Claims Operations Specialist

4 weeks ago


Berkeley Heights NJ, United States Westfield Specialty, Inc. Full time

We're seeking a skilled Claims Operations Specialist to serve as a business analyst for Westfield Specialty Claims. In this role, you'll assist in creating and refining business and functional requirements for claims processing and administration, as well as third-party solutions and reporting integrations.


Key Responsibilities:
  • Lead and support various projects, ensuring timely completion and effective collaboration with stakeholders.
  • Create business and functional requirements for Guidewire ClaimCenter, third-party solutions, and reporting integrations.
  • Participate in user acceptance testing, ensuring seamless integration and functionality.
  • Analyze data to support business decisions, providing reports to the claims team and working closely with key stakeholders to gather information and requirements.
  • Map workflows and procedures, analyze them, and suggest changes to optimize the entire claim lifecycle.
  • Develop and update claims training materials, incorporating content into training applications and participating in delivering the training.

Requirements:
  • Bachelor's degree and five or more years of P&C insurance experience.
  • Strong preference for formal business analysis skills, including supporting insurance claims processes or technology projects.
  • Experience in data collection, report creation, and communication across organizational levels.
  • Advanced proficiency with Microsoft Office suite.
  • Ability and willingness to travel as needed.

We celebrate diversity and do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, veteran status, disability status, or any other applicable characteristics protected by law.



  • Berkeley Heights, NJ, United States Westfield Full time

    Job Title: Senior Claims Specialist, Financial LinesWe are seeking a talented and enthusiastic Senior Claims Specialist, Financial Lines to join our financial lines claims team at Westfield. The ideal candidate will have significant experience in public and private D&O, E&O, EPL, Fiduciary, and Crime/Fidelity claims.Responsibilities:Directly handle, manage,...


  • Berkeley Heights, United States Westfield Full time

    We are seeking a talented Claims Professional to join our financial lines claims team at Westfield. The ideal candidate will have significant experience in public/private D&O, E&O, or EPL claims, with a strong background in securities class actions, private equity, and bankruptcy-related claims.Key responsibilities include:Directly handling and managing...


  • Berkeley Heights, United States Westfield Full time

    Job DescriptionWe are seeking talented and enthusiastic individuals to join our financial lines claims team. Candidates can be located in our Berkeley Heights, NJ, Alpharetta, GA, or New York City offices. Primary responsibility will include the direct handling and management and/or overseeing of commercial and financial lines Public and Private D&O, E&O,...


  • Middleburg Heights, Ohio, United States Quadax Full time

    Job Summary: We are seeking an Insurance Claims Specialist to join our team at Quadax. As an Insurance Claims Specialist, you will be responsible for resolving outstanding accounts receivable balances, following up with payers and patients, and responding to payer correspondence.Key Responsibilities:Follow up with payers and patients to resolve outstanding...


  • Arlington Heights, Illinois, United States The LaSalle Group Full time

    LaSalle Network is seeking a skilled Medical Billing Specialist to join their team. As a key member of the revenue cycle team, you will be responsible for ensuring accurate and timely transmission of claims, as well as resolving any issues that may arise.The ideal candidate will have 1-5 years of experience in hospital billing, preferably with Medicare, and...


  • Secaucus, NJ, United States Yusen Logistics Full time

    Position Summary The Claims Handling Specialist facilitates the cargo damage/loss claim process within the International Freight Forwarding division. The Claims Handling Specialist is responsible to receive, register, evaluate, administer, and process air/ocean cargo damage/loss claims pursuant to Yusen's claim handling procedure. They also work with...


  • Secaucus, NJ, United States Yusen Logistics Full time

    Position Summary The Claims Handling Specialist facilitates the cargo damage/loss claim process within the International Freight Forwarding division. The Claims Handling Specialist is responsible to receive, register, evaluate, administer, and process air/ocean cargo damage/loss claims pursuant to Yusen's claim handling procedure. They also work with...


  • Warminster Heights, Pennsylvania, United States Excelsia Injury Care Full time

    About Excelsia Injury CareAt Excelsia Injury Care, we provide management services to a network of healthcare companies across Maryland, Delaware, Virginia, and Pennsylvania. Our healthcare partners offer a comprehensive range of office-based diagnostic, surgical, and rehabilitation services, delivered by skilled professionals who prioritize patient outcomes....


  • Richmond Heights, Virginia, United States Behavioral Health Services of Virginia Full time

    We are seeking a highly skilled and detail-oriented Medical Biller to join our team at Behavioral Health Services of Virginia. As a Medical Biller, you will play a critical role in ensuring the accuracy and efficiency of our billing processes.Key Responsibilities:Prepare and submit billing data and medical claims to insurance companies in a timely and...


  • Berkeley Heights, United States Randstad Full time

    Job Summary:We are seeking a highly skilled Business Operations Specialist to join our team at Randstad. The ideal candidate will have a strong background in business operations, procurement, and compliance. This is a temporary position with the possibility of extension.Key Responsibilities: Approve purchase workflows through the Request-To-Pay tool...


  • Sterling Heights, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are offering a short term contract employment opportunity for a Medical Claims Analyst in STERLING HEIGHTS, Michigan. This role is in the healthcare benefits industry and will primarily be focused on disability claims analysis. The job function includes analysing and adjusting disability claims, reviewing disability...


  • Sterling Heights, Michigan, United States State Farm Insurance Full time

    Job Summary: As an Account Associate at State Farm Insurance, you will be responsible for providing exceptional customer service by addressing customer concerns and resolving problems in a professional and efficient manner. You will also assist customers with their insurance needs, process policy changes and updates, and handle incoming calls and emails...


  • Chevy Chase Heights, Pennsylvania, United States solera Full time

    At Solera, we're on a mission to transform the vehicle lifecycle into a connected digital experience. Our team of 6,500 innovative thinkers is dedicated to bringing the future to bear today through cognitive answers, insights, algorithms, and automation.The RoleWe're seeking a Senior Claims Project Manager to join our Commercial Operations team. As a key...

  • Claims Analyst

    2 weeks ago


    New Brunswick, NJ, United States Proficient Auto Logistics Full time

    Job descriptionTribeca Automotive is a leader in the auto transportation industry. We are seeking a detail-oriented Claims Analyst to join our dynamic team. This position supports the Claims Department by analyzing, adjusting, and resolving auto damage claims.DutiesReceives, reviews and acknowledges cargo claims damage notifications and FNOL in a timely...


  • Linthicum Heights, United States CommuniCare Family of Companies Full time

    CommuniCare Health Services is currently recruiting for the position of Claims Business Analyst for our Medicare Advantage plan! This is a fully remote position. PURPOSE/BELIEF STATEMENT The position of Business Analyst (Claims) reports directly to Director of Operations with strong collaborative relationships with Appeals, Provider Relations and...


  • Berkeley Heights, United States Summit Health Inc Full time

    Key Responsibilities:As a Sterilization Specialist at Summit Health Inc, you will be responsible for ensuring the highest standards of sterilization in our facilities. This includes operating autoclaves and sterilizers to sanitize instruments, equipment, and supplies. Additionally, you will be responsible for repairing broken instruments and maintaining a...


  • Linthicum Heights, United States CommuniCare Corporate Full time

    CommuniCare Corporate - CommuniCare Health Services is currently recruiting for the position of Claims Business Analyst for our Medicare Advantage plan! This is a fully remote position.PURPOSE/BELIEF STATEMENTThe position of Business Analyst (Claims) reports directly to Director of Operations with strong collaborative relationships with Appeals, Provider...


  • Maplewood, NJ, United States Tandym Group Full time

    A long-standing company in NJ is seeking a Senior Disability Claims Administrator to support their operations in Maplewood, NJ. Please apply for more information.Responsibilities:Review applications for temporary disability benefits (TBD) claims to ensure that required information is submitted and the appropriate medical documentation is receivedReview...


  • Arlington Heights, Illinois, United States The LaSalle Group Full time

    Medical Billing Specialist Job DescriptionWe are seeking a highly skilled Medical Billing Specialist to join our team at The LaSalle Group. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely transmission of medical claims, resolving issues, and pursuing unpaid accounts.Responsibilities:Ensure all claims are...


  • Manalapan, NJ, United States STRESS CARE of NJ, Inc. Full time

    Medical Billing SpecialistAt STRESS CARE of NJ, Inc., we are seeking a skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will be responsible for ensuring that all billing and collections are accurately done in a timely manner. This includes reviewing and following up on remittance advice for payment errors and denials,...