35 senior complex claims director jobs found

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. This Director is responsible for a team of 8-9 Territory Managers (field-based senior production underwriters) and the respective book of business within our Commercial Middle Market Custom Solutions organization. Territory: NY, NJ, MD, NC, SC, GA, FL This is a remote/WFH (work-from-home) role, requiring travel throughout the territory as well as conferences and leadership/team meetings.  Strong preference for the selected individual to be located...

The Professional Review Analyst analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. Candidate must be located in the greater Charlotte, North Carolina Region and able to attend in office training for a minimum of 1 week at start of employment. 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...

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 We are seeking a Financial Analyst Senior to tackle complex business challenges through advanced forecasting, planning, and financial modeling across income, profitability, liquidity, capital, leverage, asset and liability management, and operating expenses. This role mentors team members on sophisticated financial processes and analytical methodologies while ensuring all activities comply with regulatory and organizational requirements. The ideal candidate brings strong interpersonal and reporting skills, with the...

The Company    At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $2.0B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte. This is a hybrid preferred role to our offices in Charlotte, NC; New Hartford, NY; Buffalo, NY; or Woodbury, Long Island, NY.  Depending on location, remote candidates may be considered. What you will do The Specialist will be responsible for the management and effective resolution of higher exposure and complex educational institution claims. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and...

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℠. Arch began its Workday journey in 2020 and is continuing to build a strong, scalable HCM solution as part of our full platform solution.  We are seeking a Workday Support Analyst to join our People Operations team to optimize and support our Workday HCM environment. The Workday Support Analyst is a key contributor within the People Operations team, supporting the day-to-day effectiveness of our Workday HCM platform. Reporting to a Senior Workday Analyst, this role is ideal for someone looking to deepen their Workday expertise, strengthen HR systems fundamentals, and grow into increased responsibility over time. We take a consultative approach in People Operations, so you will be...

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  Protective Security Officer Senior,  you will provide armed response to emergency incidents involving workplace violence, active shooters, duress situations, medical emergencies, access control violations, and other safety and security situations in protection of the workforce. Leads the actions of team members by enforcing established procedures under minimal supervision. Performs complex duties and resolves operational problems in accordance with standard operating procedures. Provides coaching...

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 is a remote position. 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 claims as...

ABOUT HUB INTERNATIONAL: HUB International Limited (“HUB”) is the one of the largest global insurance and employee benefits broker, providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. With over 21,000 employees in 600+ offices throughout North America, HUB has grown substantially, in part due to our industry leading success in Mergers and Acquisitions. WHAT WE OFFER YOU: At HUB we believe in investing in the future of our employees.  Our entrepreneurial culture fosters an environment of open feedback and improvement that empowers our people to make the best decisions for our customers and organization.  We offer: Competitive salaries and benefits offerings Medical/dental/vision insurance and voluntary insurance options Health Savings Account funding 401k matching program Company paid Life and Short-Term Disability Plans Supplemental Life and Long-Term Disability...

Description Join us as a Field Property Claims Adjuster where you’ll be responsible for helping our customers navigate the claims process and get back on their feet following damage to the homeowner’s property.  This is a role where people who love every day to be new, different and exciting, can thrive – you’ll be traveling on the road to meet customers in person, providing hands-on assessment of damage and empathetic support .   The Field Property Claims Adjuster will be traveling locally to insured homes within Charlotte, NC (28215) and surrounding areas. To be successful within the role, candidates should live within or near this area.   Sign-On Bonus Available!  We’re offering a sign-on bonus for experienced and actively licensed new hires.   What you’ll do Investigate and evaluate onsite to resolve complex coverage and damage issues to include preparing complete estimates of repair for the covered damages. This may include...

ABOUT HUB INTERNATIONAL: HUB International Limited (“HUB”) is one of the largest global insurance and employee benefits broker, providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. With over 21,000 employees in 600+ offices throughout North America, HUB has grown substantially, in part due to our industry leading success in Mergers and Acquisitions. WHAT WE OFFER YOU: At HUB we believe in investing in the future of our employees.  Our entrepreneurial culture fosters an environment of open feedback and improvement that empowers our people to make the best decisions for our customers and organization.  We offer: Competitive salaries and benefits offerings Medical/dental/vision insurance and voluntary insurance options Health Savings Account funding 401k matching program Company paid Life and Short-Term Disability Plans Supplemental Life and Long-Term Disability...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description Responsible for creating a comprehensive estimate of damages for 1st and 3rd party material damage claims leading to the proper disposition. This role is utilized as a peer mentor having mastered our processes and obtained technical expertise. National General Insurance is seeking an experienced Auto Field Adjuster to join our field estimating team in the Durham, North Carolina area! This is a field-based, territory-specific position. We are looking for a professional with experience in auto damage assessment, proficiency in CCC One estimating software, strong negotiation and time management skills,...

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. 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...

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. 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...

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 We're looking for a collaborative and strategic HR leader to drive excellence in our HR functions through the power of data, and the ability to manage and develop a team of 10. In this role, you will be the bridge between HR, IT, and the business, ensuring our HR data solutions align with overall business strategy. You will leverage your deep understanding of HR data models, data architecture principles, and business architecture practices to design and implement scalable solutions. You'll also lead a team in...

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 is a remote role. 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 claims as...

The Company    At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $2.0B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte. This is a hybrid preferred role to our offices in Charlotte, NC; New Hartford, NY; Buffalo, NY; or Woodbury, Long Island, NY.  Depending on location, remote candidates may be considered. What you will do The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in multiple jurisdictions. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations,...

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 The USAA AML Modeling & Analytical Team is actively seeking a seasoned Senior Quantitative Risk Analyst to spearhead the development, refinement, and deployment of a comprehensive suite of Financial Crimes Models. This pivotal role will leverage expert analytical acumen and extensive technical proficiency to architect and optimize model performance for Transaction Monitoring (Actimize), Lexis Bridger Screening Systems, and Customer Risk Scoring. The successful candidate will collaborate with key stakeholders to...

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: Deliver technically complex solutions. Perform system integration support for all project work. Consult and partner with the business product owners to understand the end goal and offer solutions and recommendations during the design. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Develop customized coding, software integration, perform analysis, configure solutions, using tools specific to the...

Our employees are at the heart of what we do: helping people, businesses and society prosper in good times and be resilient in bad times. When you join our team, you are bringing this purpose to life alongside a passionate community. Feel empowered to learn and grow while being valued for who you are. At Intact, we commit to supporting you in reaching your goals with tools, opportunities, and flexibility. It’s our promise to you.  Who we are At Intact Insurance Specialty Solutions, we are experts at what we do in protecting what makes businesses unique. Our deep understanding of the specialty insurance market is the foundation for our customized solutions, backed by targeted risk control and claims services. Our employees are passionate about providing insurance coverage that’s aligned to our targeted customer groups. Intact’s Global Specialty Lines business spans across more than 20 verticals in four distinct markets: U.S., Canada, UK and Europe. The following...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Why Choose a Career with the AAA The Auto Club Group (ACG) / AAA Car Care:   At AAA Car Care, we are your preferred automotive experts providing customers with friendly, knowledgeable advice and technical expertise . With 34 stores and counting, we are the largest chains of AAA club-owned repair facilities in the USA. In our clean and conveniently located facilities, we offer a full range of automotive repair and maintenance services to AAA members and non-members.  Every AAA Car Care facility is staffed with ASE-certified technicians who ensure that every car is treated with the utmost care.   Now you know about us, but who are you? You are likely someone who is mechanically inclined, enjoys working on automobiles and...