3528 claims processor 1 jobs found

Position Summary The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers’ Compensation, or disability.  May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned. Minimum Qualifications High school diploma or GED. Six months of experience processing health and welfare claims. Basic knowledge of benefits...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Processes and delivers incoming and outgoing mail per established procedures and deadlines. Enters data and check information into designated computer systems. Maintains confidentiality at all times. Performs all duties in a safe...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Processes and delivers incoming and outgoing mail per established procedures and deadlines. Enters data and check information into designated computer systems. Maintains confidentiality at all times. Performs all duties in a safe...

The Litigation Processor is responsible for providing clerical support to the General Claims Legal Department by reviewing, analyzing, and processing incoming complaints directed to the Company. Essential Duties and Responsibilities: Provide support to staff attorneys in processing complaints. Provide support to the PIP Litigation team in processing PIP arbitration demands. Provide support as needed to FNOL (First Notice of Loss) Dept in taking claims. Receive, analyze, and process complaints, determine type of lawsuit, and prepare investigation file accordingly.  Assign trail adjuster, submit complaint to staff attorney for review. Process various types of legal letters to defense firms and insureds. Maintain Legal Exchange (electronic billing site) by creating matters, closing matter and processing attorney invoices for payment. Periodic telephone communications with insureds, plaintiff counsel and defense firms regarding the status of legal pleadings....

The Cross Family of Agencies welcomes you. We need your talent and expertise. Personal Lines Processor A Personal Lines Processor is primarily responsible for processing documents related to personal lines insurance and providing administrative support to the Producers and Account Managers. Standard duties of a Personal Lines Processor include but are not limited to : Understanding and following the Cross Basic Procedure Manual. Understanding and following the Personal Lines Workflow Manual. Auditing transaction to ensure that the correct Action Codes are being used. Following up and completing open suspense’s daily. Running the download reports daily. Processing the download report which includes reviewing new business, endorsements, renewals, cancellations, and reinstatements for accuracy. Invoicing all types of download transactions. Mailing new business letters to clients. Entering claims acknowledgements as received. Following up on...

Title: Customer Service Claims Processor                                 Department: Customer Service Union: OPEIU 29                                                                               Grade: 17 Position Summary The Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides written, verbal or face-to-face customer service to members by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Resolves customer inquiries and complaints in a timely and accurate manner. Escalates issues as appropriate....

Title: Claims Processor Department: Claims Bargaining Unit: UFCW 555 Grade: 3 Position Type: Non-exempt Hours per Week: 40 Position Summary The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned. Minimum...

Job Description Are you looking for your next opportunity?   Sompo has a unique opportunity for a Sr. Claims Counsel, EPL in our US Employment Practices Liability (“EPL) Claims team.   This position handles Employment Practices Liability claims involving Commercial Management Liability and Financial Institutions Insureds and provides legal review and policy drafting support to Underwriting.   The successful candidate will be able to provide insight and analysis on complex high profile/high exposure US EPL claims.   Location: This position will be based out of our New York, NY office. We strive for collaboration which is why we offer a work environment where our employees thrive and develop long lasting careers. Our business, your impact, our opportunity: What you’ll be doing: Manage US Employment Practices Liability (EPL) claims, related systems, and processes, while evaluating exposures and making substantive claim decisions across EPL and other...

Company Farm Family Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description PURPOSE OF THE JOB: The Training & Development Specialist is responsible for leading the development and execution of various initiatives to support new and in-force business. This role manages the development and implementation of learning content, as well as identifying strategies that ensure success within the department and enhance the experience of our audience.   ESSENTIAL FUNCTIONS: Develop, direct, record and implement formalized training programs for entry level and current partner training programs, activities, and continuous development efforts. Delivers web based and in-person trainings, including all support...

Company Farm Family Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description PURPOSE OF THE JOB: The Training & Development Specialist is responsible for leading the development and execution of various initiatives to support new and in-force business. This role manages the development and implementation of learning content, as well as identifying strategies that ensure success within the department and enhance the experience of our audience.   ESSENTIAL FUNCTIONS: Develop, direct, record and implement formalized training programs for entry level and current partner training programs, activities, and continuous development efforts. Delivers web based and in-person trainings, including all support...

Position Title Branch Banking Client Consultant II   Location Forest Hills, NY 11375   Job Summary Branch Banking Client Consultant II provides best in class experience by resolving concerns and providing various product details that focus on meeting the financial needs of our clients. Focuses on client management, client retention, and introductions to key bank partners (Mortgage, Business Banking) to ensure our clients have access to experts who can help them achieve their financial goals. This position will have greater lending and basic investment interactions and will participate in more complex banking conversations with clients.   Job Responsibilities:   Sales Performance : Support team efforts to achieve growth targets in financial performance (outstanding deposits, outstanding loans, non-interest income) and primary client acquisition. Actively   seek   and deliver the right client introductions to the right team member(s) to achieve growth...

At Swyfft, we're reshaping the way home insurance and commercial package products are priced and bound. We've created an insurance experience that's smart, instant, and designed to deliver unparalleled customer service. Our focus on lightning-fast quotes and seamless claims servicing is powered by cutting-edge technology and an Agent and Customer-centric approach that sets us apart in the industry. Joining Swyfft means becoming part of a dynamic team of forward-thinkers who thrive on moving fast and delivering exceptional products. We pride ourselves on fostering an environment where creativity and positive energy thrive. As we continue to grow and expand, we're on the lookout for experienced professionals like you to join us in transforming the insurance landscape. If you're passionate about leveraging technology to provide the best customer service experience and are ready to be a part of our journey, we welcome you to explore opportunities at Swyfft!...

We’re thrilled that you are interested in joining us here at the Amynta Group! At BTIS “Be Great” isn’t just our motto — it’s how we show up every day. As a leading commercial insurance MGA, we’re committed to delivering excellence to our retail agency partners and building strong, collaborative relationships with our carrier partners. The BTIS Workers Compensation department is currently looking for an Associate who shares our drive for greatness. In this role, you’ll play a pivotal role in the success of our New Business Underwriting Team. What You’ll Do: Underwriting : Evaluate and underwrite Workers’ Compensation new business submissions, following underwriting guidelines and performance metrics to ensure accurate and timely processing. Customer Support : Assist customers with policy-related inquiries via phone, and email - providing prompt, professional, and solutions‑focused service. Review & Analyze: Underwriting alerts, carrier bureau criteria, and...

Overview We are seeking a highly motivated Technical Lead / Lead Software Engineer to join our team. In this role, you will be a part of shaping Guardian’s most critical customer-facing digital experiences, utilizing various frameworks such as React, Next and Node. This position requires technical familiarity with building scalable, performant web applications in AWS, working collaboratively with a team of engineers, collaborating with business leaders, UI/UX, data and leadership to create best-in-class experiences for our customers. What you will get to do: Be Creative - have the freedom to innovate, modernize and create technical solutions to solve complex business problems Be Collaborative - work with product and design to deliver robust user experiences. Be Precise - understand the business goals behind every feature and create a solution that can deliver Be Awesome - launch products that you can be proud of What you bring to the table: 10+ years of...

Position Summary     Do you want to be part of a collaborative Agent Contracting &   Licensing   (AC&L)   team? Are you self-motivated, able to multi-task across several responsibilities and   possess   high quality interpersonal skills to effectively communicate with the field and business partners? Do you   lead with   a growth mindset? Do you challenge the status quo and take   incentive   to tackle   new problems ? Is a culture where “People Count,” “We Do the Right Thing,” and “We Hold Ourselves to Very High Standards” important to you ?     Are you skilled in a consumer-centric mindset?   If so,   then you may be a great fit for this CARE Specialist position   accountable for   delivering   exceptional   consumer experiences   through the work that we do .       CARE expresses the emotion we want to generate, and   it’s   also an acronym for Communicate, Advocate, Respond, and Empower –...

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℠. Position Responsibilities Ensure compliance with all local, federal and state regulations related to claims while minimizing risk/exposure to the Arch organization. Provide technical expertise and oversight to TPA adjusters handling workers compensation, auto liability & general Liability claims which also include handling and supervision of outsourced claims. Work with our TPA’s to ensure proper claims handling and service delivery, this includes Performing claims oversight on claims with an expected value of over $50,000 for guaranteed cost policies and at 50% of the retention for deductible and self-insured business Attend mediations and trials. Granting reserve 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℠. Position Summary The Auto Claims Examiner – Property Damage is responsible for the investigation, evaluation and resolution of commercial automobile claims involving property damage. You will be Arch’s point of contact with customers – directing and making decisions regarding the repair process from beginning to end. Managing your own inventory while working independently, you’ll work closely with body shops and others to negotiate repair pricing and assess liability. Ideal candidates will possess leadership and conflict management skills, along with strong attention to detail and a passion for providing excellent customer service. The ideal candidate is customer and technically...

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℠. The position is in the Actuarial Reserving department.  The employee would assist in reserving all lines of business, financial reporting, and special projects.  Special projects include pattern reviews, line of business studies, retrocession submissions, and opportunities to improve processes.  Frequent collaboration with underwriting, claims, legal, and finance departments would occur. Responsibilities Coordinate and maintain detail loss development triangles for all lines of business Develop and monitor multiple loss development factors Analyze loss characteristics Solve complex problems and develop innovative approaches with minimal supervision Build and refurbish tools 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℠. The Reserving Innovation & Data team is an exciting new opportunity within the broader Reserving and Loss Analytics team at Arch.  Its mission is to elevate how data and analytics are leveraged across Reserving.  The team will serve as both a center of expertise and a catalyst for innovation, efficiency, and more sophisticated analytics across the entire Reserving team. The VP, Reserving Innovation & Data, will play a critical role in shaping this function.  They will provide technical strategic leadership, champion best data practices, and optimize resource utilization to deliver scalable, high-quality data/analytical solutions.  They will be a key member of the Actuarial...

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℠. The position is in the Actuarial Reserving department.  The employee would assist in reserving all lines of business, financial reporting, and special projects.  Special projects include pattern reviews, line of business studies, retrocession submissions, and opportunities to improve processes.  Frequent collaboration with underwriting, claims, legal, and finance departments would occur. Responsibilities Coordinate and maintain detail loss development triangles for all lines of business Develop and monitor multiple loss development factors Become expert on one or more lines of business for reserving and annual assumption review Analyze loss characteristics Manage complex...