33 claims administrator jobs found

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.    **This position is eligible to work from home anywhere in the United States** Analyzes and investigates claims to ensure compliance and timely payment of benefits. Responds to agents and policyholders regarding pending claims and appeals. Processes complex beneficiary and ownership changes and approves eligibility of waivers for life and disability income policies. Collaborates with peers and management to ensure consistent interpretations of policies and claim payment methods. Essential Functions: Analyzes, investigates, and adjudicates individual/group life, annuity, and critical, chronic, and terminal illness claims to ensure the...

CBCS, a division of Cottingham & Butler, is growing — and we’re looking for driven individuals to join our Workers’ Compensation team as Claims Administrators. In this role, you’ll be trained to investigate, evaluate, and resolve medical-only claims while delivering the high‑quality service our clients expect. No insurance experience? No problem. We will teach you the technical side — what matters most is your ability to think critically, communicate clearly, and take ownership of your work. Responsibilities As a Claims Administrator, you will manage a caseload of medical-only Workers’ Compensation claims from start to finish. Your core responsibilities include: Reviewing and evaluating medical-only claims to understand what occurred Communicating with injured workers, medical providers, and clients Documenting claim activity accurately and consistently following CBCS Best Practices Making timely decisions within your assigned authority to resolve claims...

CBCS, a division of Cottingham & Butler, is seeking a driven leader to join our Workers’ Compensation team and lead a team of Claim Administrators. This role combines people leadership with technical oversight to ensure high-quality claim handling and client service.   Responsibilities Lead, coach, and develop a team of Claims Administrators Review claims for quality, adherence to best practices, and proper documentation Provide guidance on complex claims, escalation decisions, and reserving strategies Monitor team performance against key metrics Support hiring, onboarding, and ongoing training of team members Maintain strong communication with clients, injured workers, and providers Qualifications Prior business or claims experience preferred; leadership experience a plus Strong communication, critical thinking, and organizational skills Do you think this might be a fit for you? Send us your resume – we’d love to talk! Pay &...

Job Description: Step into a role where your client service expertise makes a meaningful impact. We are looking to add a Liability Claims Specialist to join our Creative Risk Solutions team. Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients.   Essential Responsibilities: Review coverage for commercial auto and general liability claims. Adjudicate claims, investigate bodily injury/liability claims, and negotiate settlements using "Best Practices for Claims." Maintain accurate loss information and establish/maintain reserves within authority. Research and respond to questions and complaints from insureds, claimants, agency partners, and carriers. Monitor...

Job Description: Step into a role where your client service expertise makes a meaningful impact. We are looking to add a Liability Claims Specialist to join our Creative Risk Solutions team. Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients.   Essential Responsibilities: Review coverage for commercial auto and general liability claims. Adjudicate claims, investigate bodily injury/liability claims, and negotiate settlements using "Best Practices for Claims." Maintain accurate loss information and establish/maintain reserves within authority. Research and respond to questions and complaints from insureds, claimants, agency partners, and carriers. Monitor...

Job Description: We are looking to add a Benefits Administrator to join our Talent & Culture (HR) team in West Des Moines, IA . This role will implement and manage the benefits strategies in alignment with the organization’s overall business operations to attract, retain and motivate employees. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: Administer benefit and retirement programs, such as medical, dental, life insurance, disability and 401(k). Manage and administer leave of absence with vendor and HRIS and oversee absence policies, procedures, and practices. Manage benefit vendor relationships and elevating concerns, as needed. Responsible for ensuring benefit and retirement programs are accurately reflected in Human Resources Information System (HRIS). Own annual Open Enrollment strategy, administer and...

We are seeking an experienced Account Manager with strong Third-Party Administrator (TPA) or claims experience to manage client relationships and drive performance across auto liability, general liability, and/or workers’ compensation programs. This role serves as the key liaison between clients and internal claims teams, ensuring service excellence, operational efficiency, and strong program outcomes throughout the lifecycle of each account. Key Responsibilities Serve as the primary point of contact for assigned accounts, managing relationships from onboarding through renewal Lead client meetings, claims reviews, and stewardship sessions, presenting actionable insights on claim performance, trends, and outcomes Monitor claims handling quality and TPA performance, ensuring adherence to best practices, service standards, and regulatory requirements Partner with adjusters, supervisors, and leadership to resolve escalations and improve claim outcomes Analyze claims...

Job Description: Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers’ Compensation Claims Specialist to join our team. Experience handling claims in Florida and Kentucky is required. Essential Responsibilities: Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves lost time Workers’ Compensation claims, including litigated claims. Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to...

Job Description: Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers’ Compensation Claims Specialist to join our team. Experience handling claims in Florida and Kentucky is required. Essential Responsibilities: Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves lost time Workers’ Compensation claims, including litigated claims. Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to...

Job Description: Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers’ Compensation Claims Specialist to join our team. Experience handling claims in Louisiana and Mississippi is required. Essential Responsibilities: Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves lost time Workers’ Compensation claims, including litigated claims. Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to...

Job Description: Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers’ Compensation Claims Specialist to join our team. Experience handling claims in Louisiana and Mississippi is required. Essential Responsibilities: Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves lost time Workers’ Compensation claims, including litigated claims. Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to...

Job Description: Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers’ Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred. Essential Responsibilities: Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves Workers’ Compensation claims. Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching...

SISCO, a Cottingham & Butler company, is a leading third-party benefit administration firm dedicated to maximizing the value of employee benefits for our clients. We pride ourselves on delivering an effective, yet human, experience by hiring the best employees and equipping them with the best technology. We’re looking for a people‑focused, results‑driven Service Supervisor to join our growing team. In this role, you’ll develop motivated, high‑performing employees and ensure our clients receive accurate, timely, and exceptional service. Your leadership will directly shape the experience of both our team and our customers. Essential Functions: Ensure direct reports meet performance and accuracy goals. Lead, coach, and develop team members through training, feedback, and recognition. Oversee hiring, supervision, and retention of service staff; conduct performance reviews and support professional growth. Share daily/weekly feedback with Quality Assurance and...

Job Title: Benefit Services Sales Manager Reports To:  Executive Vice President, Benefit Services Position Summary: As our Benefit Services Sales Manager, you’ll lead a high‑performing team that sells an integrated solution—SISCO(medical TPA), HealthCheck360 (wellness & advocacy), medical management, and BCC (HRIS/consolidated billing). Your charter: grow a sales team, build broker relationships coast‑to‑coast, win complex business and scale a connected platform that lowers claims cost, boosts engagement, and simplifies administration. You’ll hire, coach, and elevate sales executives, set strategy, and partner with executive leadership on product and marketing to accelerate new business and retention. Essential Functions: Supervise all sales executives, including setting activity metrics, holding regular sales meetings, and ensuring that the sales team has the necessary resources to succeed. Accompany sales executives on calls as necessary to close business....

Job Description: Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers’ Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred. Essential Responsibilities: Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves Workers’ Compensation claims. Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching...

SISCO, a Cottingham & Butler company, is a leading third-party benefit administration firm dedicated to maximizing the value of employee benefits for our clients. We pride ourselves on delivering an effective, yet human, experience by hiring the best employees and equipping them with the best technology. Our company thrives on driven, ambitious individuals like you. We are seeking driven, energetic, and customer focused candidates for our Service Representative position. We pride ourselves on putting the customer first and finding ways to improve our business. Above all else, we are committed to fostering an open-door culture where the opinions and suggestions of our team members are valued and appreciated. Our Service Center is open Monday –Thursday 7 am to 7 pm and Friday 7 am to 5 pm.  Essential Functions: Answer customer inquiries on benefits plans Process Medical/Dental Claims Ability to learn/retain large amounts of technical information...

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 Workforce Absence Payroll Coordinator Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:   Dubuque, IA   : 4141 Westmark Drive, Dubuque, IA 52002 Dublin, OH : 5500 Glendon Court Dublin OH 43016 PRIMARY PURPOSE:  To process payroll actions based on changes in leave status; to ensure the accurate and timely entry of data; and to support delivery of the highest...

Member Services Advocate Member Services Advocates play a critical role in delivering advanced advocacy services, serving as a trusted resource for members navigating complex healthcare and employer benefit situations. This role is intended for experienced professionals with a strong background in health insurance, claims resolution, or benefits administration who can independently assess issues, interpret plan details, and drive outcomes across multiple stakeholders. In this role, you will guide individuals through complex coverage scenarios, resolve escalated claims and billing issues, and partner directly with providers, carriers, and third-party administrators to ensure accurate and timely resolution. This position requires a high degree of ownership, critical thinking, and the ability to manage sensitive or multi-layered issues with minimal oversight. We are seeking candidates who bring proven, hands-on experience navigating health plans and claims processes, including...

Member Services Advocate Member Services Advocates play a critical role in delivering advanced advocacy services, serving as a trusted resource for members navigating complex healthcare and employer benefit situations. This role is intended for experienced professionals with a strong background in health insurance, claims resolution, or benefits administration who can independently assess issues, interpret plan details, and drive outcomes across multiple stakeholders. In this role, you will guide individuals through complex coverage scenarios, resolve escalated claims and billing issues, and partner directly with providers, carriers, and third-party administrators to ensure accurate and timely resolution. This position requires a high degree of ownership, critical thinking, and the ability to manage sensitive or multi-layered issues with minimal oversight. We are seeking candidates who bring proven, hands-on experience navigating health plans and claims processes, including...

Member Services Advocate Member Services Advocates play a critical role in delivering advanced advocacy services, serving as a trusted resource for members navigating complex healthcare and employer benefit situations. This role is intended for experienced professionals with a strong background in health insurance, claims resolution, or benefits administration who can independently assess issues, interpret plan details, and drive outcomes across multiple stakeholders. In this role, you will guide individuals through complex coverage scenarios, resolve escalated claims and billing issues, and partner directly with providers, carriers, and third-party administrators to ensure accurate and timely resolution. This position requires a high degree of ownership, critical thinking, and the ability to manage sensitive or multi-layered issues with minimal oversight. We are seeking candidates who bring proven, hands-on experience navigating health plans and claims processes, including...