insurance claims analyst

eBacon

<div><b>Claims Analyst &ndash; Health, Life, &amp; Disability</b><br>
<b>$60K-$80K | Full time | Hybrid / In-Office (101/Cave Creek) or Remote USA**</b><br>
<br>
We're looking for a detail-oriented Claims Analyst who thrives on hands-on data work. You'll analyze health, life, and disability insurance claims to uncover trends, identify cost drivers, and support strategic decisions. This is an individual contributor role &mdash; expect to spend significant time in Excel and SQL, manage multiple projects independently, and translate complex data into clear, actionable insights.<br>
<br>
<b>Key Responsibilities</b><ul><li>
Audit and analyze claims to ensure accurate documentation, appropriate coverage determination, and timely exposure identification.
</li><li>Manage all email and phone correspondence with clients and provider agents regarding assigned cases.
</li><li>Work with payors to resolve discrepancies and document outcomes.
</li><li>Extract and analyze claims data, identifying trends, patterns, and anomalies.
</li><li>Conduct root cause analysis on claims cost drivers and utilization patterns.
</li><li>Build and maintain Excel models for claims forecasting and trend analysis using pivot tables and advanced formulas.
</li><li>Perform financial reconciliation and validate claims processing accuracy.
</li><li>Prepare and maintain reporting on open/closed claims, reconciliation status, outstanding risks, and KPIs, flagging significant deviations.</li><li>
Identify recurring issues, cost-saving opportunities, and recommend process improvements.</li></ul><br>
<b>
Core Qualifications</b><ul><li>
2-5 years of hands-on experience in claims analysis, healthcare analytics, or financial analysis (insurance sector preferred)
</li><li>Experience with health insurance terminology (CPT codes, ICD codes, EOBs, etc.)</li><li>
Knowledge of claims adjudication processes and workflows</li><li>
Understanding of ERISA regulations and compliance requirements</li><li>
Advanced Excel skills including pivot tables, VLOOKUP/XLOOKUP, complex formulas, and data modeling</li><li>
Proficiency in SQL for querying databases and manipulating large datasets</li></ul><br>
<b>
**Must be legally authorized to work in the United States without the need for employer sponsorship.</b><br>
<br>
 <b>Who are we?</b><br>
eBacon is a financial technology software company located in Phoenix, Arizona. We create a lot of innovative financial solutions for the business world, with a focus on certified payroll and fringe benefit management for the construction industry. Our development team is in-house, so we&rsquo;re always creating cool, new things to get the job done. We have won awards for customer service and for being one of the top companies to work for in Arizona for several years and counting.<br>
<br>
We also have excellent benefits, including competitive pay, plenty of PTO, health care, 401K matching, and fun employee outings. The work we do is serious, and we work hard and take great pride in the help we give our clients, but we also don&rsquo;t take ourselves too seriously. I mean, we do have a bacon strip mascot<br>
<p>
</p><p>ShfIU5yN3n</p></div>

Claims Analyst – Health, Life, & Disability

IIQAF

<div><p><b>Location:</b> Dubai, UAE<br>
<b>Industry:</b> Hospital / Health Care<br>
<b>Job Type:</b> Full-Time<br>
<b>Salary:</b> <b>AED 7,500 &ndash; AED 8,500 per month</b></p>
<h3 class="jobSectionHeader"><b>Job Overview</b></h3>
<p>IIQAF Group is seeking a detail-oriented and analytical <b>Claims Analyst</b> to manage and process <b>healthcare insurance claims</b> efficiently within our hospital and healthcare operations in Dubai. The ideal candidate will review claim submissions, ensure accuracy, verify documentation, and coordinate with insurance providers to facilitate <b>timely reimbursement and resolution</b>.</p>
<p>This role is perfect for candidates searching for <b>Claims Analyst jobs in Dubai</b>, <b>Health Insurance Claims Specialist UAE</b>, <b>Medical Claims Processing roles</b>, or <b>Healthcare Claims Coordinator positions</b>.</p>
<h3 class="jobSectionHeader"><b>Key Responsibilities</b></h3>
<ul><li>Review and process <b>healthcare insurance claims</b> for accuracy and compliance</li><li>
Verify patient information, treatment records, and supporting documentation</li><li>
Liaise with <b>insurance companies, healthcare providers, and internal departments</b></li><li>
Identify and resolve claim discrepancies and issues promptly</li><li>
Ensure compliance with <b>UAE health insurance regulations and hospital policies</b></li><li>
Prepare <b>claims reports, data analysis, and trend tracking</b> for management</li><li>
Maintain accurate records of <b>claims processing and documentation</b></li><li>
Support audits and provide necessary information for <b>insurance reviews</b></li></ul>
<h3 class="jobSectionHeader"><b>Required Skills &amp; Qualifications</b></h3>
<ul><li>Proven experience as a <b>Claims Analyst, Medical Claims Specialist, or Insurance Claims Processor</b></li><li>
Knowledge of <b>health insurance policies, claim procedures, and healthcare regulations</b></li><li>
Strong analytical, detail-oriented, and problem-solving skills</li><li>
Proficiency in <b>claims management software and Microsoft Office Suite</b></li><li>
Excellent communication and interpersonal skills</li><li>
Familiarity with <b>UAE healthcare system and insurance regulations</b></li></ul>
<h3 class="jobSectionHeader"><b>Preferred Qualifications</b></h3>
<ul><li>Bachelor&rsquo;s degree in <b>Health Administration, Insurance, Finance, or related field</b></li><li>
Experience working in <b>hospitals, clinics, or healthcare insurance companies in Dubai</b></li><li>
Ability to handle <b>high-volume claims processing</b> efficiently</li></ul>
<h3 class="jobSectionHeader"><b>Why Join IIQAF Group</b></h3>
<ul><li>Competitive salary: <b>AED 7,500 &ndash; AED 8,500 per month</b></li><li>
Opportunity to work in a <b>professional healthcare and insurance environment in Dubai</b></li><li>
Career growth in <b>medical claims, healthcare operations, and insurance analysis</b></li><li>
Supportive and structured work culture</li></ul></div>

Claims Analyst

<div><p><b>Location:</b> Dubai, United Arab Emirates<br>
<b>Industry:</b> Insurance<br>
<b>Job Type:</b> Full-Time<br>
<b>Salary:</b> <b>AED 6,500 &ndash; AED 7,500 per month</b></p>
<h3 class="jobSectionHeader"><b>Job Overview</b></h3>
<p>IIQAF Group is seeking a detail-oriented and analytical <b>Claims Executive</b> to join our growing insurance operations team in Dubai. The ideal candidate will manage <b>insurance claims processing, claims investigation, documentation review, customer coordination, and settlement procedures</b> while ensuring compliance with UAE insurance regulations.</p>
<p>This role is ideal for candidates searching for <b>Claims Executive jobs in Dubai</b>, <b>Insurance Claims Officer UAE</b>, <b>Claims Processor Dubai</b>, <b>Motor Claims Executive UAE</b>, or <b>Medical Insurance Claims roles</b>.</p>
<h3 class="jobSectionHeader"><b>Key Responsibilities</b></h3>
<ul><li>Process and evaluate <b>insurance claims (motor, medical, property, or general insurance)</b></li><li>
Review <b>policy coverage, claim documentation, and supporting evidence</b></li><li>
Investigate and validate claims to ensure accuracy and compliance</li><li>
Coordinate with <b>policyholders, brokers, surveyors, hospitals, and third parties</b></li><li>
Prepare <b>claims reports, settlement recommendations, and documentation</b></li><li>
Ensure compliance with <b>UAE Insurance Authority regulations and company policies</b></li><li>
Maintain accurate <b>claims records in CRM and insurance management systems</b></li><li>
Handle <b>customer inquiries and claim status updates</b> professionally</li><li>
Monitor turnaround times and ensure timely claim settlement</li></ul>
<h3 class="jobSectionHeader"><b>Required Skills &amp; Qualifications</b></h3>
<ul><li>Proven experience as a <b>Claims Executive, Insurance Claims Officer, or Claims Processor</b></li><li>
Strong knowledge of <b>insurance policies, underwriting principles, and claims procedures</b></li><li>
Familiarity with <b>UAE insurance regulations and compliance standards</b></li><li>
Experience using <b>insurance management software and CRM systems</b></li><li>
Excellent analytical, negotiation, and problem-solving skills</li><li>
Strong communication and customer service abilities</li><li>
Ability to work in a <b>fast-paced insurance environment</b></li></ul>
<h3 class="jobSectionHeader"><b>Preferred Qualifications</b></h3>
<ul><li>Bachelor&rsquo;s degree in <b>Insurance, Finance, Business Administration, or related field</b></li><li>
Experience in <b>motor insurance, medical claims, or general insurance claims</b></li><li>
Professional certification in <b>Insurance or Risk Management (preferred)</b></li></ul>
<h3 class="jobSectionHeader"><b>Why Join IIQAF Group</b></h3>
<ul><li>Career growth opportunities in the <b>UAE insurance sector</b></li><li>
Professional and structured work environment</li><li>
Opportunity to work with a reputable organization in Dubai</li></ul><br>
<p></p>
<p><b>Important Notice to All Job Applicants</b><br>
<br>
IIQAF does not collect any money from candidates at any stage of recruitment. We do not ask for fees for registration, interviews, job offers, visa processing, or onboarding.<br>
<br>
If you receive calls, emails, or messages requesting payment in the name of IIQAF, please treat them as fraudulent.</p>
<ul><li>Apply only through our official website and approved channels</li><li>
Verify communications through our listed contact details</li><li><p>
Do not transfer money to recruiters or agents claiming to represent us</p><p>
Please report any suspicious activity through our official contact page.</p></li></ul></div>

Claims Executive

National General Insurance

<div><p>National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers&rsquo; evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.</p><p></p><p><b>
Job Description</b></p>
The Claims Inside Auto Trainee Analyst II is responsible for investigating and confirming the facts of loss for automobile accidents. This role determines coverage, liability, damages and otherwise adjusts and negotiates claims within authority.<p></p><p>
** We are seeking motivated individuals to begin a rewarding career in the insurance industry as Claims Adjuster Trainees! In this role, you&rsquo;ll be responsible for investigating and verifying the details of automobile accidents, including obtaining police reports, collecting witness statements, confirming coverage, and determining liability. The ideal candidates are detail-oriented, enjoy investigative work, and are passionate about helping others navigate challenging situations. <b>This is an in-office position located at either our Charlotte or Winston-Salem, NC offices, with the next training class starting in April. </b>**</p><p></p><h3 class="jobSectionHeader"><b>
Key Responsibilities</b></h3><ul><li>Handles basic investigation regarding most aspects of auto claims (coverage, liability and damages)</li><li>Identifies customer needs and works to meet those needs using appropriate customer service skills</li><li>Applies a basic understanding of systems and technology used within the company</li><li>Partners to determine subrogation or fraud potential and how to handle</li><li>Exhibits basic understanding of insurance policies written by the company, the industry, and organizational relationships within the company and department</li><li>Begins recognizing and identifying body parts of a vehicle and other potential property damage</li></ul><p></p><h3 class="jobSectionHeader"><b>
Experience</b></h3><ul><li>0-2 years experience (Preferred)</li></ul><p></p><h3 class="jobSectionHeader"><b>
Supervisory Responsibilities</b></h3><ul><li>This job does not have supervisory duties.</li></ul><p></p><p>
#LI-KR1</p><p></p><p><b>
Compensation</b></p><p>
Base compensation offered for this role is $22.84 -$29.57 hourly and is based on experience and qualifications.</p><p></p><div><div><div><div><div><div><div><div><p><br>
** Total compensation for this role is comprised of several factors, including the base compensation outlined above, plus incentive pay (i.e. commission, bonus, etc.) as applicable for the role.**</p></div></div></div></div></div></div></div></div><p><b>
Joining our team isn&rsquo;t just a job &mdash; it&rsquo;s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger &ndash; a winning team making a meaningful impact.</b></p><p></p><p>
Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.</p><p></p><p>
For jobs in San Francisco, please click &ldquo;here&rdquo; for information regarding the San Francisco Fair Chance Ordinance.</p><p><br>
For jobs in Los Angeles, please click &ldquo;here&rdquo; for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance.</p><p></p><p>
To view the &ldquo;EEO Know Your Rights&rdquo; poster click &ldquo;here&rdquo;. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs.</p><p></p><p>
To view the FMLA poster, click &ldquo;here&rdquo;. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.</p><p></p><p>
It is the Company&rsquo;s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee&rsquo;s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.</p><p></p><p>
National General Holdings Corp., a member of the Allstate family of companies, is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A&ndash; (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.</p><p></p><p><b>
Companies &amp; Partners</b></p><p></p><p>
Direct General Auto &amp; Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.</p><p></p><p><b>
Benefits</b></p><p></p><p>
National General Holdings Corp. is an Equal Opportunity (EO) employer &ndash; Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas. In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at (336) 435-2000.</p></div>

Claims Adjuster Trainee - National General

AHOLD Delhaize

<div><b>Category/Area of Expertise:</b> Risk Management &amp; Insurance<br>
<b>Job Requisition:</b> 483515<br>
<b>Address: </b>USA-NC-Salisbury-2110 Executive Drive
<br>
<b>Store Code: </b>Claims Management (5157503)
<br>
<br>
Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop &amp; Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.<br>
<br>
<b>Position Summary:</b><br>
<br>
This role is responsible for the timely, good faith adjustment and disposition of self-administered casualty claims in multiple jurisdictions. Responsibility extends to all aspects and phases of investigations to determine compensability or liability, evaluations, negotiations and settlements/denials of Workers' Compensation claims. This role has direct responsibility for managing the claim in its entirety while maintaining service and quality level targets.
<br>
<br>
This role is responsible, specialized technical work investigating and processing claims for self-insured claims programs. This role is the primary claim interface to associates, attorneys, healthcare providers, vendor partners and Brand partners.<br>
<br>
<b>Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days.</b><br>
<br>
<b>Applicants must be currently authorized to work in the United States on a full-time basis.</b><br>
<br>
<b>Principle Duties and Responsibilities:</b><br>
<br>
<b>Claims Management</b><br>
<ul><li>
Manage assigned Workers Compensation caseload within established targets and financial authority. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations.</li><li>
Monitor and ensure timely execution of all statutory deadlines or legal filings as needed.</li><li>
Analyze fact of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Brand bottom lines.</li><li>
Identify fraud indicators and actively pursue subrogation opportunities.</li><li>
Monitor and actively manage medical treatment with the goal of minimizing disability and fostering a successful re-entry to the workplace.</li><li>
Solid understanding of state and federal laws associated with employee relations, including, but not limited to: FMLA, and ADA,</li><li>
Closely monitor and manage prescriptions. Work with PBM to authorize prescriptions related to the injury.</li><li>
Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks.</li><li>
Build and maintain effective relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers.</li></ul><br>
<b>
Financial Impact Administration</b><br>
<ul><li>
Manage book of Workers' Compensation claims business up to $5 million with authority to settle/negotiate a single claim within their authority of up to $75,000 (Corporate Authority policy)</li><li>
Communicate ongoing causes of associate or customer injuries to Safety and Brands.</li><li>
Serve as the primary point of contact to address and resolve claim issues impacting associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications.</li></ul><br>
<b>
Basic Qualifications:</b><br>
<ul><li>
Licensed adjuster (as appropriate by jurisdiction)</li><li>
Bachelor's degree or 4 years WC claims experience</li><li>
Thorough knowledge of rules, regulations, statutes and procedures pertaining to workers' compensation and general liability claims.</li><li>
Knowledge of medical terminology involved in complex claims</li><li>
Strong negotiation skills.</li></ul><br>
<b>
Skills and Abilities:</b><br>
<ul><li>
Excellent interpersonal skills</li><li>
Ability to multi-task</li><li>
Attention to detail</li><li>
Excellent time management skills</li><li>
Strong analytical, planning, influence, communication, and presentation skills</li><li>
Demonstrates a personal acceptance of change and the ability to adapt and drive change</li><li>
Willingness and ability to train and mentor others</li><li>
Proficient in O365</li></ul>
ME/NC/PA/SC Salary Range: $63,440-$95,160
<br>
<br>
IL/MA/MD/NY Salary Range: $72,880 - $109,320
<br>
<br>
Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws.
<br>
<br>
#LI-SM1 #LI-hybrid<br>
<br>
At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent.<br>
<br>
Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies.<br>
<br>
Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work.<br>
<br>
We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.</div>

Analyst II Claims Adjuster

<div><b>Category/Area of Expertise:</b> Risk Management &amp; Insurance<br>
<b>Job Requisition:</b> 483515<br>
<b>Address: </b>USA-MA-Quincy-1385 Hancock Street
<br>
<b>Store Code: </b>Claims Management (5157503)
<br>
<br>
Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop &amp; Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.<br>
<br>
<b>Position Summary:</b><br>
<br>
This role is responsible for the timely, good faith adjustment and disposition of self-administered casualty claims in multiple jurisdictions. Responsibility extends to all aspects and phases of investigations to determine compensability or liability, evaluations, negotiations and settlements/denials of Workers' Compensation claims. This role has direct responsibility for managing the claim in its entirety while maintaining service and quality level targets.
<br>
<br>
This role is responsible, specialized technical work investigating and processing claims for self-insured claims programs. This role is the primary claim interface to associates, attorneys, healthcare providers, vendor partners and Brand partners.<br>
<br>
<b>Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days.</b><br>
<br>
<b>Applicants must be currently authorized to work in the United States on a full-time basis.</b><br>
<br>
<b>Principle Duties and Responsibilities:</b><br>
<br>
<b>Claims Management</b><br>
<ul><li>
Manage assigned Workers Compensation caseload within established targets and financial authority. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations.</li><li>
Monitor and ensure timely execution of all statutory deadlines or legal filings as needed.</li><li>
Analyze fact of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Brand bottom lines.</li><li>
Identify fraud indicators and actively pursue subrogation opportunities.</li><li>
Monitor and actively manage medical treatment with the goal of minimizing disability and fostering a successful re-entry to the workplace.</li><li>
Solid understanding of state and federal laws associated with employee relations, including, but not limited to: FMLA, and ADA,</li><li>
Closely monitor and manage prescriptions. Work with PBM to authorize prescriptions related to the injury.</li><li>
Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks.</li><li>
Build and maintain effective relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers.</li></ul><br>
<b>
Financial Impact Administration</b><br>
<ul><li>
Manage book of Workers' Compensation claims business up to $5 million with authority to settle/negotiate a single claim within their authority of up to $75,000 (Corporate Authority policy)</li><li>
Communicate ongoing causes of associate or customer injuries to Safety and Brands.</li><li>
Serve as the primary point of contact to address and resolve claim issues impacting associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications.</li></ul><br>
<b>
Basic Qualifications:</b><br>
<ul><li>
Licensed adjuster (as appropriate by jurisdiction)</li><li>
Bachelor's degree or 4 years WC claims experience</li><li>
Thorough knowledge of rules, regulations, statutes and procedures pertaining to workers' compensation and general liability claims.</li><li>
Knowledge of medical terminology involved in complex claims</li><li>
Strong negotiation skills.</li></ul><br>
<b>
Skills and Abilities:</b><br>
<ul><li>
Excellent interpersonal skills</li><li>
Ability to multi-task</li><li>
Attention to detail</li><li>
Excellent time management skills</li><li>
Strong analytical, planning, influence, communication, and presentation skills</li><li>
Demonstrates a personal acceptance of change and the ability to adapt and drive change</li><li>
Willingness and ability to train and mentor others</li><li>
Proficient in O365</li></ul>
ME/NC/PA/SC Salary Range: $63,440-$95,160
<br>
<br>
IL/MA/MD/NY Salary Range: $72,880 - $109,320
<br>
<br>
Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws.
<br>
<br>
#LI-SM1 #LI-hybrid<br>
<br>
At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent.<br>
<br>
Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies.<br>
<br>
Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work.<br>
<br>
We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.</div>

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 a market leader in insuring skilled nursing, assisted living and independent living facilities and this role will support the business and interact closely with internal business partners such as Underwriting, to share claim insights that aid in good underwriting decisions.<br>
<br>
Our Healthcare Claims team is seeking a Complex Claims Consultant to support our Aging Services segment. This individual contributor role is responsible for the overall investigation and management of Aging Services claims in multiple states. Recognized as a technical expert in the interpretation of complex or unusual policy coverages in area of expertise. Under general management direction, works within assigned limits of broad authority on assignments requiring a high degree of technical complexity, coordination and excellent customer service.<br>
<br>
This position enjoys a flexible, hybrid work schedule and is available in any location near a CNA office.<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 commercial 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></div><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 commercial 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 a plus.</li><li>
Typically a minimum six years of relevant experience, preferably in claim handling and litigation. Prior negotiation experience.</li><li>
Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable</li><li>
Professional designations preferred (e.g. CPCU)</li></ul><div></div><div>
#LI-KC2</div><div>
#LI-Hybrid</div><div><br>
In Illinois/New York/California, the average base pay range for a Complex Claims Consultant is $113,000 to $160,000. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location.</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>

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