42 complex claims specialist jobs found

Description Liberty Mutual has an immediate opening for a Senior Technical Claims Specialist to join our Energy Complex Team. The Senior Technical Claims Specialist determines coverage, investigates highly complex Commercial Casualty claims, determines liability, sets and adjusts reserves, evaluates the claim, negotiates a settlement, authorizes and resolves the claim. Additionally, the Senior Technical Claims Specialist demonstrates a high level of expertise and sound judgment in complex matters and may act as a subject matter expert.   You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Boston, MA; Westborough, MA; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; Indianapolis, IN; Hoffman Estates, IL; or Weatogue, CT.   Please note this policy is subject to change.   The salary range posted reflects the range for the varying pay scale that...

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. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements in compliance with all state regulatory requirements. Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling....

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This role will handle complex contract surety claims across the country. Responsibilities Assist with Commercial and Contract Underwriting which includes direct communication with agents, attorneys, and principals: Address questions/concerns re the bond forms, underlying contract obligations, indemnity agreement and/or Collateral Security Agreement and revise the agreements as necessary and appropriate; Draft and revise bond forms to conform to applicable statutes and/or Court orders; Review and...

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.    **This position can be performed remotely for candidates who reside in the Houston, Texas area ** Essential Functions: Completes on-site risk control surveys of highly sophisticated current and prospective policyholders’ operations, including in niche markets Assesses and analyzes the exposure potential and existing controls and prepares risk control reports based on findings and communicates results to insured and agents Provides consultation to policyholders regarding their operations, claims trends, and recommendations for improvement related to insured coverages, including developing written recommendations for policyholders to...

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. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements in compliance with all state regulatory requirements. Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling....

Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.   The  Claims Specialist  analyzes complex Personal Injury Protection (PIP) and Medical Payment (Med-Pay) No Fault claims, determines benefits owed, manages and adjudicates high‑exposure claims to meet service standards and client requirements. The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about coverage and eligibility, evaluating losses, medically managing claims, paying medical bills, and...

Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.   The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim’s management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers....

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! The primary purpose of this Actuary position is to provide a range of decisions based on actuarial analysis and forecasting, to maximize profit and growth and provides guidance to more junior level actuaries. Develops complex actuarial formulations leading to the recommendation of extensive and impactful pricing strategies and loss reserving. Provide consultations and clarification on actuarial models and risk issues, and influences management towards a course of action that have a potential impact on...

The 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 position is onsite in Dallas, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives 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 and non-problematic medical only claims and minor 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 needed Assists other claims professionals with more complex or problematic...

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...

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...

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...

Company: Marsh McLennan Agency Description: SUMMARY: As a Claims Specialist for the Marsh McLennan Agency, you will be a claims consultant providing oversight and advocacy on behalf of our clients throughout the process of a loss event and the life of a claim. Duties include: You will submit claims or provide guidance on claim submission; Review coverages and resolve claims issues; Ensure carrier commitments are honored; Coordinate and participate in scheduled claims reviews; Serve as your client’s advocate with adjusters and their coverage counsel; Resolve coverage disputes whenever possible; Assess and strategize to produce best possible claim outcomes; Duties may also include: Review of client’s overall claims program and individual complex claims situations; Develop strategic action plans to reach desired outcomes; Provide guidance regarding potential large settlements; Recommend suitable vendor partners, including claims TPAs, nurse triage, and...

Company: Marsh McLennan Agency Description: SUMMARY: As a Claims Specialist for the Marsh McLennan Agency, you will be a claims consultant providing oversight and advocacy on behalf of our clients throughout the process of a loss event and the life of a claim. Duties include: You will submit claims or provide guidance on claim submission; Review coverages and resolve claims issues; Ensure carrier commitments are honored; Coordinate and participate in scheduled claims reviews; Serve as your client’s advocate with adjusters and their coverage counsel; Resolve coverage disputes whenever possible; Assess and strategize to produce best possible claim outcomes; Duties may also include: Review of client’s overall claims program and individual complex claims situations; Develop strategic action plans to reach desired outcomes; Provide guidance regarding potential large settlements; Recommend suitable vendor partners, including claims TPAs, nurse triage, and...

Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure’s promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best “A” (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. We are recruiting for a Manufacturing Market Segment Director to join our team. Position Summary: The Manufacturing Market Segment Director sets the strategic direction of the manufacturing segment and is accountable for achieving growth and profit objectives. This leader drives portfolio analysis, insight...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! The Compliance Analyst is responsible for daily oversight and orchestration of specific compliance functions and must be able to address multiple compliance disciplines. Essential Functions: Develops and communicates company expectations to internal and external customers relative to assigned areas of responsibility. Meets statutory obligations within assigned areas of responsibility. Develops, enhances, and maintains business processes and procedures within assigned areas of responsibility....

The Appeals Team Lead assists injured workers, claims examiners, attorneys, providers, etc. in locating providers within the medical provider network (MPN), verifying provider inclusion in an MPN and scheduling appointments upon request for the injured worker. This position includes a moderate volume of inbound calls and a high volume of outbound calls. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling a consistent, timely delivery of our quality services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receive incoming calls, emails and faxes from the Medical Access Assistant line Communicate clearly and professionally with providers and other stakeholders via phone and email Provide excellent customer service...

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. The Excess Liability Division specializes in offering large limits of liability to protect its clients' corporate assets from catastrophic loss. The Division offers significant capacity of up to $20 million dollars for both Lead Umbrella and Excess Liability placements. This...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be an acknowledged technical expert in Markel Claims, responsible for resolving claims posing the highest exposure to the company. The position will have significant autonomy. The position will act as a leader and resource to other examiners and managers in the Casualty Claims division and will provide legal and claims support to the Casualty underwriting business partners. Job Responsibilities Manage a full case load of the most complex/high exposure claims within Casualty Claims...

Come join one of America’s fastest-growing insurance companies. Since 1848, National Life Group has aimed to keep our promises, providing families with stability in good times and in bad. Throughout that history, we have provided peace of mind to those families as they plan their futures. Our mission extends beyond the insurance and annuities policies that we offer. We strive to make the world a better place through our grants from our charitable foundation, paid volunteer time for our employees, environmentally sustainable and healthy workplaces, and events that promote the work of nonprofits in our own backyard. We foster a collaborative environment with opportunities for growth and encourage our associates to live our values: Do good. Be good. Make good. Role Summary Kickstart your career in Claims with our U-Excel comprehensive Claims Specialist training program. Join our team to learn how to review, analyze, and process claims with accuracy and compassion. You’ll...