9 claims advocate jobs found

Reporting directly to the Medical Management Supervisor, the Workers' Compensation (WC) Case Manager supports the WC Department by following the best practices associated with managing of the injured worker effectively and efficiently. The position requires the nurse to work and communicate with other members of the Medical Management team in addition to the WC Claims team, WC Claims Supervisors, and other team members. Essential Duties and Responsibilities: . Demonstrate knowledge, skills, and competency in the application of case management standards of practice. Develop and provide ongoing support of the rehabilitation plan through comprehensive assessment, planning, implementation, and overall evaluation of individual claimant needs.  Facilitate the Injured Worker’s rehabilitation by coordinating medical treatment, advocate for the Injured Worker with all medical providers and stakeholders and educate the Injured Worker on their recovery process. Understand,...

New Jersey Manufacturers Insurance Company (NJM) was founded in 1913 by a group of manufacturers seeking to provide cost-effective, safety conscious and financially secure workers' compensation insurance for their workers. From inception the Company has operated as a mutual, with a focus on the needs of its policyholders. Today, NJM Insurance Group, is a leading mid-sized U.S. property and casualty insurance company with 90 consecutive years of A+ financial strength ratings by AM BEST. Due to exceptional employee experience, NJM has been included on the latest Forbes List of Best Employers in New Jersey for the fourth year in a row. The NJM reputation for being a top provider of outstanding customer service was reaffirmed by the most recent J.D. Power Auto Insurance Claims Survey. Over the last five years, the Company has focused on a strategic plan that calls for it to become a regional property & casualty insurer and has transitioned away from its affinity-based...

Company Details     Berkley One exists to insure and protect the lifestyles of a modern generation of affluence. We seek clients that are sophisticated individuals and families who require world-class risk and claims management customized to their needs, a team of select expert independent agents and innovative digital tools to keep it simple and easy. We’ll blend our partners, products and capabilities with all that is Berkley, generating a modern solution for the customers we serve.   Our culture is one of innovation, creativity and teamwork. Our team is highly motivated, passionate about our business, and deeply experienced in developing and delivering product and service solutions in the personal insurance marketplace.  #LI-AV1  #LI-Remote This role will require a colleague to travel to cover a territory within the Northeast region therefore this person will need to reside in NJ, NY, CT or RI state.     The company is an...

Foundation Risk Partners , one of the fastest growing insurance brokerage and consulting firms in the US, is adding a Customer Service Advocate to their Corporate Synergies team in Philly Metro Region.  Job Summary: The Benefits VIP Representative handles claims resolution, benefits inquiries, coverage eligibility concerns, and other related issues for our clients' administrators and employees. They work closely with clients and carriers via phone and email to resolve matters within a 24-hour timeframe. Essential Functions: •     Address client employee insurance concerns, answer benefit-related questions, and assist with claims resolution, patient advocacy, and pre-certifications. •    Educate client employees on optimal benefit utilization and provide guidance on cost-effective plan options. •    Maintain detailed records of client interactions, entering data into Salesforce and generating client analysis reports as necessary. •    Use Salesforce to gather...

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,...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking a Director of Public Entity Insurance Administration to join our growing team in Parsippany, NJ!   To work jointly with the Profit Center Leader, division producers, claims administration and support staff in the placement and servicing of public entity accounts that are in a joint insurance fund administrated by the profit center. How You Will Contribute:   Develop a full understanding of the regulations governing joint insurance funds in the State of New Jersey. Identify all markets and other alternative risk mechanisms for the placement of public entity business. Understand and incorporate procedures that are required by alternative risk placements in the servicing of new and existing business. Be proficient in the knowledge of public entity insurance so to identify risk exposures and...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking an Employee Benefits Account Executive to join our growing team in Roseland, NJ . The Employee Benefits Account Executive serves as a key liaison for both large and small client groups, ensuring exceptional service delivery and client satisfaction in alignment with B&B’s service standards. Collaborate closely with the Team Leader and Benefits Department to support service initiatives, implement product enhancements, and strengthen both internal and external relationships. The role also involves identifying market opportunities, supporting business development efforts, and contributing to proposal creation and client retention strategies. How You Will Contribute: Independently serve as a key liaison for both large Manage and grow an existing book of business by developing strategic plans for...

Overview AmTrust Financial Services, a  fast growing  commercial insurance company, has a need for a Complex Care Case Manager, RN for Workers Compensation managed care team.     PRIMARY PURPOSE :   The  complex care case manager will provide comprehensive and quality telephonic case management for our injured employees with complex diagnoses and often catastrophic injuries. Our nurses will  be responsible for  proactively applying clinical  expertise  ensuring our injured employees receive medically  appropriate healthcare  to achieve a safe return to work or best  optimal  level of function through engagement with the injured employee,  provider  and employer. Our nurses will be empathetic informative medical resources for our injured employees, and they will partner with our adjusters to develop a personalized  holistic approach  for each claim.  These responsibilities may include  utilization  review, pharmacy oversight...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Winston Benefits, a Brown & Brown company, is seeking a Benefits Specialist to join our call center team!    A Benefit Specialist is responsible for the day-to-day servicing of clients. WHAT YOU’LL DO: Be knowledgeable of all products and services offered by Winston. Be knowledgeable of all workflow processes. Respond to all inbound service calls and voicemail messages from customers, according to Call Center Research and resolve complaints to ensure customer retention and satisfaction. Communicate with carriers on behalf of members to obtain and update necessary information. Mail voluntary insurance product brochures, applications, service request forms and claim forms as Respond to inquiries from Benefit Consultants/Enrollers. Keep Account Manager and Customer Service Manager informed of any...