51 claims management analyst jobs found

We are seeking an Operations Analyst to support our Medical Management platform and client data operations. In this role, you’ll help ensure important data is received, processed, and delivered accurately so teams and clients can rely on it for decision-making and day-to-day activities. This is a hands-on, detail-oriented position where you’ll identify and fix data issues, support system updates, and work with both internal teams and external partners to keep things running smoothly. What You'll Do Support day-to-day operations of the Medical Management platform, ensuring data accuracy, system reliability, and timely resolution of operational issues. Monitor inbound eligibility, medical, pharmacy, vision, and census files; evaluate processing outcomes and take corrective action when files are delayed, incomplete, or fail validation. Prioritize incidents, requests, and data issues based on client impact, system risk, and operational urgency, using independent...

Company Details   Berkley Agribusiness works with ambitious agribusiness clients to help them own their futures. Our culture is built on the belief that everyone has the power to create the future they deserve.  Every Berkley Agribusiness team member must have the courage to challenge the status quo, collaboratively working with our clients to find creative property and casualty insurance solutions that drive them to succeed. We depend on our ability to listen to our clients — and our experience to help them make fact-based decisions that help their businesses thrive.   Berkley Agribusiness is part of the W. R. Berkley Corporation (WRBC) . Founded in 1967, WRBC is one of the nation’s premier commercial lines property casualty insurance providers. WRBC’s international business operates in selected regions throughout the world, including Europe, South America, Australia, and Asia.   This position is based in our Urbandale, IA office which offers...

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...

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. Knowledge of operational applications, including but not limited to GENESYS cloud, FIVE9, VERINT, NICE, AWD, etc. 5 years preferred knowledge of property/casualty or life insurance products, insurance processing systems and procedures, optimal practices, state regulations, and customer service practices. Experience with Personal Lines Claims would be helpful in this role. This is a remote position. Must be able to work EST and CST business hours. This...

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 ADA Accommodation Coordinator PRIMARY PURPOSE :   To process claims and determine accommodation options following written guidelines and procedures pursuant to ADA, state and/or client requirements; to make timely referrals for appropriate disability and federal/state leave of absence eligibility review; and to ensure the ongoing processing of claims. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Informs claimants of documentation required to process claims, required...

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 Team Lead PRIMARY PURPOSE :  To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims. ESSENTIAL...

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 Clinical Specialist PRIMARY PURPOSE : Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, and/or complexity. Consults with providers and employees by providing case direction and ensures medical information substantiates the need for employee absence from work.  ESSENTIAL FUNCTIONS and RESPONSIBILITIES Performs standard clinical reviews of referred medical claims based on client...

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 Team Lead - ADA PRIMARY PURPOSE :  To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims. ESSENTIAL...

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 Sr Our teams connect! We collaborate onsite and have a hybrid work arrangement.  All candidates must live near one of our centers of excellence:   Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401 Chicago, IL : 175 W. Jackson Blvd. 12th Fl. Chicago IL 60604 PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable...

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 Clinical Specialist PRIMARY PURPOSE : Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, and/or complexity. Consults with providers and employees by providing case direction and ensures medical information substantiates the need for employee absence from work.  ESSENTIAL FUNCTIONS and RESPONSIBILITIES Performs standard clinical reviews of referred medical claims based on client...

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 Sr PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims,...

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 Sr PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims,...

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 Sr - French Canadian Bilingual French Canadian Speaking Required PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations;...

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 Team Lead Our teams connect! We collaborate onsite and have a hybrid work arrangement.  All qualified candidates must live near our center of excellence in Dubuque, IA . PRIMARY PURPOSE :  To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional...

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 Dubuque Open House Hiring Event Open House Hiring Event – Launch Your Career With Us! Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. The company provides a broad range of resources tailored to our clients’ specific needs in casualty, property, marine, benefits, brand protection and other lines. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help...

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 Team Lead PRIMARY PURPOSE :  To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims. ESSENTIAL FUNCTIONS and...

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. We’re looking for a technically strong workers compensation underwriter to help steer a growing portfolio of WC programs. You’ll be the go-to expert for complex WC referrals and program questions, directly impacting profitability, volatility, and partner experience across our book. What you’ll do Underwrite complex WC program and large account referrals end-to-end (exposures, losses, structure, and pricing recommendations). Use internal pricing tools,...

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 Team Lead PRIMARY PURPOSE :  To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims. ESSENTIAL...

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 ADA Accommodation 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 Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401 Coralville, IA:  3273 Ridgeway Drive Coralville IA 52241 Dublin, OH : 5500 Glendon Court Dublin OH 43016 New Albany, OH : 7795 Walton...