40 Results for

Claims Examiner Jobs in Pennsylvania

Jobs

New!

McKnight, PA6 days ago

$100,000–$140,000 Per Year
Full-time

CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #UnderwriterJobs. Described compensation is not definite nor precise and may be estimated and approximate and is negotiable depending on market conditions and candidate availability and other factors and is solely at the discretion of employers.

Philadelphia, PA14 days ago

$100,000–$140,000 Per Year
Full-time

New!

Philadelphia, PA2 days ago

$85,000–$92,000

Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff. Education/Experience: Bachelor’s degree in related field (preferred); three (3) or more years related experience; or equivalent combination of education and experience.

New!

PA5 days ago

$55,000–$63,000 Per Year

Penn Mutual and its affiliates offer a comprehensive suite of competitive products and services to meet the unique needs of Financial Professionals and their clients, including life insurance, annuities, wealth management and institutional asset management. This includes: race, creed, color, national origin, ancestry, citizenship age, gender (including pregnancy), sexual orientation, gender identity or expression, domestic partnership or civil union status, marital status, genetic information, disability, religious observance or practice, liability, veteran status or any other classification protected under applicable law.

New!

PA5 days ago

$125,000–$145,000 Per Year

Draft well written and comprehensive captioned reports to request reserve and settlement authority on higher exposure cases that outline all critical aspects of the case in preparation for roundtable presentations to the carrier partners. Supporting the Construct Defect Claims team, you will independently manage moderate to high exposure claims involving alleged defects in residential and commercial construction.

Philadelphia, PA30+ days ago

Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Reimagining insurance to make a bigger difference to the world American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the worlds most far-reaching property casualty networks.

Philadelphia, PA30+ days ago

$97,100–$131,130 Per Year

In this role, the responsibilities include actively managing commercial general liability claims for high severity, complex general liability, and auto accounts, as well as the associated excess and umbrella policies, in jurisdictions throughout the United States. Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs.

Philadelphia, PA28 days ago

$75,000–$85,000 Per Year

Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims.

Philadelphia, PA30+ days ago

High school diploma or equivalent 1-3 years of experience in claims analysis or healthcare operations Strong knowledge of medical terminology, CPT, HCPCS, ICD-10 codes Proficiency in claims processing systems and Microsoft Excel Excellent analytical, problem-solving, and communication skills Ability to manage multiple priorities in a fast-paced environment. This role focuses on identifying discrepancies, improving accuracy, and supporting operational efficiency through data-driven insights.

Philadelphia, PA30+ days ago

$123,400–$166,000 Per Year

In this role, the responsibilities include but not limited to actively manage a caseload and provide oversight to third-party administrator claims handlers for commercial New York Labor Law coverage, liability, and damage claims. Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs.

PA30+ days ago

Remote

$22.41–$28.02 Per Hour

Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objecting and otherwise using primarily the fingers rather than the entire hand. The Claims Examiner I obtains and analyzes data for thorough, fair, objective, and timely processing of New York State statutory Short-Term Disability and Paid Family leave claims.

PA28 days ago

Remote

$75,000–$85,000 Per Year

To analyze Workers Compensation Lost-Time claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PA30+ days ago

Remote

$70,000–$80,000 Per Year

To analyze Medical Only & Lost-Times Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PA22 days ago

Remote

$63,404–$88,765 Per Year

To analyze GL Litigated, Premise, Auto, Bodily Injury & Product claims on behalf of our valued dedicated client to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Wayne, PA30+ days ago

Notice: Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment visa at this time. Back to Open Opportunities Returning Applicant Login Now.

Pittsburgh, PA23 days ago

Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success.

Philadelphia, PA30+ days ago

n \nResponsibilities after training include:\n\n Contribute to a collaborative environment by raising new ideas, demonstrating teamwork, high motivation, positive behavior and effort to achieve goals and objectives \n \n\n Complete accurate and timely coverage, liability and damage investigations and evaluations on complex Employment Practices Liability insurance policies\n \n\n Establish, document and execute appropriate strategies to bring early and cost-effective resolution to assigned claims\n \n\n Represent the company at meetings with management and business partners, as well as virtually at mediations. underwriters) \n Developing the ability to analyze initial claim reports\n Developing an understanding of the legal system\n Understanding how to effectively investigate and document findings\n Understanding Chubb's products to appropriately determine coverage\n Learning to interpret and apply insurance contracts\n Learning how to negotiate settlements\n* If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.\n\n.

Philadelphia, PA30+ days ago

$79,300–$134,700 Per Year

The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. Chubb seeks a Senior Claim Examiner on the Multinational Casualty claims team that provides technical, specialized claim handling on behalf of Chubbs Multinational customers in the U.S. and abroad.

New!

Philadelphia, PA2 days ago

$85,000–$90,000

This role handles highly complex claims and plays a critical part in ensuring compliance with state regulations, timely investigations, accurate reserving, and effective claim resolution. The position requires strong analytical judgment, excellent communication skills, and consistent collaboration with clients, claimants, vendors, legal counsel, and internal teams.

PA30+ days ago

$86,000–$101,500 Per Year

Qualifications / Experience Required: A practical knowledge of commercial claims, as well as an exceptional customer service focus typically achieved through: • A minimum of two years experience adjudicating first and third party commercial Garage Bodily Injury claims. Essential Responsibilities: • Working under technical direction and within significant limits and authority, adjudicate Garage Bodily Injury claims of higher technical complexity with a direct impact on departmental results.

Wayne, PA30+ days ago

At USLI, we are committed to fostering a vibrant and inclusive community that celebrates the rich diversity of all ethnicities, nationalities, abilities, genders, gender identities, sexual orientations, ages, religions, socioeconomic backgrounds and life experiences. Benefits include performance-based triannual bonuses, medical benefits paid at 100% for full-time employees and 80% for eligible part-time employees, a profit-sharing program, free lunch every day while onsite and more than 450 annual personal and professional development courses.

Norristown, PA30+ days ago

Remote

$51,807–$83,551 Per Year

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.

New!

Harrisburg, PA6 days ago

$59,345–$90,211 Per Year

This includes the following activities: reviewing policy files, claim files, complaint files, underwriting files, rate structures and rating manuals, underwriting manuals, practices and guidelines, policy terminations, marketing and sales, and producer licensing; determining proper selection of sample files and accuracy of data and information; conducting interviews with insurance company staff to elicit information; and identifying violations of statute, regulation, and policy conditions. This includes the following activities: documenting examination findings; preparing summaries and final reports, which include a comprehensive narrative of the examination and recommended corrective action; and providing clarification and interpretation of insurance rules, statutes, and regulations.

New!

Philadelphia, Pennsylvania5 days ago

Responsible to reconcile daily import, acceptance and rejection reports and collaborates with Billing Manager on all issues causing claim delays and achieving the HRHS CBO clean claims targets established by Senior Leadership. The Corporate Finance Department strives to contribute to this mission by working with the entire organization to provide the most positive financial climate possible, for continued caring, comforting and healing for all in need.

Pittsburgh, PA30 days ago

$50,460–$121,371 Per Year

Superior Academic Achievement is based on:(1) Class Standing - Applicants must be in the upper third of the graduating class in the college, university, or major subdivision, such as the College of Liberal Arts or the School of Business Administration, based on completed courses; OR (2) Grade-Point Average (G.P.A.) - Applicants must have a grade-point average of either (a) 3.0 or higher out of a possible 4.0 ("B" or better) as recorded on your official transcript, or as computed based on 4 years of education, or as computed based on courses completed during the final 2 years of the curriculum; or (b) 3.5 or higher out of a possible 4.0 ("B+" or better) based on the average of the required courses completed in the major field or the required courses in the major field completed during the final 2 years of the curriculum. FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university.

Pittsburgh, PA30 days ago

$50,460–$121,371 Per Year

New!

Philadelphia, PA2 days ago

PA19 days ago

$125,000–$145,000 Per Year

Harrisburg, PA7 days ago

$67,736–$102,905 Per Year

How much graduate coursework have you completed in addiction studies; health and risk communication; health care administration/management; health care informatics/information management; health economics; health education; health insurance studies; health leadership; health policy; health sciences; health services; occupational health and safety; occupational therapy; quality, safety and risk management in health care; physical therapy; psychology; public health; social work; speech therapy; or vocational rehabilitation?. We invest in our employees by providing competitive wages and encouraging financial wellness by offering multiple ways to save money and ensure peace of mind including multiple retirement and investment plan options.

Philadelphia, PA29 days ago

You will work closely with other team members and cross functional teams such as configuration and Account Management to resolve discrepancies and improve claims processing experience for BlueCard members. • Responsible for evaluating current business processes and developing, implementing, testing and maintaining Technology for more cost effective or quality improvement processing.

Philadelphia, PA30+ days ago

The AVP Manager will be responsible for leading a team of Workers'' Compensation professionals in delivering the highest quality claim work product while meeting all internal and external compliance requirements for the jurisdictions of Alabama, Delaware, District of Columbia (DC), Florida, Georgia, Maryland, Mississippi, North Carolina, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia. In-depth knowledge of Southeast jurisdictional nuances (Alabama, Delaware, District of Columbia (DC), Florida, Georgia, Maryland, Mississippi, North Carolina, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia) is required; knowledge of additional states is a plus.

New!

Pittsburgh, PA6 days ago

The Dealer Auditor will plan and execute audits, communicate audit findings, perform root cause analysis, and work closely with dealership and corporate stakeholders to drive corrective actions and improve compliance. This role plays a critical part in ensuring warranty policies and procedures are applied consistently and in identifying trends, risks, and opportunities for improvement within warranty operations.

Work At Home, PA14 days ago

$66,330–$145,860 Per Year

The position plays a key role in identifying fraud risks, supporting program integrity efforts, and helping to prevent financial losses related to fraud, waste, and abuse. Directs complex investigations, including data analysis, interviews, and document review, to identify potential fraud, waste, and abuse, including NSA-related activity.

New!

Pittsburgh, PA6 days ago

$48.28–$48.28 Per Hour

Preferred Qualifications: Prior audit experience (financial, compliance, operational, or dealership/franchise) Experience with automotive OEM dealership management systems Experience with highly automated/digital processes; including but not limited to remote auditing techniques, claims processing, and optical recognition software Experience researching, implementing, or authoring technical requirements, policies/procedures, and other governing documents Certified Internal Auditor, Certified Fraud Examiner, or PMP Certification The candidate will be based in the Pittsburgh, PA or Columbus, OH metro area, with travel of 80+%, and will report to a Dealer Audit Lead Auditor or Manager. The Dealer Auditor will also play a key role in addressing recurring violations by providing consistent, ongoing communication of findings, conducting root cause analysis, and recommending possible corrective actions to stakeholders at both the dealership and corporate levels.

PA30+ days ago

$46,988–$122,400 Per Year

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.

Macungie, PA30+ days ago

Contractor

Special knowledge, Skills, and Abilities: Analytical ability necessary to evaluate and determine the health status of a patient and implement proper care; Interpersonal skills necessary to interview, teach and counsel patients and interact with clients/employers, A comprehensive understanding of outpatient adult medicine, patient care procedures, medical protocols, and testing procedures is necessary. Work collaboratively with the onsite Mack Truck/Volvo teams: To coordinate and plan health and wellness events and initiatives; To manage workers compensation claims; To expand clinic services and reach.

Macungie, PA30+ days ago

Special knowledge, Skills, and Abilities: " Analytical ability necessary to evaluate and determine the health status of a patient and implement proper care; " Interpersonal skills necessary to interview, teach and counsel patients and interact with clients/employers, " A comprehensive understanding of outpatient adult medicine, patient care procedures, medical protocols, and testing procedures is necessary. " Work collaboratively with the onsite Mack Truck/Volvo teams: " To coordinate and plan health and wellness events and initiatives; " To manage workers' compensation claims; " To expand clinic services and reach.

Conshohocken, PA12 days ago

Remote

While performing the duties of this job, the employee is: Frequently required to sit; speak or hear; use hands to finger, handle, feel objects, and reach with hands and arms; Occasionally required to stand and walk; Extensive use of computer and keyboard and viewing of computer screen is required; Specific vision abilities required by this job include vision, and ability to adjust focus. ESSENTIAL DUTIES AND RESPONSIBILITIES include, but are not limited, to the following: Perform timely, objective clinical audits of disability claim files (short-term and long-term), including review of medical records, treating provider notes, diagnostic tests, functional assessments, and vocational information.

Philadelphia, PA30+ days ago

$80,000–$150,000 Per Year

Analyze and calculate ability to pay settlements and judgments, including analyzing debt covenants, borrowing capacity, adjusted earnings, and earnings per share financial ratios, accounts receivable, and accounts payable aging schedules, tax considerations, assessing collectability, and developing payment terms and schedules. CGS is seeking a Senior Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and ability-to-pay analyses, which serve a significant role in determinations regarding investigations, prosecutions, settlements, and recovery in these matters, which can be voluminous and complex.

New!

Harrisburg, PA2 days ago

$51,971–$79,062 Per Year

Associate degree from an accredited college/university with an area of concentration in accounting, business, data analytics, finance, economics, math, or a closely related field; or. The Department of the Auditor General's DEI program includes recruitment efforts focused on attracting a diverse population of qualified candidates.

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Claims Examiner Jobs in Pennsylvania

Ins Claims Specialist Medical Malpractice - Pittsburgh, PA Diedre Moire Corp.

laims Examiner MedMal Diedre Moire Corp.

Workers Compensation Claims Examiner III TeemaGroup

Sr Claims Examiner I The Penn Mutual Life Insurance Company

Sr. Casualty Claims Examiner Construction Howden Group Holdings Ltd

Claims Examiner - Federal Workers' Compensation American International Group Inc (AIG)

Senior Claims Examiner, Casualty Arch Capital Group Ltd

Claims Examiner, Commercial Auto Arch Capital Group Ltd

Senior Claims Examiner Blue Cross and Blue Shield Association

Senior Claims Examiner, New York Labor Law Arch Capital Group Ltd

Claims Examiner I - SSL Matrix Absence Management, Inc.

Workers Compensation Claims Examiner | NY Jurisdiction | NY Licensing | Remote Sedgwick Claims Management Services, Inc.

Workers'''' Compensation Claims Examiner | NY & VT Jurisdictional Knowledge | Remote Sedgwick Claims Management Services, Inc.

Liability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims Experience | Remote Sedgwick Claims Management Services, Inc.

Claims Examiner or Associate Claims Examiner - Employment Practices Wayne United States Liability Insurance Company

Claims Examiner - Subrogation Claims Auto-Owners Insurance Group

Senior Claim Examiner Chubb Ltd

Senior Claim Examiner-Multinational Chubb Ltd

Claims – Workers’ Compensation TEEMA Group

Garage Bodily Injury Claims Adjuster Argo Group International Holdings Inc

Property Claims Team Leader United States Liability Insurance Company

Claims Specialist CorVel Corp

Insurance Market Conduct Examiner 1 Commonwealth of Pennsylvania

Claims Processor Redeemer Health

Realty Specialist (Document Examiner) (TERM Appointment) United States Army

Realty Specialist (Document Examiner) (TIME LIMITED ASSIGNMENT) United States Army

Claims Processor Holy Redeemer Health System Inc

Sr. Casualty Examiner Construction Howden Group Holdings Ltd

Medical Records Examiner Commonwealth of Pennsylvania

Business Analyst - Claims Dale Workforce Solutions

AVP, Claim - Worker''s Comp Chubb Ltd

Dealer Auditor HireTalent

Fraud, Waste & Abuse (FWA) Investigator - No Surprises Act (NSA) CVS Health Corp

Audit - Dealer Auditor Mindlance

Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

Advanced Practitioner Providers Apidel Technologies

Advanced Practitioner Providers 22nd Century Technologies, Inc.

Contract Clinical Auditor Marsh & McLennan Companies Inc

Senior Auditor Contact Government Services LLC

Auditor 1 Commonwealth of Pennsylvania

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