Claims Preparation Jobs

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 remote insurance claims specialist role focuses on evaluating and resolving complex environmental and toxic tort claims for a specialized team. The position involves reviewing loss notices, interpreting policy coverage for primary and excess layers, establishing reserves, and negotiating settlements to ensure timely fund disbursement. Candidates must possess a bachelor's degree and five or more years of experience handling specialty claims involving pollution or asbestos. The opportunity offers a supportive culture with significant room for professional advancement, comprehensive benefits, and a flexible work-from-home arrangement.

This remote insurance role involves evaluating and resolving complex environmental and toxic tort claims for a specialized team. The position requires reviewing loss notices, interpreting policy coverage for primary and excess layers, establishing reserves, and negotiating payments to ensure timely disbursement. Candidates with a bachelor's degree and over five years of experience in environmental, pollution, or general liability claims are sought. The opportunity offers a collaborative environment with strong potential for professional advancement, comprehensive benefits, and flexible work-from-home arrangements.

This role is an Insurance Claims Specialist focusing on complex environmental, toxic tort, and asbestos matters within a rapidly growing insurance firm. The position involves reviewing loss notices, interpreting policy coverage, establishing reserves, and managing primary, excess, and umbrella claims. Key responsibilities include coordinating defense counsel and expert witnesses, evaluating liability and damages, and participating in settlement conferences. The opportunity offers significant career growth with a strong internal promotion culture, remote work flexibility, and the possibility of relocation support.

This remote legal role focuses on managing complex environmental, toxic tort, and asbestos insurance claims for a rapidly expanding company. The position involves reviewing loss notices, interpreting policy coverage, establishing reserves, and coordinating defense counsel and expert witnesses. Key responsibilities include evaluating liability and damages, participating in settlement conferences, and developing strategic claims handling protocols. The opportunity offers significant career growth with a strong internal promotion culture, relocation assistance, and a collaborative work environment.

This remote insurance claims specialist role focuses on reviewing and resolving complex cases involving asbestos exposure, pollution, and environmental health hazards. The position requires analyzing policy coverage, evaluating liability and damages, managing litigation, and facilitating settlement conferences to ensure timely client reimbursement. Ideal candidates possess a bachelor's degree and five to ten years of experience in toxic tort or environmental claims, with a law degree being advantageous. The opportunity appeals to professionals seeking meaningful work in a supportive culture that values continuous improvement and employee growth. The role offers significant flexibility through remote work arrangements while allowing individuals to contribute to critical environmental health resolutions.

This remote legal role involves representing insureds and the company in toxic tort, environmental, pollution, and asbestos litigation. The attorney assesses claim values and exposure risks while managing the full litigation lifecycle, including reviewing discovery, preparing pleadings and trial briefs, and attending hearings or mediations. The position offers the appeal of working from home with a collaborative team environment and opportunities for professional growth within a specialized insurance defense practice.

This remote Insurance Claims Specialist role focuses on managing complex environmental claims involving asbestos, toxic torts, and pollution hazards within the Livonia, Michigan area. The position requires investigating, evaluating, and resolving specialty claims while assessing liability, ensuring policy compliance, and negotiating settlements. Ideal candidates possess a bachelor's degree and over five years of experience in environmental health hazard claims, with a law degree being advantageous. The role offers a collaborative environment with significant opportunities for professional growth and a comprehensive benefits package including retirement plans and paid time off.

This remote insurance role focuses on analyzing and resolving complex environmental hazard claims, including asbestos exposure, toxic tort, and pollution cases. The position involves performing detailed coverage analysis, conducting thorough investigations, negotiating settlement payments, and managing reserve adjustments. Candidates with a bachelor's degree and over five years of direct experience in specialty claims are sought to join a highly trained team. The opportunity is appealing due to the company's commitment to professional development through paid certification courses and continuous training, alongside a culture that empowers employees. The role offers significant career growth potential with long-term incentives and upward mobility within a supportive environment.

This role involves serving as an Insurance Defense Attorney specializing in environmental claims, including pollution, asbestos, and toxic tort matters. The position is based in Franklin Township, New Jersey, with remote work options available. Key responsibilities include representing companies and policyholders in civil litigation, drafting legal documents such as pleadings and briefs, developing case strategies for discovery and trials, and providing clear legal counsel to claims representatives. The role offers a collaborative environment with opportunities to lead training sessions for internal teams. It appeals to candidates seeking professional growth through tuition reimbursement, comprehensive benefits, and a flexible work arrangement that supports a balanced lifestyle.

This remote insurance role focuses on managing complex long-tail and latent environmental claims, including toxic tort, asbestos, and pollution cases. The position involves reviewing loss notices, interpreting policy coverage, establishing reserves, and coordinating defense counsel and expert witnesses. Key responsibilities also include evaluating liability and damages while supporting the development of strategic claims handling protocols. The role offers the appeal of working from home with a collaborative team environment and access to a comprehensive benefits package including retirement matching and health coverage. A bachelor's degree and five to ten years of relevant experience are required.

This remote insurance specialist role focuses on reviewing and resolving complex claims involving asbestos exposure, pollution, and environmental health hazards. The position requires analyzing policy coverage, evaluating liability and damages, managing litigation, and facilitating settlement conferences to ensure timely client reimbursement. Ideal candidates possess a strong background in toxic torts and environmental law, with a bachelor's degree and five to ten years of experience. The role offers a flexible work-from-home arrangement within a supportive culture that values professional growth and employee well-being.

This remote insurance claims specialist role focuses on evaluating and resolving complex environmental, toxic tort, and pollution claims. The position involves reviewing loss notices, interpreting policy coverage for primary and excess layers, establishing reserves, and negotiating payments to ensure timely disbursement. Candidates with a bachelor's degree and over five years of experience in specialty claims are sought to join a team that values professional growth. The opportunity offers a flexible work-from-home arrangement, comprehensive benefits, and a supportive culture that encourages advancement through tuition reimbursement and performance-based incentives.

This remote insurance role focuses on managing complex long-tail and latent environmental claims, including toxic tort, asbestos, and pollution cases. The position involves reviewing loss notices, interpreting policy coverage, establishing reserves, and coordinating defense counsel and expert witnesses. Key responsibilities also include evaluating liability and damages while developing strategic claims handling protocols. The role offers the appeal of working from home with a supportive team environment and access to a comprehensive benefits package. Candidates should have a bachelor's degree and five to ten years of relevant experience in high-risk claims handling.

This General Liability Claims Consultant role within The Hartford Global Specialty Claims Division handles complex bodily injury and property damage claims from inception to resolution. Key responsibilities include conducting investigations, making coverage determinations, managing litigation and counsel, and setting financial reserves for high-value cases. The position appeals to professionals seeking a mission-driven environment where they can shape the future of insurance while developing strategic resolution skills. The role offers a flexible hybrid or remote work arrangement, with in-office expectations varying by location, and provides opportunities to contribute to broader enterprise goals and product development initiatives.

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.

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.

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 Training and Documentation Specialist role within the Claims PIT department focuses on researching, developing, and maintaining training curricula and operational workflows for Claims Operations staff. Key responsibilities include delivering training sessions, conducting quality reviews during training periods, and updating departmental processes. This position is ideal for candidates with a bachelor's degree or relevant experience in medical claims processing, billing, or industry coding formats. The role offers a structured schedule from Monday to Friday with occasional evening and weekend availability as needed, providing an opportunity to support team efficiency and professional development within a specialized claims environment.

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 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.

This full-time Claim Representative role within the General Liability department at Travelers focuses on investigating, evaluating, and resolving bodily injury and property damage claims. The position involves conducting thorough investigations with various parties, analyzing policy coverage, managing claim reserves, and negotiating settlements to ensure fair and timely resolutions. The role appeals to candidates seeking a collaborative culture rooted in innovation and a commitment to serving customers and communities. While the position is based in Alpharetta, GA, it offers opportunities for professional growth within a reputable industry leader. The company actively supports military-affiliated job seekers and requires a bachelor's degree along with specific claim handling experience.

This senior product management role at Counterpart Health focuses on owning customer integrations for a primary care tool designed to improve patient outcomes. The position involves ensuring data completeness and reliability across claims, pharmacy, and clinical sources while building scalable integration infrastructure that leverages AI to automate validation. Key responsibilities include managing direct relationships with enterprise customers, resolving data quality issues, and creating reusable patterns to accelerate onboarding for future clients. The role appeals to candidates seeking to drive impact in value-based care within a remote-first culture that prioritizes work-life balance through flexible time-off and no-meeting Fridays. It offers significant professional growth opportunities through mentorship and the chance to shape a product that directly supports physicians in managing chronic conditions.

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.