40 claims operations analyst jobs found

Job Summary The Claims Operations Analyst is responsible for supporting data-driven decision-making across claims operations through reporting, analysis, operational insights, and process optimization. Responsibilities can include, but are not limited to, developing and maintaining recurring and ad hoc reports, analyzing operational and claims data, supporting billing oversight activities, and assisting with operational workflows related to claims administration and vendor management. This role is expected to leverage reporting tools, analytics, and emerging AI-enabled technologies to improve reporting accuracy, efficiency, and visibility across the organization. The Claims Operations Analyst will partner with operational leaders and cross-functional teams to provide meaningful insights, identify trends and opportunities, and support informed business decisions through accurate and impactful reporting. Additional responsibilities may include supporting servicer maintenance...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Senior Auto Adjuster, you will work within defined guidelines and framework, responsible to adjust highly complex auto insurance claims presented by or against our members to include the end-to-end claims process and settling claims in compliance with state laws and regulations. Accountable for delivering best...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. One80 Intermediaries is seeking a Travel Claims Examiner and Customer Service Representative  to join our growing team!        We are looking for a Travel Claims Examiner and Customer Service Representative to join our team. In this role, you will be responsible for reviewing and analyzing claims to ensure they are processed accurately and in accordance with policy provisions. You will handle moderate to complex claim issues, ensuring that all necessary documentation is obtained, and claims are either approved or denied based on established guidelines.    How You Will Contribute:     Analyze and research claim issues of moderate to complex difficulty.  Ability to comprehend complicated workflows, policy certificates, and policy provisions.  Review and apply policy provisions in processing of claims received....

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. One80 Intermediaries is seeking a Travel Claims Examiner and Customer Service Representative  to join our growing team!        We are looking for a Travel Claims Examiner and Customer Service Representative to join our team. In this role, you will be responsible for reviewing and analyzing claims to ensure they are processed accurately and in accordance with policy provisions. You will handle moderate to complex claim issues, ensuring that all necessary documentation is obtained, and claims are either approved or denied based on established guidelines.    How You Will Contribute:     Analyze and research claim issues of moderate to complex difficulty.  Ability to comprehend complicated workflows, policy certificates, and policy provisions.  Review and apply policy provisions in processing of claims received....

The Doctors Company is seeking an experienced Vice President of Underwriting to join our team. This is a hybrid opportunity based in our Jacksonville, FL office.   Qualifications: Bachelor’s degree or equivalent, preferably in Business or Economics. RPLU or CPCU designation, or progress in obtaining such a designation, is preferred. Eight (8) or more years Insurance management or supervisory experience, with emphasis on working with multiple staff and business teams, including underwriting and product development. Ten (10) or more years Commercial general liability or professional liability insurance underwriting, claims and/or product development experience with insurance or contract law strongly preferred. Responsibilities Leadership Development & Staff Management Develop and communicate regional, department, and individual staff plans that support corporate priorities. Discuss performance expectations for each role and identify any staff...

We are seeking a hands-on ServiceNow Claims Lead Engineer to serve as the technical subject matter expert (SME)  for a highly customized specialty claims platform built on ServiceNow. This role is focused on architecture, design, and hands-on development , working closely with engineering leadership, product stakeholders, and a Software Integrator (SI) to deliver scalable, high-quality solutions. The platform leverages ServiceNow Customer Service Management (CSM), App Engine, and Integration Hub  with extensive scripted customizations and complex integrations across policy administration, financial systems, and enterprise data platforms . This role is ideal for someone who enjoys building and evolving complex platforms , staying close to the code, and acting as the go-to technical authority  for ServiceNow architecture and implementation.   Key Responsibilities: Platform Architecture & Technical Ownership Serve as the ServiceNow technical authority...

Overview At AmTrust Financial Services, we are expanding our internal strategic consulting capabilities to accelerate execution across enterprise strategic projects, AI, automation, and operations transformation priorities. The Strategic Consultant, AI & Operations Transformation will partner with business, Operations, Claims, Product, IT, Data, and executive stakeholders to define future-state “North Star” visions for priority workflows and strategic initiatives, benchmark AI and automation opportunities against those North Stars, and translate high-priority business objectives into executable plans with measurable outcomes.   This role is designed for a high-performing consultant with prior experience at a management consulting firm who can bring structured problem-solving, process redesign expertise, analytical rigor, and executive-ready communication to complex transformation efforts. The successful candidate will help AmTrust evaluate business...

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 Senior Forward Deployed Engineer Remote role, open to U.S. based candidates. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES Owns a build stream end to end within a pod: problem shaping with the Principal, implementation, production operation, and instrumentation of the outcome the business said it would measure. Designs, builds, and operates production Generative AI agents, workflows, and applications — including request orchestration, tool execution, state management,...

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 Principal Forward Deployed Engineer Remote role, open to U.S. based candidates. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES Owns the technical outcome of a value-stream pod from problem shaping through production operation, including whether work contributes to shared capability or is incomplete. Partners directly with business transformation leadership, examiners, nurse reviewers, and operations — sitting with users, shaping ambiguous problems, and refusing work...

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 Principal Architect - AI PRIMARY PURPOSE: The AI Principal Architecture within the Transformation Office serves as the enterprise executive accountable for AI architecture strategy, governance, and platform direction—driving large-scale business transformation through applied Generative AI, Agentic AI, and advanced intelligence capabilities. This role establishes and evolves the enterprise “intelligence layer” as a strategic capability, ensuring AI is delivered...

The Sr Client Relationship Manager (Sr. CRM), Commercial Risk, is the primary relationship manager for a portfolio of mid to high complexity clients, overseeing commercial insurance programs, renewals, retention, strategic partnership, and advanced service needs. This role applies advanced commercial insurance expertise to lead a multi-year renewal strategy, ensure completion of compliance requirements, analyze complex coverage and exposure trends, and provide proactive, strategic guidance that strengthens client relationships, satisfaction, and retention. Operating with a high degree of independence, the Sr. CRM drives day-to-day client delivery, leads pivotal planning in partnership with Advisors, and resolves escalated or highly complex service issues. This role also mentors colleagues, contributes to process improvement initiatives, and ensures the delivery of a consistent "Peace of Mind" client experience. The Sr. CRM collaborates closely with the Client Executive, Client...

About Fortegra Fortegra is a specialty insurance company and services provider headquartered in Jacksonville, Florida. We partner with distribution partners, MGAs, and program administrators to deliver insurance solutions and services. Our Finance team turns complex financial and operational data into insight that guides the business. Role Overview The Senior Manager of FP&A leads assigned planning and performance management workstreams and serves as the primary finance partner to designated businesses or functions. Reporting to the VP, FP&A, this hands-on role owns forecasts, analyzes business performance, and develops recommendations that support management decisions. The Senior Manager also reviews the Financial Analyst’s work and coaches a Leadership Development Program (LDP) participant. Key Responsibilities ·        Own assigned components of the annual operating plan, reforecast, and monthly performance reviews, including timelines, assumptions,...

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:      Orlando, FL :  12650 Ingenuity Dr Orlando FL 32826  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...

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 Business Development Director - Midwest or Southeast PRIMARY PURPOSE:  To expand and enhance the company's top line through diligent relationship building and maintenance with prospective clients across an area; to identify and address prospective and existing client opportunities for marketing the company's programs; and to ensure sales goals, objectives and profit margins are met. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Identifies, develops and maintains...

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 Director of Product Management, Data Science PRIMARY PURPOSE: The Director of Product Management, Data Science defines and executes product strategy and outcomes for a portfolio of data science products, including predictive models, statistical and forecasting solutions, and advanced analytics capabilities. This role owns roadmap direction, investment prioritization, and delivery accountability, ensuring data science work moves beyond analysis and experimentation into...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Join a Team Built on Relationships, Growth, and Results! Brown & Brown is seeking an experienced Commercial Lines Account Executive to join our growing team in Jacksonville, Florida. As an Account Executive, you will serve as a trusted advisor to commercial clients, partnering closely with Producers, carrier partners, and internal teams to deliver exceptional service, develop tailored insurance solutions, and drive client retention and growth. This role combines relationship management, strategic account oversight, and business development support to ensure clients receive best-in-class risk management guidance and insurance expertise. At Brown & Brown, we are a meritocracy where performance, initiative, and achievement are recognized and rewarded. We offer the entrepreneurial spirit of a local office backed by the resources,...

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.  CNA seeks to offer a comprehensive and competitive benefits package to our employees that helps them — and their family members — achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA’s benefits, check out our Candidate Guide . Leads and directs operations activities and/or customer service for the business unit ensuring effective delivery of service to all levels of internal and external customers. Collaborates with leadership and directs teams to assure strategic, operational and developmental goals of the functional area are met. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with...

Company Summary The Baldwin Group is guided by the Azimuth, our cultural constitution and True North, aligning our mission, vision, values, and promises to colleagues and clients alike. The Head of Data & Analytics owns the build-out and ongoing operation of Baldwin's enterprise data foundation- the governed, AI-ready lakehouse, the enterprise ontology and knowledge graph, and the analytics capability that the firm's growth, operating, and AI ambitions all depend on. This is a builder's role. This leader is accountable for delivery: onboarding priority data domains into the Databricks lakehouse, modeling Baldwin's core business entities and relationships into a usable knowledge graph, standing up the governance and controls that make our data trustworthy in a regulated industry, and putting accurate, timely insight in the hands of the colleagues who run our businesses. Reporting to the Chief Technology Officer, this leader executes within the enterprise data, AI, and...

Claims Representative - CH09CN Sr Representative Claims - CH08BE 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.           This position can be filled as a Claim Representative or Sr. Claim Representative based on experience. The Workers’ Compensation Claim / Sr. Claim Representative is accountable for planning, recommending, and executing the investigation of workers’ compensation claims. Our dynamic team of claim professionals provide superb customer service with the valuation, disposition and settlement of worker compensation claims while consistently adhering to our corporate claim settlement policies. Additionally, the representatives will work within established procedures in adherence to statutory, regulatory and...