13 workers compensation claims specialist 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.  This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by...

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 is a remote role. Candidate must be fully bilingual in English and Spanish.   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...

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 role is available for onsite, hybrid, and remote work arrangements.    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...

The Liability Claims Specialist manages non-complex and non-problematic Liability claims under direct supervision of a senior claims professional. This role aims to achieve optimal outcomes for both CorVel and our clients. The Liability Claims Specialist handles litigated files and works with delegated limited authority, adhering to company best practices. This role is available for onsite, remote, and hybrid work arrangements.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Manages non-complex and non-problematic medical only claims and minor lost-time liability claims under close supervision 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 Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates...

The Loss Control Specialist provides expert risk management solutions and loss control services to current and prospective policyholders, identifying potential hazards and risks within the workplace, assessing the insured's safety protocols and procedures, and implementing effective strategies to minimize accidents or injuries and mitigate subsequent workers' compensation claims. This professional provides valuable insights to Underwriting as to workplace findings, assisting them in properly pricing risk, and works closely with our larger policyholders to enhance the overall safety culture within the organization, resulting in fewer incidents and improved operational efficiency. Extensive travel utilizing various forms of transportation, including but not limited to car, plane or train, required.    ESSENTIAL RESPONSIBILITIES The Loss Control Specialist will provide Loss Control consultative support to current and prospective policyholders in an assigned territory. This...

The Loss Control Specialist provides expert risk management solutions and loss control services to current and prospective policyholders, identifying potential hazards and risks within the workplace, assessing the insured's safety protocols and procedures, and implementing effective strategies to minimize accidents or injuries and mitigate subsequent workers' compensation claims. This professional provides valuable insights to Underwriting as to workplace findings, assisting them in properly pricing risk, and works closely with our larger policyholders to enhance the overall safety culture within the organization, resulting in fewer incidents and improved operational efficiency. Extensive travel utilizing various forms of transportation, including but not limited to car, plane or train, required.    ESSENTIAL RESPONSIBILITIES The Loss Control Specialist will provide Loss Control consultative support to current and prospective policyholders in an assigned territory. This...

CorVel is seeking a Senior Liability Claims Specialist.  The Senior Liability Claims Specialist manages within company best practices with heavy complex auto and litigation experience and at least 5 years of experience. Additionally, the Specialist will work within delegated authority to best possible outcomes for CorVel and our clients. This is a remote role. Florida applicants are preferred and Municipality experience is also preferred.    ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles 1st and 3rd party Auto and General Liability claims Establishes reserves and authorizes payments within reserving authority limits 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...

Company Details     At Verus Specialty Insurance, a proud member of the esteemed W.R. Berkley Corporation (NYSE: WRB), we stand as a leading Excess and Surplus Lines provider delivering comprehensive solutions across the United States. Backed by the formidable strength of a Fortune 500 titan and operating with the agility of a nimble startup, we blend the best of both worlds to foster innovation and excellence in everything we do.   Our nationwide operations are supported by a robust network of select wholesale producers, ensuring that our reach and capabilities are always close at hand. We are driven by a forward-thinking leadership that champions a dynamic culture where questioning the norm is not just welcomed but expected. This ethos empowers our team to consistently surpass customer expectations and drive the industry forward.   At Verus, we are more than just a company; we are a community that thrives on collaboration, growth, and taking...

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:   Job Description $2,500 Sign-On Bonus Payment Terms: $1000 paid after 30 days of employment, $1500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $29,000 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer...

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:   $2,500 Sign-On Bonus Payment Terms: $1000 paid after 30 days of employment, $1500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $29,000 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  · Tuition...

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:   $2,500 Sign-On Bonus Payment Terms: $1000 paid after 30 days of employment, $1500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $29,000 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  · Tuition...

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...

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:   $2,500 Sign-On Bonus Payment Terms: $1000 paid after 30 days of employment, $1500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $29,000 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  ·...