Specialist, Claims Operations
QBE Americas, Inc.
Primary Details Time Type: Full time Worker Type: Employee Location: USA - Marblehead, MA and Atlanta, GA Work Arrangement: Hybrid The salary range for this role is: $76,000-125,500K The Opportunity The role supports the day‑to‑day operational execution of A&H Claims by managing workflows, coordinating with internal and external partners, and driving consistency across intake, reporting, and process execution. The focus is on improving efficiency, data quality, and overall claims operations performance. Responsibilities Support day‑to‑day claims operations by tracking workflows, following up on outstanding items, and ensuring workflows are progressing as expected. Coordinate with internal teams and external partners to gather claim information and assist with issue resolution. Help manage intake and backlog by organizing incoming work and routing items appropriately. Review reports and data for completeness, flagging any missing or inconsistent information. Assist with maintaining accurate records to support reporting and audit readiness. Escalate issues or delays and support follow‑through to resolution. Support process improvements by identifying efficiencies and assisting with implementation of standardized workflows. Provide general operational support to the Claims team as needed. Work Experience Required: 1-3 years of experience in a professional, administrative, or operational support role. Required: Strong organizational skills with the ability to manage multiple tasks and follow through on details. Required: Experience working with data, reports, or tracking workflows in a structured environment. Preferred: Experience in medical stop loss insurance, claims, or a related industry. Preferred: Experience working with external partners, vendors, or shared service teams. Preferred: Familiarity with claims systems, reporting tools, or operational processes. Qualifications Bachelor’s degree or equivalent combination of education and relevant work experience. Strong organizational, communication, and follow‑up skills. Proficiency in Microsoft Office (Excel, Outlook, Teams) and comfort working with data and reports. Ability to manage multiple tasks, prioritize work, and meet deadlines in a fast‑paced environment. Compensation Package The salary range for this role is provided above. The salary offer will be decided based on the role’s complexity, its location, and the candidate’s professional background, including their education and experience. Beyond the base salary, regular full‑time and part‑time employees will also be eligible for QBE’s annual discretionary bonus plan based on business and individual performance. Benefits Hybrid Working – a mix of working from home and in the office. 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender‑equal basis. Competitive 401(k) program with company match up to 8%. Well‑being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice. Tuition Reimbursement for professional certifications and continuing education. Employee Network and Community – QBE actively supports six Employee Networks and many ways to give back to your community. Commitment to Diversity QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information. Equal Employment Opportunity QBE provides equal employment opportunities to applicants and employees without regard to race, color, gender, gender identity, sexual orientation, religious practices and observances, national origin, pregnancy, childbirth or related medical conditions, protected veteran status or disability or any other legally protected status. Skills Analytical Thinking Business Process Improvements Claims Settlement Critical Thinking Customer Service Insurance Analysis Insurance Claims Management Insurance Policies Intentional collaboration Managing performance Negotiation Problem Solving Risk Management Sound Judgment Stakeholder Management #J-18808-Ljbffr QBE Americas, Inc.
$18 - $27 per hour
...the essential support staff who keep our operations running smoothly every role at... ...Services Director, the Payment Poster/EDI Specialist is responsible for the accurate and timely... ...to ensure proper filing of supplemental claims to insurance companies. The staff in this...OperationsClaimsFixed term contractWork at officeFlexible hours$24 - $36 per hour
...the essential support staff who keep our operations running smoothly — every role at... ...! Position Summary: Revenue Cycle Specialist performs a wide spectrum of billing functions... ...cause, identify trends, correct, appeal), Claim Edits (ensure clean claim submission), Transaction...OperationsClaimsFixed term contractImmediate startFlexible hours- ...Job Description Job Description Summary: The WIC Program Specialist provides administrative support to ensure smooth program operation in the core areas of reception work, file management, certification, benefits issuance, notifications, computer & work phone...OperationsTemporary workWork at officeLocal areaAfternoon shift
$76k - $125.5k
QBE Americas, Inc. is looking for a full-time employee to support day-to-day claims operations in Marblehead, MA. The role involves managing workflows and coordinating with various teams to enhance operational efficiency. Candidates should possess a bachelor’s degree and...OperationsClaimsFull time- ...across LEO early childhood programs. The Developmental Behavior Specialist works with the Social Emotional Behavior Manager and the... ...behavior support (Pyramid Model) in the classroom and at home. Operations and Monitoring: Provides direct behavior support in center-...OperationsWork experience placementRemote work
$17.7 - $26.54 per hour
...implementing prevention measures through monitoring and surveillance. Candidates need at least one year of experience in retail operations or customer service, along with strong reporting skills and the ability to maintain confidentiality. The hourly rate ranges from...OperationsHourly pay- ...Containment Lead Manage a portfolio of complex claims by conducting loss investigations,... ...to ensure understanding of Claims operations and encourage a collaborative approach to... ...enhancing the business Participate in claims specialist onboarding by sharing technical...OperationsClaimsFull timePart timeWork experience placementWork at officeWork from home
- ...Health Information Management Specialist The Health Information Management Specialist will accurately and efficiently perform activities related to the smooth operation of the Health Information Department. In this role, the HIM specialist provides support to the department...OperationsFull timeTemporary workWork at office
$15.5 per hour
...rates and retrieval procedures to guests upon arrival. Issues claim checks only after receiving vehicle keys and collects claim checks... ...and divide with 10’s and 100’s; ability to perform these operations using units of American money Ability to understand 24 hour...OperationsClaimsHourly payTemporary workPart timeWork experience placementSeasonal workShift work$23 - $25 per hour
...Behavioral Specialist (CNA) Job Category: Operations Group Requisition Number: BEHAV003262 Full-Time On-site Hunt Skilled Nursing Danvers, MA 01923, USA +7 more locations Pay or shift range: $23 USD to $25 USD The estimated range is the budgeted amount for this...OperationsWeekly payFull timeShift work$64 per hour
...Type: Local Contract WCS Healthcare is currently seeking an Operating Room Nurse for a contract assignment at a Prestigious Hospital... ...Support ● Reception, Clerical, Call Center ● Claims Appeals/Denials/Reimbursement ● Insurance Pre-Authorizations...OperationsClaimsHourly payWeekly payContract workLocal areaShift workRotating shiftWeekend work$58 per hour
...and Pharmacy Techs ● Dental Hygienist, Dental Assistants OPERATIONS & FINANCE ● Practice Management ● Clinical Operations ● Administrative Support ● Reception, Clerical, Call Center ● Claims Appeals/Denials/Reimbursement ● Insurance Pre-Authorizations...OperationsClaimsHourly payWeekly payContract workLocal areaShift workRotating shift$65k - $85k
...train. Create and establish tools to track and measure learning and outcomes. Embrace new and emerging technologies to support operations and customers through flexibility and the ability to learn and adapt to change. Demonstrate a willingness to give and receive feedback...OperationsSummer holidayWork at officeFlexible hours- About the job Administrative Assistant / Operations Specialist Position Overview We are looking Operations Specialist and administrative assistant... ...and Leave of Absence Specialists on all worker compensation claims and return to work coordination activities Coordinate with...OperationsClaimsWork at office
- ...decision making. • Tracks employee LOA and workers compensation claims for the US. Serves as a point of contact and coordinator of... ...and FMLA. Keeps abreast of state leaves laws. • Supports HR Operations team and acts as a backup when needed. • Performs other related...OperationsClaimsFlexible hours
- ...monitoring, and training inventory best practices and standard operating procedures for the entire store, including both front end and pharmacy... ...front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but...OperationsClaimsWork experience placementLocal areaFlexible hoursShift workAfternoon shift
$24 - $29 per hour
...time, ten-month position reporting to the Managing Director of Operations and Human Resources. This employee ensures student access to nutritional... ...(when applicable). Prepare and provide monthly reimbursement claims. Ensure Cafeteria and Kitchen organization and cleanliness in...OperationsClaimsFull timeContract workWork at officeLocal area- ...Senior Record Retrieval Specialist Take your career to the next level with this unique opportunity for growth and development within a dynamic national company! ISG provides national claim and litigation support to the insurance and legal communities. We help our clients...ClaimsFull timeWork at officeRemote work
- ...certified, assists with and coaches pharmacy technicians in the operation of pharmacy systems and cashiers in the operation of the... ...those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient...OperationsClaimsApprenticeshipWork experience placementLocal areaImmediate startFlexible hoursAfternoon shift
- The Claims Analyst will be responsible for supporting the effective management of claims portfolios through data analysis, forecasting... ...trends Partner with Claims, Finance, Actuary, IT, and Operations teams to validate data accuracy and ensure consistency across reporting...OperationsClaims
- ...proactively, identifying needs, servicing until satisfied, etc.). Operations Provides customers with courteous, friendly, fast, and... ...to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and...OperationsClaimsWork experience placementSeasonal workLocal areaImmediate startFlexible hoursShift workAfternoon shift
- ...development within a dynamic national company! ISG provides national claim and litigation support to the insurance and legal communities.... ...claim outcomes. We are looking for a Senior Record Retrieval Specialist to join our Medical Records team. ONLY CANDIDATES WITH PRIOR...ClaimsFull time
- ...THIS IS A FULLY REMOTE POSITION! Reimbursement Specialist - Healthcare Industry Assignment Length: 13-26 weeks Schedule : 8:30... ...knowledge of respective financial class Obtains and tracks claim status via phone and online portals Composes and follows up...ClaimsWork at officeLocal areaRemote workMonday to Friday
$30.77 - $34.24 per hour
Principal Account Clerk (Operations) Location: Salem, Massachusetts | Fiscal Year: 2026-2027 Job ID: 5768024 | Application Deadline: Posted... ...spending categories year over year; report monthly claims and prepare monthly Meals Tax. Communicate regularly with city...OperationsClaimsHourly payWeekly payFull timeFor contractorsWork at office- ...The Assistant Store Manager is to oversee the daily retail operations, insure the highest standards of helpful customer service, and... ...and assisting customers on the sales floor Resolve customer claims and complaints in a manner that is timely, courteous and discreet...OperationsClaims
$18 - $22 per hour
...We are seeking an Office Coordinator to manage the day-to-day operations of our office and play a vital role in facilitating care delivery... ...data entry, reconciling data across systems, and submitting claims, on an as-needed basis alongside broader office responsibilities...OperationsClaimsFull timeWork at officeLocal areaMonday to FridayShift work- ...Principal Account Clerk (Operations)-INTERNAL ONLY, Salem Public Schools, Salem, MA [SY2026-2027] Salem Public Schools, where belonging... ...benchmark spending categories year over year. Reporting monthly claims, and preparing Monthly Meals Tax Communicating with distinct...OperationsClaimsWeekly payFull timeFor contractorsWork at office
- QBE Insurance Group is seeking a Cost Containment Lead in Marblehead, MA to manage complex claims for the Accident and Health business unit. The ideal candidate will negotiate settlements and ensure effective communication with internal and external stakeholders. This...Claims
- ...for Communication/ Beverly School for the Deaf ASL Bilingual Specialist Job Description Reports To: Director of Early Childhood... ...to and in excess of 50 pounds Work environment may involve operation of school vehicles in the transportation of students to and from...Operations
- ...Job Site Specialist Morgan Memorial Goodwill Industries' mission is to help individuals with barriers to self-sufficiency to achieve... ...and crawling. Utilizes finger dexterity to perform computer operations, handle or feel objects, tools, or controls. May be...OperationsInternshipWork at officeImmediate start
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