21 senior claims representative jobs found in Plano, TX

Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.   Are you looking for an opportunity to join a claims team with a fast-growing company that has consistently outpaced the industry in year-over-year growth? Liberty Mutual has an excellent claims opportunity available. As a Commercial Insurance Claims Representative , you will review, and process simple and straightforward Commercial claims within assigned authority limits consistent with policy and legal requirements. In addition to a wide range of benefits, as a direct employee, your insurance education and training are paid by Liberty Mutual.   You will be required to go into the office...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be an acknowledged technical expert in Markel Claims, responsible for resolving claims posing the highest exposure to the company. The position will have significant autonomy. The position will act as a leader and resource to other examiners and managers in the Casualty Claims division and will provide legal and claims support to the Casualty underwriting business partners. Job Responsibilities Manage a full case load of the most complex/high exposure claims within Casualty Claims...

MSIG USA continues to grow!  Company Overview: MSIG USA is the US-based subsidiary of  MS&AD Insurance Group Holdings, Inc. , one of the world’s top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business’s unique risks. Summary/Job Purpose: Underwrites profitable property business on a nationwide basis in accordance with Corporate goals. Essential Functions: Selects and underwrites complex property risks within delegated underwriting authority. Reviews applications and requirements to determine acceptability of risk in accordance with Company guidelines and standards. Perform all aspects of the underwriting process and due diligence including review and analysis of financial documents and individual risk factors....

MSIG USA continues to grow!  Company Overview: MSIG USA is the US-based subsidiary of  MS&AD Insurance Group Holdings, Inc. , one of the world’s top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business’s unique risks. Summary/Job Purpose: Underwrites profitable property business on a nationwide basis in accordance with Corporate goals. Essential Functions: Selects and underwrites complex property risks within delegated underwriting authority. Reviews applications and requirements to determine acceptability of risk in accordance with Company guidelines and standards. Perform all aspects of the underwriting process and due diligence including review and analysis of financial documents and individual risk factors....

We’re thrilled that you are interested in joining us here at the Amynta Group! The primary focus of the Underwriter is producing, underwriting and retaining profitable business for the company. With respect to the commercial lines P&C insurance sector, underwriters are oftentimes at the forefront of the underwriting process for their team, and as such are expected to underwrite insurance risks in accordance with the approved business plan, individual authority levels and company policy. Underwriters report directly to the Senior Vice President (SVP) Underwriting and contribute directly to the production and retention goals of their respective team and product line. In that regard, their day to day role is to underwrite, maintain and grow the Brit portfolio in accordance with their team’s business plan, strategy, authority levels and regulatory environment. The primary focus of the Underwriter is producing, underwriting and retaining profitable business for the company. With...

The Appeals Team Lead assists injured workers, claims examiners, attorneys, providers, etc. in locating providers within the medical provider network (MPN), verifying provider inclusion in an MPN and scheduling appointments upon request for the injured worker. This position includes a moderate volume of inbound calls and a high volume of outbound calls. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling a consistent, timely delivery of our quality services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receive incoming calls, emails and faxes from the Medical Access Assistant line Communicate clearly and professionally with providers and other stakeholders via phone and email Provide excellent customer service...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim, Legal Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program,...

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. Great American is one of the few carriers with a dedicated Property & Inland Marine Division and, in the industry segments it covers, with expertise second to none. From the underwriters to claims representatives, the focus is strictly on property and inland marine coverages....

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBLITIES: Project client claim data to develop budgets, calculate client rates, benefit costs, and IBNR reserves Review experience reporting for accuracy Collaborate with consultants and account teams to prepare and deliver client financial presentations Assess complex client risk, understanding the strategic implications of the competitive carrier/product marketplace, and make sound underwriting-based assumptions Manage and oversight of underwriting support team Renew and market carriers for assigned book of business Analyze / negotiate annual renewals and proposals from carriers for accuracy and financial...

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBLITIES: • Project client claim data to develop budgets, calculate client rates, benefit costs, and IBNR reserves • Review experience reporting for accuracy • Collaborate with consultants and account teams to prepare and deliver client financial presentations • Assess complex client risk, understanding the strategic implications of the competitive carrier/product marketplace, and make sound underwriting-based assumptions • Manage and oversight of underwriting support team • Renew and market carriers for assigned book of business • Analyze / negotiate annual renewals and proposals from carriers for accuracy and financial reasonableness...

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. Company Overview: We are a leading, privately owned Property/Casualty insurance carrier, committed to delivering innovative solutions and superior service to our clients and distribution partners. Our dynamic culture rewards leadership, integrity, and an entrepreneurial spirit. Position Summary: As Regional Vice President for the Houston/Dallas regions, you will drive regional strategy to effectively and efficiently distribute our Property/Casualty...

Description At Liberty Mutual, we’re committed to delivering exceptional legal services to our customers around the world, working to uphold and protect our policyholders’ rights and positively impacting our business. As an Associate Attorney at Liberty Mutual, you’ll join a diverse team that values a healthy work/life balance and enjoy benefits that include eligible performance bonuses, 20 days of flexible time off each year, personal holidays, and a 401(k) plan with matching contributions. If you’re looking for a place to build a long-term career while making a positive difference, consider joining our legal team where you’ll represent Liberty Mutual and our policyholders in moderately complex civil litigation matters involving claims for monetary damages or compensation for personal injuries or property damage of moderate value.   Liberty Mutual Insurance offers an engaging opportunity for an Associate Attorney to represent the company and its...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Care Team Representative Entry-level, Care Team Representative Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you’ll need to live near one of our dynamic Centers of Excellence📍 Irving, TX : 2201 W. Royal Lane, Suite 125, Irving TX 75063 ✨ What we offer: A stable, consistent work environment —both in-office and virtual A comprehensive training program to help you support employees and...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Disability Representative Disability Representative Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you’ll need to live near our dynamic Center of Excellence📍 Irving, TX. 2201 W. Royal Lane Suite 125 Irving, Tx 75063 ✨ What we offer: A stable, consistent work environment —both in-office and virtual A comprehensive training program to help you support employees and customers from some of the...

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: Please review the following job description: Process claims, which includes evaluating policy for coverage; working with the insured, outside adjusters, agents and attorneys on the claim and coordinating the payment of claims. In addition, prepare reports such as loss runs and monthly bordereau. ESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned...

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: Process claims, which includes evaluating policy for coverage; working with the insured, outside adjusters, agents and attorneys on the claim and coordinating the payment of claims. In addition, prepare reports such as loss runs and monthly bordereau. ESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both...

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along with CMS and state guidelines. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receiving and analyzing appeal documentation to determine appropriate actions Accurately setting up and initiating the appeals process timely, ensuring information aligns with provided documents Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards Utilize applicable tools and resources to complete setup Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Medicare, Medicaid, and commercial insurance guidelines...

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along with CMS and state guidelines. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receiving and analyzing appeal documentation to determine appropriate actions Accurately setting up and initiating the appeals process timely, ensuring information aligns with provided documents Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards Utilize applicable tools and resources to complete setup Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Medicare, Medicaid, and commercial insurance guidelines...

The CERIS Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.  Clinical and/or technical expertise is utilized to address the provision of medical care and to identify inappropriate billing practices and errors inclusive of, but not limited to; duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time increment discrepancies, inconsistencies with  diagnosis, treatment frequency and duration of care, DRG validation, service/treatment vs. scope of discipline, use of appropriate billing protocols, etc. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and...

The Customer Service Representative is responsible for addressing client and/or provider inquiries via email, fax, telephonic, or written correspondence ensuring adherence to contractual and state guidelines as well as client instructions.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Take inbound calls and makes outbound calls as needed. Analyzes client and provider inquiries to determine appropriate steps for resolution. Performs review of claim history to ensure accurate information is communicated to internal and external customer. Works directly with internal departments and management for resolution of Customer Service inquiries. Able to accurately communicate CERIS findings to clients and providers in written and verbal format. Maintain reports and spreadsheets as needed. Additional duties as assigned.   KNOWLEDGE & SKILLS:  Excellent communication, verbal, written and organizational skills. Prior knowledge of...