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Required Qualifications: Board Eligible or Board Certified in Occupational and Environmental Medicine, Preventive Medicine, Physical Medicine & Rehabilitation (PM&R), or a closely related specialty (including Family Medicine or Internal Medicine with applicable experience), or ability to obtain certification prior to employment. Practice Highlights: Focus on work-related injury/illness/environmental exposures, worker evaluations for various organizations/jobs (commercial drivers, public safety, manufacturing, and others), and Medical Review Officer services/oversight.

YEAR

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

UnitedHealth Group Inc

Occupational Medicine Physician, (MD/DO) Corvallis, OR

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Leads or directs the preparation of cases for presentation to outside agencies, leads or directs pursuit of criminal or civil actions through gathering and documenting relevant data, organizing and summarizing facts and testifying on behalf of the company in civil or criminal matters. Performs a combination of duties in accordance with departmental guidelines: Leads the detailed analysis and completion of thorough and timely investigations of suspected claim fraud by following Best Practice Guidelines and collaborating with insureds, claimants, witnesses and experts.

CNA's approach to research is a modern iteration of the Newtonian principle that complex, dynamic processes are best understood through direct observation of events and people.

That was the methodology CNA analysts first applied in the 1940s when they pioneered the field of operations research by helping the Navy address the German U-boat threat. Not content to study the problem from afar, this small group of MIT scientists insisted on deploying with Navy forces in order to observe operations and collect the data needed for meaningful analyses. Their groundbreaking work, and the anti-submarine warfare equations it produced, set a standard for operations research methods that CNA has maintained for 75 years.

Today, with more than 500 professionals at our headquarters and 50 researchers in the field, CNA still takes a multi-disciplinary, real-world approach to our work. On-site analysts carefully observe all aspects of a process—people, decisions, actions, consequences—and then collaborate with a headquarters-based research team to assess data and arrive at findings.

CNA's objective, empirical research and analysis helps decision makers develop sound policies, make better-informed decisions, and manage programs more effectively. Our work, which in its early decades focused solely on defense-related matters, has grown to include investigation and analysis of a broad range of national security, defense, and public interest issues including education, homeland security and air traffic management. Through our Center for Naval Analyses and Institute for Public Research, we provide public-sector organizations with the tools they need to tackle the complex challenges of making government more efficient and keeping our country safe and strong.

SIU Senior Consultant

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Collaborate with senior leaders of the Legal, Data, Finance, and Service Delivery teams to create and update fraud prevention and detection strategies based on observed patterns and trends as well as industry best practices. With over 1,300 municipal and utility partners, that means providing their customers with access to affordable home repair plans, making it easier, faster and less expensive to have their home repair needs met.

HomeServe USA Corp

Assistant Manager Data Analysis

Oversees investigations involving account takeover, check fraud, ACH fraud, wire fraud, elder financial exploitation, money mule activity, identity theft, cyber-enabled fraud, new account fraud, loan fraud, employee misconduct, and other financial crimes. Collects, analyzes, and disseminates intelligence related to organized fraud groups, money mule activity, account takeover schemes, elder financial exploitation, check fraud, wire fraud, cyber-enabled fraud, and emerging fraud threats.

BankUnited Inc

Fraud Investigations Manager

HomeServe USA

In this role, you will help ensure the accuracy, consistency, and compliance of medical claims processing operations by evaluating performance, identifying trends, and supporting continuous improvement efforts. Experience auditing healthcare operations, medical claims processing, eligibility verification, prior authorizations, or related healthcare transactions preferred.

Datamark, Inc.

Quality Assurance Specialist - Medical Claims

We’re in search of highly motivated Bodily Injury Claims Examiners with prior casualty and bodily injury experience, in private passenger automotive liability claims, looking to help deliver world-class service to our clients. Negotiate claims settlements for evaluated damages with insureds, claimants and/or attorneys as assigned from letter of representation through settlement or verdict.

We know you know GEICO, but we want you to know that with us, you’ll find a rewarding career no matter which path you take. Our over 37,000 associates have been unexpectedly delighted to find that their jobs have turned into successful, illuminating careers. You know us for insurance. Get to know us for careers, too. Visit us at http://www.geico.jobs for more!

GEICO

Bodily Injury Claims Examiner

Appcast Exclusive 1

We’re in search of highly motivated Casualty Claims Examiners with prior casualty and bodily injury experience, in private passenger automotive liability claims, looking to help deliver world-class service to our clients. Negotiate claims settlements for evaluated damages with insureds, claimants and/or attorneys as assigned from letter of representation through settlement or verdict.

Casualty Claims Examiner

Appcast PX 2

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Jobot is on a mission to connect good people with good jobs. By combining AI-powered technology with the expertise of Jobot Pros, our experienced recruiters, we help you find career opportunities that align with your goals and values.
Founded in 2018 and employee-owned since 2024, Jobot is committed to fostering a culture of kindness, respect, innovation, and connection.  As an industry leader, we’ve been recognized as a top workplace by Forbes, Fortune, USA Today, and Staffing Industry Analysts (SIA).
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Jobot

Software Patent Prosecution Attorney

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. #insurancecareers #insurancejobs #claimsexaminer #WorkersCompClaims #WorkersCompensationClaims #paralegalcareers.

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

Senior Workers' Compensation Claims Examiner - Federal Claims

Based in Mooresville, N.C., Lowe’s supports the communities it serves through programs focused on creating safe, affordable housing, improving community spaces, helping to develop the next generation of skilled trade experts and providing disaster relief to communities in need. Settle claims within authority and in an appropriate manner consistent with Lowe’s objectives and values by determining liability, obtaining demands and making offers to claimants, requesting settlement checks, making filings with regulatory agencies, and disposing of salvage, pursuing subrogation when appropriate.

Lowe's Home Centers

Senior Claims Examiner

Pay Range: There are a host of factors that can influence final salary including, but not limited to, geographic location, Federal Government contract labor categories and contract wage rates, relevant prior work experience, specific skills and competencies, education, and certifications. As a valued team member, you'll be part of a high-performing group dedicated to our customer's missions and driven by a higher purpose - to ensure the safety of our nation.

CACI International Inc

Claims Examiner

Initial Screening Criteria: Specialized experience is defined as experience in one or more of the following areas: investigations, audits, accounting, public policy, healthcare administration, contract monitoring, legal work, Texas Medicaid program experience or healthcare compliance monitoring in Medicaid or Medicare, Managed Care Organizations (MCO), Dental Maintenance Organizations (DMO), or Dental Service Organizations (DSO). Requirement #2: Two years of specialized experience in any of the following areas: investigations, audits, accounting, public policy, healthcare administration, contract monitoring, legal work, Texas Medicaid program experience or healthcare compliance monitoring in Medicaid or Medicare, Managed Care Organizations (MCO), Dental Maintenance Organizations (DMO), or Dental Service Organizations (DSO).

Texas Health and Human Services Commission

Investigator V

Answer verbal and written inquires and customer service queued calls on Group claims from insureds, group policy holders, agents, physicians, hospital attorneys, Workers' Compensation Board, Workers' Compensation carriers, State agencies, other insurance carriers, TPA's, Reinsurers and internal staff. Knowledge of ERISA regulations, statutory disability claims administration, required offsets and deductions, disability duration and medical management practices and Social Security application procedures strongly preferred.

Renaissance Life & Health Insurance Company of America

Life & DI Claims Examiner I

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The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure. Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf .

HOUR

Prime Healthcare Services Inc

ESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted hospital and professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Responsible to prepare files and documents for the annual health plan delegation oversight audits, assist Claims Supervisor with MSO management reports, and other special projects as needed.

North East Medical Service

Claims Examiner II

The Commercial Auto Claims Examiner will contact Insureds, Claimants and others by telephone and correspondence regarding information and documents necessary to evaluate and resolve claims, claim processes and related matters, and resolution alternatives. The Commercial Auto Claims Examiner will be responsible for investigating, evaluating, providing defense if appropriate, negotiating and resolving assigned commercial auto property damage and bodily injury claims.

AllSearch is one of the leading providers of industrial sales recruiting, manufacturing recruiting, HVAC recruiting, and construction / building product recruitment in the United States today. In complement to our largest practices, we also run long-standing, thriving niche recruitment practices specializing in the areas of both Insurance, and Engineering. Each practice is run by an industry veteran who spent a more than a decade working hands–on within the industry their recruiting practice represents. Talk about inside knowledge! Whether you’re a client looking for premier talent, or a candidate looking for a rewarding career opportunity, we can help you reach your goals. #StepYourJobUp

AllSearch Professional Staffing Inc.

Commercial Auto Claims Examiner - Insurance - Base Salary to 105k/year - Atlanta, GA

Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge 2) functional knowledge of law and insurance regulations in various jurisdictions 3) demonstrated advanced verbal and written communications skills 4) demonstrated advanced analytical, decision making and negotiation skills Investigate, evaluate, and determine settlement value or denial of liability for severe to major-level general liability claims. ATHENS POSITION DETAILS Position Title: Senior Claims Examiner – General Liability Department: Property & Casualty Reports To: Claims Supervisor FLSA Status: Exempt in all states but California (Remote or Hybrid) Job Grade: 13 Career Ladder: Next step in progression could include Complex Claims Examiner ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976.

Athens Administrators

Senior General Liability Claims Examiner

Based in Mooresville, N.C., Lowe's supports the communities it serves through programs focused on creating safe, affordable housing, improving community spaces, helping to develop the next generation of skilled trade experts and providing disaster relief to communities in need. Settle claims within authority and in an appropriate manner consistent with Lowe's objectives and values by determining liability, obtaining demands and making offers to claimants, requesting settlement checks, making filings with regulatory agencies, and disposing of salvage, pursuing subrogation when appropriate.

Lowe's Companies, Inc.

Additional duties may be assigned: Advanced knowledge in the following areas: 1) claims handling concepts, practices, and techniques, to include but not limited to coverage issues, and product line knowledge 2) functional knowledge of law and insurance regulations in various jurisdictions 3) demonstrated advanced verbal and written communications skills 4) demonstrated advanced analytical, decision making and negotiation skills Investigate, evaluate, and determine settlement value or denial of liability for severe to major-level commercial auto claims. ATHENS POSITION DETAILS Position Title: Senior Claims Examiner – P&C Department: Property & Casualty Reports To: Claims Supervisor FLSA Status: Exempt in all state but California Job Grade: 13 Career Ladder: Next step in progression could include Complex Claims Examiner ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976.

Claims Examiner Jobs in the United States

Occupational Medicine Physician, (MD/DO) Corvallis, OR UnitedHealth Group Inc

SIU Senior Consultant CNA

Assistant Manager Data Analysis HomeServe USA Corp

Fraud Investigations Manager BankUnited Inc

Assistant Manager Data Analysis HomeServe USA

Quality Assurance Specialist - Medical Claims Datamark, Inc.

Bodily Injury Claims Examiner GEICO

Casualty Claims Examiner GEICO

Software Patent Prosecution Attorney Jobot

Senior Workers' Compensation Claims Examiner - Federal Claims American International Group

Senior Claims Examiner Lowe's Home Centers

Claims Examiner CACI International Inc

Investigator V Texas Health and Human Services Commission

Life & DI Claims Examiner I Renaissance Life & Health Insurance Company of America

Claims Examiner Prime Healthcare Services Inc

Claims Examiner II North East Medical Service

Commercial Auto Claims Examiner - Insurance - Base Salary to 105k/year - Atlanta, GA AllSearch Professional Staffing Inc.

Senior General Liability Claims Examiner Athens Administrators

Senior Claims Examiner Lowe's Companies, Inc.

Senior Commercial Trucking Claims Examiner Athens Administrators

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