Claims Specialist
Jobtailor
Provide full cycle support for workers' compensation, general liability, product, and cyber claims Engage directly with team members to provide service Process and document claims in compliance with legislative provisions, company policies, and insurance industry best practices Act in a fiduciary role for the large deductible Consult on the calculation and posting of claim case reserves Negotiate and resolve claims Manage claims from beginning to closure Serve as the primary contact for claim mitigation and resolution recommendations and decisions Provide end-to-end administrative support for return-to-work assignments for full and restricted returns across U.S. QVC locations and panel providers Track and comply with necessary statistics for management Evaluate and submit settlement authority proposals and reserve increases and decreases Prepare reports detailing claim status, payments, reserves, and claim trends Requirements 3+ years leading end-to-end review of insurance claims 3+ years supporting workers' compensation and general liability claims 3+ years using claims service vendor systems or onsite database software to maintain claims history continuity 3+ years using customer portals, payroll and HR resource systems, and team member data management 3+ years applying jurisdictional requirements and applicable case law for each claim and respective state 3+ years partnering with panel providers to evaluate claims Experience documenting the claim review cycle preferred Must reside in New Jersey, Delaware, or Pennsylvania Relocation assistance is not available Core Competencies Demonstrates expertise in managing the full cycle of insurance claims, including workers' compensation and general liability, while ensuring compliance with legislative provisions and industry best practices. Proficient in utilizing claims service vendor systems and customer portals for effective claims management and reporting. Highest-signal resume keywords Workers' Compensation Claims Management General Liability Claims Support Claims Service Vendor Systems Claims Documentation and Reporting Jurisdictional Requirements Application ATS Optimization Keywords Hard Skills Claims Processing Claims Negotiation Claims Documentation Claims Reserve Calculation Claims Trend Analysis Soft Skills Team Collaboration Customer Service Industry Keywords Insurance Industry Best Practices Fiduciary Role Claim Mitigation Settlement Authority Proposals Return-to-Work Assignments Tools & Technologies Claims Service Vendor Systems Customer Portals Payroll Systems HR Resource Systems #J-18808-Ljbffr Jobtailor
$18 - $22 per hour
...Job Description Job Description Title: Authorizations Specialist The Impact You Will Have: Liberty Home Guard is the country... ...services, negotiating with vendors and technicians, and ensuring all claims adhere to company guidelines, ultimately contributing to the...SuggestedWork at officeFlexible hours- A leading automotive service provider is looking for a Mechanical Claims Adjuster to investigate and negotiate vehicle repair claims in a professional remote environment. The role requires automotive knowledge and a strong background in claims adjustment. Candidates should...SuggestedRemote jobHourly payWork from home
- ...Teleperformance is seeking a Licensed Claims Insurance Specialist to manage inbound and outbound communications and resolve inquiries, delivering a seamless customer experience in a high-velocity environment. This role requires an active Adjuster license and ability to...SuggestedRemote workWork from home
- Liberty Mutual Insurance seeks a Claims Specialist to manage a caseload of routine to moderately complex workers' compensation claims from investigation to resolution. You will assess liability, negotiate settlements, and coordinate with claimants, policyholders, appraisers...SuggestedWork at office
$20 - $26 per hour
Claims Specialist Remote | Full-Time Base pay range $20.00/hr - $26.00/hr About Zaya Zaya Care is a venture‑backed startup with a mission to establish a new standard of affordable prevention and recovery care, beyond the hospital setting. Zaya champions the voices of...SuggestedFull timePrivate practiceRemote workShift work- ...risks into opportunities through specialized reinsurance solutions and expert guidance. About the Role Reporting to the Senior Claims Specialist, you will work closely with the Underwriting and Middle Office/Operations teams of MS Reinsurance. This role will be...Contract workWork at office
$100k - $130k
...CRV, and Shield Capital. The Hook: Why this role matters now Step into a high-impact role on our global Claims and Incident Management team. As a Claims Specialist, you won't just process paperwork; you will own the day-to-day investigation and management of Cyber, Technology...Flexible hours- A community-focused medical practice in New Jersey is seeking a Workers' Compensation and Motor Vehicle Scheduling/Support Specialist. This full-time role emphasizes managing appointments, verifying insurance, and providing excellent patient service for work-related and...Full time
- Jobtailor in the United States seeks an experienced Premises Liability Claims Adjuster to join our team. You will examine, adjust, and defend claims against insureds while reviewing policy coverage and supporting allegations with solid factual investigations. You will...
$150k - $200k
Claims Specialist, Transactional Liability Department: Claims Employment Type: Permanent - Full Time Location: US - New York Reporting To: Margaret Murphy Compensation: $150,000 - $200,000 / year Description At CFC, we’re offering an exciting opportunity to join our...Permanent employmentFull time- MetroPlus in New York is looking for a Claims Service Correspondent responsible for providing accurate responses to claim inquiries from healthcare providers. This role involves coordination with multiple departments and resolving issues professionally. Qualifications...
$55.13k - $110.64k
...Pennsylvania; however, we will consider candidates who reside in any of our listed payroll approved states. Job Summary This Lost Time Claims Specialist, Workers’ Compensation manages indemnity claims, investigates, evaluates, and determines compensability for work‑related...TraineeshipWork at officeRemote workFlexible hours- Westfield Specialty Claims is seeking talented professionals to proactively investigate and handle lawyers and architects/engineers professional liability claims from first notice through resolution. Responsibilities include coverage evaluation, litigation management,...
- RV Value Mart Inc. is seeking a detail-oriented warranty claims specialist to process and submit warranty claims, verify customer vehicle information, and review repairs for proper authorization. You will monitor claim status, reconcile payments, and maintain warranty journals...
- Managing indemnity claims remotely, the full-time Iowa Licensed Lost Time Claims Specialist will evaluate and determine compensability for work-related injury and disease claims while ensuring cost-effective outcomes and collaboration across teams. Key responsibilities...Full timeRemote work
- CNA Insurance in the United States seeks an individual contributor to manage commercial claims of low to moderate complexity within the General Liability line. The role involves investigating, evaluating, and resolving claims under company protocols, with focus on quality...Work at officeFlexible hours
- ...and confident in their work. We offer many learning opportunities with room for professional growth. About the Role The Claims Verification Specialist is responsible for verifying patient information, documentation, and insurance coverage for No-Fault (PIP), Workers’...Full time
- Description *** CA, OR, NV and/or NY workers' compensation claims experience are preferred but not required. *** *** Candidates residing... ...will be subject to in-office requirements *** The Claims Specialist works within a Claims Team, using the latest technology to manage...Work at officeLocal area
$69.6k - $92.4k
...customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your... ...Essential Job Functions And Responsibilities Manages an inventory of claims to evaluate compensability/liability. Plans and conducts claim...Full timePart timeSeasonal workWork at officeRemote work$55.13k - $110.64k
...listed payroll approved states. Lost Time Workers' Compensation claims handling experience in any of the following states Illinois,... ...West Virginia, Wisconsin. JOB OBJECTIVE: The Lost Time Claims Specialist, Workers’ Compensation primarily manages indemnity claims. The...TraineeshipWork experience placementWork at officeRemote workFlexible hours$85k - $145k
...pregnancy, race, religion, sex, sexual orientation, veteran status, or any basis prohibited by the laws that govern its operations. Claims Specialist - Employment Practices Liability & Ancillary Lines Job Code P01013 About The Team AXIS is a leading provider of specialty...Work at officeShift work3 days per week- CNA Insurance is seeking an experienced individual contributor to manage commercial claims with moderate to high complexity. You will investigate, verify coverage, and determine settlements while maintaining strong customer service and regulatory compliance. Ideal candidates...
$135k - $150k
...opportunity employer. Responsibilities Investigate, evaluate, negotiate, and resolve complex and high-exposure litigated and non-litigated claims across bodily injury, property damage, personal and advertising injury, and professional liability lines. Analyze coverage,...Full timeLocal area- SourceProSearch is seeking a Claims Specialist with 1-2 years of experience to work in our New York office. The ideal candidate should be comfortable with technology and platforms. This position requires at least 2 days per week in the office. Job Responsibilities: Format...Work at officeShift workWeekend workAfternoon shift2 days per week
- ...talented and enthusiastic individuals to proactively investigate and directly handle lawyers' and accountant's professional liability claims. What you will do: Be responsible for primary and excess lawyers, accountants, insurance agents and brokers, and architects and...Remote workWeekend work
- Job Title: Customer Service Representative - Healthcare Claims Pay Rate: $25 to $30/hr. on W2 Job Summary We are seeking a dedicated Customer Service Representative to join a healthcare organization supporting members, providers, and prospective members. This role is responsible...Work at officeLocal area
- ...Wright Automotive Group in Pennsylvania is seeking a Warranty Clerk to manage warranty repair orders, submit manufacturer claims, and coordinate with service teams to ensure timely processing. The ideal candidate has warranty experience, strong attention to detail, and...Work at office
- ...Wright Automotive Group is seeking a Warranty Administrator to manage warranty repair orders and claims, coordinate with technicians and service staff, and ensure accurate documentation and timely processing. The role involves maintaining receivables schedules, coordinating...
- ...Allstate Insurance Company is seeking a remote, full-time Claims Resolution Adjuster to investigate automobile accidents involving bodily injury, assess coverage and damages, and negotiate settlements while delivering strong customer service. Key responsibilities include...Full timeRemote work
- A national insurance services provider seeks a Full‑Time Field Claims Representative for virtual assignments in Pennsylvania. The role involves managing on-site insurance property claim inventory and ensuring excellent customer relations. Key qualifications include strong...Full timeWork at officeLocal areaNight shift
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