328 claims analyst i jobs found

Claims Analyst I Who we are American International Group, Inc. (AIG) is a leading global insurance organization. AIG member companies provide a wide range of property casualty insurance in approximately 70 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets and manage risks. We’re also committed to making a positive difference for our colleagues and in the communities where we work and live. We encourage colleagues to give back to the causes they care most about, supporting these efforts through our Volunteer Time Off and Matching Grants Programs. Get to know the business General Insurance is a leading provider of insurance products and services for commercial and personal insurance customers. It includes one of the world’s most far-reaching property casualty networks. General Insurance offers a broad range of products to customers through a diversified, multichannel...

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 Lead Business Operations Analyst for Claims Workforce Analytics, you will have a strong focus on workforce analytics, requiring consistent delivery of reporting, effective packaging of that information, and confident presentation of findings. This position demands a candidate who can function akin to a Project Manager,...

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 Business Operations Analyst Senior, you will consult with the business to understand and define opportunities and recommend solutions by analyzing data and providing key insights to inform decisions. Provide subject matter expertise on all matters of business analytical or operational data needs. Work closely...

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 investigating and confirming the facts of loss for basic to advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. We are looking for an experienced Auto Adjuster to join our Northeastern team. The ideal candidate will have a strong background in auto liability and coverage evaluation. If you're ready to plant your roots with a stable organization and supportive team, we’d love to hear from you! Our team is open to candidates in the Eastern or Central time zone states. Key...

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 investigating and confirming the facts of loss for basic to advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. We are seeking an Auto Adjuster to join our growing team! In this role, you’ll be responsible for investigating and verifying the details of automobile accidents, including obtaining police reports, collecting witness statements, confirming coverage, and determining liability. The ideal candidates are detail-oriented, enjoy investigative work, and are passionate about helping others...

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 investigating and confirming the facts of loss for advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Candidates local to our office in Ontario, California will start and train in-office. Hybrid/remote options available within 6-12 months. Every claim presents a new challenge. This role is ideal for someone who enjoys problem-solving, analyzing information, and making confident decisions while supporting customers and internal partners. Key Responsibilities • Applies increased...

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 investigating and confirming the facts of loss for advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Every claim presents a new challenge. This role is ideal for someone who enjoys problem-solving, analyzing information, and making confident decisions while supporting customers and internal partners. Key Responsibilities • Applies increased experience in the Adjuster II level or a rotation into a specialty position (Coverage, Investigation Specialist, Total Loss, Initial Handler,...

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 This role is responsible for investigating and managing non-attorney represented bodily injury claims from initial report through resolution. You will evaluate coverage, determine liability, assess damages, and negotiate claims within your level of authority. In this role, you will work directly with customers to gather information, explain the claims process, and provide a clear and supportive experience. You will also identify potential subrogation or fraud and partner with internal teams to achieve the best outcome. We are seeking an Experienced Bodily Injury Adjuster to join our team supporting...

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 This role utilizes analytical skills to create a comprehensive estimate of damages for 1st and 3rd party material damage claims leading to the proper disposition. National General is seeking an Auto Damage Estimator responsible for writing accurate and timely auto repair estimates while delivering a high-quality service. This role requires strong time management skills, proficiency in CCC ONE estimating software, and keen attention to detail. Preferred candidates are located in Eastern or Central time zones . Key Responsibilities • Applies thorough understanding of regulatory compliance...

The Setup Team Lead is responsible for assisting and supporting the Setup Supervisor with ensuring the Setup Team meets protocol. This role will assist with supervisory functions when the Setup Supervisor is absent. The Setup Team Lead is responsible for ½ production. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Must maintain ½ production quota Organize and distribute claims according to established priority Provide guidance to analysts, aiding with resolution of problems or questions Process complex/problematic claims according to protocol Maintain production standards and production requirements Comply with standard protocol for processing problem claims Function as liaison between analysts and clients Professionally communicate with other offices and internal departments Train new team members Assist co-workers, supervisor and management in accomplishing production goals Maintain HIPAA compliance in all aspects of...

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 investigating and confirming the facts of loss for advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. We are seeking an Auto Adjuster to join our organization and support claims across the Northeastern region. This is a fully remote position with a 12:00 p.m.–9:00 p.m. EST schedule. The team manages a variety of auto claims with lower policy limits, with some potential exposure to MMR. If you’re looking for an afternoon shift and are eager to grow your career in the auto insurance field, this...

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 investigating and confirming the facts of loss for basic to advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. *** We’re seeking experienced Auto Adjusters to join our growing team. In this role, you’ll investigate automobile claims by reviewing police reports, gathering witness statements, verifying coverage, and determining liability. The ideal candidate is detail-oriented, analytical, and committed to helping customers navigate challenging situations with confidence and care. ***...

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.  Join an analytics team within the Property & Casualty Claims department that helps bring data to life through visualizations and analysis. In this role, you’ll partner directly with Claims leaders to understand business needs and deliver analytics, dashboards, and data solutions that influence operational decisions and strategic initiatives. Ideal candidates are eager to learn Looker, SQL, insurance analytics, and enterprise data processes in a collaborative team environment. We are seeking someone with a curiosity and desire to learn traditional analytics and explore AI enabled analytics. This position enjoys a flexible, hybrid work schedule of 2 days per week in our Chicago, IL...

The Procurement Analyst plays a critical role in supporting Enhanced Bill Review Programs by securing essential medical documentation, including itemizations and medical records needed to process claims accurately and efficiently. This position involves proactive outreach to providers, managing inbound inquiries, and ensuring all documentation meets quality and compliance standards, including HIPAA regulations. The Procurement Analyst is detail-oriented, organized, and thrives in a fast-paced environment where meeting production goals and collaborating with team members are key to success. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Spend approximately 80-85% of the shift making outbound calls to providers to obtain required information; may also send email or fax requests Respond to inbound calls regarding claim status and related inquiries Maintain accurate records of all communications between the company, providers, and...

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 This role is remote eligible in the continental U.S. with occasional business travel. However, individuals residing within 60 mile radius of a USAA office will be expected to work on-site 4 days per week. We have multiple exciting opportunities available on our Modeling Factory and Insights & Development teams. As...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned KNOWLEDGE & SKILLS: Ability to work independently...

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits Utilize applicable tools and resources to complete internal audits and/or appeals Timely completion of internal audits and/or appeals Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and analytical skills for...

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits Utilize applicable tools and resources to complete internal audits and/or appeals Timely completion of internal audits and/or appeals Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and...

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 Business Rules Analyst Lead, you will lead in facilitating business requirements by means of design, workflow analyses and facilitated discussions with end users. Detailed understanding of supported technology to both manage and facilitate business needs when required. Translates users' business requirements for...

The Repricing Quality Assurance Analyst is responsible for reviewing, analyzing, and monitoring repricing audit data across multiple platforms to ensure accuracy, compliance, and efficiency. Works closely with internal teams to maintain contractual and organizational standards, enhance operational effectiveness, and improve client satisfaction. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify and resolve quality issues within repricing processes Develop and implement QA policies and procedures Monitor compliance with pricing guidelines and contractual requirements Investigate repricing discrepancies and apply corrective actions Prepare QA reports and documentation Collaborate with stakeholders to align quality objectives Provide training and guidance on repricing standards Conduct risk assessments to mitigate potential errors Maintain confidentiality of client data, PHI, and PII Additional duties as assigned...