Reinsurance & Stop-Loss Claims Specialist
CVS Health
CVS Health is seeking a dedicated Adjuster for Reinsurance/Stoploss claims in a full-time capacity. The role requires reviewing complex medical claims, applying eligibility guidelines, and performing adjustments while maintaining compliance with processing guidelines. You will handle inquiries, support pre-authorizations, and partner with cross-functional teams to ensure accurate pricing and reimbursements. Strong attention to detail and healthcare knowledge are essential. #J-18808-Ljbffr CVS Health
$27.5 - $30.5 per hour
POSITION SUMMARY: Responsible for underwriting loss mitigation applications in accordance with Treasury, Company and Investor guidelines while following company’s policies and procedures under general supervision. Makes sound underwriting decisions and ensures that all...SuggestedTemporary work$60k - $75k
...Work® Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Workers Compensation | Jurisdiction: MI, TX, IN, IL,... ..., sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over...SuggestedFull timeContract workLocal areaRemote workFlexible hours$65k - $85k
...Work® Fortune Best Workplaces in Financial Services & Insurance Claim Examiner - Product Liability | Multi-State Jurisdiction |... ...available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over...SuggestedFull timeWork at officeRemote workFlexible hours$70k - $85k
...Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation | Jurisdiction: MD & NJ | Licensing... ..., sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over...SuggestedWork at officeRemote workWork from homeFlexible hours$50k - $55k
...Fortune Best Workplaces in Financial Services & Insurance Claims Representative, Auto PRIMARY PURPOSE OF THE ROLE: To analyze... ...Ability to review and assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first...SuggestedFull timeContract workWork at officeLocal areaFlexible hours- Humana, Inc. is seeking a Claims Process and Policy Professional I to handle TRICARE-related inquiries, research claim issues, and support policy interpretations. The role emphasizes accuracy, timely responses, and collaboration with internal teams. Candidates should be...Remote job
$19.39 - $24.19 per hour
...reviewing, evaluating online entry, correcting errors and/or performing quality control review and final adjudication of paper/electronic claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Reviews processed claims and...For contractorsLocal area$18.5 - $42.35 per hour
...Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines.... ...Responsibilities Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise. Applies...Remote jobHourly payFull timeWork experience placementLocal area- Sedgwick is hiring a Claims Adjuster - Liability to analyze complex claims and negotiate settlements for high-exposure cases. This role supports clients nationwide from a remote setup, requiring a home-state license and all-states jurisdiction experience. You will work...Remote job
$27.55 - $30.61 per hour
...you for considering opportunities with us! Commercial Senior Auto Claims Adjuster - Remote Requisition Number R8094 Commercial Senior... ...moderate complexity. Answer inbound calls, open claims, acquire loss details from all involved parties and Investigate, evaluate, negotiate...Remote jobHourly payH1bWork from homeMonday to FridayFlexible hoursShift workDay shiftWeekday work$25.32 - $28.13 per hour
...for considering opportunities with us! Job Title Commercial Auto Claims Adjuster - Remote Requisition Number R8093 Commercial Auto... ...complexity liability claims including property damage claims and total losses. You will be responsible for verifying coverage on policies with...Remote jobHourly payH1bWork from homeMonday to FridayFlexible hoursShift work$60.8k - $76k
...with highly motivated individuals on high-performance teams? Join WWT today! What is the SCLO Team and why join? The Contract Specialist Services role resides within our Sales Operations Service Contract & Licensing Operations team and interacts directly with Inside...Full timeContract workRemote workFlexible hoursShift work$90k - $112k
...Fortune Best Workplaces in Financial Services & Insurance Assistant Claims Manager (Product Liability) PRIMARY PURPOSE To oversee technical... ...needs; and to oversee budget preparation and profit and loss management. Has direct and/or indirect responsibility for 25 or...Work at officeLocal areaFlexible hours- CVS Health is seeking a Claims Adjudicator to review and adjudicate complex medical claims with precision. You will apply medical necessity guidelines, verify coverage, and resolve issues to ensure a positive member experience. You will work in a high-volume environment...Remote job
- Sedgwick is hiring a Claim Examiner for multi-state general and product liability, with hybrid work options. The role analyzes complex claims, negotiates settlements, and coordinates with clients and carriers. Candidates in the Montpelier, VT region are welcome to apply...Remote jobFlexible hours
- ...Adjustment is looking for people who are interested in helping homeowners receive the maximum amount they are entitled from their insurance claim. Join Metro, a renowned and trusted 30 year old business to take charge of your future. Position Details: Reliable Training - No...Remote jobFull timePart timeFlexible hours
- State of Vermont is seeking an Associate Insurance Rate & Form Analyst in Montpelier to review property and casualty filings. The role emphasizes detail orientation, timely handling of a high filing load, and clear communication with filers and companies to ensure compliance...Work at office
- ...Job Description Job Description JOB SUMMARY Directly handle a diverse claims caseload of multiple coverage types, including casualty and D&O, with a large percentage of losses of moderate to high complexity and financial severity. Claims assigned occasionally involve...Contract workWork at officeRemote workNight shift
- The Insurance Rate & Form Analyst reviews property and casualty rate and form filings for the Vermont Department of Financial Regulation, working primarily independently while collaborating with a larger team. The role requires attention to detail, strong organizational...
- Sedgwick is seeking a Claims Examiner for Workers Compensation to analyze and adjudicate complex WC claims for clients, determining benefits due while aligning with service expectations and client requirements. Office location involves a hybrid model: two days in office...Remote jobWork at officeWork from home
$29.73 per hour
Title: Associate Insurance Rate & Form Analyst Application Deadline Date: 10/15/2026 Location: Montpelier, VT, US Position Type: Permanent Schedule Type: Full Time Minimum Salary: $29.73 Maximum Salary: $46.49 Overview The Rate and Form Analyst will primarily be tasked...Permanent employmentFull timeWork at officeFlexible hours- The Associate Insurance Rate & Form Analyst reviews property and casualty rate and form filings for the Vermont Department of Financial Regulation in Montpelier. The role involves managing a high filing load, meeting statutory deadlines, and communicating compliance issues...
- Mobilitas is hiring a Commercial Auto Claims Adjuster - Remote to handle non-complex to moderately complex commercial auto claims from home. You will investigate, evaluate and settle claims, verify coverage and communicate with insureds, claimants, and service providers...Remote jobFlexible hours
- ...as a remote‑first company serving the modern mobility sector. We hire bilingual and motivated individuals to handle commercial auto claims with a focus on Pacific Time Zone operations, flexible scheduling, and strong customer engagement. The role emphasizes experience...Remote jobFlexible hours
- Sedgwick is seeking an Assistant Claims Manager (Product Liability) to oversee technical and operational functions, ensure quality delivery, and manage staffing and budget for a small team. The role emphasizes compliance, client relationships, and process improvement....Remote job
$75k - $86k
Contract Specialist I (Mid-Level) (0020) OCT Consulting is a business management and technology consulting firm that provides support to Federal Government clients. We provide consulting services in the areas of Strategy, Process Improvement, Change Management, Program...Contract workTemporary workFor contractorsWork at office$63.94k - $95.68k
Job Description: Analytical Mechanics Associates (AMA) seeks a mid-level to senior Contracts Administrator to independently manage the full life cycle of prime contracts and task orders, subcontracts AMA awards to other companies, agreements under which AMA performs as...Permanent employmentContract workTemporary workFor contractorsFor subcontractorWork at officeLocal areaImmediate startRemote work- OCT Consulting LLC seeks a Contract Closeout Specialist (Junior) to support Federal Government contracts. The role requires 2-3 years of closeout experience, FAR knowledge, and DHS/CBP familiarity. Remote work is allowed, with onsite in Washington, DC at least two days...Contract workRemote work2 days per week
- National Life Group in Addison, TX is seeking a Contracts Specialist to ensure accurate processing of contracts, amendments and appointments, compliant with state and federal licensing rules. You will deliver customer-service oriented contracting to distributors and employees...Monday to Thursday
$60k - $75k
Contract Closeout Specialist (Junior) (0035) OCT Consulting is a business management and technology consulting firm that supports Federal Government clients. We provide consulting services in the areas of Strategy, Process Improvement, Change Management, Program and Project...Contract workTemporary workFor contractorsWork experience placementWork at officeRemote work2 days per week
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