UNKNOWN

FEED

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. At least 2 years of experience in claims, and/or customer service experience in a clerical role - preferably in a managed care setting, or equivalent combination of relevant education and experience.

Molina Healthcare Inc

Senior Examiner, Claims(Florida)

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This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. 2-4 years of casualty claims handling experience;">2-4 years of casualty claims handling experience;">2-4 years of casualty claims handling experience; experience with environmental, products liability, life sciences, professional liability, bodily injury, or property damage claims is preferred.

YEAR

Markel Group Inc

Claim Examiner

This role requires strong technical claims expertise, sound litigation judgment, coverage analysis capability, and the ability to partner effectively with carriers, insureds, defense counsel, coverage counsel, employment counsel, mediators, and internal stakeholders. Prior experience as Claims Counsel, Coverage Counsel, National General Adjuster, Executive General Adjuster, Senior Claims Examiner, Complex Claims Specialist, or Senior Complex Claims Consultant.

Davies Group Ltd

Senior Complex Claims Consultant / Claims Counsel - EPL/Professional Liability

Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. In this role, you will serve as a primary resource for the Claims Suspense team, helping ensure suspended Medi-Cal claims are reviewed, researched, priced, and resolved accurately and timely.

Gainwell Technologies LLC

Claims Suspense Team Lead - Remote CA

OTHER

Operating with minimal supervision, this role requires strong analytical judgment, regulatory knowledge, and a commitment to delivering timely, accurate, and compliant claim outcomes. This organization is a professional risk management and claims administration firm committed to delivering responsive, compliant, and high-quality claims services.

TEEMA Group

Workers’ Compensation Claims III

WorkWolf

HOUR

Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency. Skills: Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business.

Looking for a great job? Join eTeam. We’re looking for talented staffing professionals to join our staff. We also provide contract assignments and full-time jobs at Fortune 2000 Companies. We’ve been named one of the best companies to work for by Staffing Industry Analysts and New Jersey Business.

eTeam Inc.

Claims Adjuster - Workers Compensation (Hourly)

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AIG Warranty delivers a full range of service solutions including warranty management administration, extended service programs, customer service support, service network management, claims processing services, and service contract underwriting. Your Contribution: The Claims Examiner - Bilingual are the ones our clients turn to in times of need and will act with speed, composure, compassion and knowledge to solve problems and the work they do every day is the heart of AIG's business.

AIG and its member companies form one of the world’s leading insurance organizations. We provide insurance for businesses and individuals, helping individual customers plan for their futures by offering life insurance, travel insurance, product warranty, auto insurance and retirement products. Our commercial clients have come to rely upon our risk expertise and financial strength to help them address some of their most complex challenges – from huge construction projects to protecting themselves from the emerging threats to data security. We offer our people the chance to grow in a dynamic company that values teamwork, fresh perspectives, and a commitment to helping their clients.

American International Group Inc (AIG)

Claims Adjuster- Bilingual

FULL_TIME

As Paychex and Paycor come together, we're combining innovative technology, data-driven insights, AI, and human expertise to help organizations work smarter, support their people, and achieve better business outcomes. About Us: Paychex is reimagining how businesses manage their workforce by bringing payroll, HR, benefits, and advisory services together into a single connected HCM platform.

Paychex

Litigation and Claims Analyst

[AW]-iCims

Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff. Effectively manages a caseload of 130 to 140 workers’ compensation files, including very complex claims.

Elite

Sr. Workers' Compensation Claims Adjuster

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Role Overview: Investigate, evaluate, and resolve advanced, large-loss, and complex workers compensation claims with a high degree of autonomy. We're looking for a Senior Claims Examiner- Workers Compensation (California) with a passion for claims management to join our team!

Based in Atlanta, Georgia, Crawford &amp; Company is the world's largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with an expansive global network serving clients in more than 70 countries. 

The Crawford System of Claims Solutions(SM) offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines, including property and casualty claims management, workers compensation claims and medical management, and legal settlement administration 

The Company's shares are traded on the NYSE under the symbols CRDA and CRDB.

Crawford & Company

Sr Claim Examiner-Wc (Ca)

As Paychex and Paycor come together, we're combining innovative technology, data-driven insights, AI, and human expertise to help organizations work smarter, support their people, and achieve better business outcomes. Paychex is reimagining how businesses manage their workforce by bringing payroll, HR, benefits, and advisory services together into a single connected HCM platform.

Paychex Inc

The Temporary UM Claims Examiner supports Utilization Management and Claims Operations by reviewing claims requiring UM intervention, validating authorization requirements, identifying continuity of care protections, researching claim discrepancies, and ensuring accurate routing and adjudication of claims. This role performs administrative and analytical review activities and escalates clinical determinations to licensed UM staff when appropriate.

We are a $125 Million, NMSDC-certified Minority & Woman owned Workforce Solutions Company headquartered in the DC metro area with presence across US with global presence - Canada, Mexico, India, UK, Malaysia, Indonasia, Hongkong, Singapore, UAE. We are specialized in providing Workforce Solutions, SOW project delivery, Engineering Solutions, Creative Services. We currently support 100+ Fortune companies globally and across multiple industry segments. We are currently supporting several massive programs across industry segment nationally/globally (Intel, Ally, AMD, QUALCOMM, Morgan Stanley, Kraft/ Mondelez, MNP, Amdocs, Dell, SanDisk, Medtronic, Becton Dickinson, GE, Lockheed Martin, UTC, L-3 Communications, Caterpillar, BMW, Mercedes Benz, National Grid, Dominion, Energy Future Holdings, PSEG, 3M, Fidelity, Aetna, Humana, Johnson & Johnson, Pfizer, Merck etc). 
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, identity, national origin, disability, or protected veteran status.

LanceSoft Inc

Claims Clerk I

house network, and a hard-wired internet connection capable of continuously supporting outstanding call quality and high-speed response rates. Previous experience in a medical office type setting, including some knowledge of insurance, claims, billing or coding, with an understanding of the different types of insurance (Medicare/Medicaid and/or Child Plus).

As a process transformation company, Sutherland rethinks and rebuilds processes for the digital age by combining the speed and insight of design thinking with the scale and accuracy of data analytics. We have been helping customers across industries from financial services to healthcare, achieve greater agility through transformed and automated customer experiences for over 30 years. 

Headquartered in Rochester, N.Y., Sutherland employs thousands of professionals spanning 19 countries around the world. To learn more, please visit us at www.sutherlandglobal.com.

Sutherland Global Services Inc

Health Claims Specialists

As a process transformation company, Sutherland rethinks and rebuilds processes for the digital age by combining the speed and insight of design thinking with the scale and accuracy of data analytics. We have been helping customers across industries from financial services to healthcare, achieve greater agility through transformed and automated customer experiences for over 30 years. 

Headquartered in Rochester, N.Y., Sutherland employs thousands of professionals spanning 19 countries around the world. To learn more, please visit us at www.sutherlandglobal.com.

Sutherland

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Identify premature conclusions, missing investigative steps, unsupported valuations, improper communications, and failures to distinguish covered damage from excluded or unrelated loss. Experience handling claims in at least one area such as property, auto physical damage, bodily injury, general liability, commercial casualty, catastrophe, or specialty claims.

Mercor

Insurance Claims Specialist - Fully Remote

Manatal

Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX or FL Additional State Adjuster License(s) may be required within 180 days. Relies on extensive experience and judgment to plan and accomplish goals with a minimum 8-10 years of complex/major claims experience including proficiency in investigation and resolution of severe to major casualty and general liability claims.

Senior Claims Adjuster – GL

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POSITION SUMMARY: Under general supervision, manages workers’ compensation indemnity claims of moderate to complex difficulty from inception through resolution within assigned authority limits and established company and client guidelines. QUALIFICATIONS REQUIRED: Education/Experience: Bachelor’s degree in related field (preferred); and three (3) to five (5) years related experience; or equivalent combination of education and experience.

Work Comp Claims Adjuster (Texas Jurisdiction)

Claims Examiner III Must have TEXAS workers' compensation license and seeking 5 years experience in lost time work comp claims for TEXAS jurisdiction. DUTIES AND RESPONSIBILITIES: Effectively manages a caseload of 110 to 160 workers’ compensation files, including very complex claims.*.

Senior Claims Adjuster_TEXAS WC License

Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Working under the direction of the Claims Appeals Supervisor, you will serve as a primary resource for Appeals Examiners, help coordinate daily workflow, provide training and guidance, monitor quality and performance, and assist with complex appeals and operational issues.

Claims Appeals Team Lead - Onsite - West Sacramento, CA

As part of our internship program you will receive: Targeted business training designed to help you refine your professional skills and acumen critical to the success of Westfield professionals; Technical training to deepen your skill level within your chosen discipline; and an understanding of the broader insurance industry; Access to additional training to compliment your professional development. An Claims Intern at Westfield Specialty works on a variety of projects to gain hands-on experience in the insurance industry and develop technical skills.

Claims Examiner Jobs in the United States

Senior Examiner, Claims(Florida) Molina Healthcare Inc

Claim Examiner Markel Group Inc

Senior Complex Claims Consultant / Claims Counsel - EPL/Professional Liability Davies Group Ltd

Claims Suspense Team Lead - Remote CA Gainwell Technologies LLC

Workers’ Compensation Claims III TEEMA Group

Claims Adjuster - Workers Compensation (Hourly) eTeam Inc.

Claims Adjuster- Bilingual American International Group Inc (AIG)

Litigation and Claims Analyst Paychex

Sr. Workers' Compensation Claims Adjuster Elite

Sr Claim Examiner-Wc (Ca) Crawford & Company

Litigation and Claims Analyst Paychex Inc

Claims Clerk I LanceSoft Inc

Health Claims Specialists Sutherland Global Services Inc

Health Claims Specialists Sutherland

Insurance Claims Specialist - Fully Remote Mercor

Senior Claims Adjuster – GL Elite

Work Comp Claims Adjuster (Texas Jurisdiction) Elite

Senior Claims Adjuster_TEXAS WC License Elite

Claims Appeals Team Lead - Onsite - West Sacramento, CA Gainwell Technologies LLC

2027 Summer Intern Program- Claims Intern, Berkeley Heights, NJ Westfield Insurance Co

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