Our client is a healthcare benefits administration company. As a Claims Processor, you will play a pivotal role in ensuring the accuracy and efficiency of health insurance and health share claims processing for our hospital and health care clients. Key responsibilities include: - Process complex health insurance and health share claims from intake through resolution - Manage claim escalations, billing disputes, and legacy/backlog claim work - Review and audit work completed by offshore claims team members - Identify patterns and flag payment integrity issues - Collaborate with senior leadership on process improvements and workflow efficiency

Role Description As a Claims Processor, you will play a pivotal role in ensuring the accuracy and efficiency of health insurance and health share claims processing for our hospital and health care clients. - Process complex health insurance and health share claims from intake through resolution - Manage claim escalations, billing disputes, and legacy/backlog claim work - Review and audit work completed by offshore claims team members - Identify patterns and flag payment integrity issues - Collaborate with senior leadership on process improvements and workflow efficiency Qualifications - 2+ years of health insurance or TPA claims processing experience - Experience processing complex health insurance or health share claims end-to-end, from intake through resolution - Experience handling claims escalations, billing disputes, or legacy/backlog claim work - Professional fluency in English - Authorized to work in the United States - Based in the United States - Available to work 8:00am–5:00pm Central Time (CST) - Experience collaborating with senior leadership on process improvements or workflow efficiency initiatives Requirements - Experience reviewing or auditing work completed by an offshore claims processing team - Proficiency using Google Sheets for day-to-day claims processing work - Experience using SAVVOS, IPS, or Healthcloud in a production claims processing environment - Familiarity with health share, self-funded, or employer-sponsored health plans Benefits - Competitive salary of $55,000–$60,000 per year - Generous Paid Time Off (PTO): Unlimited PTO - Paid Holidays: Recognize and celebrate US Holidays with paid time off. - Full-Time Remote Work: Embrace the flexibility of a full-time work-from-home arrangement, allowing you to create a comfortable and efficient workspace in the comfort of your home.

Title: Associate Claims Specialist - Workers Compensation - Northeast Region Location: Northeast Remote United States Job Category Claims Typical Starting Salary $57,000 to $82,000 Minimum Salary $50,000.00 Maximum Salary $84,000.00 Schedule Full-Time Flexible Time Off Annual Accrual - days 15 Job Description: Description Ready to grow your career in a role that makes a meaningful impact? Liberty Mutual is hiring Workers' Compensation Claims Specialists in our Northeast Region to help injured workers navigate the claims process and return to work with confidence. We're hiring across multiple levels-Associate Claims Specialist, Claims Specialist I, and Claims Specialist II-depending on your experience. The salary range posted reflects the varying pay scale across various locations. In this role, you'll manage a caseload of routine to moderately complex claims, making key decisions on compensability, evaluating losses, and negotiating fair outcomes. You'll collaborate closely with claimants, policyholders, attorneys, and partners throughout the claim lifecycle. Training is a critical component of your success, and that success starts with reliable attendance and active engagement. Training will include 1 week of travel to our Plano, TX office in July. This role is remote within the Northeast region. Candidates must reside in Connecticut, Delaware, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, or Vermont. Candidates residing within 50 miles of our offices in Weatogue, Connecticut, or Westborough, Massachusetts, will be expected to work onsite up to two days per month. On-site expectations may evolve based on business needs. Responsibilities - Manages an inventory of claims to evaluate compensability/liability. - Establishes action plans based on case facts, best practices, protocols, regulatory issues, and available resources. - Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages. - Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves as necessary, during the processing of the claims, and refers claims to the subrogation group or Special Investigations Unit as appropriate. - Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. - Performs other duties as assigned. Qualifications - Effective interpersonal, analytical and negotiation abilities required - Ability to provide information in a clear, concise manner with an appropriate level of detail - Demonstrated ability to build and maintain effective relationships - Demonstrated success in a professional environment; success in a customer service/retail environment preferred - Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent - Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory - Licensing may be required in some states About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices - California - Los Angeles Incorporated - Los Angeles Unincorporated - Philadelphia - San Francisco

Role Description Are you ready to lead and inspire a team of dedicated claims professionals? We’re recruiting for a Motor Claims Team Leader to join Gallagher Bassett, where you’ll play a pivotal role in managing daily team operations, fostering staff development, and delivering exceptional client service. As a key figure in our organisation, you’ll leverage your expertise in the claims process to provide invaluable support and guidance to your team. You’ll also act as a role model, setting the standard for excellence and ensuring compliance with Service Level Agreements and Gallagher Bassett’s Best Practices. This is an exciting opportunity to join a growing company that values leadership, collaboration, and innovation. How you'll make an impact - Lead and supervise a team to ensure compliance with Service Level Agreements. - Approve claims settlements within your financial authority. - Ensure the team is knowledgeable about Service Instructions and Policy Wordings. - Liaise with clients to meet their requirements and attend client review meetings as needed. - Provide training and support team development in line with the Gallagher Bassett Learning & Development Prospectus. - Complete appraisals in a timely manner and foster staff development. - Act as an escalation point and respond promptly to complaints. - Manage solicitors in litigated cases to uphold litigation standards. - Assist the Head of Operations with general office administration to ensure smooth operations. Qualifications - Previous experience as a Team Leader in a regulated environment. - Technical expertise and knowledge within your scope of responsibility. - Proven client-facing experience, with the ability to build and maintain strong client relationships. - A commitment to delivering exceptional client service and achieving Gallagher Bassett’s Best Practices. - Excellent listening, written, and verbal communication skills. - The ability to create a positive work environment, treat others with respect, and inspire high performance. - A proactive approach to developing others and fostering a culture of continuous improvement. Requirements - Please be advised that, due to the nature of this role and the type of clients we serve, an enhanced external background check is a requisite part of our recruitment process. Benefits - Minimum of 25 days holiday, plus bank holidays, and the option to ‘buy’ extra days. - Defined contribution pension scheme, which Gallagher will also contribute to. - Life insurance, which will pay 4x your basic annual salary, which you can top-up to 10x. - Income protection, we’ll cover up to 50% of your annual income, with options to top up. - Health cash plan or Private medical insurance. - Three fully paid volunteering days per year. - Employee Stock Purchase plan, offering company shares at a discount. - Share incentive plan, HMRC approved, tax effective, stock purchase plan. - Critical illness cover. - Discounted gym membership, with over 3,000 gyms nationally. - Season ticket loan. - Access to a discounted voucher portal to save money on your weekly shop or next big purchase. - Emergency back-up family care. - And many more…