108 claims service specialist i jobs found

The Senior Indemnity 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 is a remote position. 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 Coordinates early return-to-work efforts...

The Senior Claims Indemnity 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 is a remote position. 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 Coordinates early return-to-work efforts...

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. National General is seeking an Unrepresented Bodily Injury Consultant (IHBI). The ideal candidate is located in the EST or CST time zones. Who is a self-motivated professional with strong time management skills, capable of working independently while effectively prioritizing tasks. Exceptional customer service, organizational abilities, and attention to detail are essential. Key...

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of the Claims Department and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established 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 more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of...

Job Description: We are looking to add a Subrogation Specialist to join our Creative Risk Solutions team in West Des Moines, IA . In this role, you’ll dig into the details, uncover liability, and drive meaningful financial impact for our clients—all while growing your career with a forward‑thinking claims team. Creative Risk Solutions, a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. Essential Responsibilities: Identify subrogation and salvage opportunities on automobile, work comp, and general liability claims. Coordinate subrogation efforts against at-fault parties and their insurance carriers. Submit arbitration applications for collections and respond to arbitrations defending...

Job Description: We are looking to add a Subrogation Specialist to join our Creative Risk Solutions team in West Des Moines, IA . In this role, you’ll dig into the details, uncover liability, and drive meaningful financial impact for our clients—all while growing your career with a forward‑thinking claims team. Creative Risk Solutions, a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. Essential Responsibilities: Identify subrogation and salvage opportunities on automobile, work comp, and general liability claims. Coordinate subrogation efforts against at-fault parties and their insurance carriers. Submit arbitration applications for collections and respond to arbitrations defending...

Job Description: We are looking to add a Sr. Client Service Consultant to join our Property Casualty team in Kansas City, MO . Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: Take ownership and lead accounts by servicing the largest and most complex accounts; Client Service Specialist and Client Service Consultant support dependent upon account size. Demonstrates exceptional customer service and operates as an effective partner with clients to include, but not limited to: Market renewal policies and negotiate with insurance company underwriters; Reviews insurance in place and assesses future needs of client; Evaluates and recommends insurance options for clients; Maintains an awareness of complex or significant claims situations and assists in claims process management as requested, to ensure client claim issues are...

Job Responsibilities and Requirements Obtains and analyzes information to make claim decisions and payments of Short Term Disability (STD) claims.  The goal of the position/role is to consistently pay the accurate amount for each claim in accordance with the contract. Research Applies knowledge of disability products, policies and contracts. Interprets and applies contract/policy definitions of disability and relevant provisions, clauses, exclusions, riders and waivers as well as statutory requirements. Utilizes reference materials and tools regarding medical, vocational and disability issues to identify and evaluate claim information in a fair and objective manner. Efficient use of applicable disability claims system(s). Applies routine medical and technical claims skills, practices, and procedures. Utilizes most efficient means to obtain claim information. Analysis and Adjudication Fully investigates all relevant claim issues. Provides...

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 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...

CorVel leverages proprietary software to deliver claims management, bill review, and case management services. The Product Support Specialist II provides advanced application support for CorVel’s proprietary systems. This role focuses on diagnosing, troubleshooting, and resolving complex application issues while adhering to established policies and procedures.          The Product Support Specialist II works under general supervision, demonstrates strong problem-solving skills, and takes initiative to expand technical knowledge as systems and technologies evolve.   This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Troubleshoot and resolve application issues submitted through ServiceNow by field offices and business users, ensuring timely resolution and high user satisfaction Provide professional, effective support via ServiceNow, email, and phone Serve as a subject-matter expert for CorVel proprietary applications and ServiceNow ITSM processes...

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 is a remote position. 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 Coordinates early return-to-work efforts with the...

Job Description: We are looking to add a Sr. Workers’ Compensation Claims Specialist, Supervisor to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in multiple states . This team member will provide high quality claims handling oversight and expertise for all CRS customers on litigated and complex claim situations. This includes assisting staff supervised with investigating, communicating, evaluating, and resolving claims utilizing the CRS Best Practice of Claim Handling. Assisting claim staff with goals, career pathing, and ensuring engagement. Essential Responsibilities: Claims Management: Adjudicate claims during staffing shortages, investigate, and negotiate settlements per “Best Practices for Claims.” Monitor and document claim files, focusing on Coverage, Investigation, Reserves, Plan of Action, Legal, and Medical Management. Recommend adjustments as needed. Research and respond to questions and complaints...

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:   Why Choose a Career with the AAA The Auto Club Group (ACG) Established brand that has been around for over 100 years.  Our members know and trust us! Branch Offices house travel, membership, insurance sales and support employees You will be challenged to drive new business with competitive products and help retain The Auto Club Group's 14+ million members. Excellent Opportunities to Build a Career Path: The Member Representative can be the start of a long-term career with The Auto Club Group.   Your position could lead to a rewarding career and opportunities to grow and pursue other ACG roles such as:  Other Branch positions – Field Insurance Sales Agent, Travel Agent or Other Departments such as: Call Centers (ERS, Sales and Service,...

The Pharmacy Specialist will work to support people who have been injured on the job. This role will respond to departmental inquiries regarding pharmacy benefits for pharmacy lines of business. The Pharmacy Specialist works closely with pharmacies, claims adjusters, providers, claimants and other CorVel offices to quickly and professionally answer questions. This position is not quota driven, nor is this a “scripted” position. This role requires a service minded individual, active listening and pro-active problem solving skills to be successful. The Pharmacy Solutions team hours are 8 a.m. to 11 p.m., Monday through Friday.   This is a remote role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Answer pharmacy calls and e-mails in a prompt, friendly and professional manner Assure escalated issues are referred to the management team Consult with claims adjusters regarding medications and pharmacy eligibility Utilize proprietary programs to track inquiries and enter...

We are adding a Senior Claims Specialist   to our team! Who We Are: Since 1909, National Guardian Life Insurance Company (NGL) has been one of America’s most successful and highly rated independent life insurance companies. We specialize in a suite of innovative products for life’s journey, giving people the financial stability, careful guidance and peace of mind to lead a life filled with confidence, dignity and grace.   NGL's Core Values – integrity, dependability, collaboration, compassion and growth are a foundation of our company and help to build on the interactions we have with our policyholders, partners, funeral homes and each other. We believe in creating an inclusive, welcoming environment for all where diversity is celebrated, and everyone is encouraged to live their best, most authentic self. We offer  Employee Resource Groups for employees to get involved, learn, network, and offer professional and personal development opportunities. With...

The CareIQ Intake Specialist provides administrative customer service assistance to claimants, providers, and claims management by receiving and entering new ancillary healthcare referrals. Utilizing proprietary systems and knowledge from training, a CareIQ Intake Specialist will provide excellent telephonic and written customer service to both inbound and outbound customers. A CareIQ Intake Specialist operates with a high focus on accuracy and urgency to ensure that service orders are received quickly in alignment with the claimant and customer needs. This is a remote role. The work schedule for this role is Monday - Friday: 2:30 PM - 11:00 PM EST. ESSENTIAL FUNCTIONS & RESPONSIBILITES: Provides quality and friendly telephonic customer service in an inbound and outbound high-volume call-center environment Completes accurate data entry and review Able to learn and operate corporate proprietary systems Enters assigned electronic (email/fax/data feed) orders...

The CareIQ Intake Specialist provides administrative customer service assistance to claimants, providers, and claims management by receiving and entering new ancillary healthcare referrals. Utilizing proprietary systems and knowledge from training, a CareIQ Intake Specialist will provide excellent telephonic and written customer service to both inbound and outbound customers. A CareIQ Intake Specialist operates with a high focus on accuracy and urgency to ensure that service orders are received quickly in alignment with the claimant and customer needs. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITES: Provides quality and friendly telephonic customer service in an inbound and outbound high-volume call-center environment Completes accurate data entry and review Able to learn and operate corporate proprietary systems Enters assigned electronic (email/fax/data feed) orders into coordination system Ensures all case stakeholders are updated regularly...

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 a Bodily Injury Extended Handler Adjuster to join our growing team. The ideal candidate will have a 2+ years of experience handling attorney-represented bodily injury claims. This role manages claims across the Northeastern states, with exposure ranging from soft tissue injuries to fracture claims. Litigation experience is not required. Experience with Colossus is preferred....

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established 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 more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of claims...