132 claims manager workers compensation jobs found

You have a clear vision of where your career can go. And we have the leadership to help you get there.  At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.  Under general direction manages a team of claims professionals for a specific line of business. Responsibilities include overseeing all claim resolution activities of the team to ensure accurate and timely disposition of claims in accordance with company protocols. This position works within broad authority limits and is accountable for implementing company initiatives and driving overall team results. JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Oversees the work activities of a team of claims professionals and has full management responsibility by setting and communicating expectations,...

- Multi-state commercial insurance carrier is seeking a Senior SIU Investigator. The SIU Senior Investigator reviews and investigates referrals to the SIU to identify suspicious indicators of potential fraud committed by claimants, insureds, agents, brokers, providers and attorneys and conducts investigations of varying complexity. This is a remote position and reports to the SIU Manager. The ideal candidate will have proficiency in investigating claims across multiple lines of business to include Workers Compensation. Key Accountabilities/Deliverables: Evaluate SIU referrals to establish if there are suspicious elements present that might warrant a SIU investigation and prepare concise investigative plans of action. Submit assignments to vendors for various investigative tasks when warranted and manage those assignments while controlling costs. Obtain, evaluate, and act on information and documentation received and communicate effectively with the claims staff, other...

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 Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer Collects data and analyzes information to make decisions regarding certification or denial of treatment Documents all work in the appropriate manner Promotes utilization review services with stakeholders Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have thorough knowledge of both CPT and ICD coding Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers...

Sr UW Program Manager - UE07DE We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.              The Client Service Executive (CSE) is responsible for supporting profitable growth and retention of accounts. Additionally, the CSE will understand an account's needs while developing and delivering an end-to-end service offering that differentiates The Hartford in the marketplace. We look to the CSE to support the end-to-end service mission while delivering engaging customer presentations that demonstrate professional diplomacy, articulated messaging and a friendly confidence that drives positive outcomes for our customers. As an integral member of the service team, you support the service mission by delivering customer presentations that...

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 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, employees...

The Workers’ Compensation Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The WC Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises WC claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional...

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...

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Responsibilities Ensure compliance with all local, federal and state regulations related to claims while minimizing risk/exposure to the Arch organization. Provide technical expertise and oversight to TPA adjusters handling workers compensation, auto liability & general Liability claims which also include handling and supervision of outsourced claims. Work with our TPA’s to ensure proper claims handling and service delivery, this includes Performing claims oversight on claims with an expected value of over $50,000 for guaranteed cost policies and at 50% of the retention for deductible and self-insured business Attend mediations and trials. Granting reserve and...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work 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 and care coordination.    This position will be hybrid out of Princeton, NJ, Latham, NY, or Nashua, NH office.  Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review...

The 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 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 return-to-work efforts with the...

RT Specialty, a division of Ryan Specialty, is a leading wholesale distributor of specialty insurance products and services. Our experienced brokers are specialized in property, casualty, professional lines, transportation and workers’ compensation, providing creative solutions to retail brokerage firms. We define ourselves through our superior execution on behalf of our clients, which has established us as a leader in the industry. Position Summary The Quality Assurance Representative supports underwriting quality, regulatory compliance, and operational excellence by conducting detailed reviews of insurance files, documentation, and business processes. This role is responsible for identifying quality concerns, monitoring trends, analyzing root causes, and partnering with underwriting and operational teams to drive corrective actions and process improvements. The position plays a key role in ensuring adherence to carrier guidelines, regulatory requirements, and internal...

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 Underwriting 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,...

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Job Summary The Assistant Vice President within Arch Construction is responsible for the technical underwriting and account management of large account construction casualty programs. Responsibilities Technical Underwriting Solicits and reviews new and renewal account information required to evaluate a risk. Identifies all potential exposures and hazards in relation to coverage requested and individual risk characteristics. Assesses insurance and related financial risk and structures appropriate loss sensitive program to effectively protect against frequency, severity, catastrophic and credit risk Engage other internal resources as necessary Underwrites prices and...

Complex Director, Excess At AIG, we are reimagining the way we help customers to manage risk. Join us as a Complex Director in Excess Claims to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make your mark in Excess Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair, and professional service with empathy and efficiency. How you will create an impact Are you interested in handling some of the largest and most complex Casualty claims in the industry? Your deep technical claims expertise will be put to the test in the investigation, evaluation and disposition of new and existing...

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 seeking experienced insurance professionals who combine strong underwriting expertise with a relationship-focused approach. In this role, you'll manage a personal lines portfolio, make sound underwriting decisions, and partner with agents to drive profitable growth while delivering an exceptional customer experience.   What We're Looking For Personal Lines underwriting experience preferred Experience managing a book of business and making independent...

RT Specialty, a division of Ryan Specialty, is a leading wholesale distributor of specialty insurance products and services. Our experienced brokers are specialized in property, casualty, professional lines, transportation and workers’ compensation, providing creative solutions to retail brokerage firms. We define ourselves through our superior execution on behalf of our clients, which has established us as a leader in the industry. Position Summary The Account Executive supports our wholesale brokerage team helping place and manage complex Property & Casualty risks with a focus within the habitational business verticals (non‑construction). The role assists with new business and renewal submissions, trade execution, and the review of policies and invoices, while ensuring regulatory compliance. Working closely with internal teams, the Account Executive stays informed on market trends and provides insights that support effective placements and strong broker and agent...

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 Underwriting 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,...

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 Workers Compensation Claims Representative | NY Jurisdiction & NY Licensing Required We are seeking a highly motivated and experienced Workers' Compensation Claims Representatives to join our team. The ideal candidate will have at least 2 years of claims handling experience , with a strong background in New York jurisdictional regulations and processes. This position is responsible for managing and processing workers' compensation claims, ensuring timely 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. Job Description Summary Do you have a strong desire to resolve insurance claims by providing 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 claims resolution, while following processes that provide fair resolution, customer satisfaction and cost management, then we want to hear from you! As a Field Consultant, we’ll count on you to...