47 claims representative jobs found in Philadelphia, PA

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 Representative (IAP) - Workers Compensation Training Program | Marlton, NJ Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? A stable and consistent work environment in an office setting. A training program to learn how to investigate and resolve complex situations for employees and customers from some of the world’s most reputable brands. Career development and promotional...

Foundation Risk Partners , one of the fastest growing insurance brokerage and consulting firms in the US, is adding a Customer Service Advocate to their Corporate Synergies team in Philly Metro Region.  Job Summary: The Benefits VIP Representative handles claims resolution, benefits inquiries, coverage eligibility concerns, and other related issues for our clients' administrators and employees. They work closely with clients and carriers via phone and email to resolve matters within a 24-hour timeframe. Essential Functions: •     Address client employee insurance concerns, answer benefit-related questions, and assist with claims resolution, patient advocacy, and pre-certifications. •    Educate client employees on optimal benefit utilization and provide guidance on cost-effective plan options. •    Maintain detailed records of client interactions, entering data into Salesforce and generating client analysis reports as necessary. •    Use Salesforce to gather...

The Customer Service Representative plays a vital role in supporting the Workers’ Compensation department by managing inbound and outbound calls and providing exceptional service to claimants and internal teams. This entry-level position is ideal for individuals looking to start a career in insurance, claims management, or customer service within a professional environment. You will assist claim adjusters by addressing inquiries, clarifying information, and ensuring accurate communication between all parties. Training will be provided to help you succeed and grow in this role. This role is available for remote or hybrid work arrangements.  ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Answer and return inbound and outbound phone calls promptly and professionally. Review claim history in the system and provide accurate information to callers. Collaborate with claim adjusters to clarify details and resolve inquiries. Document interactions and maintain accurate records...

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. 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 all employees feel included, empowered, and enabled to perform at their best. Heritage Insurance Services, a member of TCP LLC, a fully owned subsidiary of Great American Insurance Group, is seeking a  Commercial Lines Account Representative. Heritage Insurance is an insurance affiliate of American Financial Group, the parent company of Great American...

Job Description About Acrisure A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more.  In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible. Job Summary:  The Employee Benefits Account Executive is responsible for managing a book of business, policy quotes and carrier liaison for assigned clients/groups. Regularly interacts with new and existing clients while being responsible for devising creative...

Job Title: Client Advisor - Commercial Lines Agency/Platform: Mid-Atlantic Platform Locations: Wayne, PA - Philadelphia, PA - Pittsburgh, PA, Clearfield, PA - Dubois, PA, Erie, PA - Annapolis, MD - Washington DC - About Acrisure: Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters, including Insurance, Reinsurance, Cyber Services, Mortgage Origination and more. Acrisure employs over 17,000 entrepreneurial colleagues in 21 countries and have grown from $38 million to $4.3 billion in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win. Job Summary: As an Acrisure Sales Professional, you will play a lead role in growing revenue and...

About Acrisure: Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters, including Insurance, Reinsurance, Cyber Services, Mortgage Origination and more. Acrisure employs over 17,000 entrepreneurial colleagues in 21 countries and have grown from $38 million to $4.3 billion in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win. Job Summary: As an Acrisure Sales Professional, you will play a lead role in growing revenue and maximizing business opportunities with total client selling. Your focus will be on driving new business acquisition, fostering client relationships, and expanding Acrisure’s footprint within the insurance marketplace as well as...

The MCS department is searching for a PIP Claims Assistant . The PIP Claims Assistant reports directly to the PIP Administrator/Supervisor, the PIP Claims Assistant supports the PIP Department by performing assigned claim functions and tasks. The position requires the assistant to work and communicate with the PIP Claims Representatives, PIP Supervisors, and other team members. The position also interacts with NJM policyholders, associated injured parties or their legal representatives, medical providers, and other departments within NJM, as needed. Hours Monday-Friday, specific hours are subject to selected start time between 8am-9am pending supervisory approval. Hybrid opportunity after training is completed (3 days in office, 2 days remote) Essential Duties and Responsibilities: Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and...

The First Notice of Loss Associate serves as the first point of contact for policyholders, claimants or other parties reporting claims. They are responsible for addressing customer inquiries concerning the claim process and collecting essential details about the incident, to accurately and efficiently establish new Auto, Property and Commercial claims. Schedule: Monday to Friday (10:45am-7pm) and 1 Saturday a month (8:30am-4:30pm)   Essential Duties and Responsibilities: Receive initial reports of loss or damage from policyholders, claimants or other parties. Accurately process information into the system for assignment to an adjuster. Address customers’ questions and concerns related to the claims process and procedures and offer clear instructions on the next steps. Determine appropriate coverage and complete necessary follow-ups in a timely manner. Navigate systems with proficiency to access appropriate information to service callers. Perform additional...

The First Notice of Loss Associate serves as the first point of contact for policyholders, claimants or other parties reporting claims. They are responsible for addressing customer inquiries concerning the claim process and collecting essential details about the incident, to accurately and efficiently establish new Auto, Property and Commercial claims.   Tuesday to Saturday (8:15am-4:30pm). This includes a 5% shift differential. Essential Duties and Responsibilities: Receive initial reports of loss or damage from policyholders, claimants or other parties. Accurately process information into the system for assignment to an adjuster. Address customers’ questions and concerns related to the claims process and procedures and offer clear instructions on the next steps. Determine appropriate coverage and complete necessary follow-ups in a timely manner. Navigate systems with proficiency to access appropriate information to service callers. Perform additional duties...

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. 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. Essential Duties and Responsibilities: Accurately audit and process standard medical bills for routine procedures within statutory timeframes, by following medical coding guidelines and department policies and procedures Verify correct payee and provider information and...

NJM Insurance Group, is a leading mid-sized U.S. property and casualty insurance company with 90 consecutive years of A+ financial strength ratings by AM BEST. Due to exceptional employee experience, NJM has been included on the latest Forbes List of Best Employers in New Jersey for the fourth year in a row. The NJM reputation for being a top provider of outstanding customer service was reaffirmed by the most recent J.D. Power Auto Insurance Claims Survey. Over the last five years, the Company has focused on a strategic plan that calls for it to become a regional property & casualty insurer and has transitioned away from its affinity-based membership model. To that end, the Company has added an independent agency model for new lines of middle and large commercial and has more than doubled its product offerings. NJM now offers its various products to businesses across New Jersey, Pennsylvania, New York, Maryland, Delaware, and Connecticut. Celebrating its 110-year...

Do you have a passion for customer service? Are you looking for a company that offers you more? Come talk to NJM Insurance Group, a 6 - time recipient of the Forbes Best Employers in New Jersey about joining our Contact Center! Join a best-in-class team that has been certified by J.D. Power for providing personal lines customers with an exceptional Auto Claims Experience - 7 years in a row ! Our Contact Center team enjoy: Salary begins at $51,120.55 with the potential to earn more if you are licensed with experience (Salary is commensurate with experience and credentials) Company paid training and professional state licensure. Potential annual bonus incentive worth up to 7.5% of your first year’s base salary Hybrid work schedule once training is completed An outstanding benefits package (outlined below), including a 401k with a dollar for dollar match up to 8% The Opportunity NJM is seeking talented, friendly customer service orientated...

Join NJM Insurance Group’s Medical Claim Services (MCS) team as a Business Process Operations Analyst, where you will play a key role in driving process improvement and support business continuity and technology initiatives. The primary purpose of this role is to provide consistent support to business users in both technology and non-technology operations, including incident management, production support, and departmental activities and assist in the seamless operationalization of new processes and technology solutions, ensuring smooth transitions and effective change management for business users. This position requires subject matter expertise (SME) in Personal Injury Protection (PIP), Workers’ Compensation, and/or General Claims. The ideal candidate will have a strong understanding of current business processes and the ability to identify, design, and implement effective improvements. Essential Duties and Responsibilities: Support Strategic Plan, Leadership, and...

New Jersey Manufacturers Insurance Company (NJM) was founded in 1913 by a group of manufacturers seeking to provide cost-effective, safety conscious and financially secure workers' compensation insurance for their workers. From inception the Company has operated as a mutual, with a focus on the needs of its policyholders. Today, NJM Insurance Group, is a leading mid-sized U.S. property and casualty insurance company with 90 consecutive years of A+ financial strength ratings by AM BEST. Due to exceptional employee experiences, NJM has been included on the latest Forbes List of Best Employers in New Jersey for the fourth year in a row. The NJM reputation for being a top provider of outstanding customer service was reaffirmed by the most recent J.D. Power Auto Insurance Claims Survey. Over the last five years, the Company has focused on a strategic plan that calls for it to become a regional property & casualty insurer and has transitioned away from its...

The Personal Lines Claims Specialist, Senior appropriately manages and resolves bodily injury claims across multiple states, and if necessary, through the litigation process.  This includes contacting insureds, claimants, attorneys, witnesses and other carriers, and investigating, negotiating, and settling claims based on company guidelines and applicable law, as well as securing and maintaining required licenses. This position could be filled at the Level II or Senior Level, based on skills and experience. Essential Duties and Responsibilities: Initiate appropriate action to conclude all clams in a manner consistent with existing law, licensure and company guidelines Conduct ongoing review independently and with supervisor of all assigned files focusing on adequacy of reserves and required investigation Communicate effectively with trial counsel and prepare required reports necessary for evaluation and conclusion of litigated claims Investigate, review, analyze, and...

New Jersey Manufacturers Insurance Company (NJM) was founded in 1913 by a group of manufacturers seeking to provide cost-effective, safety conscious and financially secure workers' compensation insurance for their workers. From inception the Company has operated as a mutual, with a focus on the needs of its policyholders. Today, NJM Insurance Group, is a leading mid-sized U.S. property and casualty insurance company with 90 consecutive years of A+ financial strength ratings by AM BEST. Due to exceptional employee experience, NJM has been included on the latest Forbes List of Best Employers in New Jersey for the fourth year in a row. The NJM reputation for being a top provider of outstanding customer service was reaffirmed by the most recent J.D. Power Auto Insurance Claims Survey. Over the last five years, the Company has focused on a strategic plan that calls for it to become a regional property & casualty insurer and has transitioned away from its affinity-based...

Reporting directly to the Medical Management Supervisor, the Workers' Compensation (WC) Case Manager supports the WC Department by following the best practices associated with managing of the injured worker effectively and efficiently. The position requires the nurse to work and communicate with other members of the Medical Management team in addition to the WC Claims team, WC Claims Supervisors, and other team members. The WC Team Lead also interacts with the associated injured parties or their legal representatives, medical providers, and other departments within NJM, as needed. The official NJM job title is Medical Management Coordinator. Essential Duties and Responsibilities: Demonstrate knowledge, skills, and competency in the application of case management standards of practice. Develop and provide ongoing support of the rehabilitation plan through comprehensive assessment, planning, implementation, and overall evaluation of individual claimant needs.  Facilitate...

The Subrogation Claims Rep II is responsible for analyzing and conducting investigation of all assigned files for recovery and resolution of subrogation claims utilizing effective negotiation skills of liability and damage disputes. Responsibilities: Receive and process subrogation claims, seeking recoveries from adverse parties and/or their insurance carriers. Thoroughly review, evaluate and investigate subrogation claims to obtain necessary information for prompt resolution. Negotiate subrogation claims and resolve liability and/or damage disputes for successful recoveries.  Efficiently credit recovery checks and issue deductible payments to our insured. Claims are settled and negotiated based on company guidelines and applicable state negligence laws. Professionally respond and communicate on all subrogation related issues. Provide excellent customer service to our policyholders. Comply with department procedures and metrics. Required Qualifications: Minimum...

Our Commercial Lines department is seeking a Premium Auditor with strong organizational and time management skills. The field auditor will be responsible for performing audits of Commercial Lines policies in accordance with company, industry and government rules and regulations in order to establish appropriate classifications, exposures, and basis of premium for each insured in. This position will cover Middlesex, Somerset and Union County. Essential Duties and Responsibilities: Conducting Premium Audits on Commercial Lines policies, which can include multi-state and/or multi-line policies. Performing a thorough review of the policyholder’s records to identify the insured’s exposures to the coverage provided. Verifying employer classes, claimant information, tax identification numbers, and payroll for the audit period, as well as other appropriate information required to ensure a complete and thorough audit. Documenting and processing the audit to explain deviations...