Adjudicate high-end General Liability claims involving serious injuries, complex coverage scenarios, and legal disputes.
Develop case strategies for satisfactory resolution, coordinating with local counsel, clients, and medical or legal experts.
Work in a remote, flexible environment with opportunities for career growth and comprehensive benefits.
Sedgwick is the world's leading risk and claims administration partner, helping clients navigate the unexpected with expertise and AI-enabled technology. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides a caring culture, professional development, and work-life balance.
Investigate, evaluate, negotiate, and resolve complex property claims, including litigated and environmental losses.
Conduct coverage analysis and collaborate with legal, engineering, and restoration experts on complex files.
Provide technical guidance, mentoring, and strong customer service in a fully remote environment.
The hiring company is an insurance organization specializing in complex property claims management and customer support. It operates as a fully remote Canadian team and emphasizes flexibility, professional development, and community involvement.
Manage the investigation, evaluation, and resolution of complex auto and homeowner's casualty claims, including severe and catastrophic injuries.
Collaborate closely with trial counsel and attend mediations, arbitrations, trials, hearings, and conferences.
Maintain accurate reserves, oversee counsel billing, and identify suspicious claims for SIU or subrogation.
Liberty Mutual is a global insurance company that provides property and casualty insurance, showing up for people in their toughest moments. With a large and diverse workforce, the company fosters an inclusive culture that values professionalism, integrity, and empathy, and invests in employees' growth and well-being.
Review and analyze insurance and home warranty claims, including eligibility and coverage.
Communicate claim decisions to customers and internal teams, handling escalations.
Work fully remotely from India on U.S. Eastern Time while meeting productivity targets.
This partner company manages and analyzes insurance and home warranty claims for clients. They offer a fully remote, inclusive, and collaborative work environment with wellness programs and global opportunities.
Manage the full lifecycle of PIP and Medical Payments claims, from coverage verification and investigation to settlement or denial.
Apply medical cost-containment strategies, coordinate experts, and identify subrogation opportunities while meeting compliance standards.
Work remotely within the US, maintaining accurate claim files and communicating professionally with claimants and stakeholders.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. The partner company is seeking a remote Associate PIP Claims Rep to handle Personal Injury Protection claims across multiple states in a structured, compliance-focused environment.
Manage accident-related accounts from intake to resolution, coordinating no-fault and liability benefits.
Submit claims to carriers, maintain accurate records in AcciClaim, and monitor insurance portals.
Work independently, set priorities, and communicate professionally with patients and adjusters.
Revecore helps hospitals recover revenue they've earned so they can continue serving patients and communities. Trusted by more than 1,300 hospitals across 48 states, the company combines specialized expertise with proprietary technology and fosters a supportive, innovative workplace.
Lead external customer audits and utilization management oversight activities as a subject matter expert.
Analyze complex UM data, investigate findings, and prepare evidence-based responses for regulators and accreditation organizations.
Collaborate with operational, technical, and client-facing teams to drive compliance and process improvements.
This company is a healthcare organization specializing in utilization management and regulatory compliance. It operates with a remote team across the United States, fostering a collaborative and improvement-driven culture.
Collaborate with claimants, attorneys, medical providers, and insured businesses to ensure accurate, fair, and efficient claim outcomes.
This company provides workers' compensation claims management services, handling lost-time claims across multiple jurisdictions. The role is fully remote, emphasizing independent work, sound judgment, and high-quality service.
Convert raw medical claims (837 EDI, UB-04, CMS-1500) into canonical models applying healthcare coding standards.
Perform data quality audits and write SQL/Spark SQL queries to validate pipeline output and detect overpayment patterns.
Act as SME on claims coding, adjudication rules, and payer policy, mentoring analysts and collaborating with cross-functional teams.
Machinify is a healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients across the US. Deployed by over 85 health plans and representing more than 270 million lives, the company combines an AI-powered platform with industry expertise to maximize financial outcomes and reduce healthcare costs.
Handle a growing portfolio of primary first-party cyber claims, supporting end-to-end adjudication with increasing independence.
Complete a structured onboarding program with mentorship, progressing from supervised to independent file handling.
Partner with customers, brokers, and external vendors to respond to cyber incidents and reach optimal claim outcomes.
Converge fuses cyber insurance, security, and technology to deliver clear, confident cyber protection. Their team of top-tier professionals spans underwriting, technology, and claims.
Manage an inventory of workers' compensation claims to evaluate compensability and liability.
Plan and conduct investigations to confirm coverage, determine damages, and negotiate settlements within authority limits.
Maintain detailed claim files, authorize timely payments, and represent the company at arbitrations, mediations, or trials.
National Interstate, a member of Great American Insurance Group, provides commercial transportation insurance and alternative risk transfer programs across all 50 states. Its dedicated team has earned multiple Top Workplace honors, with a culture built on integrity, transparency, collaboration, and employee development.
Adjust the most complex and high exposure Allied Health claims requiring advanced technical expertise and negotiation.
Investigate coverage, draft reservation of rights, and manage litigation with defense counsel and experts.
Collaborate with internal and external stakeholders to drive optimal resolution strategies.
Integrated Specialty Coverages is a technology and data-driven commercial MGA and insurance wholesaler. Backed by Onex Partners, it combines insurance and technology to drive innovation and growth.
Investigate new claims, make liability/coverage decisions, and negotiate settlements for auto, property, and liability losses.
Manage outside adjusters and experts, ensure state compliance, and maintain required licenses.
Handle small claims suits and respond to time-sensitive arbitrations and DOI complaints.
ClaimsPro LP, part of Davies, provides insurance claims management services, handling liability, auto, property, and marine claims across the US. Davies is Canada's largest privately owned insurance services provider, fostering a culture of continuous learning and technical excellence.
Investigates and processes commercial claims, evaluating coverage and damages within assigned authority.
Communicates directly with insureds, claimants, agents, and internal customers to resolve claims.
Documents claim files, negotiates settlements, and identifies fraud or subrogation potential.
Liberty Mutual is a global insurance company offering commercial and personal insurance products and services. With a fast-growing and inclusive culture, the company values employee development, well-being, and diversity across its large national workforce.
Manages claim strategies and resolutions while advocating for optimal client outcomes.
Communicates claim information to internal and external clients and maintains strong relationships.
Develops expertise in multiple coverage lines and participates in presentations and new business pitches.
IMA Financial Group is an independent insurance brokerage providing risk management, employee benefits, and wealth management solutions. With a focus on associate ownership and team-based culture, the company has been recognized as a best place to work by multiple publications and operates nationally.
Manage a portfolio of first-party cyber insurance claims from notification through resolution, supporting the full adjudication process.
Complete structured onboarding and training while working under experienced professionals to build independent claims handling skills.
Collaborate with customers, brokers, legal counsel, and cybersecurity vendors to achieve timely and effective claim outcomes.
A specialized cyber insurance provider that helps clients navigate cyber incidents through dedicated claims management and risk mitigation. The company emphasizes structured training, direct mentorship, and a collaborative culture across claims, underwriting, legal, and security teams.
Oversee delegated audits related to UM, Credentialing, Claims, Enrollment, and Appeals processes to ensure compliance with payer contracts.
Educate staff, update policies and workflows, and act as a liaison between payers and local market leadership during audits.
Operationalize regulatory communications from governing bodies and document process changes for upstream and downstream teams.
Dignity Health Management Services offers integrated management and business services to healthcare providers, focusing on managed care administrative and clinical services to contain costs and improve quality. It is part of CommonSpirit Health, a large health system with a mission-driven culture centered on community and patient care.
Manage an inventory of claims to evaluate compensability and liability.
Conduct investigations, negotiate settlements, and authorize payments within assigned authority.
Maintain detailed claim files and communicate with insureds, claimants, and external partners.
National Interstate, a member of Great American Insurance Group, provides commercial transportation insurance and alternative risk transfer programs across the U.S. The broader group employs over 8,500 people and values integrity, transparency, and collaboration.
Lead advanced compliance activities for healthcare administrative products including HSAs, FSAs, HRAs, and COBRA.
Apply expert regulatory judgment to risk assessments, compliance monitoring, investigations, and corrective actions.
Collaborate with stakeholders to integrate compliance requirements into strategic initiatives and leverage AI-powered tools.
HealthEquity empowers healthcare consumers by providing administrative solutions like HSAs, HRAs, FSAs, and COBRA. The company is a large, mission-driven organization that values inclusion and connects health and wealth for American families.