Complex Reinsurance/Stop-Loss Medical Claims Adjuster
CVS Health
CVS Health is seeking an experienced Reinsurance/Stoploss Claims Adjuster in Massachusetts. You will review and adjust high-dollar medical claims, apply guidelines, and collaborate with multiple teams to ensure accurate adjustments and compliant payments. You will handle inquiries, rework discrepancies, and potential training for junior staff as part of a collaborative, fast-paced claims team. Must have an Associate degree or equivalent experience and 2+ years in medical claim processing. #J-18808-Ljbffr CVS Health
$94k - $197k
...0 Job Category: Claims Description L... ...immediate opening for a Complex Claims Specialist... ...our Miscellaneous Medical Facilities Claims... ...for underwriting, reinsurance, and senior... ...damages, establish and adjust reserves,... ...and support major loss response efforts....MedicalFull timeWork at officeLocal areaImmediate startRemote work$83k - $157k
...0 Job Category: Claims Description Looking... ...? Senior Complex Construction Claims... ...or high-exposure losses $500,000+). You will... ...when appropriate, medical and causation experts... .... Set and adjust reserves based on... ...Underwriting, Risk Control, Reinsurance/Excess, Product...MedicalFull timeWork at officeLocal areaImmediate startRemote workHome office- ...Workers' Compensation Claims Specialists in our Northeast... ...routine to moderately complex claims, making key... ...compensability, evaluating losses, and negotiating fair... ...reserve requirements, adjusting reserves as necessary,... ...insurance coverage and medical terminology helpful, but...MedicalWork at officeLocal areaRemote work
- Crawford & Company is seeking an experienced Claims Professional to investigate and settle advanced, large loss and complex claims with minimal supervision in a Massachusetts... ...and mentorship of new hires. A WC adjuster license is required where applicable. #J-188...Suggested
$65k
...on damage severity and repair complexity. Prepares estimates for the... ...rd party auto physical damage claims using guided photographs provided... ...inconsistencies between the loss description and the physical... ...wellness programs including medical, dental, vision, 401k plan,...MedicalHourly payWork experience placementLocal areaFlexible hours$18.5 - $42.35 per hour
...community at a time. Position Summary Review, research, and adjust complex Reinsurance/Stoploss medical claims, splitting claims into multiple claim statuses;... ...processing experience. Familiarity with Reinsurance/Stop loss medical claims. Demonstrated ability to handle...MedicalHourly payFull timeContract workTemporary workLocal area$37.66 - $44.33 per hour
...the unique coverage and claims-handling needs of... ...Workers' Compensation Claims Adjuster Employment Type:... ...providing the best service on loss control and claims,... ...employees receive excellent medical care if needed due to a... ...of higher technical complexity for our customers in MD...MedicalHourly payTemporary workRemote work$57k - $113k
...0 - $113000.00 Job Category: Claims Description Join us as a Field Property Claims Adjuster where you'll be responsible for... ...and evaluate onsite to resolve complex coverage and damage issues to include... ...workload, from first notice of loss to final closure. Be...Full timeFor contractorsWork at officeLocal areaRelocation packageNight shift$66.8k - $81.6k
...journey has already begun. As an auto damage claims adjuster , you’ll serve as Progressive’s point of... ..., write estimates, determine total loss evaluations, and set clear expectations... ...dollar-for-dollar company match up to 6% Medical, dental & vision, including free...MedicalTemporary workWork experience placementH1bWork at officeLocal areaFlexible hours$50k - $55k
...each year Health insurance (medical, dental, vision) Annual 401(k... ...where they will learn basic adjusting skills and develop investigative... ...automobile physical damage claims. The successful candidate will... ...Responsibilities Sets up first notice of losses (FNOL) using Safety’s...MedicalFull timeTraineeshipWork experience placementWork at officeFlexible hoursShift work- Schedule: Full-Time Job Category: Claims Description Join us as a Field Property Claims Adjuster where you'll be responsible for... ...new hires. Handle moderate to complex claims independently while managing... ...workload, from first notice of loss to final closure. Be expected to...Full timeFor contractorsWork at officeLocal areaWork from homeRelocation packageNight shift
$72k
...Group is currently seeking a motivated and ambitious Stop Loss Analyst to join our team. This position will report... ...stop loss carrier portals. Analyze, pull, and review medical, pharmacy, eligibility, and stop loss claim data for self-funded clients, including 50% reports,...MedicalContract workTemporary workWork at officeLocal area- ...the training period. ** General Summary: A Complex Claims Specialist will possess experience in handling complex medical liability claims, while demonstrating a... ...professional liability strongly preferred NY adjusters license required within the first 6 - 12...MedicalWork at officeNight shift
$72k - $141k
...coverage and provides best-in-class claim service. We are seeking a... ...starter to join our team as a Complex Claims Consultant handling... ...informed of significant risks and losses by completing loss summaries,... ...obtain and maintain an Insurance Adjuster License within 90 days of hire...Full timeWork experience placementWork at officeLocal areaShift work$54k - $57.5k
...reside within a reasonable commute of Progressive's Bedford, NH Claims office at 43 Constitution Dr. Suite 203, Bedford, NH 03110.... ...Benefits 401(k) with dollar-for-dollar company match up to 6% Medical, dental & vision, including free preventative care Wellness &...MedicalTemporary workTraineeshipWork experience placementH1bWork at officeLocal areaMonday to FridayFlexible hours- ...role. Job Category: Claims Description Liberty Mutual... ...focus on Miscellaneous Medical Facilities (MMF) and... ...claims from first notice of loss through resolution he... ...brokers, risk managers, and reinsurers. As required, maintains insurance adjuster licenses. *This...MedicalFull timeWork at officeLocal areaImmediate startRemote work
- ...settlement authority on highly complex claims valued in excess of Market... ...oversight of all large losses for a specific CSA or CSAs.... ...We are seeking Large Loss Adjusters to join our growing team! This... ...provisions of the Family and Medical Leave Act (FMLA) and telling...MedicalContract workWork at officeWork from homeHome officeVisa sponsorshipWork visa
- Liberty Mutual Fire Insurance Co. is seeking a Field Property Claims Adjuster to help customers navigate the claims process after damage to... ...hires. Primary duties include onsite investigations, complex claim handling, and coordination with contractors, with training...For contractorsRelocation packageNight shift
$38.22 per hour
...Claims Analyst Trillium Professional is now seeking a Claims Analyst... ...is responsible for managing complex pharmacy insurance claims,... ...healthcare revenue cycle, coding, medical billing, patient accounting,... ...communications by responding STOP to any electronic communication...MedicalContract workWork at officeRemote work- Description The Claims Specialist works within a Claims... ...routine to moderately complex claims from the... ...compensability, evaluating losses, and negotiating settlements... ...reserve requirements, adjusting reserves, as necessary,... ...techniques, medical terminology and legal aspects...MedicalWork experience placementWork at officeLocal area
- ...Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal... ...external clients. Workers Compensation (WC) Adjuster License required according to... .... The core benefits* offered include: Medical, Dental and Vision Plans Prescription...MedicalFull time
$80.72k - $145.3k
...As a dedicated Property Adjuster Specialist, you will work... ...evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze... ...to physically inspect losses within your locally assigned... ...benefits include comprehensive medical, dental and vision plans,...MedicalHourly payFull timeH1bLocal areaRemote workAfternoon shift$85k - $105k
## Claims Service Specialist IV - Commercial Lines Bodily InjuryApplylocations... ...service and minimizing net loss payout.* Contacts all insureds... ....* Interprets and evaluates medical reports to determine if they... ...5+ years of progressive Claim Adjuster experience* Demonstrated...Medical- Arbella 56 Group in Quincy, MA is seeking a Claims Service Specialist IV for Commercial... ...supervision, you will investigate and resolve complex claims, guiding litigation, and mentoring... ...effective coordination with legal and medical professionals. Responsibilities include evaluating...Medical
$15 - $20.4 per hour
...TJX Companies Store Loss PreventionAt TJX Companies, every day brings new opportunities for growth, exploration, and achievement. You... ...service or hours requirements are also eligible for: 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long...MedicalHourly payTemporary workLocal areaHome officeFlexible hours$15 - $18.6 per hour
...Opportunity: Contribute To The Growth Of Your CareerSupports the District Loss Prevention Manager and Store Management by executing core... ...or hours requirements are also eligible for: 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long...MedicalHourly payTemporary workLocal areaHome office$15 - $20.4 per hour
...TJX Companies Store Loss Prevention At TJX Companies, every day brings new opportunities for growth, exploration, and achievement... ...service or hours requirements are also eligible for: 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long...MedicalHourly payTemporary workLocal areaHome officeFlexible hours- We are seeking a Senior Construction Claims Analyst to serve as a key contributor within the firm’s Claims Group, supporting complex claims and dispute resolution efforts across major... ...delay, disruption, acceleration, loss of productivity, cumulative impact, differing...Contract workFor contractors
- Liberty Mutual Insurance is seeking a Field Property Claims Adjuster in Quincy, MA. You will travel locally to insured homes, assess damages onsite, and guide customers through the claims process with empathy and clarity. You’ll handle end-to-end claims from first notice...Local areaRelocation package
- IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth...
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