Claims Administration Jobs

This role involves joining Oliver Wyman's Insurance and Asset Management Practice in New York as an Associate or Engagement Manager. The position focuses on delivering strategic insights to life insurers, property and casualty carriers, and asset managers regarding strategy, operations, and risk management. Key responsibilities include managing project workstreams, conducting data analysis and research, synthesizing findings into client presentations, and mentoring junior consultants. The opportunity is appealing due to the firm's global reputation, a culture that fosters ownership and professional development, and the chance to work on high-impact projects involving emerging technologies like generative AI. The role operates within a hybrid work model requiring three days per week in the New York office, with travel as needed for client engagements.

This remote role at Sedgwick involves analyzing complex workers' compensation claims to determine benefits, manage litigation, and negotiate settlements. Key responsibilities include calculating claim reserves, processing benefit payments, ensuring compliance with state regulations, and coordinating vendor referrals for investigations. The position appeals to professionals seeking a career within a globally recognized organization that prioritizes a caring culture, work-life balance, and professional growth. The role offers the opportunity to utilize advanced technology in a supportive environment while contributing to meaningful outcomes for individuals facing unexpected challenges.

This remote Claims Examiner role at Sedgwick focuses on adjudicating complex workers' compensation claims across multiple state jurisdictions. The position involves analyzing technically difficult cases, negotiating settlements, calculating reserves, and managing litigation processes to ensure timely resolutions. As a floater on a dedicated account, the role requires knowledge of 32 states and preferably holds a reciprocal license. The position is appealing due to Sedgwick's caring culture, extensive professional development opportunities, and flexible work arrangements that support work-life balance. Employees benefit from a collaborative global environment, comprehensive benefits, and the chance to contribute to meaningful solutions for clients worldwide.

This remote role at Sedgwick involves analyzing complex workers' compensation claims for California-based cases. The position requires managing high-exposure files, negotiating settlements, calculating reserves, and handling litigation processes while ensuring compliance with state regulations. Key responsibilities include coordinating vendor referrals, managing claim recoveries, and maintaining professional relationships with claimants and clients. The opportunity is appealing due to Sedgwick's caring culture, recognition as a top workplace, and the chance to work with advanced AI-enabled technology within a global organization. The role supports work-life balance and offers significant professional growth for experienced claims professionals.

This full-time Senior Claims Examiner role within the Property & Casualty department focuses on managing complex commercial auto and trucking claims. The position involves investigating severe liability cases, determining settlement values, managing litigation processes, and establishing appropriate financial reserves. Key responsibilities include mentoring junior staff, communicating with brokers and attorneys, and ensuring compliance with insurance regulations across multiple jurisdictions. The role offers a hybrid work arrangement requiring weekly office attendance in select locations, with the remainder of the week available for remote work. Candidates are drawn to the company's inclusive culture, reputation as a Best Place to Work, and opportunities for professional growth within a family-owned organization.

This temporary remote role involves managing complex and high-profile Workers' Compensation claims for a national risk management firm. The specialist is responsible for investigating claim validity, establishing financial reserves, authorizing payments, and negotiating settlements while coordinating early return-to-work efforts. The position offers the appeal of working within a stable, growing organization known for its supportive culture and career advancement opportunities. Key duties include collaborating with case managers and attorneys to reduce claim costs and maintaining compliance with state regulations. The role requires strong analytical skills and industry experience to ensure optimal outcomes for all parties involved.

This remote Payment Integrity Professional 2 role within Humana's healthcare division focuses on leveraging claims data and analytic tools to ensure accurate payment outcomes. Key responsibilities include analyzing medical claims to identify trends and anomalies, conducting root-cause analysis on incorrect payments, and developing mitigation strategies to reduce costs. The position also involves collaborating with internal stakeholders and external vendors to manage code edit functions and drive process optimization. The opportunity is appealing due to the company's commitment to associate well-being, offering a Fortune 100 work environment with strong professional development resources, comprehensive benefits, and a flexible remote work arrangement that includes occasional travel for training.

The Employee Success Associate - Leave Administration role supports the Operations team by managing complex leave of absence and ADA claims for multiple clients. Key responsibilities include verifying leave eligibility, reviewing medical documentation, coordinating with healthcare providers and insurance carriers, and facilitating interactive accommodation discussions. The position requires maintaining accurate files, drafting official correspondence, and ensuring compliance with federal and state regulations. This opportunity appeals to candidates seeking a remote-first environment with a focus on Gold Standard service delivery and professional growth in HR administration. The role offers a collaborative culture where employees can develop foundational knowledge of leave laws while working independently with occasional travel for team events.

This hybrid Analyst Quality Control role supports the Physicians Billing Service Accounts Receivable Management Team by ensuring efficient workflow processes and high-quality output. Key responsibilities include conducting monthly reviews of staff performance to verify accuracy, developing and updating written guidelines and policies, and assisting with the onboarding and training of new hires. The position offers a flexible work arrangement with primarily remote duties and a required monthly office visit. The role is appealing for its focus on continuous improvement within a collaborative environment, offering opportunities to influence quality metrics and support team growth at a mission-driven institution.

This entry-level Consultant role within the Construction Advisory team supports dispute resolution and claims practices for large construction and engineering projects. The position involves performing forensic accounting, cost analysis, and damages quantification while assisting lead analysts in preparing expert reports. Key responsibilities include conducting loss of productivity and prolongation cost analyses, managing project controls, and delivering client presentations. The role appeals to candidates seeking to build a strong industry foundation by working alongside experienced professionals on complex matters. It offers a collaborative environment with frequent client interaction, opportunities to develop advanced data research skills, and a focus on professional growth through high-level report writing and deadline management.

The Customer Success Manager role serves as the dedicated point of contact for key producer accounts within Trustmark's insurance division. The position focuses on managing post-implementation relationships, triaging complex service issues, and collaborating with subject matter experts to ensure timely resolutions. Key responsibilities include tracking service level metrics, analyzing trends to drive process improvements, and conducting quarterly reviews to maintain high customer satisfaction and Net Promoter Scores. This opportunity appeals to professionals seeking a purpose-driven environment where diversity, inclusion, and mutual respect are core values. The role offers significant career growth within a collaborative team that supports a mission to improve wellbeing, with a hybrid work arrangement that includes up to 20% travel for relationship building.

The Vice President and Chief Medical Information Officer role at Allegheny Health Network is a strategic executive position dedicated to architecting the digital future of care delivery. The incumbent leads digital transformation initiatives, optimizes clinical workflows, and manages the Clinical Informatics Council to align technology with the Living Health model. Key responsibilities include overseeing enterprise electronic health record systems, fostering cross-functional collaboration between clinical and technology divisions, and driving data-driven population health strategies. This position offers the opportunity to shape the operational and cultural direction of a large integrated delivery network while maintaining an active clinical practice. The role emphasizes a collaborative environment where innovation and clinical credibility converge to improve patient outcomes and reduce administrative burdens.

The Claims Technical Supervisor role provides technical leadership for the Benefit Plan Administration and EDI operations teams within a fast-paced healthcare environment. Key responsibilities include supervising daily workflow operations, providing subject-matter expertise on claims processing and regulatory requirements, and leading quality assurance activities to ensure operational accuracy. The position also involves partnering with IT and business stakeholders to support system updates and tracking performance metrics. This hybrid role based in Indianapolis offers a collaborative culture that values work-life balance, continuous learning, and career development opportunities.

The Claims Operations Supervisor role provides day-to-day leadership for claims processing, adjudication, and mailroom functions within a hybrid team based in Indianapolis. Key responsibilities include supervising daily workflows, resolving complex claim escalations, monitoring quality metrics, and partnering with cross-functional teams to drive process improvements. This position appeals to candidates seeking a career in a company that prioritizes work-life balance, continuous learning, and professional development. The role offers a collaborative environment focused on operational excellence and includes opportunities for team coaching and workflow optimization.

This full-time Senior Estate Administration Attorney role at Steinbacher Goodall & Yurchak supports the Legal & Regulatory Compliance team in managing complex post-death estate and trust matters. Key responsibilities include guiding clients through probate and settlement processes, interpreting wills and trusts, handling tax compliance, and appearing in Pennsylvania courts. The position also involves mentoring junior staff and collaborating with financial professionals to ensure accurate asset distribution. The role appeals to experienced attorneys seeking a supportive culture that values continuous learning and high-quality service. It offers a hybrid work arrangement balancing in-office collaboration with remote flexibility, allowing professionals to deepen their expertise in elder law while making a meaningful impact on families.

The Senior Manager of Benefits and Claims is a leadership role within Ocean State Job Lot's corporate team, responsible for overseeing both the benefits and claims departments. Key duties include managing a comprehensive benefits package and 401(k) plan, administering leave programs in compliance with federal and state laws, and supervising workers' compensation and liability claims to mitigate risk. The position involves leading two teams, analyzing data to drive strategic improvements, and serving as the primary liaison with insurance carriers and brokers. This opportunity appeals to candidates seeking to shape a total rewards strategy for a rapidly growing retailer with a strong community focus. The role offers a hybrid work arrangement requiring three days in the corporate office and provides access to extensive perks such as health coverage, tuition reimbursement, and employee discounts.

This remote role involves administering and maintaining litigation and claims functions for medical malpractice cases within a professional liability insurance team. Key responsibilities include coordinating with insurance adjusters and outside counsel, conducting legal research, and preparing detailed reports on litigation status, expenses, and trend analysis. The position also requires developing litigation policies and managing day-to-day claims activities. The opportunity is appealing due to the vibrant, growth-oriented work environment and extensive professional development options available within an extraordinary organization.

The ADV Manager EU role serves as the operational backbone for ANINE BING's European wholesale business, based at the Paris headquarters. The position manages the full order lifecycle within NetSuite, ensures strict shipping compliance for major key accounts, and coordinates with third-party logistics partners and sales agents. This role is appealing for its opportunity to build foundational infrastructure for a growing global fashion brand in a creative, people-first environment. The position offers a hybrid work arrangement with a preference for in-person collaboration, alongside benefits such as flexible time off, exclusive product discounts, and a dynamic culture that values ownership and cross-functional teamwork.

The Analyst, Tech. Operations Government Programs role supports Navitus Health Solutions in executing pharmacy benefit processes for government programs while ensuring compliance with CMS regulations. Key responsibilities include managing complex tasks such as enrollment administration, claims adjudication, error reconciliation, and coordinating with federal agencies and external vendors. The position requires maintaining accurate process documentation and meeting strict deadlines, often involving work outside standard business hours. This opportunity appeals to candidates seeking a mission-driven environment that prioritizes affordable medication access, offering a collaborative culture that fosters creativity and professional growth. The role is fully remote, providing flexibility for eligible residents, and is supported by comprehensive benefits including paid time off, parental leave, and a 401(k) match.

The Wage Fraud Investigator role within the Maine Department of Labor's Bureau of Unemployment Compensation focuses on protecting the state's Unemployment Trust Fund by identifying benefit overpayments. Key responsibilities include reviewing unemployment claims and wage audits to determine if overpayments were accidental or intentional, validating identity documents to prevent fraud, and participating in appeal hearings to defend investigative findings. This position offers a hybrid work arrangement requiring at least one day per week in an office after training, with occasional statewide travel. The role is appealing for its purposeful mission to ensure program integrity, the opportunity to utilize analytical and interviewing skills in a professional setting, and access to a comprehensive benefits package including significant health insurance contributions, retirement matching, and generous paid leave.

This full-time Outside Sales Representative role focuses on selling electrical distribution products to contractors within an assigned territory. The position requires extensive travel and in-person interactions to develop new prospects and maintain relationships with established customers. Key responsibilities include meeting annual gross margin budgets, managing customer complaints, monitoring local market conditions, and assisting with account collections. The role is appealing due to Graybar's employee ownership culture, which fosters a collaborative environment where staff can grow through educational reimbursement and career development programs. The company offers a comprehensive benefits package including health coverage, profit sharing, and a 401(k) match. While the position involves significant travel and the use of a personal vehicle with reimbursement, it provides predictable schedules without weekend or night shifts.

The Community HR Director leads human resources operations for a senior living community in West Yarmouth, MA, with a focus on reducing turnover and enhancing employee satisfaction. Key responsibilities include managing the full recruitment lifecycle, coordinating training and development programs, handling employee relations and performance management, and overseeing payroll and benefits administration. The role requires ensuring compliance with labor laws and fostering a positive, inclusive culture aligned with core values of humor, empathy, and trust. This full-time, on-site position offers significant growth opportunities within an innovative organization that prioritizes work-life balance, autonomy, and continuous learning for its staff.

This role serves as an ADA Associate or Specialist within the operations team, delivering comprehensive leave and accommodation services to clients and their employees. Key responsibilities include administering ADA cases and leaves of absence, engaging in the interactive discussion process, reviewing medical documentation, and acting as the primary point of contact for employees and HR teams. The position requires coordinating with insurance carriers and maintaining accurate case files while adhering to federal and state regulations. The opportunity is appealing for individuals seeking to develop expertise in disability law and employee relations within a remote-first culture that values collaboration and continuous learning. While primarily remote, the role requires living near specific office locations in California, Georgia, Arizona, or Oklahoma for bi-weekly in-person gatherings and occasional travel for client meetings.

This permanent Contract Administrator role supports a construction company's operations by managing the full lifecycle of contracts from drafting to closure. The position involves overseeing negotiation, financial reporting, and compliance with federal and state regulations while coordinating with project managers and finance teams to ensure accurate budgeting. Key responsibilities include developing contract management procedures, mitigating legal risks, and handling contract closeouts and dispute resolution. The role appeals to experienced professionals seeking career advancement and stability under an experienced leadership team. Candidates must hold a bachelor's degree and possess at least three years of experience in contract administration within the construction industry.

The Real Property Acquisition Agent II role within Pima County's Real Property Services Department focuses on managing the acquisition, sale, and disposition of real estate for public infrastructure projects. Key responsibilities include negotiating directly with property owners, reviewing engineering plans and legal documents for compliance, and preparing acquisition agreements in adherence to state and federal regulations. The position also involves managing relocation assistance for displaced occupants and overseeing the administrative closure of real estate files. This opportunity appeals to candidates seeking to contribute to community development through meaningful public service work. The role requires a mix of office-based analysis and field inspections, offering a stable career path within a government agency committed to inclusive employment practices.