24 claims clinical specialist jobs found

Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 24,000 employees spanning over 56 countries. People join Howden for many different reasons, but they stay for the same one: our culture. It’s what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities – work / life balance, career progression, sustainability, volunteering – you’ll find like-minded people driving change at Howden. Financial Lines Group   Financial Lines is one of the most dynamic and fast-evolving areas of the insurance industry. It focuses on protecting organizations against complex risks, from cyber-attacks and professional liability claims to regulatory investigations, management...

Primary Details Time Type: Full time Worker Type: Employee Senior Specialist - Cyber Claims Location: USA – New York Work Arrangement: Hybrid   The salary range for this role is:  $124,000-$186,00K The Opportunity The purpose of this role is to provide exceptional claims service to customers by managing complex claims effectively. This includes assessing policy coverage, investigating, evaluating, and negotiating intricate claims, collaborating with suppliers and stakeholders, and offering senior technical guidance and support. Your New Role Responsibilities: Provide technical guidance and analysis for complex and high-value claims. Assist in implementing and maintaining claims management strategies. Maintain comprehensive knowledge of insurance guidelines and policies. Build and maintain relationships with stakeholders. Manage a portfolio of complex or high-value claims. Act as an escalation point for customer complaints. Provide...

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This role is available for remote, onsite and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in...

The Company  Willis Towers Watson (NASDAQ: WLTW) is a leading global advisory, broking and solutions company that helps clients around the world turn risk into a path for growth. With roots dating to 1828, Willis Towers Watson has 40,000 employees serving more than 140 countries. We design and deliver solutions that manage risk, optimize benefits, cultivate talent, and expand the power of capital to protect and strengthen institutions and individuals. Our unique perspective allows us to see the critical intersections between talent, assets and ideas – the dynamic formula that drives business performance. Together, we unlock potential. Learn more at willistowerswatson.com. The Business Corporate Risk and Broking We know how companies can unlock potential through effective risk management. Our clients rely on us to craft strategies to quantify, mitigate, and transfer risk, taking advantage of our global capabilities, specialist industry experience, and unparalleled market...

The Company    At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $2.0B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, our Home Office is based in Central New York, with Regional Office locations including NYC, Dallas, and Charlotte. What you will do You'll be responsible for adjusting auto bodily injury claims in primarily New York venues. You'll be communicating with all parties involved and completing investigations in a timely and thorough manner. This position will include contact with attorneys on serious claim matters, and you will consult with a supervisor on more complex coverage and technical matters. This position requires strong analytical skills, attention to detail, and the ability to negotiate and settle...

If you’re passionate about helping people protect what matters most to them at a Fortune 100 company with nearly $70 billion in annual sales, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. Job Description Summary Do you have a strong desire to provide prompt, courteous and fair service to customers? Are you a skilled investigator, negotiator and communicator? If you thrive in an environment where you can problem-solve workers’ compensation claims resolution, while following processes that provide fair resolution, customer satisfaction and cost management, then we want to hear from you! As a Claims Specialist, you’ll investigate and handle...

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. We are seeking a results-oriented, analytically-minded  Performance & Talent Operations Manager/Specialist  to join our HR team. This key role will be responsible for overseeing and enhancing our global talent management processes within Workday, ensuring the seamless execution of performance cycles—including goal setting, year-end reviews, and talent assessments—on a global scale. Additionally, you will develop functional reports and dashboards, providing...

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. The Insurance Company Licensing Specialist will primarily be responsible for assisting with key aspects of the Starr Companies’ (re)insurance company regulatory and licensing compliance function, both domestically and internationally. This entails the completion and tracking of (re)insurance company license applications and registrations, license and registration renewals, corporate amendment filings, the submission and tracking of affiliate transactions for...

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. The Insurance Company Licensing Specialist will primarily be responsible for assisting with key aspects of the Starr Companies’ (re)insurance company regulatory and licensing compliance function, both domestically and internationally. This entails the completion and tracking of (re)insurance company license applications and registrations, license and registration renewals, corporate amendment filings, the submission and tracking of affiliate transactions for...

Job Description Sompo has a unique opportunity for a Finance Vendor Management Specialist to join our Finance Operations team.  As a Finance Vendor Management Specialist, you will play a key role in ensuring the accurate setup and ongoing maintenance of SAP Business Partner accounts. You’ll collaborate closely with cross-functional teams to support efficient vendor onboarding and maintenance while upholding internal controls and compliance standards. The ideal candidate brings strong analytical and communication skills, a collaborative approach, and a commitment to delivering high-quality service to internal stakeholders. Location : This position will be based out of our Purchase, NY office. We strive for collaboration which is why we offer a work environment where our employees thrive and develop long lasting careers. Our business, your impact, our opportunity: What you’ll be doing: Process and maintain Business Partner setup and change requests...

The Subrogation Specialist identifies subrogation potential within company standards and best practices and handles recovery for Workers Compensation and Property/Auto damage. This role prepares lien notice letters, negotiates settlements, and provides customer service to all stakeholders. This role is available for remote, hybrid and onsite work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify subrogation potential based on facts of loss, working closely with Workers' Compensation Claims Specialists or Liability Claims Specialists (property/auto) Contact liability insurance carriers or third-party attorneys to negotiate settlements Identify at fault parties and send lien notice letters of recovery rights via mail/email Maintain diary to follow up on claims status and Third Party settlements Negotiate recovery of clients’ damages Communicate claim status with claimant and clients' risk management Adhere to client guidelines & participate...

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early...

The Company    At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $2.0B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte. This is a hybrid role to our offices in Charlotte, NC; Woodbury, Long Island, NY; New Hartford, NY; Richardson, TX.   What you will do The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in multiple jurisdictions, including New York. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage...

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. Job Title:  Director, Quality Engineering Location:  New York, NY / Philadelphia, PA / Atlanta, GA Department:  Starr Technology Group Overview: The Director, Quality Engineering plays a critical leadership role responsible for operationalizing and scaling Starr’s Quality Engineering (QE) strategy. This leadership position is tasked with leading the execution of QE methodologies, managing QE teams, and driving the maturity of automated and manual...

Join us as an Underwriting Manager, Ocean Cargo to make more of your specialist expertise and experience. Make your mark in Specialty Underwriting The Underwriting Manager will contribute to the growth of the business by underwriting Cargo products under general direction, performing highly technical complex assignments within area of expertise.  Responsible for large accounts, building, maintaining strategic client and broker relationships, and developing new business submissions. Managing a team of Underwriter’s across multiple geographies and taking ownership of the regions P&L performance. How will you create an impact: Providing technical direction to management, less senior underwriters, producers, and claims adjusting colleagues Accepting, declining or modifying new and renewal submissions: identifying exposures and analysis required to underwrite an account, as well as the coverage policies;  determining the exposures to loss assumed and restricted by...

The Company Willis Towers Watson (NASDAQ: WLTW ) is a leading global advisory, broking and solutions company that helps clients around the world turn risk into a path for growth. With roots dating to 1828, Willis Towers Watson has 39,000 employees in more than 120 territories. We design and deliver solutions that manage risk, optimize benefits, cultivate talent, and expand the power of capital to protect and strengthen institutions and individuals. Our unique perspective allows us to see the critical intersections between talent, assets and ideas — the dynamic formula that drives business performance. Unlock your potential at Willis Towers Watson.   The Business Corporate risk and broking We know how companies can unlock potential through effective risk management. Our clients rely on us to craft strategies to quantify, mitigate, and transfer risk, taking advantage of our specialist industry experience and unparalleled market know-how. The result is a new way of embracing risk...

This is an opportunity to join Ascot Group - one of the world’s preeminent specialty risk underwriting organizations. Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we’re bound by a common mission and purpose: One Ascot. Our greatest strength is a talented team who flourish in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way. The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our unique Fusion Model: Client Centric, Risk Centric, Technology Centric. Built to be resilient, Ascot maximizes client financial security while delivering bespoke products and world class service — both pre- and post-claims....

Primary Details Time Type: Full time Worker Type: Employee S enior Technical Claim Specialist (Financial Lines) Location: USA –New York, NY and Chicago, ILL Work Arrangement: Hybrid   The salary range for this role is:  $139,500-236,500 The Opportunity Manages the complete investigation, evaluation and resolution of assigned portfolio of complex claims emanating from Management and Professional Lines (MLPL) business segments, specifically Directors and Officers and Employment Practices Liability for our Private Company portfolio. Engages, directs and manages external advisors and vendors including legal service professionals, discovery vendors, data and security experts and consultants across highly complex portfolio of matters. Your new role: • Manage a diverse portfolio exclusively of high severity claims which includes conducting fact, liability and loss investigations and interpreting insurance contracts in an effective...

The Workers’ Compensation Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is an onsite role in Brooklyn, NY. Once full trained, the employee will be able to work from home one day per week. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as...

The WC Disability Claims Specialist manages within company best practices workers’ compensation claims to best possible outcome, supporting the goals of claims department and of CorVel. This role manages the claims toward closure and looks for settlement opportunities throughout reviews. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim Reviews for validity and compensability of the claim Reviews and revises reserve and authorizes payments within reserving authority limits Ensures timely and accurate payment of WC claim benefits, including indemnity and medical Initiates investigations, including alive and well checks as needed to confirm continued payment of benefits Manages workers’ compensation claims toward closure (targeted case load is 250–300 files) Develops strategies and pursues settlement and/or claim closures, whenever possible Communicates claim status...