Senior Health Claims Strategist
$101.7k - $155.9kMunich Re Specialty - North America
We are adding to our diverse team of experts and are looking to hire those who are committed to building a culture that enables the creation of innovative solutions for our business units and clients. The Company Welcome to Munich Re Specialty - North America, a leading specialty insurance provider dedicated to delivering exceptional underwriting, claims, and risk management expertise to our partners and customers. As a trusted industry expert, we offer a broad range of comprehensive and customized solutions, including casualty, professional lines, property, surety, and public entity coverages. With the financial strength and global resources of our A+ Superior (A.M. Best) rated organization, we provide unmatched stability and reliability. Our team is committed to superior service levels, a distinctive approach to specialty solutions, and a deep understanding of the complex risks our clients face. Join our team and be part of a dynamic and experienced organization that is shaping the future of specialty insurance in North America. The Opportunity Future focused and always one step ahead! The Senior Claims Specialist on the Healthcare team plays a critical role in our growing Claims Department and will be responsible to direct all aspects of file handling on both in-house and third-party administered claims, with growth opportunity in technical handling and professional development. The Senior Claims Specialist will also direct the adjusting and litigation process, strategically partner with counsel, experts and vendors, and drive optimal claim resolutions. The Senior Claims Specialist will analyze and determine coverage, manage the claim investigation, evaluate the overall claim, communicate promptly with internal and external stakeholders, and pursue recoveries and risk transfer where warranted. Key Responsibilities Thorough investigation and assessment of claims related to healthcare, damages, pursuit of recoveries and subrogation/contribution opportunities. Demonstrate an in-depth understanding of coverage issues, policy forms, contracts, regulatory requirements, and changing legal landscape for specialty line claims. Proactively and promptly manage claims, considering all aspects with a strategic vision for optimal claim outcome. Continually evaluate claims to set appropriate, timely reserves over the life of the claim to reflect changes in exposure. Demonstrate strong technical claims proficiency through consistent execution of best claim practices. Strategically coordinate and manage outside counsel and vendors to obtain optimal claim outcome. Present high exposure claims to Claims Leadership and Key Stakeholders. Collaborate with internal and external business partners for client meetings, product development and improvement, and account audits. Look for ways to improve claim efficiencies and outcomes (innovative mindset). Qualifications Bachelor’s degree required. Law degree preferred. 7 years plus experience in handling specialty claims. Experience in handling Life Sciences and/or Allied Health claims preferred. Detail‑oriented, adaptable, and strategic in decision‑making. Understanding of technical claims proficiency and execution of best claim practices. Ability to work independently, multi‑task, and remain self‑motivated in a fast‑paced environment. Strong organizational skills and time management of claims desk. Strong business acumen and ability to collaborate with other departments and vendors. Customer‑service and relationship oriented. Innovative, dynamic and growth mindset. Good verbal and writing skills for internal and external communication, presentations and reporting. Good analytical thinking, advocacy and negotiation skills. Willingness to travel for mediations, settlement conferences, and client or account meetings (up to 25 %). Maintain valid adjusters’ license(s) in states assigned or an ability to obtain same. The Company is open to considering candidates in numerous locations, including Philadelphia (PA), Chicago (IL), Atlanta (GA), Princeton (NJ), or Hartford (CT). The base salary range anticipated for this position is $101,700 - $155,900 , plus opportunity for company bonus based upon a percentage of eligible pay. In addition, the company makes available a variety of benefits to employees, including health insurance coverage, an employee wellness program, life and disability insurance, 401k match, retirement savings plan, paid holidays and paid time off (PTO). The salary estimate is adjusted to reflect the varying market conditions across different locations, with the higher end being more aligned with the Princeton job market. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have and comparison to other employees already in this role. Most candidates will start in the bottom half of the range. Insurance Benefits Two options for your health insurance plan (PPO or High Deductible). Prescription drug coverage (included in your health insurance plan). Vision and dental insurance plans. Additional insurance coverages provided at no cost to you, such as basic life insurance equal to 1x annual salary and AD&D coverage that is equal to 1x annual salary. Short and Long Term Disability coverage. Supplemental Life and AD&D plans that you can purchase for yourself and dependents (includes Spouse/domestic partner and children). Voluntary Benefit plans that supplement your health and life insurance plans (Accident, Critical Illness and Hospital Indemnity). Additional Benefits A robust 401k plan with up to a 5% employer match. A retirement savings plan that is 100% company funded. Paid time off that begins with 24 days each year, with more days added when you celebrate milestone service anniversaries. Eligibility to receive a yearly bonus as a Munich Re employee. A variety of health and wellness programs provided at no cost. Paid time off for eligible family care needs. Tuition assistance and educational achievement bonuses. A corporate matching gifts program that further enhances your charitable donation. Paid time off to volunteer in your community. At Munich Re, we see Diversity, Equity and Inclusion as a solution to the challenges and opportunities all around us. Our goal is to foster an inclusive culture and build a workforce that reflects the customers we serve and the communities in which we live and work. We strive to provide a workplace where all of our colleagues feel respected, valued and empowered to achieve their very best every day. We recruit and develop talent with a focus on providing our customers the most innovative products and services. We are an equal opportunity employer. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. #J-18808-Ljbffr Munich Re Specialty - North America
- A health insurance provider is seeking a Claims Analyst to manage Stop Loss claims according to established standards. The role involves evaluating claims, building client relationships, and analyzing losses. Candidates should possess a high school diploma and extensive...SeniorClaims
$140k - $170k
Hiscox is seeking a Senior Complex Claims Specialist to manage Miscellaneous Professional Liability claims with responsibilities from negotiation... ...between $140,000 and $170,000 plus extensive benefits including 401(k) matching and health coverage. #J-18808-Ljbffr HiscoxSeniorClaimsWork at office2 days per week- Vega is seeking a Senior Bodily Injury Adjuster to join their growing team in Atlanta, GA... ...hybrid role involves managing bodily injury claims while delivering superior customer... ...benefits package, including flexible PTO and comprehensive health coverage. #J-18808-Ljbffr VegaSeniorClaimsFlexible hours
- Zurich North America is seeking an individual for a claims role in their Major Case Unit, part of the Commercial General Liability Team. The position offers a hybrid work model emphasizing flexibility while engaging in collaborative activities. The ideal candidate will...SeniorClaimsWork at office
- Munich Reinsurance America, Inc is seeking a Senior Claims Specialist to drive optimal claim resolutions in their Atlanta office. The role... ...communication skills. The position offers competitive benefits including health insurance, 401k matching, and paid time off. #J-18808-Ljbffr...SeniorClaimsWork at office
- A global market leader in benefits solutions is seeking a senior business developer to drive the acquisition of new Health and Benefits clients. You will develop strategies to penetrate the market, maintain relationships, and ensure clients' health and welfare plan designs...Senior
$79.3k
...Company : Highmark Health Job Description : JOB SUMMARY This role is responsible for supporting the execution of member activation and engagement initiatives across products and solutions, with a particular focus on the clinical side of the business. As part...SeniorFor contractorsWork at officeLocal areaRemote work3 days per week- ...About the Opportunity We are hiring a Senior Personalization Solution Architect with deep... ...package covering 100% of monthly health premiums for employees and 85% of costs for... ...through copycat websites, fake email addresses claiming to be from our company, or social media....SeniorClaimsFull timeWork at officeLocal areaWorldwide
$93.9k - $153.65k
Elevance Health is seeking a Group Underwriting Consultant in Atlanta, GA. This role involves underwriting and pricing complex large group new business, with exposure to senior stakeholders. Candidates should possess a BA/BS and at least 5 years of experience in medical...SeniorWork at office- Grady Health System is seeking a Contracts Specialist in Atlanta, GA to manage the organization's medical and surgical supply portfolio. This role involves strategic sourcing, contract negotiation, and maintaining high-quality services while optimizing financial resources...SeniorContract work
- ...Senior Claim Account Executive Our not-so-secret sauce. Award winning, inclusive, top workplace culture doesn't happen overnight.... ...Marsh McLennan Agency (MMA) provides business insurance, employee health & benefits, retirement, and private client insurance solutions...SeniorClaimsLocal areaNight shift
- Company : Highmark Inc. Job Summary Are you ready to make a significant impact in the world of health insurance? As a Senior Claims Analyst specializing in Stop Loss claims, you will play a crucial role in reviewing, evaluating, and processing Excess Risk and Reinsurance...SeniorClaimsWork at office
- ...Investigator Senior Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined... ...corporate and client funds paid on fraudulent claims. How you will make an impact: Claim...SeniorClaimsTemporary workLocal area1 day per week
- A leading healthcare provider in Atlanta seeks a Senior Administrator for the Physician Contracting Department. The role involves constructing complex compensation models, acquiring Fair Market Value opinions, and performing financial analysis. Ideal candidates will have...Senior
- Primary DetailsTime Type: Full time Worker Type: Employee Senior Claims Specialist- Accident & Health (Medical Stop Loss) Location: USA - MA, Marblehead; Atlanta, GA Work Arrangement: Hybrid or Remote The salary range for this role is:$88,000-145,000K...SeniorClaimsFull timePart timeWork experience placementWork at officeRemote workWork from home
- ...Nurse Case Manager Senior - Field Nurse Nurse Case Manager Senior - Field Nurse Work... ...care plans designed to optimize member health care across the care continuum. Performs... ...Assists in problem solving with providers, claims or service issues. Coordinate referrals...SeniorClaimsWork at officeLocal areaMonday to FridayAfternoon shift
- ...Senior Claims Advocate - Property and Casualty Our not-so-secret sauce. Award-winning, inclusive, top workplace culture doesn't happen... ...Agency (MMA). MMA provides business insurance, employee health & benefits, retirement, and private client insurance solutions...SeniorClaimsWork at officeLocal areaNight shift3 days per week
- ...providing insights based on client needs. A Bachelor's degree is required, and strong skills in client engagement and treasury products are essential. PNC offers a comprehensive benefits package including health coverage, 401(k), and paid time off. #J-18808-Ljbffr PNCSenior
- ...ROLE SUMMARY The Senior Health Data Analyst builds the data layer that powers Blueprint's Rural Health Transformation Program (RHTP) engagements... ...tied to state and CMS reporting requirements. Integrate claims data, APCDs, HEDIS measures, BRFSS, PRAPARE, and other sources...SeniorClaimsWork at officeRemote workFlexible hours
- ...Nurse Audit Senior - Operating Room Shift: Days, Monday- Friday, EST/CST Location: Virtual : This role... ...patterns of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record...SeniorClaimsFull timeTemporary workWork at officeLocal areaMonday to FridayShift work1 day per week
$82.19k - $123.29k
...Nurse Audit Senior (Operating Room) Virtual: This role enables associates to work virtually... ...is a proud member of the Elevance Health family of companies, Carelon Insights, formerly... ...health care providers through prepayment claims review, post payment auditing, and...SeniorClaimsFull timeTemporary workWork experience placementLocal area1 day per week$84.48k - $126.72k
...Group Underwriter Senior Location: This role requires associates to be in-office 1 -... ...Communicates with sales, administration and claims to assess the rating and administrative... ...In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits...SeniorClaimsTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week$98.12k - $147.18k
...Advanced Analytics Analyst Senior - Medical Economics Location: Atlanta, GA; Norfolk,... ...current or future visa sponsorship. Carelon Health is a proud member of the Elevance Health... ...of core Carelon products leveraging claims, authorization, and membership data to tell...SeniorClaimsTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week$249.97k - $388.13k
...is seeking an experienced and visionary Senior Director, Global Clinical Development (GCD... ...regulatory affairs on interactions with global health authorities. • Provides strategic and... ...application processing fee, even if claimed you will be reimbursed, this is not Otsuka...SeniorClaimsTemporary workLocal areaFlexible hours$106.61k - $284.28k
...We’re building a world of health around every individual — shaping a more connected, convenient... ...platform. Position Summary As a Senior Product Manager within the A&BC... ...Familiarity with medical and pharmacy claims data and their application in Healthcare...SeniorClaimsHourly payFull timeTemporary workWork at officeLocal areaRemote work2 days per week1 day per week$124k - $280k
...Data, Analytics & AI Industry/Sector: Health Services Time Type: Full time... ...of health system and health plans. As a Senior Manager, you will drive use case development... ...Guide teams in processing clinical notes, claims data, ADT feeds, and other structured and...SeniorClaimsFull timeH1b$64.83k - $85.09k
Senior Analyst, Payment Integrity Disputes Remote Hi, we're Oscar. We're hiring a Senior... ...join our Disputes team. Oscar is the first health insurance company built around a full... ...disputes and issue resolution in the Oscar claim environment for both the Oscar Insurance...SeniorClaimsFull timeContract workWork at officeRemote work- Enlace Health is a specialty value‑based care company focused on reducing the cost of care... ...draw inspiration from each other. As the Senior Health Care Economics & Value‑Based... ...working the following types of data: Medical claims data Enrollment and eligibility data Provider...SeniorClaimsTemporary workWork experience placement
$25.48 - $60.63 per hour
...Job Description Oracle Health Principal Consultant - Inpatient/Outpatient Pharmacy United States Job Identification: [Unique... ...interfaces, mail routing, inventory tracking, healthplan design, and claims resolution. Career Level - IC2 Responsibilities Basic...SeniorClaimsHourly payTemporary workWork experience placementLocal areaRelocationFlexible hours$178.3k - $407k
...a better working world. AI & Data, Advanced Analytics - Health Sector – Senior Manager - Consulting We are helping our clients transform... ...AI), applying structured and unstructured data (e.g. EHR, claims, ERP, financial, RWE, supply chain) to drive high-quality, data...SeniorClaimsWork experience placementSummer holidayFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Health Claims Strategist. Be the first to apply!
- workplace strategist Atlanta, GA
- brand strategist Atlanta, GA
- technology strategist Atlanta, GA
- business strategist Atlanta, GA
- communications strategist Atlanta, GA
- senior strategy consultant Atlanta, GA
- design strategist Atlanta, GA
- investment strategist Atlanta, GA
- strategist Atlanta, GA
- digital strategist Atlanta, GA

