- NJM Insurance (Trenton, NJ)
- NJM's Workers ' Compensation Claims Team is seeking an experienced Complex Claim Specialist . This is a full-time position and offers a hybrid schedule ... after training. The Complex Claim Specialist will be...may manage select Catastrophic (CAT) losses assigned by the Complex Claims Supervisor for developmental purposes. This… more
- Travelers Insurance Company (Irvine, CA)
- …Compensation claims including catastrophic loss, specified serious injury and other complex claims . Attempt to resolve through innovative and expert claim ... or multiple back, shoulder or knee surgeries, knee replacements, claims involving complex offsets, permanent restrictions and/or...to inquiries - verbal and written. + Keeping injured worker apprised of claim status. + Engage… more
- Crawford & Company (Brea, CA)
- Excellence In Everything We Touch We are always searching for Workers Compensation Claim Examiners in the California region to join our awesome team! The purpose ... not a job post. Position Summary Administers and resolves non- complex short term claims of low monetary...adjusting reserves, as necessary, during the processing of the claim . + Identifies wage loss expenses and wage exposures… more
- Lithia & Driveway (Medford, OR)
- …Management The Specialist , Risk Management will oversee the administration of workers ' compensation, auto, property, and general liability claims . This role ... claim types-Auto Liability (AL), General Liability (GL), and Workers ' Compensation (WC)-handled both internally and by our TPA...the TPA to assist in developing action plans for complex claims and implementing process improvements. +… more
- MetLife (Bloomfield, CT)
- …lives of our customers and our communities. The Senior Long Term Disability (LTD) Claims Specialist evaluates long term disability insurance claims in ... and within prescribed time service standards. In this role, the Senior LTD Claims Specialist is required to exercise independent judgment, critical thinking… more
- MetLife (Cary, NC)
- …Key Responsibilities: * Independently manage an assigned caseload of the most complex claims which consists of pending, ongoing/active and appeal reviews. ... Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time...regulations. Provides timely and detailed written communication during the claim evaluation process which outlines the status of the… more
- BrightSpring Health Services (Englewood, CO)
- …to the Reimbursement Compliance Project Manager of the RCM Team, the Claims Escalation Specialist /Team oversees stakeholder and executive relationships by ... providing responses to escalated payer issues identified by our Regulators, RCM Specialist and Executives. The Specialist will ensure the department maximizes… more
- Allied Universal (Fargo, ND)
- …(4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims + High school diploma with a minimum of six (6) ... experience conducting complex insurance investigations or adjusting complex claims + Ability to be properly...Fraud Claim Law Associate (FCLA) + Fraud Claim Law Specialist (FCLS) + Certified Protection… more
- Allied Universal (Durango, CO)
- … claims with red flags that suggest fraudulent behavior In relation to an Insurance claim . The Claims / SIU Specialist must use their extensive knowledge ... claims for a variety of coverage to include workers ' compensation, general liability, property and casualty and disability...Fraud Claim Law Associate (FCLA) + Fraud Claim Law Specialist (FCLS) + Certified Protection… more
- Sedgwick (Chicago, IL)
- …+ Makes independent claim determinations, based on the information received, to approve complex claims or make a recommendation to team lead to deny ... of regulations, financial payment processing, and error correction of complex or high exposure claims . **ESSENTIAL FUNCTIONS...with claimant and client on all aspects of the claims process including claim approval, decision authority… more