corporate claims examiner

ClaimsPro LP

<div><h1 class="jobSectionHeader"><b>Company:</b></h1>
ClaimsPro LP - International Programs Group<p></p>
Property Claims Examiner - Remote (anywhere in the US)<p></p><p><br>
Reporting to a Claims Supervisor, the Claims Examiner is responsible for investigating and settling property and first party claims and third-party claims, with an emphasis on strong communication and customer service, while utilizing state specific guidelines.</p><p></p><p>
IPG works in the contiguous 48 states, Hawaii, and Puerto Rico handling a variety of claims including, but not limited to auto physical damage, inland marine cargo, dealers' open lot, property damage (commercial and homeowners) and general liability.</p><p></p><p><b>
Job Responsibilities:</b></p><ul><li><p>
Initiate the investigation of new claims</p></li><li><p>
Make liability/coverage decisions</p></li><li><p>
Evaluate and negotiate settlements of collision, specified perils, and property damage, as appropriate.</p></li><li><p>
Manage and oversee the work of outside adjusters, appraisers and experts.</p></li><li><p>
Establish contact with the insured and claimant within established protocol.</p></li><li><p>
Recognize coverage issues and bring them to the attention of the supervisor.</p></li><li><p>
Develop basic understanding of liability and coverage principles.</p></li><li><p>
Recognize state specific laws and claims regulations throughout the United States to insure proper compliance in claims investigation including sending and securing proper documentation.</p></li><li><p>
Complete research to determine market value on automobiles and heavy equipment to make recommendations on total loss settlement values using proper state valuation methods.</p></li><li><p>
Summarize and make recommendations for disposition of claims in excess of the individual settlement authority.</p></li><li><p>
Respond to time sensitive material including but not limited to intercompany arbitration hearings, and department of insurance complaints.</p></li><li><p>
Manage a diary system to systematically review and resolve claims within the specified state compliance guidelines.</p></li><li><p>
Maintain state license by completing continuing education coursework and/or work towards a claims designation.</p></li><li><p>
Handle small claim suits as needed.</p></li><li><p>
Other duties as assigned by the claims supervisor</p></li><li><p>
Duties may be added, deleted or changed at any time at the discretion of management, formally or informally, either verbally or in writing.</p></li></ul><p></p><p><b>
Qualifications, Education and/or </b><b>Experience
</b></p><ul><li><p>High School Diploma or Equivalent required</p></li><li><p>
Bachelor&rsquo;s degree is preferred</p></li><li><p>
Experience with Lloyd&rsquo;s of London is considered an asset</p></li></ul><p></p><p><b>
Computer Skills</b></p><ul><li><p>
Proficient in Microsoft Office</p></li><li><p>
Experience with Xactimate</p></li></ul><p></p><p><b>
Certificates, Licenses, Registrations</b></p><ul><li><p>
Able to be licensed in states, countries where necessary</p></li><li><p>
AIC designation preferred</p></li></ul><p></p><p><b>
Competencies</b></p><ul><li><p>
Use of clear, rational, thinking supported by evidence to audit fees of independent adjusters, appraisers, and other vendors in order to properly manage and pay expense invoices.</p></li><li><p>
Strong writing skills and proper use of grammar to prepare written status reports for the principal. Document claim file notes clearly with all communications and activities that occur during of handling the claim using factual and objective information.</p></li><li><p>
Ability to plan and exercise conscious control over the amount of time spent on specific activities.</p></li><li><p>
Strong Communicator (verbal and written)</p></li><li><p>
Ability to multi-task and handle high volume of concurrent tasks</p></li><li><p>
Work collaboratively with others inside and outside the company</p></li></ul><p></p><p><b>
Environment/Working Conditions:</b></p><ul><li><p>
Dynamic environment with tight deadlines, number and changing priorities</p></li><li><p>
All prospective employees must pass a background check</p></li><li><p>
Office environment including prolonged periods of computer use</p></li><li><p><b>
Location: Remote working but may require some travel to home office, etc.</b></p></li></ul><p></p><p>
We welcome and encourage applications from people with disabilities. Accommodation is available on request for candidates throughout the recruitment and assessment process.</p><p></p><p><b>
Unsolicited Outreach Statement &ndash; Recruitment Agencies</b></p><p></p><p>
We will not accept unsolicited resume submittals from third- party recruiters and hereby request agencies not to contact our employees or managers directly to present candidates. Be advised we will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume and will consider any unsolicited resumes forwarded public information. We welcome resumes submitted directly from candidates.</p></div>

Property Claims Examiner - Remote

Markel Corporation

<div><div>What part will you play? If you&rsquo;re looking for a place where you can make a meaningful difference, you&rsquo;ve found it.</div>
The work we do at Markel gives people the confidence to move forward and seize opportunities, and you&rsquo;ll find your fit amongst our global community of optimists and problem-solvers. We&rsquo;re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.
Join us and play your part in something special!
This position will be responsible for the resolution of moderate to high complexity and moderate to high exposure claims which can be subject to disputes that must be resolved in mediation or litigation. The primary purpose of this job is to handle claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis, to timely and accurate resolution; ensuring mitigation of indemnity and expense exposure while communicating developments and outcomes as necessary to all internal and external stakeholders. The position will have increased responsibility for decision making within their authority and work with minimal oversight and will provide training and be a technical referral point for other team members.<div></div><div>
Responsibilities</div><ul><li>
Handles healthcare malpractice/negligence claims including the following:</li><li>
Analyzes coverage and communicates coverage positions</li><li>
Conducts, coordinates, and directs investigation into loss facts and extent of damages</li><li>
Confirms coverage of claims by reviewing policies and documents submitted in support of claims</li><li>
Drafts coverage position letters</li><li>
Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure</li><li>
Handles claims in all jurisdictions</li><li>
Handles litigated and non-litigated bodily injury claims with values up to $450,000 in all jurisdictions, managing the process from inception of the claim until conclusion, including settlement, trial, or appeal, when litigated.</li><li>
Monitors excess and reinsurance claim files with varying levels of attachment point;</li><li>
Identify losses which should be reported to SIU.</li><li>
Participates in special projects or assists other team members as requested</li><li>
Provides excellent and professional customer service to insureds while maintaining a high level of production.</li><li>
Represents Markel in mediations, as required</li><li>
Monitors trial, as required</li><li>
Sets reserves within authority or makes recommendations concerning reserve changes to manager</li></ul><div></div><div>
Education</div><ul><li>
Bachelor&rsquo;s degree or equivalent work experience</li><li>
JD , advanced degree, or focused technical degree a plus</li></ul><div></div><div>
Certification</div><ul><li>
Must have or be eligible to receive claims adjuster license.</li><li>
Successful achievement of industry designations (INS, IEA, AIC, ARM, SCLA, CPCU) or</li><li>
Participation in industry training opportunities (CLM Claim College, Munich Re Training, FDCC, etc.)</li></ul><div></div><div>
Work Experience</div><ul><li>
Minimum of 7-15 years of claims handling experience or equivalent combination of education and experience in insurance</li><li>
Successful completion of 5 years as a Claims Examiner</li></ul><div></div><div>
Skill Sets</div><ul><li>
Excellent written and oral communication skills</li><li>
Strong analytical and problem solving skills</li><li>
Strong organization and time management skills</li><li>
Experience in negotiation, mediations, arbitrations and monitoring trials on higher value complex claims</li><li>
Ability to influence claims stakeholders and to effectively direct claims strategy</li><li>
Strong vendor management skills are required including the ability to provide direction and guidance to defense attorneys, independent adjusters, building consultants, forensic accountants and other experts while controlling expenses.</li><li>
Ability to assist with technical training to team claim handlers as required</li><li>
Well developed and advanced expertise and knowledge in most technically complex claims topics</li><li>
Policy language skills enabling accurate and consistent policy wording interpretation</li><li>
Experience in effectively following up on recommendations from technical claims audits and continuous file handling improvement.</li><li>
Ability to deliver outstanding customer service</li><li>
Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word)</li><li>
Ability to work in a team environment</li><li>
Strong desire for continuous improvement</li></ul><div></div><div>
US Work Authorization</div><div></div><div>
US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future.</div><div></div><div>
Pay information:</div><div>
The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The salary for the position is $73,000 - $107,250 with a 15% bonus potential.</div><div></div><div><div><div>
Who we are:</div></div><div></div><div><div>
Markel Group (NYSE &ndash; MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world.</div></div><div></div><div><div><br>
We&rsquo;re all about people | We win together | We strive for better</div></div><div></div><div><div><br>
We enjoy the everyday | We think further</div></div><div></div><div><div><br>
What&rsquo;s in it for you:</div></div><div></div><div><div>
In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work.</div></div><div><ul><li><div>
We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees&rsquo; needs at all stages of life.</div></li></ul></div><div><ul><li><div>
All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&amp;D insurance.</div></li></ul></div><div><ul><li><div>
We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave.</div></li></ul></div><div></div><div><div><br>
Are you ready to play your part?</div></div><div></div><div><div>
Choose &lsquo;Apply Now&rsquo; to fill out our short application, so that we can find out more about you.</div></div></div><div></div><div><div><div><br>
Caution: Employment scams</div></div><div></div><div><div>
Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These &quot;job offers&quot; include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that:</div></div><div><ul><li><div>
All legitimate job postings with Markel will be posted on <div>Markel Careers</div>. No other URL should be trusted for job postings.</div></li></ul></div><div><ul><li><div>
All legitimate communications with Markel recruiters will come from Markel.com email addresses.</div></li></ul></div><div></div><div><div><br>
We would also ask that you please report any job employment scams related to Markel to <div>rarecruiting@markel.com</div>.</div></div><div></div><div><div><br>
Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law.</div><div></div><div><br>
Should you require any accommodation through the application process, please send an e-mail to the <div>rarecruiting@markel.com</div>.</div><div></div><div>
No agencies please.</div></div></div></div>

Senior Claims Examiner, Global Medical & Healthcare Claims

AmTrust Financial

<div>Overview:
<div>
The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Maintains a solid understanding of AmTrust&rsquo;s mission, vision, and values. Upholds the standards of AmTrust and the Claims organization.</div>
Responsibilities:
<ul><li>Follows AmTrust policies and procedures in managing claims.</li><li>
Investigates the claim and coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured, claimant, witnesses and medical providers.</li><li>
Evaluates, establishes, maintains and adjusts reserves based on fact, company standard and experience.</li><li>
Skillfully negotiates claims, turning adverse perspectives into quick resolution. Gains trust of other parties to negotiations and demonstrates good sense of timing. Approaches discussions from merits or strengths of case.</li><li>
Leverages strong critical thinking and decision-making skills to gather, assess, analyze, question, verify, interpret and understand key or root issues.</li><li>
Establishes effective relationships with internal or assigned counsel for customized defense plan. Applies company principles and standards including planning, organizing and monitoring legal panel services and cost in partnership with internal legal counsel.</li><li>
Communicates with internal managed care and medical resources to ensure coordination with medical providers, injured workers and employers in developing return to work strategies and treatment plans.</li><li>
Obtain medical records (past and present), police, ambulance and other agency reports as required.</li><li>
Provides insights and input when reviewing claims of others. May be sought out by others for advice.</li><li>
Writes in a clear, succinct and fact-based manner in claims files as well as in other communication.</li><li>
Manages mail and diary entries effectively and efficiently.</li><li>
Provides exceptional customer service.</li><li>
Performs other functional duties as requested or required.</li></ul>
Qualifications:
<div><b>
Required:</b></div><ul><li>
3+ years experience as a Workers Comp adjuster</li><li>
MS Office experience (Work, Excel, Outlook)</li><li>
Effective negotiation skills</li><li>
Strong verbal and written communication skills</li><li>
Ability to prioritize work load to meet deadlines</li><li>
Ability to manage multiple tasks in a fast-paced environment</li></ul><div></div><div><i><br>
This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust has the right to revise this job description at any time.</i></div><div></div><div><i><br>
The expected salary range for this role is $32-$44/hr.</i></div><div></div><div><i><br>
Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations</i></div>
What We Offer:
<div>
AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical &amp; Dental Plans, Life Insurance, including eligible spouses &amp; children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.</div><div></div><div><br>
AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.</div><div></div><div><br>
AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.</div></div>

Lead Claim Examiner I, CA

<div><div>What part will you play? If you&rsquo;re looking for a place where you can make a meaningful difference, you&rsquo;ve found it.</div>
The work we do at Markel gives people the confidence to move forward and seize opportunities, and you&rsquo;ll find your fit amongst our global community of optimists and problem-solvers. We&rsquo;re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.
Join us and play your part in something special!
What part will you play? If you&rsquo;re looking for a place where you can make a meaningful difference, you&rsquo;ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you&rsquo;ll find your fit amongst our global community of optimists and problem-solvers. We&rsquo;re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.<br>
<br>
Join us and play your part in something special!<br>
<br>
This position will be the acknowledged technical expert and be responsible for the resolution of high complexity and high exposure claims. The position will have significant responsibility for decision making and work autonomously within their authority.<div></div><div>
Responsibilities:</div><ul><li>
Investigate, negotiate and settle primary and excess policy cyber, privacy liability and technology errors &amp; omissions claims.</li><li>
Investigate and evaluate coverage for complex primary and excess cyber and technology errors &amp; omissions policies; make coverage determinations; draft complex coverage correspondence; effectively communicate coverage positions to policyholders and other stakeholders; manage complex claims involving coverage litigation.</li><li>
Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.</li><li>
Contribute and assist in the implementation of a wide range of initiatives, claims exposure reports and action plans brought forth by the team&rsquo;s Director.</li><li>
Communicate with underwriting as needed to manage claims and to alert of any significant developments.</li><li>
Promptly communicate with management on adverse claim developments and provide information on pertinent issues affecting cyber and technology errors &amp; omissions product lines.</li><li>
Proven ability to work in a collaborative team environment. Analyze and convey summations of complex issues; recognize alternative approaches and develop action plans, both orally and in written form.</li><li>
Maintain and adhere to Markel&rsquo;s guidelines and procedures.</li><li>
Ensure proper adherence to internal reporting requirements.</li><li>
Participate in agent related functions and meetings as required.</li><li>
Actively participate in the ongoing training and development of the claims examiners.</li></ul><div></div><div>
Requirements:</div><ul><li>
5-10+ years of handling cyber and/or technology errors &amp; omissions policies required. Excess liability (quota share, first layer and high layer) claims experience a plus.</li><li>
College degree and/or professional designation required, JD preferred.</li><li>
Excellent written and oral communication skills.</li><li>
Sound comprehension of insurance coverage posed by cyber and technology errors &amp; omissions and excess liability policies.</li><li>
Ability to analyze and convey summations of complex issues both verbally and in writing; recognize alternative approaches and develop action plans.</li><li>
Experience in determining contractual obligations, insurance coverage analyses, and investigations. Insurance coverage litigation experience a plus.</li><li>
Ability to manage complex litigation, set loss and expense reserves and evaluate settlement values.</li><li>
Work collaboratively and as team player willing to assist within the Unit and Professional Liability Division as needed.</li><li>
Ability to proactively self-manage a caseload.</li><li>
Travel required as necessary (approximately 20%).</li></ul><div></div><div>
US Work Authorization</div><div></div><div>
US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future.</div><div></div><div>
Pay information:</div><div>
The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The national average salary for the Executive Claims Examiner, Cyber and Technology E&amp;O Clams is $97,520 - $134,090 with 25% bonus potential.</div><div></div><div><div><div>
Who we are:</div></div><div></div><div><div>
Markel Group (NYSE &ndash; MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world.</div></div><div></div><div><div><br>
We&rsquo;re all about people | We win together | We strive for better</div></div><div></div><div><div><br>
We enjoy the everyday | We think further</div></div><div></div><div><div><br>
What&rsquo;s in it for you:</div></div><div></div><div><div>
In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work.</div></div><div><ul><li><div>
We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees&rsquo; needs at all stages of life.</div></li></ul></div><div><ul><li><div>
All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&amp;D insurance.</div></li></ul></div><div><ul><li><div>
We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave.</div></li></ul></div><div></div><div><div><br>
Are you ready to play your part?</div></div><div></div><div><div>
Choose &lsquo;Apply Now&rsquo; to fill out our short application, so that we can find out more about you.</div></div></div><div></div><div><div><div><br>
Caution: Employment scams</div></div><div></div><div><div>
Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These &quot;job offers&quot; include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that:</div></div><div><ul><li><div>
All legitimate job postings with Markel will be posted on <div>Markel Careers</div>. No other URL should be trusted for job postings.</div></li></ul></div><div><ul><li><div>
All legitimate communications with Markel recruiters will come from Markel.com email addresses.</div></li></ul></div><div></div><div><div><br>
We would also ask that you please report any job employment scams related to Markel to <div>rarecruiting@markel.com</div>.</div></div><div></div><div><div><br>
Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law.</div><div></div><div><br>
Should you require any accommodation through the application process, please send an e-mail to the <div>rarecruiting@markel.com</div>.</div><div></div><div>
No agencies please.</div></div></div></div>

Executive Claims Examiner, Cyber and Technology E&O Claims

NTT DATA

<div>At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.<br>
<br>
For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.<br>
<br>
<b>Claims Examiner-Xcelys </b><b>Location: Fully Remote</b> <b>Pay Rate: $20.00 Per hour</b> <b>Start Date: 4/13/2026</b> <b>M-F 8:00am-5pm CT.</b> <b>Employment Type: Long Term Contract/Not Direct Hire</b><br>
<br>
<b>MUST HAVE XCELYS EXPERIENCE</b><br>
<br>
To serve as a Medical Claims Processor within the Xcelys environment. Provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations.<br>
<br>
<b>Role Responsibilities:</b>
<div><ul><li>Adjudication &amp; Review</li></ul>
</div><ul><li>Process comprehensive medical claims using Xcelys and associated subsystems</li>
<li>Resolve complex pends, coding issues, and contract exceptions</li>
<li>Author overpayment/underpayment determinations and coordinate appeals</li></ul>
<div><ul><li>Quality &amp; Compliance</li></ul>
</div><ul><li>Engage in quality reviews, audits, root cause analyses</li>
<li>Monitor accuracy, variance, and rework metrics</li>
<li>Ensure alignment with regulatory and internal compliance guidelines</li></ul>
<div><ul><li>Support</li></ul>
</div><ul><li>Act as escalation point and subject matter expert</li></ul>
<div><ul><li>Process &amp; System Improvement</li></ul>
</div><ul><li>Participate in system testing, UAT, and workflow enhancements</li>
<li>Recommend improvements, document system and process changes</li></ul>
<div><ul><li>Reporting &amp; Analytics</li></ul>
</div><ul><li>Prepare production, pending, and quality reports</li>
<li>Identify trends and recommend corrective actions</li></ul>
<div><ul><li>Cross-Functional Collaboration</li></ul>
</div><ul><li>Liaise with provider relations, legal, IT, compliance teams</li>
<li>Support internal initiatives related to claims systems / operational improvements</li></ul><br>
<b>
Required Skills/Experience
</b><ul><li>2+ years claims adjudication experience</li>
<li>Minimum of 1 year experience in Xcelys
</li><li>2+ years in coding (CPT, ICD-10, HCPCS)</li>
<li>2+ years provider contracts, pricing, regulatory guidelines experience</li></ul>
<b>Preferences</b>
<ul><li>Excellent analytical and communication skills</li>
<li>Experience training staff or acting as a mentor</li>
<li>Familiarity with system testing and documentation</li>
<li>Ability to manage high-volume workload and meet performance metrics</li></ul>
<b>Education: Verifiable high school diploma or GED</b><br>
<br>
About NTT DATA Services:<br>
<br>
NTT DATA Services is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.<br>
<br>
NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.<br>
<br>
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is <b>($20/hourly )</b>. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.<br>
<br>
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&amp;D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.</div>

Xcelys Medical Claims Examiner (Remote)

GEICO

<div>
 <strong>
  At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
  <br/>
  <br/>
 </strong>
 <strong>
  Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers&rsquo; expectations while making a real impact for our company through our shared purpose.
  <br/>
  <br/>
 </strong>
 <strong>
  When you join our company, we want you to feel valued, supported and proud to work here. That&rsquo;s why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
  <br/>
  <br/>
 </strong>
 <strong>
  Increase your earning potential with a $2,500 Sign-On Bonus! Ask your Recruiter for more details!
  <br/>
  <br/>
 </strong>
 <strong>
  Salary range: $69,700K - $105,000K
 </strong>
 <em>
  (commensurate with experience and location/job market)
  <br/>
  <br/>
 </em>
 <strong>
  Work schedule/hybrid structure:
 </strong>
 Core hours are Monday - Friday, 8:00 AM to 4:30 PM CST &ndash; 3 days In-Office/week. Flexibility may be needed to support early or late shifts based on business needs.
 <br/>
 <br/>
 <strong>
  Orientation period (Training and Transition Schedule &ndash; 6 months):
 </strong>
 Monday &ndash; Friday, 8:00 AM to 4:30 PM CST; up to 4 days In-Office/week until fully oriented.
 <br/>
 <br/>
 Come grow with GEICO&rsquo;s Casualty Claims Team! It&rsquo;s an exciting time!
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 <strong>
  We&rsquo;re in search of highly motivated Casualty Claims Examiners with prior casualty and bodily injury experience,
 </strong>
 in private passenger automotive liability claims, looking to help deliver world-class service to our clients.
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 <br/>
 In this role, you will have an opportunity to work with a thriving team of professionals experienced in attorney represented automobile liability claims. As a Casualty Claims Examiner, your ability to provide exemplary service and technical expertise to resolve various types of injury claims is key. Your team will manage complex investigations, coverage determinations, liability assessments, and bodily injury claim resolutions&mdash;through both settlement and litigation. You will play a pivotal role in delivering operational excellence by resolving claims with the highest level of customer service. The ideal candidate has a demonstrated willingness to learn, is open to feedback and adapts well to change.
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  Job Requirements
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  <br/>
 </strong>
 <ul>
  <li>
   Minimum five (5) years of highly successful Bodily Injury claims handling experience
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   Must have prior private passenger automotive liability claims experience
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   Must have an active Adjuster license at time of hire
  </li>
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   Outstanding customer service and professional communication skills, both oral and written
  </li>
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   Understanding and ability to execute and comply with Department of Insurance Guidelines and Requirements as established in the Insurance Code
  </li>
  <li>
   Exceptional negotiating skills
  </li>
  <li>
   Proficient computer skills with ability to function in all Microsoft Office Programs
  </li>
  <li>
   Highly organized
  </li>
  <li>
   Ability to multi-task and prioritize successfully in a fast paced, high-volume environment
  </li>
  <li>
   Litigation handling experience, preferred but not required
  </li>
  <li>
   Demonstrated ability to exercise good judgement
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  GEICO offers a hybrid work model that is designed to support flexibility. This position will have in-office requirements 3 times a week after successful completion of the orientation period. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit.
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  Job Duties And Responsibilities
  <br/>
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 </strong>
 <ul>
  <li>
   Provide customer service to our policyholders and those who may become our policyholders that exceed their expectations and deliver on the GEICO promise, communicating and guiding them through the claims process
  </li>
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   Assure coverage for each loss and all policy provisions before processing payments
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   Investigate all aspects of the claim to determine liability percentage and legal responsibility
  </li>
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   Identify and evaluate claims indicators of fraud and escalate as appropriate
  </li>
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   Utilize all claims tools provided to properly evaluate liability and extent of damages
  </li>
  <li>
   Evaluate damages in accordance with investigative findings and establish value to pay only what is owed
  </li>
  <li>
   Negotiate claims settlements for evaluated damages with insureds, claimants and/or attorneys as assigned from letter of representation through settlement or verdict.
  </li>
  <li>
   Authorize negotiated payment for established damages within your designated authority
  </li>
  <li>
   Submit requests for authority on evaluations that exceed your personal, assigned authority
  </li>
  <li>
   Ensure all compliance requirements are met in a timely and professional manner and in accordance with guidelines
  </li>
  <li>
   Adjust reserves adequately on all new and existing claims
  </li>
  <li>
   Participate as an active member of claims forums as required
  </li>
  <li>
   Communicate findings to claims management team as required or as may be needed depending on high exposure or unusual loss findings
  </li>
  <li>
   Perform other duties as may be assigned
   <br/>
   <br/>
  </li>
 </ul>
 litigation, auto liability, liability claims, bodily injury, casualty
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 <br/>
 #geico400
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 <br/>
 At this time, GEICO will not sponsor a new applicant for employment authorization for this position.
 <br/>
 <br/>
 <strong>
  The GEICO Pledge
  <br/>
  <br/>
 </strong>
 <strong>
  Great Company:
 </strong>
 At GEICO, we help our customers through life&rsquo;s twists and turns. Our mission is to protect people when they need it most and we&rsquo;re constantly evolving to stay ahead of their needs.
 <br/>
 <br/>
 We&rsquo;re an iconic brand that thrives on innovation, exceeding our customers&rsquo; expectations and enabling our collective success. From day one, you&rsquo;ll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people&rsquo;s lives.
 <br/>
 <br/>
 <strong>
  Great Careers:
 </strong>
 We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career &ndash; and your potential &ndash; in mind. You&rsquo;ll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
 <br/>
 <br/>
 <strong>
  Great Culture:
 </strong>
 We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
 <br/>
 <br/>
 As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
 <br/>
 <br/>
 <strong>
  Great Rewards:
 </strong>
 We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.
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 <ul>
  <li>
   Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family&rsquo;s overall well-being.
  </li>
  <li>
   Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.
  </li>
  <li>
   Access to additional benefits like mental healthcare as well as fertility and adoption assistance.
  </li>
  <li>
   Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.
   <br/>
   <br/>
  </li>
 </ul>
 The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
 <br/>
 <br/>
 GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
 <br/>
 <br/>
</div>


Casualty Claims Examiner ($2,500 Sign-On Bonus)

CNA Insurance

<div><div>You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.</div><div></div>
CNA is one of the premier providers of professional liability insurance. CNA Financial Lines has an opening for a Complex Claims Consultant handling Private D&amp;O, Fiduciary and Employment Practice Liability (EPL) Claims. This individual will work with insureds, attorneys and brokers regarding the handling and/or disposition of mid to high severity claims.<br>
<br>
This individual will investigate claims, coordinate discovery, and team with defense counsel on litigation strategy. This individual will be able to utilize claims policies and guidelines, review coverage, determine liability and damages, set financial reserves, secure information to negotiate and settle claims, and present claims to leadership, as needed. Critical to success in this role is the ability to be highly organized, independently motivated and responsive/communicative.<br>
<br>
CNA offers a hybrid work environment in one of the following locations: Chicago, Glastonbury, Lake Mary, Wyomissing, NYC area preferred, but candidates near any CNA location will be considered.<div></div><div>
JOB DESCRIPTION:</div><div></div><div>
Essential Duties &amp; Responsibilities</div><div><i>
Performs a combination of duties in accordance with departmental guidelines:</i></div><ul><li>
Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.</li><li>
Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information.</li><li>
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.</li><li>
Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.</li><li>
Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.</li><li>
Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner.</li><li>
Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.</li><li>
Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely.</li><li>
Keeps senior leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct summaries to senior management.</li><li>
Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.</li><li>
Mentors, guides, develops and delivers training to less experienced Claim Professionals.</li></ul><div><i>
May perform additional duties as assigned.</i></div><div></div><div>
Reporting Relationship</div><div>
Typically Director or above<br>
<br>
Skills, Knowledge &amp; Abilities</div><ul><li>
Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.</li><li>
Strong communication and presentation skills both verbal and written, including the ability to communicate business and technical information clearly.</li><li>
Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions, and to effectively evaluate and resolve ambiguous, complex and challenging business problems.</li><li>
Strong work ethic, with demonstrated time management and organizational skills.</li><li>
Ability to work in a fast-paced environment at high levels of productivity.</li><li>
Demonstrated ability to negotiate complex settlements.</li><li>
Experience interpreting complex specialty insurance policies and coverage.</li><li>
Ability to manage multiple and shifting priorities in a fast-paced and challenging environment.</li><li>
Knowledge of Microsoft Office Suite and ability to learn business-related software.</li><li>
Demonstrated ability to value diverse opinions and ideas.</li></ul><div></div><div>
Education &amp; Experience</div><ul><li>
Bachelor's Degree or equivalent experience; JD preferred.</li><li>
Typically a minimum of five to seven years of relevant experience, preferably in claim handling</li></ul><div></div><div>
#LI-CP1</div><div>
#LI-Hybrid</div><div></div><div><i>
I</i><i>n certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In </i><i>District of Columbia</i><i>,</i><i> </i><i>California, Colorado, Connecticut, </i><i>Illinois</i>, <i>Maryland</i><i>, </i><i>Massachusetts</i>,<i> New York and Washington,</i> <i>the national base pay range for this job level is</i><i> $72,000 to $141,000 </i><i>annually. Salary</i><i> determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees &ndash; and their family members &ndash; achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA&rsquo;s benefits, please visit </i><div><i>cnabenefits.com</i></div><i>.</i></div><div></div><div>
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact <div>leaveadministration@cna.com</div>.</div></div>

Complex Claims Consultant - EPL, Private & NFP D&O

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