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In this role, you will utilize your expertise and independent judgment to interpret complex policy coverages, manage investigative activities, and direct litigation strategies. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from and its affiliates, and contracted partners.

Abacus Service Corporation

Sr Claim Examiner- WC

jobdiva

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.

YEAR

Argo Group International Holdings Ltd.

Bodily Injury Claims Adjuster, Garage

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Qualifications / Experience Required: An advanced knowledge of commercial general liability property damage claims typically acquired through: Licensed Claims Examiner (Based on state) Must be licensed or have ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims within 120 Days. Essential Responsibilities: Working under limited technical direction and within broad limits and authority, adjudicate moderately complex commercial general liability property damage claims, potentially with significant impact on departmental results.

Senior Commercial General Liability Property Damage Claims Adjuster

This Job Description indicates the general nature and level of work to be performed in this position and it is not intended to contain or be interpreted as a comprehensive inventory of all the duties, responsibilities, functions and qualifications required of the position. Complete physical activity inventory of the position includes: Work requires frequent sitting, standing, walking and use of keyboard/computer.

Circle K Stores

Incident and Intake Investigation Manager

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ADAPTED_NOW

HOUR

Track progress against substantiation-rate and findings-volume targets (set once POC window and initial data are confirmed). Our Client, an American Technology company, is looking for a Senior SIU Analyst - FWA Detection for their Bowie, MD location.

ICONMA&nbsp;is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.
<ul class="ic_list">
<li>Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.</li>
<li>Certified Woman-Owned Business Enterprise (WBE); certified by Women&rsquo;s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).</li>
<li>Founded in 2000</li>
<li>2000+ Employees</li>
</ul>
The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.

Iconma

Senior SIU Analyst - FWA Detection

Iconma Staffing

As a Senior Field Security Investigator, you will conduct investigations of suspected cases of fraud or other illegal activities against the Company, including interviewing, database inquiries, taking statements, and locating sources of information and witnesses. Experience handling in-person or phone statements from various parties in an investigation in a way that builds GEICO's customer base and promotes customer satisfaction through efficient, accurate, and courteous interactions.

GEICO GENERAL INSURANCE COMPANY

Senior Field Investigator

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The Senior Special Investigative Unit (SIU) Auditor investigates and audits potential healthcare fraud, waste, abuse, and coding irregularities across claims, billing, documentation, and reimbursement. For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.

Premera Blue Cross

Senior Special Investigative Unit (SIU) Auditor

This role will serve as a trusted advisor to surety carriers, legal counsel, claims professionals, and contractors by delivering financial analysis, investigative accounting, economic damage quantification, and project fund analysis related to bonded construction projects and disputes. MDD, a Davies Company, is seeking a highly experienced Senior Surety Manager to lead complex surety-related forensic accounting engagements within our Construction & Surety practice.

Davies Group Ltd

Senior Surety Manager

A typical day will include the following: Evaluates each claim in light of facts; Affirm or deny coverage; investigates to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.

Philadelphia Insurance Companies

Sr. Claims Examiner - PIP

Investigation and overpayment administration: Facilitate claims investigation, negotiate settlements, interpret medical records, respond to Department of Insurance complaints, and authorize payment to claimants and providers. Overpayment reviews and recovery of claims overpayment; corrected financial histories of patients and service providers to ensure accurate records.

Guide Well

Claims Examiner I

Make decisions and resolve conflicts in such areas as application of coverages to submitted claims, application of laws of jurisdiction to investigatory facts, application of policy exclusions and exceptions as well as the ability to read and understand contracts, hold harmless and indemnity agreements. Volunteer opportunities to support our local communities- We have an adoration for helping others which is why we have worked hard to establish partnerships with organizations such as Children's Miracle Network and Habitat for Humanity that allow us to give back.

Swift Transportation began operations on October 10th, 1966 transporting imported steel through the ports of Los Angeles to Arizona and Arizona cotton for export back through to Southern California.

Jerry Moyes, founder, began with the same entrepreneurial, can-do spirit that is one of Swift’s core values today. The original operation was conducted under the name of Common Market. Operating authority was purchased from a descendant of the Swift Meat Packing family, hence, today’s name of Swift Transportation. Jerry, with his father, brother and a partner, grew the business, with typical start up challenges, to a $25 million annual revenue in 1984. With the passing of Jerry’s father, Carl Moyes, Jerry became the sole owner. By 1990, Swift had grown to a $125 million carrier with 800 trucks. Swift’s significant revenue growth is attributable to internal growth with existing customers as well as acquisitions. Since 1988, Swift has acquired 13 different motor carriers. Today, Swift generates over $4 billion in revenue and operates nearly 20,000 trucks.

Swift’s terminal network has grown to over forty full service facilities in both the continental United States and Mexico. Swift owns 100% of Trans-Mex, a Nuevo Laredo, Mexico based carrier. Swift offers border crossing services at all major Mexican border crossings. Swift maintains a presence in every Canadian province each day. Swift is unquestionably the largest full-truckload motor carrier in North America.

Swift Transportation

Senior Claims Examiner

Some of the Claim Examiner responsibilities include but are not limited to: Makes timely and appropriate contacts, determines, and completes appropriate level of investigation to make determination of coverage, assess liability and determine damages for complex and specialized claims. For candidates located in San Francisco, CA; Washington DC; our Massachusetts based offices and the New York City metro area, the base salary range is $111,000 -$130,000.

Intact Insurance Specialty Solutions

Claims Examiner - Transactional Surety (Hybrid)

Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally): Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms. Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.

TRISTAR Insurance Group, Inc

WC Claims Examiner III (Hybrid)

Provides senior level support for claims examination activities including evaluation of adjudication of claims to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors. Oversees the reduction of defects by identifying error issues as they relate to pre-payment of claims through adjudication, and recommends solutions to resolve issues.

Molina Healthcare Inc

Senior Examiner, Claims (Remote)-Must reside in Florida

FULL_TIME

Overview: We are seeking experienced professionals to join our Workers’ Compensation team in two key roles: Senior Claim Examiner and Lead Claim Examiner . Both positions play a critical role in managing workers compensation claim files and ensuring compliance with state regulations while delivering exceptional service.

AmTrust Financial Services, Inc.

Senior Claim Examiner II

[AW]-iCims

We are seeking experienced professionals to join our Workers' Compensation team in two key roles: Senior Claim Examiner and Lead Claim Examiner. Both positions play a critical role in managing workers compensation claim files and ensuring compliance with state regulations while delivering exceptional service.

Amtrust Financial Services Inc

Senior Claim Examiner I

Both positions play a critical role in managing workers compensation claim files and ensuring compliance with state regulations while delivering exceptional service. Reviewing and analyzing medical bills to confirm charges and treatment are workers' comp injury-related and in accordance with the treatment plan.

Senior Claim Examiner I, OK

The Workers'' Compensation Examiner Lead is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Communicates with internal managed care and medical resources to ensure coordination with medical providers, injured workers and employers in developing return to work strategies and treatment plans.

Lead Claim Examiner I

Final offer amounts are determined by multiple factors including candidate experience and expertise and may vary from the amounts listed above are determined by multiple factors including candidate experience and expertise and may vary from the amounts listed above. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information.

Sana Benefits Inc

Contract Claims Processor (Month to Month)

Proficient computer skills and extensive knowledge of the Microsoft suite of Office products, including Outlook, Word, Excel, and PowerPoint; knowledge of state EDI systems and/or familiarity with CA Workers Compensation terminology are a plus. 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 is the world&rsquo;s largest publicly traded property and casualty insurance company and the largest commercial insurer in the U.S.
With operations in 54 countries and territories, we are a major personal lines writer, as well as a leading middle market, small commercial and large industrial commercial insurer, providing a wide range of traditional and specialty coverages.
As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. And we combine the precision of craftsmanship with deep experience to conceive, craft and deliver the very best insurance coverage and service to individuals and families and to businesses of all sizes.
Our products and services are distributed through brokers, independent agents, exclusive agents and various forms of direct marketing.
What we deliver:
<ul>
<li>Extensive product and service offerings</li>
<li>Broad distribution capabilities</li>
<li>Service excellence</li>
<li>Risk expertise</li>
<li>Underwriting discipline</li>
<li>Exceptional financial strength</li>
<li>Local operations globally</li>
</ul>

Claims Examiner Jobs in the United States

Sr Claim Examiner- WC Abacus Service Corporation

Bodily Injury Claims Adjuster, Garage Argo Group International Holdings Ltd.

Senior Commercial General Liability Property Damage Claims Adjuster Argo Group International Holdings Ltd.

Incident and Intake Investigation Manager Circle K Stores

Senior SIU Analyst - FWA Detection Iconma

Senior Field Investigator GEICO GENERAL INSURANCE COMPANY

Senior Special Investigative Unit (SIU) Auditor Premera Blue Cross

Senior Surety Manager Davies Group Ltd

Sr. Claims Examiner - PIP Philadelphia Insurance Companies

Claims Examiner I Guide Well

Senior Claims Examiner Swift Transportation

Claims Examiner - Transactional Surety (Hybrid) Intact Insurance Specialty Solutions

WC Claims Examiner III (Hybrid) TRISTAR Insurance Group, Inc

Senior Examiner, Claims (Remote)-Must reside in Florida Molina Healthcare Inc

Senior Claim Examiner II AmTrust Financial Services, Inc.

Senior Claim Examiner I Amtrust Financial Services Inc

Senior Claim Examiner I, OK Amtrust Financial Services Inc

Lead Claim Examiner I Amtrust Financial Services Inc

Contract Claims Processor (Month to Month) Sana Benefits Inc

Claim Technical Assistant Chubb Ltd

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