3110 claims processor jobs found

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...

   Human Resources Generalist Location: Fairlawn, Ohio or any of our OH offices (travel to Fairlawn, OH about 1-2 times per month) Employment Type: Full-Time, Hybrid Position Summary We are seeking a Human Resources Generalis t to support the day-to-day operations of the HR department while continuing to build and broaden their HR expertise. In this role, you will provide foundational support across employee relations, talent acquisition, onboarding, HR administration, HRIS maintenance, compliance, and employee experience. Acting as an approachable resource for employees and managers, you will help ensure HR programs and policies are administered consistently, effectively, and in alignment with company values. Working with the HR team, you will play an active role in talent development by helping coordinate university recruiting, attending career fairs, and supporting the day-to-day administration of our internship program. Additionally, you will support vital...

There's never been a better time to join NJM! With a nationally ranked reputation for outstanding customer service and a history that spans more than a century, NJM is a leading provider of worker's compensation, automobile, and homeowners insurance in New Jersey. Our MCS (Medical Claims Services) Medical Bill Processing Department has an opening for a Bill Processor and is seeking a candidate who has excellent communication skills as well as strong organizational and time management skills. Reporting to a Supervisor in Medical Claim Services Bill Processing, the Bill Processor (BP) is responsible and accountable for the timely audit and processing of medical bills. Timely and accurate processing is vital to ensuring that medical bills meet all regulatory timeframes. Schedule: Monday-Friday, specific hours are subject to selected start times between 8:00am-9:00am pending supervisory approval. Essential Duties and Responsibilities: Essential functions of this job are...

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...

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 We are seeking a talented Business Process Owner I (Mid-Level) to join the Life Claims Experience team, where you will contribute to owning and enhancing the operational delivery of the death claim experience within the Life Company's Claims department. This dynamic role offers a unique opportunity to influence how we...

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 We are currently seeking a talented Business Process Owner I to join the Life Claims Experience team who will champion and enhance the death claim experience within Life Company's Claims department. This is an exciting opportunity to shape how we deliver a seamless, empathetic, and efficient claims journey for our members...

Overview WTW’s Insurance Consulting and Technology (ICT) business is accelerating—and we’re seeking ambitious, high-energy actuarial consultants ready to help shape the future of insurance. As part of our market-leading client teams, you’ll contribute to a broad portfolio of high-impact engagements spanning reserving, pricing, capital modeling, data analytics, AI and advanced technology. You’ll begin by building deep technical expertise as an individual contributor, while a career in consulting will continuously expand your commercial and leadership capabilities—from financial and project management to budgeting, business development, client and colleague engagement, and the innovation and launch of next-generation solutions. About ICT and Our Actuarial Consulting Business ICT brings together forward-looking advisory expertise, industry-leading technology and software, and powerful analytics to help insurers turn complexity into opportunity. As a globally...

WTW is a leading global advisory, broking and solutions company that helps clients turn risk into a path for growth. With over 40,000 employees across 140+ countries, we design and deliver solutions that manage risk, optimize benefits, cultivate talent, and expand the power of capital. The Role We are seeking a strategic and commercially focused Sales Operations Business Partner to support growth across Corporate Risk & Broking (CRB) North America. This role sits at the heart of the business, partnering with regional and specialty leaders, as well as producers, to drive decision-making, performance and growth outcomes. As part of a broader North America Sales Operations team, this role will align to a defined portfolio of regions, specialties and/or producers, working alongside peers with similar remits. The successful candidate will act as a trusted advisor—owning growth insight, shaping planning activities, and enabling leadership to make informed decisions that drive...

Willis Towers Watson is seeking a Director, Affinity & Programs to lead the implementation and ongoing management of insurance programs and embedded distribution partnerships. This individual will serve as a pivotal team member for affinity partners while coordinating across broking, underwriting, compliance, operations, technology, and servicing team within WTW’s Select segment to deliver seamless insurance solutions. The ideal candidate is highly organized, operationally focused, and able to manage multiple complex initiatives simultaneously. This role will lead operational execution and ensure programs are aligned with Select’s processes, services, placement protocols, and technology model. Primary Responsibilities Program Strategy & Management •    Execute affinity and embedded insurance strategies across multiple industry verticals.  •    Build sustainable, scalable operating models in partnership with our Select segment that support long-term program growth....

DUTIES: SCOR Global Life Americas Reinsurance Company seeks AVP Actuary - Risk Management in Charlotte, NC, to establish enterprise risk management governance processes and controls. Analyze, quantify, assess and recommend mitigating factors for risks inherent in new business opportunities. Assist in prioritizing research projects. Communicate risk governance goals, highlight implementation risk and strategies for mitigation. Ensure buy-in to plans from key stakeholders (including product line management, pricing committee, SGLA corporate).  Participate in technical risk analytics projects. Ensure governance processes are followed in a timely fashion. Identify project risk and manage implementation hurdles early. Assist production of Risk Dashboards. Drive completion of ORSA/CISSA for regulated entities, including challenging management’s models and assumptions. Provide actuarial expertise in development of regulatory guidelines and reports including ORSA. Maintain...

This is an opportunity to join Ascot Group - one of the world’s preeminent specialty risk underwriting organizations. Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we’re bound by a common mission and purpose: One Ascot. Our greatest strength is a talented team who flourish in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way. The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our unique Fusion Model: Client Centric, Risk Centric, Technology Centric. Built to be resilient, Ascot maximizes client financial security while delivering bespoke products and world class service — both pre- and post-claims. Ascot...

Job Description Client Experience Representative Build the future with us Are you driven by the life insurance industry and eager to contribute to the purpose of a company that aims to help its clients feel confident and secure about their future? As a Client Experience Representative , you will play a key role in answering questions and providing customer assistance to all policyholders and agents regarding policy information via telephone, e-mail, fax, and occasionally in person. This position is a great opportunity to showcase your skills and fully realize your potential within a caring and trustworthy company. Here, people and their development are at the heart of our priorities, fostering an environment that encourages collaboration and innovation. What you’ll accomplish with us As a Client Experience Representative , you’ll be at the core of our mission. Here are the main responsibilities: Communicates with customers through inbound and outbound phone...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Contents Evaluator Associate PRIMARY PURPOSE : To evaluate content inventories and assist in the research of personal property claims. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Evaluates residential and commercial contents inventories on both a Replacement Cost and Actual Cash Value (ACV) basis. Finalizes inventory in preparation of reporting including: preparing enclosures, preparing letters, and making detailed notes for reporting purposes. Facilitates use of...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Complaints Handler Job Location: Ireland, remote working  Job Type: Permanent   Remuneration : Competitive salary taking into account skills, experience and qualifications   We have a fantastic opportunity for a Complaints Handler and can be based anywhere in Ireland. Are you passionate about delivering fair customer outcomes and driving continuous improvement? As a Complaints Handler, you will play a key role in investigating and resolving customer complaints in a timely, professional, and compliant manner. Working closely with customers and internal stakeholders, you will conduct detailed investigations, assess evidence, determine outcomes,...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Director Demand Generation & ABM, Integrated Marketing Strategy Job Description PRIMARY PURPOSE : The Director, Integrated Marketing Strategy & ABM leads the development and execution of integrated marketing campaigns that align brand, demand generation and account-based marketing (ABM) strategies to drive pipeline growth, executive engagement and strategic account penetration. This role partners closely with sales, business development,...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, Auto | General Liability | Bodily Injury | New Jersey Claims Required PRIMARY PURPOSE OF THE ROLE To investigate, evaluate, negotiate, and resolve complex general liability claims while ensuring excellent service delivery to clients and claimants. This role manages high-exposure claims, including litigated matters, with a focus on timely resolution, cost containment, and compliance with client and regulatory requirements. ESSENTIAL RESPONSIBILITIES...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims,...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Workforce Absence Team Lead - Claims Assistant Team PRIMARY PURPOSE :  To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure...