Claims Manager

3 weeks ago

Tampa, United States Everspan Group Full time

Job Summary:

This role functions as a liaison between the Everspan Claims Department and its business partners (underwriting, MGAs, TPAs, reinsurers, brokers, insureds and claimants) by providing necessary administrative support as well as serving as a back-up resource to the Claims Team in the First Notice of Loss, Payment Processing and other administrative functions as needed.

Primary Duties/Responsibilities: Manage and maintain claims email inbox and provide telephone support for claims calls Complete claim system transactions as assigned, including new claim set ups (if needed) and triaging new claims to the correct line of business Provide daily work oversight in support of Head of Claims and Professional Staff Serve as a technical expert for claims and acts as a problems solver for systems and procedural matters Assist Management in reviewing existing and future processes to ensure best practices are implemented and followed On an ad-hoc basis, support Ambac-Group claims initiatives, including but not limited to advising on claims/TPA diligence and overall claims/TPA operational matters Provide training, support and clarification to others as requested Work with business partners to ensure the timely processing of information related to insurance policies Analyze and validate data to ensure accuracy and quality Provide oversight to TPAs and any third party vendors as needed Assist in problem solving all clerical processes and coding entries Assist in Vendor Payment Allocation and TPA account funding Responsible for operational readiness of TPAs Assist with coordination of projects and special assignments such as audit preparation Access information in response to inquiries from attorneys, brokers, insureds and outside business partners Maintain records and complete projects specific to accounts handled by Management Gather necessary information compiling ad hoc claims reports Maintain panel counsel list and preferred vendor list as directed by Head of Claims Monitor and respond to critical business and customer needs in a timely and professional manner Ensure establishment of a working electronic data exchange initiatives, including claims bordereaux transmission process Import of all TPA bordereaux for evaluation and reconciliation Improve quality, simplify processes, and reduce cycle times of claims procedures

Education, Experience, and Other Qualifications: Bachelor's degree or equivalent experience 5+ years insurance and/or claim handling experience (commercial claims a plus) Knowledge of multiple state statutes, including good faith claim handling practices, regulations, and guidelines Excellent communications (telephone, e-mail and interpersonal) skills as required Exceptional attention to detail and a customer-centric outlook Strong analytical and organizational skills Software: All Windows operating systems, Microsoft Word, Excel Knowledge of various claim systems and claim processing. Ability to analyze, think outside the box and build long-standing relationships Proven success collaborating with team members at all levels of the organization Good sense of timing and the ability to recognize and solve problems Ability to prioritize and allocate work actions based on importance, value, urgency and customer needs

Please No Recruiter Solicitations.

#J-18808-Ljbffr

  • Workers Compensation Claims Examiner

    1 month ago

    Tampa, United States Packard Claims Administration Full time

    Job DescriptionJob DescriptionPackard Claims Administration is a fast paced and growing TPA looking for a Workers Compensation Claims Examiner to join our team. We pride ourselves on having a family oriented environment that makes for an enjoyable place to work.Responsibilities:Must have and maintain a FL adjusters license (620 Florida All lines Adjusting...

  • Claims Manager

    1 month ago

    Tampa, United States Everspan Group Full time

    Job Summary: This role functions as a liaison between the Everspan Claims Department and its business partners (underwriting, MGAs, TPAs, reinsurers, brokers, insureds and claimants) by providing necessary administrative support as well as serving as a back-up resource to the Claims Team in the First Notice of Loss, Payment Processing and other...

  • Claims Manager

    2 weeks ago

    Tampa, United States Everspan Group Full time

    Job Summary: This role functions as a liaison between the Everspan Claims Department and its business partners (underwriting, MGAs, TPAs, reinsurers, brokers, insureds and claimants) by providing necessary administrative support as well as serving as a back-up resource to the Claims Team in the First Notice of Loss, Payment Processing and other...

  • Claims Manager

    7 hours ago

    Tampa, United States Slide Full time

    Slide is a cutting-edge Tampa based Technology Enabled Insurance company who is disrupting the industry! To revolutionize all facets of property insurance, we need to do things differently. Therefore, certain traits are required of Sliders in order to be successful in our fast-paced environment. Being able to contribute innovative solutions (Best Idea...

  • Claims Manager

    8 hours ago

    Tampa, United States Slideinsurance Full time

    Slide is a cutting-edge Tampa based Technology Enabled Insurance company who is disrupting the industry! To revolutionize all facets of property insurance, we need to do things differently. Therefore, certain traits are required of Sliders in order to be successful in our fast-paced environment. Being able to contribute innovative solutions (Best Idea...

  • Claims Supervisor

    1 day ago

    Tampa, Florida, United States Insurance Placement Solutions Full time

    Insurance Placement Solutions has an immediate opening for a Commercial Auto Fast Track Claims Supervisor with our client. As a member of our client's claims team, utilize your knowledge of commercial auto fast-track claims to independently investigate, evaluate, and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will...

  • Claims Adjuster

    1 day ago

    Tampa, Florida, United States Insurance Placement Solutions Full time

    Insurance Placement Solutions has an immediate opening for an Auto Bodily Injury Claims Adjuster with our client. As a member of our client's claims team, utilize your knowledge of auto bodily injury to independently investigate, evaluate and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will administer and resolve...

  • Claims Manager

    4 weeks ago

    Tampa, United States Truist Full time

    ESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. 1. Coach experienced Claim Team to identify client needs and develop strategies for dealing with claim and service...

  • Claims Adjuster

    1 day ago

    Tampa, Florida, United States Insurance Placement Solutions Full time

    Insurance Placement Solutions has an immediate opening for a Remote Commercial General Liability/Auto Claims Adjuster with our client in the U.S. As a member of our client's claims team, utilize your knowledge of general liability to independently investigate, evaluate and resolve assigned claims in order to achieve appropriate outcomes. In this position,...

  • Claims Adjuster

    24 hours ago

    Tampa, Florida, United States Insurance Placement Solutions Full time

    Insurance Placement Solutions has an immediate opening for a Remote Commercial General Liability/Product Liability Claims Adjuster with our client. As a member of our client's claims team, utilize your knowledge of general liability to independently investigate, evaluate, and resolve assigned claims in order to achieve appropriate outcomes. In this position,...

  • Claims Adjuster

    1 day ago

    Tampa, Florida, United States Insurance Placement Solutions Full time

    Insurance Placement Solutions has an immediate opening for a Remote Commercial Auto/General Liability Claims Adjuster with our client. As a member of our client's claims team, utilize your knowledge of general liability to independently investigate, evaluate, and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will...

  • Claims Adjuster

    7 days ago

    Tampa, Florida, United States Insurance Placement Solutions Full time

    Auto Warranty Claims Adjuster Responsibilities:Act as the main contact for new auto warranty claims, addressing queries and collecting necessary details from claimants.Conduct thorough investigations to validate and identify warranty claims, ensuring adherence to company policies and legal standards.Manage incoming calls regarding warranty claims, offering...

  • Claims Adjuster

    1 month ago

    Tampa, Florida, United States Insurance Placement Solutions Full time

    Insurance Placement Solutions has an immediate opening for a Remote Construction Defect Claims Adjuster with our client. As a member of our client's claims team, utilize your knowledge of construction defect to independently investigate, evaluate, and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will administer and...

  • Senior Claims Attorney

    1 week ago

    Tampa, United States Lemery Connects Recruiting & Consulting Full time

    Job Posting: Senior Claims AttorneyLocation: Tampa, FLReports to: Vice President - ClaimsBasic Function: Our client is seeking a Senior Claims Attorney to support its claims operations and oversee the administration of claim notices, establishment and management of claim reserves, investigation, administration, and resolution of complex claims. The Senior...

  • Senior Claims Attorney

    4 weeks ago

    Tampa, United States Lemery Connects Recruiting & Consulting Full time

    Job Posting: Senior Claims AttorneyLocation: Tampa, FLReports to: Vice President - ClaimsBasic Function: Our client is seeking a Senior Claims Attorney to support its claims operations and oversee the administration of claim notices, establishment and management of claim reserves, investigation, administration, and resolution of complex claims. The Senior...

  • Medical Claims Examiner

    19 hours ago

    Tampa, United States SNI Companies Full time

    Job Description Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services •Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria •Review different lines of business to include Medicare, Medicaid...

  • Claims Analyst

    1 day ago

    Tampa, United States Leading Edge Administrators Full time

    Job Summary: The Claims Analyst will provide timely and accurate processing and adjudication of claims. The role will research, and process claims or related requests for covered members or providers across various products including medical, pharmacy, vision and related healthcare options. Duties and Responsibilities: Work from a queue to review assigned...

  • Claims Manager

    9 hours ago

    Tampa, United States McGriff Full time

    **Must be able to travel to one of our Florida offices as needed** Summary: Act as a leader and coach for commercial claim organization in their efforts to manage and advise in claim matters for clients and prospects. May also provide support for solving complex claims or leading claim consulting teams in specialized industry verticals. Overseeing a team of...

  • Medical Claims Examiner

    8 hours ago

    Tampa, United States SNI Companies Full time

    Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services •Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria • Review different lines of business to include Medicare, Medicaid and...

  • HealthCare Claims Adjudicator/Claims Examiner-Mostly Remote

    1 month ago

    Tampa, United States Imagenet LLC Full time

    Job DescriptionJob DescriptionImagenet is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. We are looking for Claims Examiners to join our rapidly growing team in Tampa. Experience is preferred but not necessary. Candidates with the right aptitude and...