13 senior claim consultant jobs found

SUMMARY:  Primarily responsible for approval, completion, and processing mail audits; processing adjustments and reviewing phone and physical audits as determined by the Senior Premium Analyst or staff field auditor in a multi-functional business unit.  Provides direct customer service via phone, fax, and e-mail to internal and external customers including, but not limited to; Business Development Consultants and Service Center representatives, Finance, and other Premium Audit staff, as well as agents, attorneys, NCCI / regulatory bureaus, and policyholders.  PRIMARY RESPONSIBILITIES:  •    Analyze, research, approve, complete and process mail audits. •    Review phone and physical audits for audit findings which need to be communicated to relevant internal staff, including but not limited to Business Development, Work safe Consulting Services, and Claims to amend the policy accordingly. •    Analyze, research, approve, complete, and process the following audit adjustment types:...

SUMMARY:   Primarily responsible for providing customer service and underwriting technical support to agencies and policyholders related to underwriting rules, procedures and regulations, policy, and audit information.   Reviews & approves/declines endorsement requests and responds to bureau criticisms to maintain policies and stay in compliance with Accident Fund’s and bureau rules and regulations. Verifies coverage for current policy and/or additional named insureds/DBA’s/locations.   Completion of experience rating promulgations or Loss Pricing & Projection Model.   Mentors PPRs & CBR’s with basic questions and policy information.   Contacts include state rating bureaus, Service Center staff, Business Development Consultants, Business Development Managers, Corporate Underwriting, Finance Department, Claims Department, agents, and policyholders.   ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned. Respond to...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking an Employee Benefits Financial Analyst to join our growing team in Grand Rapids, MI or Troy, MI !   The Employee Benefits Financial Analyst provides guidance and support for the financial consulting needs of employee benefit clients. They will use technical expertise to assist clients in understanding and managing  their financial and utilization metrics.   The Financial Analyst collaborates with the Financial Consultant to review monthly financial reports, utilization metrics, and benchmarks. Supports clients in negotiating renewal proposals and offers recommendations for plan changes and alternative funding options.   How You Will Contribute:     Assist in the oversight of monthly financial reports. Help develop reporting requirements and customize reports as needed. Support Benefit...

Employment-based non-immigrant visa sponsorship and/or assistance is not offered for this specific job opportunity. We will only consider candidates who are currently authorized to work in the United States and who will not require sponsorship now or in the future. Please note: student visas, CPT, OPT, H-1B, TN, and other temporary work authorizations are considered restricted forms of employment eligibility. Once these expire, the candidate must be able to present another valid form of work authorization.   Contract Dates: June 2027 through August 2027 Other hiring locations for this role are: Boston, MA; New York, NY; Atlanta, GA; San Francisco, CA; Houston, TX; Dallas, TX We are in the business of transforming tomorrows. Join us and transform yours.   The Business   Create your future. In Health & Benefits (H&B), our purpose is that through our colleagues we help our clients make a difference in the lives of their employees. We help large and mid-size...

This position is responsible for planning, organizing, and monitoring the audit coordination processes for the OGACC - Office of the General Auditor & Corporate Compliance – Emerging Markets (OGACC – EM). This position interacts routinely with the Company executives, directors, and managers, as well as BCBSM. This role requires exercising discretion and judgment in assisting the general auditor and internal audit staff. Discretion and judgment are also required when communicating with executives and staff throughout the enterprise and BCBSM. This position performs executive support tasks which may be highly confidential and sensitive in nature utilizing considerable independent judgment. Performing high-level administrative work, including organizing, scheduling, coordinating, researching, compiling, exchanging, and sometimes analyzing information for executive(s) and the department is also required. Leads on-site audit activities between OGACC - EM and the enterprise....

Position Summary Responsible for planning, organizing, directing, and executing complex analytical initiatives that support Health Care Value programs and performance management activities. This position operates with a high degree of independence and is responsible for researching, analyzing, and interpreting healthcare data to identify trends, evaluate program performance, quantify savings, and provide actionable business recommendations. The Senior Healthcare Analyst partners with internal stakeholders, vendors, providers, and leadership teams to develop analytical solutions, monitor contractual performance, and deliver strategic insights that improve healthcare affordability, quality, and operational effectiveness. Key Responsibilities Healthcare Analytics & Performance Measurement Lead the research, analysis, and evaluation of healthcare claims, authorization, utilization, provider, and membership data to identify trends, risks, and opportunities....

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our Claims team is currently seeking an Adjuster PIP - Consultant Casualty Claims. This is a full-time, exempt role with a hybrid work schedule (two days in the office) in one of our Hanover offices: Howell, MI Southfield, MI Grand Rapids, MI   POSITION OVERVIEW:  The Consultant Casualty Claims is responsible for managing no-fault claims that typically involve minimal to moderate injury and disability severity. Duties include verifying coverage, evaluating medical bills and applicable no-fault benefits for payment, and maintaining clear communication with claimants, third parties and providers. Claims may also involve negotiating settlements, handling of...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our Claims team is currently seeking an Adjuster PIP - Consultant Casualty Claims. This is a full-time, exempt role with a hybrid work schedule (two days in the office) in one of our Hanover offices: Howell, MI Southfield, MI Grand Rapids, MI   POSITION OVERVIEW:  The Consultant Casualty Claims is responsible for managing no-fault claims that typically involve minimal to moderate injury and disability severity. Duties include verifying coverage, evaluating medical bills and applicable no-fault benefits for payment, and maintaining clear communication with claimants, third parties and providers. Claims may also involve negotiating settlements, handling of...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our Claims team is currently seeking an Adjuster PIP - Consultant Casualty Claims. This is a full-time, exempt role with a hybrid work schedule (two days in the office) in one of our Hanover offices: Howell, MI Southfield, MI Grand Rapids, MI   POSITION OVERVIEW: Michigan Assigned Claims Plan The Consultant Casualty Claims is responsible for managing a caseload of moderate complexity claims from start to finish.  This includes conducting thorough investigations, assessing liability, negotiating settlements within defined authority limits, and maintaining clear communication with claimants, third parties, and legal representatives. The role requires strong...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our Claims team is currently seeking an Adjuster PIP - Consultant Casualty Claims. This is a full-time, exempt role with a hybrid work schedule (two days in the office) in one of our Hanover offices: Howell, MI Southfield, MI Grand Rapids, MI   POSITION OVERVIEW: Michigan Assigned Claims Plan The Consultant Casualty Claims is responsible for managing a caseload of moderate complexity claims from start to finish.  This includes conducting thorough investigations, assessing liability, negotiating settlements within defined authority limits, and maintaining clear communication with claimants, third parties, and legal representatives. The role requires strong...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, this specific role could have the flexibility to work from home up to 3 days per week. Auto-Owners Insurance, a top-rated insurance carrier, is seeking motivated nursing professional to join our team. The position requires the person to: ·        Collaborate with claims associates to provide medical expertise in the investigation, evaluation, and appropriate resolution of injury claims including workers’ compensation, personal injury protection (no fault), and liability. ·        Evaluate medical records for relatedness to the injury and appropriate utilization of medical treatment and services. ·        Prepare and deliver trainings to claims...

About Acrisure  A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more.   In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible. Job Summary:  As the Manager of Retirement, Financial and Education Benefits, you will be responsible for overseeing the design and administration of our retirement and financial wellness offerings for employees across all 50 U.S. states. Reporting to the VP of Total...

The Doctors Company is seeking a Manager Alternative Risk Underwriting. This is a hybrid opportunity based at any TDCG or PRA office. The Underwriting Manager, Alternative Risk is responsible for the profitable growth, retention, and overall management of a complex portfolio of alternative risk accounts within TDC. This position has direct accountability for $80 million in annual premium volume and $5 million in fronting and claims handling fee revenue. The ideal candidate is a highly experienced underwriting professional with deep expertise in alternative risk structures, medical professional liability insurance, captive and self-insured programs, and complex client relationship management. This individual will operate with significant autonomy, serving as the primary business leader for their portfolio while partnering with internal stakeholders to deliver exceptional underwriting, financial, and service results. The role requires a strategic, disciplined, and commercially...