individual product basis. Support loss ratio planning in evaluating ceded loss ratios and monitor loss emergence against plan assumptions, Support the compilation...

- The Core Specialty Data Analytics Team is looking for a Data Analyst.   This dynamic role is responsible for supporting all lines of business during an exciting time of growth Key Accountabilities/Deliverables: Execute analysis on data to identify and correct data issues. Extracting data from various sources and transforming that data to perform analysis and create actionable visualizations. Live our Values: Embrace a “bring-it-on” attitude to attack issues and questions within the dept and across the organization. Standardize ad hoc processes and drive continuous improvement for automating and optimizing performance of ongoing processes, including development of data processing pipelines. Help Others Succeed: Act as a key contributor in resolving complex or expediated requests, where end-to-end ownership and analytical skills are needed to provide a solution. As mentioned, we all work and grow together! The more successful one member is, the...

- Serve as a Technical Specialist working on the Duck Creek Insurance Platform , responsible for the design, configuration, and extension of core insurance systems supporting Policy, Billing, and Claims  workflows. This role focuses on delivering compliant, scalable insurance products by configuring platform capabilities, extending business logic, and integrating with enterprise systems. You will partner closely with product managers, business analysts, QA, and integration teams to implement rules, forms, transactions, and APIs, applying industry best practices and modern integration patterns while working within the Duck Creek ecosystem. The selected candidate will be required to work a hybrid schedule (3 days in office / 2 remote)  from our Cincinnati, OH  or Dallas, TX office. No relocation assistance  is offered for this role. Key Accountabilities & Deliverables Configure insurance product models—including lines, coverages, underwriting rules, rating...

- As a Corporate Contract Recruiter for Core Specialty, you will recruit for open requisitions and facilitate the full life cycle of a hire. You will work with managers to ensure the requisitions are filled in a timely manner. Candidates must be able to work a hybrid schedule in Cincinnati, OH at our Headquarters. Key Accountabilities/Deliverables: Recruitment of open positions for a wide variety of roles which include - Finance, Accounting, Operational support, Legal, entry level Claims, Underwriting, etc. Coordinate with Hiring Managers to ensure a smooth and compliant recruiting process. Handle recruitment activities which include: screening candidates, scheduling interviews, negotiating offers, and initiating background checks.   Actively source candidates through a variety of methods. Provide a positive candidate experience and ongoing communication regarding status throughout all stages of the recruiting process. Build strong...

- The Senior Support Analyst role combines both analytical and technical skills.   This role is responsible for ensuring the successful ingestion and validation of Bordereau data files from insurance agencies. This role plays a critical part in verifying data layout and schema compliance, analyzing data quality, building and managing data pipelines & data flows to ingest data and designing insightful experience reporting using Power BI. The analyst serves as a key liaison between internal teams and external partners to ensure data integrity and reporting excellence. Key Accountabilities/Deliverables: Engage with insurance agencies to review and validate Bordereau file layouts for ingestion readiness. Confirm data schemas align with internal ingestion requirements and standards. Analyze and validate data fields for completeness, accuracy, and consistency. Build and maintain data pipelines and dataflows within Microsoft Fabric (e.g., Dataflows Gen2, Pipelines)....

- The Core Specialty Actuarial Reserving Team is looking for a Senior Actuarial Associate. This dynamic role will primarily be responsible for general liability (both primary and excess) and workers compensation lines of business during an exciting time of growth. The role will primarily focus on evaluating reserve adequacy for the existing portfolio, developing and maintaining appropriate diagnostic tools, and providing actuarial subject matter expertise as need to senior leadership and other business partners. Key Accountabilities/Deliverables: Perform Quarterly Reserve Reviews (and ad-hoc analysis as needed) for assigned product groups to ensure that adequate reserves are recorded and correctly reported at each quarter-end. Help ensure all regulatory requirements related to loss reserves are met in a timely fashion. Collaborate with Pricing, Claim, and Underwriting on periodic deep dive reviews on select reserve segments. Aid in the development and...

Why Openly Openly is rebuilding insurance from the ground up. We are re-envisioning and enhancing every aspect of the customer experience. Doing this requires a rapidly growing team of exceptional, curious, empathetic people with a wide range of skill sets, spanning technology, data science, product, marketing, sales, service, claims handling, finance, etc. The Openly Difference We created Openly because we saw an evident gap in the market for premium insurance made simple. Consumers deserve more complete coverage at competitive prices. The Price Difference : Using cutting-edge data and technology, we provide you with customizable, competitive prices to protect your most valuable assets. The Policy Difference: Coverages are truly customizable to meet your individual protection needs, for both standard coverages and optional add-ons. The Experience Difference: From tailored claims handling to highly responsive customer service, we are...

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. The Crop Division of Great American has been helping generations of farmers take control of their risks since 1915. The D​ivision is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI...

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. 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...

The salary range for this job posting is $97,153.00 - $194,990.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. Description Encova Insurance has an immediate opening for Production Underwriter, Package Lines for accounts averaging over $75k in premium. Ideal candidates will reside in the Madison or Milwaukee, Wisconsin areas. This position will travel the assigned territory to visit agencies in order to develop new and existing relationships. A company vehicle will be provided. We may hire a senior level depending on candidate qualifications and the posting is inclusive of the non-senior and senior-level full range....

The salary range for this job posting is $55,132.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. The salary range for this job posting for candidates who reside in Illinois is $59,630 - $119,670 annually + bonus + benefits. While we may prefer candidates who reside in Illinois, we will consider candidates who live in any of our listed payroll approved states. This position will manage predominantly lost time claims in Iowa, and other states within the CL Large North region. The position reports to the Director, Workers' Compensation Claims. We may hire a senior level depending on the candidate's background and...