17 complex claims consulting director jobs found

Position Summary The Director of Clinical & Cost Containment is a senior strategic role within Strategic Benefit Resources (SBR) responsible for leading the clinical consulting and cost containment program capabilities that differentiate SBR's self-funded solutions in the wholesale distribution market. This individual serves as the primary clinical subject matter expert across SBR's book of business, partnering with sales, distribution, and stop-loss consulting teams to evaluate, implement, and communicate clinical cost containment strategies that drive measurable financial outcomes for employer clients. This role bridges clinical expertise and consultative sales support — working directly with broker/consultant partners, TPAs, stop-loss carriers, and employer plan sponsors to identify high-cost claim drivers, optimize vendor program selection, and develop clinical frameworks that reduce plan cost and improve member outcomes. Why This Role Exists As the...

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 Senior Property Adjuster, you will work within defined guidelines and framework, investigate, evaluate, negotiate and settle complex property insurance claims presented by or against our members. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with...

This is your opportunity to join AXIS Capital – a trusted global provider of specialty lines insurance and reinsurance.  We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture.  As a member of AXIS, you join a team that is among the best in the industry. At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work.  All qualified applicants will receive consideration for employment without regard to any protected characteristic, including age, color, disability, ethnicity, gender identity, marital status, national origin, pregnancy, race, religion, sex, sexual orientation, veteran status, or...

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 This is a field based role in the Georgia, USA area. Candidates who are willing and able to work in the state of Georgia are encouraged to apply. Within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance...

This is your opportunity to join AXIS Capital – a trusted global provider of specialty lines insurance and reinsurance.  We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture.  As a member of AXIS, you join a team that is among the best in the industry. At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work.  All qualified applicants will receive consideration for employment without regard to any protected characteristic, including age, color, disability, ethnicity, gender identity, marital status, national origin, pregnancy, race, religion, sex, sexual orientation, veteran status, or...

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 Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory...

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 Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements...

Job Type: Permanent Build a brilliant future with Hiscox   Senior Technical Business Analyst Location: Atlanta, GA | Hybrid: 2 days /week in office We are looking for an experienced Senior Technical Business Analyst to bolster our evolving technical capability within the US business. You will be expected to work on a range of product changes between Hiscox’s own and third-party applications. These product changes support our strategic priorities to digitize complex processes, enable improved process efficiency, and enhance the service we provide our brokers and direct customers. What You’ll Be Doing: Working in US IT, focusing on the conversion of business requirements into functional and non-functional technical requirements & solutions that realize the business objectives. Producing high-quality analyst artifacts, including but not limited to, user stories, functional and non-functional specifications, and interactive prototypes. Conducting solution...

Job Description TITLE:                                                 Team Leader – Marine Claims DEPARTMENT:                                  EIMC REPORTS TO:                                    VP Specialty Marine & Transportation STATUS:                                             Regular, full-time; exempt           SUMMARY OF JOB PURPOSE   EIMC, an Engle Martin company, is an independent marine consulting services company providing supply chain loss control and claims investigation expertise to insurers, brokers, 3PLs and industrial partners. The Marine Claims Team Leader will provides leadership and direct supervision to a team of Marine Claims Consultants who investigate marine cargo, stock throughput, hull and liability claims. PRIMARY JOB RESPONSIBILITIES Learns, leverages, and develops team member strengths and skillsets with assigned work. Proactively monitors and corrects performance through reviews and audits based on standardized metrics....

The Baldwin Group is an award-winning entrepreneur-led and inspired insurance brokerage firm delivering expertly crafted Commercial Insurance and Risk Management, Private Insurance and Risk Management, Employee Benefits and Benefit Administration, Asset and Income Protection, and Risk Mitigation strategies to clients wherever their passions and businesses take them throughout the U.S. and abroad. The Baldwin Group has award-winning industry expertise, colleagues, competencies, insurers, and most importantly, a highly differentiated culture that our clients consider an invaluable expansion of their business. The Baldwin Group (NASDAQ: BWIN), takes a holistic and tailored approach to insurance and risk management. The Sr Claims Consultant is considered an expert in managing insurance claims on an individual and portfolio level for our clients, and is utilized as a trainer, mentor with their technical expertise. The Sr Claims Consultant must be able to work with minimal oversight,...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where your clinical talent and leadership abilities contribute to our competitive edge.    PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management to proactively drive best in class outcomes including appropriate medical...

The Account Manager's main responsibility is to manage daily client service needs for a designated book of business, which may be overseen by a Producer or Account Executive responsible for service, placement, and business development. This role involves extensive use of system tools and frequent client communication via email or phone. The Account Manager must strictly adhere to corporate procedures, including maintaining data integrity within the system of record. As a key part of the client team, the Account Manager also provides guidance to any third-party vendors managing aspects of the account. Your Impact: Client management: At the direction of the Producer or Account Executive (Prod/AE), participates in renewal strategy including discussion of the markets to approach, claims reviews and exposure gathering. Manages a renewal book of business, including creation of submissions, supporting the placement process, including Proposals and Binding. Provide support in...

Position Summary:   The Claims Executive is responsible for accurate reporting and filing of claim litigation to the respective Carrier, in addition to handling complex claims scenarios along with resolution of claims disputes. The Claims Executive functions as an insurance claims professional that provides guidance to the Customers and Producers on more complex claims issues. Claims Executive is responsible for monitoring the assigned inventory of accounts, answering phone calls, consulting on claims related issues. Duties include; handling customer service calls as needed, reviewing claims on an as needed basis. Essential Tasks: Reports to the Claims Operations Manager on workflow issues and the handling of assigned claims inventory Service and be the point of contact for assigned threshold accounts. Ability to review policy language and offer a professional opinion regarding coverage, settlements, reserve practices, etc. Handle and work with carrier and client on...

Position Summary:   This Claims Consultant is responsible for accurate reporting and filing of claim notices to the respective Carrier, in addition to reporting handling claim scenarios along with resolution of claims disputes. The Claims Consultant’s functions as a claims representative that provides needed updates to claims related matters to Customers and Producers. Claims Consult is responsible for monitoring the claims inventory, answering phone calls, consulting on claims related issues. Duties include; handling customer service calls as needed, reviewing claims on an as needed basis. Essential Tasks: Reports to the Claims Operations Manager and/or Team Lead on workflow issues and the handling of assigned claims inventory Understand Claims Handling guidelines and Workflows. Ability to train in Sagitta and ImageRight, including document uploads and complete tasks Ability to analyze insurance policies for coverage eligibility Reporting claims to assigned...

Who We Are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance services to customers in more than 80 countries and jurisdictions. These diverse offerings include products and services that help businesses protect their assets and manage risks.   Get to know the business General Insurance is a leading provider of insurance products and services for commercial insurance customers. It includes one of the world’s most far-reaching property casualty networks. General Insurance offers a broad range of products to customers through a diversified, multichannel distribution network.   Risk Consulting at AIG   AIG Risk Consulting helps AIG’s Underwriting teams identify, understand, and mitigate risk to the portfolio and to individual accounts.  Our people provide in-depth research and analysis of the issues our...

Join Starr, a global leader in commercial insurance with over a century of expertise. We empower our employees to innovate, make impactful decisions, and build lasting client relationships worldwide. At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex. Grow your career with a rapidly growing company that invests in its people and their ability to drive real progress. RESPONSIBILITIES Position oversees overall loss control service direction, coordination, and evaluation of new business and dedicated accounts in their respective regional office.   Helps to ensure quality accounts are added to the portfolio while also assessing individual account service needs once bound.  Monitors loss development on the book of business and readily perform and deploy loss control resources where needed to maintain profitability and...

GenAI Product Analyst Be part of something groundbreaking   At AIG, we are making long-term investments in a brand-new, innovative Generative AI team , designed to explore new possibilities for how artificial intelligence can be applied in insurance and beyond, and we need your help.   With the support and investment needed to explore new frontiers in generative AI, you’ll be working alongside talented colleagues, innovating and leading projects that will transform how we manage risk and serve our customers.   This team is central to our vision of the future and the core of our business offering. We will incorporate best-in-class engineering and product management principles and your guidance and collaboration will be critical to its success. To rapidly advance and innovate, we need your skills and expertise to build world-class products. If you’re excited by the opportunity to create meaningful impact at scale, we’d love to hear from you.  Who we are   AIG is a...