Claims Consultant
$48k - $55kTata Consultancy Services
Job Description To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments. Responsibilities Review and analyze claim nuances, eligibility review, and type of claims (intermittent or continuous). Review and analyze medical information (e.g., attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined. Approval or denial on FMLA claims as per Insurance carrier and employer’s guidelines. Analyze, approve and authorize assigned claims and determine benefits due pursuant to US paid family law regulations. Review claims for "Not in good order" cases and work on securing missing documentation including employee, physician, or employer outreach. Communicate clearly with the claimants and clients to set expectations on all aspects of the claims process either by phone and/or written correspondence. Review client critical deliverables, manage the overall workload, and second-level process escalation. Determine benefits due, make timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets. Refer cases as appropriate to team lead and clinical case management. Manage day-to-day workload and first-level process escalation, and review processes for accuracy and timeliness where applicable in case of peer reviews. Provide ideas to management on continuous improvement and service level management. Perform other duties or participate in special projects as assigned. Requirements 1+ year of Disability/FMLA/PFL claims or insurance claims experience. Experience working with FINEOS. Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports. Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices (mandatory). Excellent oral and written communication, including presentation skills. Strong analytical, decision making, problem solving, and people management skills. Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT). Willingness to embrace change in a fast paced work environment. A strong desire to continuously learn and improve. Identify escalated cases and work with Team Leader to develop a plan to address key issues. Qualifications Associateship. TCS Employee Benefits Summary Discretionary Annual Incentive. Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans. Family Support: Maternal & Parental Leaves. Insurance Options: Auto & Home Insurance, Identity Theft Protection. Convenience & Professional Growth: Commuter Benefits & Certification & Training Reimbursement. Time Off: Vacation, Time Off, Sick Leave & Holidays. Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing. Salary Range: $48,000 - $55,000 per year. #J-18808-Ljbffr
- ....You are:An experienced Epic Resolute Professional Billing and Claims Certified ConsultantThe Work:Depending on the client engagement... ...points if you have:• Minimum of 1 year of experience working for a consulting firm• Experience in at least 1 full implementation of Epic•...SuggestedFull timeWork experience placementLive inWork at officeLocal area3 days per week
- CCMSI in Dallas, TX is seeking an experienced Workers’ Compensation Claim Consultant to manage a complex portfolio of Texas WC claims with empathy and professional judgment. You will lead investigations, guide claim strategy, and ensure timely resolutions. With 5+ years...Suggested
$49k - $72k
...Bonus based on performance Opportunity for advancement Signing bonus Position Overview Are you looking for a place to be a trusted consultant that customers depend on for their family’s needs? If so, you may be a great fit for our Agency! About Us Andrew Jantz State Farm...SuggestedFull timeFor contractorsWork at officeRelocation packageMonday to Friday$49k - $72k
...Responsive Recruiter Are you looking for a place to be a trusted consultant that customers depend on for their family's needs? If so, you may be a great fit for our Agency! About Us Andrew Jantz State Farm is committed to providing exceptional insurance solutions...SuggestedFor contractorsWork at officeMonday to Friday- ...Notifies customer and designated personnel of findings, adjustments, and recommendations such as denied or approved warranty, payment of a claim, credit of customer’s account, or adjustment of customer’s bills Recommends to management improvements in product, packaging,...SuggestedWork at office
- Tata Consultancy Services is seeking an experienced claims professional to provide Absence case management and adjudication for Disability/FMLA/Paid Family Leave, ensuring timely benefit payments and adjustments based on medical documentation. The role involves reviewing...
- ...Sedgwick is seeking a Claims Adjuster - Liability with a hybrid work arrangement. You will analyze liability claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations and client requirements...Work at officeWork from homeFlexible hours
- ...CornerStone Staffing in Dallas, TX seeks a Liability Claims Adjuster onsite to investigate, evaluate, and resolve third-party liability claims in auto or commercial casualty environments. The role emphasizes applying Texas liability laws, documenting findings, and negotiating...Work at office
$75k - $80k
...Multi-Line Claim Consultant – General Liability / Premises (National Accounts)Compensation: $75,000–$80,000 annually (based on experience)Schedule: Monday–FridayWork Model: Fully RemoteBuild Your Career With Purpose at CCMSIAt CCMSI, we partner with global clients to...Remote work- ...CCMSI in the United States is seeking a seasoned Multi-Line Claim Consultant for a remote role. You will investigate, adjust, and manage a high-volume caseload across jurisdictions, from assignment through resolution, with emphasis on litigation exposure and client instructions...Remote work
- ...Lone Star Park in Grand Prairie, TX is seeking a Claims Clerk assistant to support daily racing operations. You will handle phone inquiries, input foal papers and silks, and assist with race draws, maintaining accurate lists of jockeys and weights in the condition book...
$57k - $70k
...we offer the GEICO Pledge: Great Company, Great Culture, Great Rewards, and Great Careers. Your Impact at GEICO As an Auto Claims Specialist, you’ll reassure customers and offer solutions when they need us the most with empathy and care. You will guide policyholders...Hourly payFull timeWork at officeLocal areaImmediate startFlexible hoursWeekend workAfternoon shift$65k - $80k
Overview Workers' Compensation Claim Adjuster (TX jurisdiction) Location: Dallas, TX Schedule: Hybrid - after initial training Salary... ...an experienced and highly skilled Workers’ Compensation Claim Consultant to manage a complex portfolio of claims with confidence,...Work at office- Mechanical Envelope AdjusterBasic Function:Set up, troubleshoot, repair, and maintain envelope converting equipment, making necessary adjustments for adequately functioning equipment, and producing quality products. Strong mechanical skills are required. The company will...Shift work
$20 - $33 per hour
Envelope AdjusterWe are currently seeking a skilled Envelope Adjuster familiar with working on envelope converters to join our team in Grand Prairie, Texas. This role offers a competitive hourly rate ranging from the upper $20s to $33/hr +/-, depending on experience and...Hourly payRelocationRelocation package- ...the use of initiative and independent judgment, the Contract Specialist V performs highly advanced, senior level, technical and consultative work assisting with the oversight of the daily operations and contract management activities from contract development to contract...Full timeContract workTemporary workPart timeFor contractorsRemote workMonday to FridayShift work
- ...A leading insurance claims training company in Grand Prairie, Texas is seeking Independent Insurance Claims Adjusters. The role offers a dynamic career path with opportunities for growth. Candidates should ideally be Licensed Claims Adjusters with experience, but those...
$65.68k - $94.42k
...Anticipated End Date: 2026-09-04 Position Title: Rating/Claims System Analyst Job Description: Rating/Claims Systems Analyst... ...the systems post-implementation. Provides end user support, consultation, liaison communications, helpdesk triage, training, reporting,...Full timeTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week- ...surplus.Amerisure is currently recruiting for a Senior Commercial Auto & General Liability Adjuster with experience with handling claims that deal with risk transfer, subcontractors, and general contractors. This role will be hybrid onsite three days a week. The ideal...For contractorsFor subcontractorWork at officeLocal areaFlexible hoursNight shift3 days per week
- When someone needs insurance coverage for the unique, the unusual, or the unconventional, they come to Burns & Wilcox. Burns & Wilcox offers unparalleled resources and exposure for those looking to excel in the specialty insurance industry. We are looking for candidates...Worldwide
$110k - $200k
Job Description:At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. We do this by driving Responsible Growth and delivering for our clients, teammates, communities and shareholders every day.Being...Full timeWork at officeFlexible hoursDay shift$100k - $165k
...Equipment Dealers, and other Marine coverages. This position will collaborate within a large team of commercial underwriters, operations, claims, marketing, and Home Office management as necessary. We are looking for a candidate who is highly motivated, results oriented with...For contractorsLocal areaHome office$115k - $150k
HIRING!! Commercial P&C, E&S Underwriter, Hybrid - Dallas, TXThis A-rated E&S insurance carrier continues to experience robust growth across the U.S. They specialize in contract binding and write a diverse range of property and casualty (P&C) classes on a non-admitted basis...Contract workWork at office- Job Id: 24011Job Type: PermanentIndustry: InsuranceWorksite Location: Remote - Texas (Dallas-Fort Worth Metro)Location: Dallas-Fort Worth, TX 75201Join a forward-thinking specialty insurance group recognized for delivering unique solutions across complex risks. They foster...Remote workFlexible hours
$750 per week
ApexFocusGroup collaborates with research firms, universities, and trusted brands to gather genuine consumer insights. We help connect everyday people with flexible remote market research opportunities that influence real products, services, and customer experiences. Role...Part timeCasual workRemote workFlexible hours$110k - $160k
HIRING!! Commercial P&C, E&S Underwriter, Hybrid, TXA-rated E&S insurance carrier continues to experience robust growth across the U.S. and they are actively seeking experienced Commercial E&S Underwriters to join their expanding team, in their Dallas office.This is contract...Contract workWork at office$96k - $181k
...management.Maintain productive relationships with all partners, including mortgage bankers, borrowers, HUD staff, and third-party consultants—through a collaborative approach and timely disclosure of transaction risks.Actively contributes market intelligence, industry...Full timeWork at officeFlexible hoursNight shift$100k - $125k
Who We AreJoin a team that puts its People First! First American's Direct division provides comprehensive title insurance protection and professional settlement services for real estate purchases, refinances and equity loans. Since 1889, First American (NYSE: FAF) has held...Full time$96k - $181k
Location:8117 Preston Road, Suite 400, Dallas TexasThe selected candidate will be responsible for performing comprehensive due diligence and underwriting activities for Fannie Mae, Freddie Mac, and Private Placement Affordable multifamily mortgage loans. This role requires...Full timeWork at officeFlexible hoursNight shift- ...and professional manner Utilize systems and technology to complete account management tasks Accurately document and process customer claims in appropriate systems Follow all required scripts, policies, and procedures Utilize knowledge base and training to accurately...Full timeTemporary workWork experience placementCasual workWork at officeLocal areaWork from homeShift work
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