62 special investigator sr jobs found

Creates and maintains an ongoing awareness on the part of all claim file handlers toward recognition of "red flags" in claim cases, leading to the detection, investigation and mitigation of potentially fraudulent and/or inflated claims. Performs a variety of duties and responsibilities to bring about resolution, compromise, denial and/or prosecution of fraudulent claims. Is accountable for controlling costs for contracted activities. The ideal candidate's preferred location is in Eastern Pennsylvania, with travel required throughout the state and others. What You’ll Do: As a Special Investigator Sr with Sentry, you will create and maintain an ongoing awareness on the part of all claim file handlers toward recognition of suspect behavior in claims cases, leading to the detection and resolution of potentially suspect/inflated claims. In addition, you will… Investigate moderate to complex claims both inside and outside the office, to identify suspect or inflated claims...

Creates and maintains an ongoing awareness on the part of all claim file handlers toward recognition of "red flags" in claim cases, leading to the detection, investigation and mitigation of potentially fraudulent and/or inflated claims. Performs a variety of duties and responsibilities to bring about resolution, compromise, denial and/or prosecution of fraudulent claims. Is accountable for controlling costs for contracted activities. This ideal candidate's preferred location for this position is in or around the Tampa, Fl area with travel required in and around Tampa. What You’ll Do: As a Special Investigator Sr with Sentry, you will create and maintain an ongoing awareness on the part of all claim file handlers toward recognition of suspect behavior in claims cases, leading to the detection and resolution of potentially suspect/inflated claims. In addition, you will… Investigate moderate to complex claims both inside and outside the office, to identify suspect or...

Creates and maintains an ongoing awareness on the part of all claim file handlers toward recognition of "red flags" in claim cases, leading to the detection, investigation and mitigation of potentially fraudulent and/or inflated claims. Performs a variety of duties and responsibilities to bring about resolution, compromise, denial and/or prosecution of fraudulent claims. Is accountable for controlling costs for contracted activities. The ideal candidate's preferred location is in or around the Nashville, TN or Memphis, TN with traveled required in and around those areas. What You’ll Do: As a Special Investigator Sr with Sentry, you will create and maintain an ongoing awareness on the part of all claim file handlers toward recognition of suspect behavior in claims cases, leading to the detection and resolution of potentially suspect/inflated claims. In addition, you will… Investigate moderate to complex claims both inside and outside the office, to identify suspect or...

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:   Salary Job Description:   Sr Claim Specialist - Medical Management Unit – The Auto Club Group   What you will do: The Auto Club Group is seeking prospective  Senior   Claim Specialists  who can work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims.   In this position, you will have the opportunity to: ·          Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   ·          Complete coverage analysis on the most complex claims. ·          Ensure all possible policyholder benefits are identified.  ·          Create additional sub-claims if needed....

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 diversity and recognize the benefits gained when people from different cultures, backgrounds and experiences work collaboratively to achieve business results. We are intentionally focused on fostering an inclusive culture and know valuing diversity is an essential leadership quality. Our goal is to create a workplace where all employees feel included, empowered and enabled to perform at their best. Great American's Bond Division has been underwriting surety and fidelity bonds for over 90 years. Great American is known for...

- This position and reports to the SIU Manager. The ideal candidate will have a proficiency in investigating claims across multiple lines of business to include Workers Compensation. The SIU Senior Investigator reviews and investigates referrals to the SIU to identify suspicious indicators of potential fraud committed by claimants, insureds, agents, brokers, providers and attorneys and conducts investigations of varying complexity. Key Accountabilities/Deliverables: Evaluate SIU referrals to establish if there are suspicious elements present that might warrant a SIU investigation and prepare concise investigative plan of action. Effective time management skills, proactive execution of investigative plans, and flexibility are necessary to ensure the effectiveness of this position. The investigator must understand and exhibit appropriate investigative behaviors and methods while conducting investigations, including development of the facts, due diligence with...

Company Details   Berkley Southeast Insurance Group (BSIG) is a member company of W. R. Berkley Corporation, a Fortune 500 Company, whose insurance company subsidiaries are rated A+(Superior) by A. M. Best Company. BSIG provides local underwriting, risk services, claim, marketing and audit services for agents and policyholders in Alabama, Georgia, Mississippi, South Carolina, North Carolina and Tennessee. We take a broad approach to underwriting for ‘best in class’ businesses, primarily in: construction, light manufacturing, wholesale, distribution and business service industries. Company URL:                                         www.berkleysig.com Responsibilities The Senior Property Claim Specialist position is responsible for the quality handling and resolution of a wide variety of commercial property claims in a timely and professional manner with emphasis on providing quality service while controlling...

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. The Opportunity Within defined guidelines and framework responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in compliance with state laws and regulations. Accountable for delivering exceptional member service through setting appropriate expectations, proactive communications, advice, and empathy. What you'll do: With the use of digital tools, evaluates and appraises highly complex auto physical damage claims...

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.  A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work® Most Loved Workplace®  Forbes Best-in-State Employer...

Overview Skyward Specialty is a property and casualty insurance holding company formed in 2007. Based in Houston, Texas, and with staff throughout the country, Skyward Specialty provides admitted and non-admitted solutions to retail and wholesale distributors, managing general agents and captive markets. We have built highly respected businesses in specialty lines including management professional liability, medical stop loss, surety, E&S property and liability, and large commercial property, as well as multi-line solutions for the energy, trucking and construction industries.   At Skyward Specialty, we approach this business differently. In fact, we’re different from most others in our industry in just about every way. We have the spirit of a start-up with the security of over $1.7 billion in Written Premium. We put immense brain power and energy into finding greater insights to uncover better opportunities for our clients, partners, and people. We think...

Sr Representative Claims - CH08BE Sr Representative Clms CA - CH08AN Consultant Claims CA - CH08BN Consultant Claims - CH08CE We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.           The General Liability Litigation Senior Claim Representative or Consultant is accountable for delivering superior customer service and successfully investigating, reserving, recommending and implementing strategies to resolve claims consistent with corporate claim standards, policies and procedures and statutory, regulatory and ethics requirements.  The selected candidate will partner with Staff Legal and outside counsel to resolve General Liability cases including: Premise Liability, Operations Claims, Product Liability, Professional Claims,...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity...

NJM’s Workers’ Compensation Claims Team is seeking a Claim Account Specialist. This is a full-time position and offers a hybrid schedule after training.   The Claims Account Specialist will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary information to effectively evaluate the claim and implement an action plan to manage the claim. The Claims Account Specialist will work with and communicate to NJM policyholders, injured workers, medical providers, the NJM Medical Services Administration Department, the NJM Special Investigation Unit, WC Legal Staff, other departments within NJM, and vendors as needed.   This role is based in NJM’s- Hammonton, NJ office location.   Responsibilities: ·          Execute on strategic and operational goals and objectives of the WCC department and company business goals, guidelines, and programs ·          Recommend process improvements where applicable...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity...

If you’re passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. Location: T he location of this position is flexible and open to virtual and/or remote based applicants. What to Expect: This role is an individual contributor role. Although it doesn't immediately involve leadership responsibilities, there is potential in the future for the role to grow and change. Ideal Candidates will have:  Surety Claims and/or strong Construction Litigation experience highly preferred. JD preferred. (Internal Use Only) Compensation Band: H3 #LI-BC1 Job Description Summary If you can put your...

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. The Opportunity As a dedicated Sr. Injury Adjuster, you will work within defined guidelines and framework, responsible to adjust attorney involved moderately complex bodily injury and UM claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations. Accountable for delivering a concierge level of best in class member service through setting appropriate expectations, proactive communications, advice, and compassion....

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.   Join us and play your part in something special! This position will be responsible for the resolution of moderate to high complexity and moderate to high exposure claims which can be subject to disputes that must be resolved in mediation or litigation. The primary purpose of this job is to handle claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis, to timely and accurate resolution; ensuring mitigation of indemnity and expense exposure while communicating developments and outcomes as necessary...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we CARE through our values, ESG initiatives and IDE journey. Our Claims team is currently seeking a Sr. PIP Adjuster in our Howell MI - Southfield, MI or Grand Rapids, MI locations.  The Hanover Insurance Group has adopted a Hybrid work model that allows for 3 days of remote work each week with the balance of time being in the office. This is a full time, exempt role. POSITION OVERVIEW: Responsible for the investigation, negotiation and resolution of claims in accordance with policy provisions, best practices and jurisdictional requirements. Includes the input of claim data and guiding insureds and claimants through the claim process and options. IN THIS ROLE, YOU WILL:  Work within significant limits and authority on assignments of higher...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we CARE through our values, ESG initiatives and IDE journey. Our Claims team is currently seeking a Sr. PIP Adjuster in our Syracuse, NY locations.  The Hanover Insurance Group has adopted a Hybrid work model that allows for 3 days of remote work each week with the balance of time being in the office. This is a full time, exempt role. POSITION OVERVIEW: Responsible for the investigation, negotiation and resolution of claims in accordance with policy provisions, best practices and jurisdictional requirements. Includes the input of claim data and guiding insureds and claimants through the claim process and options. IN THIS ROLE, YOU WILL:  Work within significant limits and authority on assignments of higher technical complexity and...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we CARE through our values, ESG initiatives and IDE journey. Our Claims team is currently seeking a Sr. PIP Adjuster in our Syracuse, NY locations.  The Hanover Insurance Group has adopted a Hybrid work model that allows for 3 days of remote work each week with the balance of time being in the office. This is a full time, exempt role. POSITION OVERVIEW: Responsible for the investigation, negotiation and resolution of claims in accordance with policy provisions, best practices and jurisdictional requirements. Includes the input of claim data and guiding insureds and claimants through the claim process and options. IN THIS ROLE, YOU WILL:  Work within significant limits and authority on assignments of higher technical complexity and...