Claims Assessment Specialist

2 weeks ago


Garden City, New York, United States BCForward Full time
Job Overview

BCForward is seeking a Claims Assessment Specialist.

Role Overview:

The Claims Assessment Specialist will be responsible for investigating, evaluating, and resolving claims with a focus on delivering fair and timely outcomes. This role requires a blend of technical expertise and interpersonal skills to manage complex cases effectively.

Key Responsibilities:

  • Conduct thorough investigations and evaluations of claims to ensure prompt and equitable resolutions.
  • Adjust reserves or provide recommendations to align with corporate policies.
  • Handle severe exposure claims with a commitment to high-quality service.
  • Process claims payments within the designated authority.
  • Review claims processed by insurance adjusters and further investigate any questionable claims.
  • Verify and analyze data to confirm the validity of claims and ensure compliance with company procedures.
  • Document claim payments, reserves, and new claims accurately in the computer system.
  • Collaborate with legal counsel on claims that may require litigation.
  • Engage with claimants, medical professionals, or employers to gather additional information as needed.
  • Maintain organized claim files, including records of settled claims and those requiring detailed analysis.

Qualifications:

  • Bachelor's Degree.
  • Active New York state adjuster's license is required; additional state licenses are a plus.
  • Strong analytical skills and proficiency in document management and database software.
  • Competence in Microsoft Office applications.
  • Two to four years of relevant experience in claims management.
  • Exceptional attention to detail and strong communication skills.
  • General knowledge of applicable state and national laws and regulations.
  • Understanding of medical and legal terminology.
  • Experience in a goal-oriented claims production environment.

Benefits:

BCForward provides a comprehensive benefits package for eligible employees, including major medical, HSA, dental, vision, life insurance, short-term and long-term disability, and a 401k plan.

About BCForward:

Founded in 1998, BCForward is a Black-owned firm dedicated to providing innovative solutions that support organizations worldwide in achieving their business and technology objectives. With a strong commitment to diversity and excellence, BCForward has established itself as a leader in workforce management and consulting services.

BCForward is an equal opportunity employer, and all qualified applicants will receive consideration for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity, national origin, or disability.



  • Garden City, New York, United States BCForward Full time

    Job OverviewBCforward is in search of a dedicated Claims Assessment Specialist to join our dynamic team.Position Title: Claims Assessment SpecialistJob Type: On-SiteCompensation: $19.00/hr. – $20.00/hr.Role Responsibilities:Conduct thorough investigations, evaluations, and resolutions of claims, utilizing both technical expertise and interpersonal skills...


  • Garden City, New York, United States Orlin & Cohen Medical Specialist Group Full time

    Company Overview:Orlin & Cohen Medical Specialist Group is a leading orthopedic practice in the region, renowned for its extensive network of offices and dedicated healthcare professionals. Position Summary:We are seeking a Claims Management Specialist to join our dynamic team. This full-time role offers a structured schedule from Monday to Friday, with...


  • Garden City, New York, United States Collabera Full time

    Job OverviewPosition Summary:Industry: InsuranceTitle: Insurance Claims SpecialistLocation: 100% RemoteCompensation: $18.00/hr - $20.00/hrKey Responsibilities:Conduct thorough investigations, assessments, and resolutions of claims, utilizing both technical expertise and interpersonal skills to ensure fair and timely case management while contributing to a...

  • Claims Specialist

    2 weeks ago


    Garden City, New York, United States BCForward Full time

    Job OverviewBCforward is actively seeking a dedicated Claims Specialist to join our team.Position: Claims Specialist Location: Not Specified Compensation: $15/hr - $20/hr on W2 Contract Duration: 9+ MonthsKey Responsibilities: • Conduct thorough investigations, evaluations, and resolutions of claims, utilizing both technical expertise and interpersonal...


  • Jersey City, New Jersey, United States Crum and Forster Full time

    Position Overview: Senior Risk Assessment SpecialistWe are looking for a Senior Risk Assessment Specialist to join our esteemed Seneca team. This role is pivotal in underwriting and promoting our property insurance products across the Northeast region.Key Responsibilities:Risk Evaluation: Assess and determine risk acceptance or rejection, ensuring alignment...


  • Garden City, New York, United States Orlin & Cohen Medical Specialist Group Full time

    Orlin & Cohen Medical Specialist Group is a leading orthopedic practice in the region, boasting 20 locations across various counties. With over 25 years of experience, we are proud to employ more than 1200 dedicated healthcare professionals. Our team members benefit from competitive salaries, outstanding medical benefits, and generous paid time off. We are...


  • Jersey City, New Jersey, United States CHUBB Full time

    About the RoleThe Chubb Senior Claims Specialist - TPA Oversight position operates on a hybrid work schedule, with a balance of in-office and remote work. This role is focused on technical claim handling for Chubb insureds nationwide.Key ResponsibilitiesManage complex general liability and automobile claims, including investigation, coverage determination,...


  • Jersey City, New Jersey, United States Aegistech Full time

    Job Summary:Aegistech is seeking a highly skilled and experienced Insurance Claims Representative to join their team in a Hybrid position that requires travel of 20-30% (domestic/International).Key Responsibilities:Manage assigned bodily injury and property damage claim files, including evaluation of claims, evaluation of coverages, establishment of...


  • Garden City, New York, United States Sean Mccarthy - State Farm Agent Full time

    Job OverviewPOSITION SUMMARY:As a Client Relations Specialist at Sean McCarthy - State Farm Agent, you play a crucial role in our operational success and client satisfaction. Your primary focus is to enhance our agency's growth through strong client connections and by serving as a bridge between client requirements and agency services.Our workplace is...


  • Garden City, New York, United States Sean Mccarthy - State Farm Agent Full time

    Job OverviewPOSITION SUMMARY:As a Client Relations Specialist at Sean McCarthy - State Farm Agent, you play a crucial role in our operational success and customer satisfaction. Your primary focus is to foster strong relationships with clients while serving as a bridge between their needs and our agency's offerings. By effectively marketing relevant products...


  • Garden City, New York, United States Sean Mccarthy - State Farm Agent Full time

    Job OverviewPOSITION SUMMARY:As a Client Relations Specialist at Sean McCarthy - State Farm Agent, you play a crucial role in our operational success and customer satisfaction. Your primary focus is to foster strong client relationships while serving as a key link between client requirements and our agency's various departments. You enhance customer...


  • Jersey City, New Jersey, United States CHUBB Full time

    Senior Claims Analyst - TPA Oversight - Major Accounts - Moderate About The Chubb Career Opportunity The Chubb Senior Claims Analyst - TPA Oversight position operates on a hybrid work schedule (3 days in office, 2 days remote). Overview This role is centered on the technical management of claims for Chubb's insured clients across the nation....


  • Jersey City, New Jersey, United States CHUBB Full time

    Senior Claims Analyst - TPA Oversight - Major Accounts - Moderate Overview of the Opportunity at Chubb The Senior Claims Analyst - TPA Oversight role is designed for a hybrid work environment, allowing for a combination of in-office and remote work. Position Summary This position is centered around the technical management of claims for Chubb...


  • Jersey City, New Jersey, United States CHUBB Full time

    Senior Claims Analyst - TPA Oversight - Major Accounts - Moderate Overview of the Chubb Opportunity The Senior Claims Analyst - TPA Oversight role operates under a hybrid work model, combining in-office and remote work. Position Summary This position is dedicated to the technical management of claims for Chubb's insured clients across the...


  • Jersey City, New Jersey, United States Arch Capital Group Full time

    About the RoleWe are seeking a highly skilled Senior Claims Examiner to join our Excess Casualty Team at Arch Capital Group. As a key member of our Claims Division, you will be responsible for actively handling and managing an Excess casualty caseload.Key ResponsibilitiesIdentify and assess coverage issues, draft coverage position letters, and retain...


  • Jersey City, New Jersey, United States AIG Full time

    Director of Complex Claims Management - Healthcare Professional LiabilityWe invite you to explore the opportunity of becoming a Director of Complex Claims Management, where you will play a pivotal role in a leading claims organization.Your Contribution to Claims ExcellenceOur Claims teams are recognized as the trusted advisors for clients, consistently...


  • Jersey City, New Jersey, United States AIG Full time

    Job SummaryWe are seeking a highly skilled and experienced Claims Complex Director to join our team at AIG. As a key member of our Claims function, you will be responsible for managing a portfolio of complex and high-exposure medical malpractice claims.Key ResponsibilitiesManage a portfolio of complex and high-exposure medical malpractice claims, applying...


  • Garden City, New York, United States St. John's Episcopal Hospital Full time

    Job OverviewAbout Us:St. John's Episcopal Hospital stands as a vital healthcare provider, delivering emergency and outpatient services to a diverse and underserved community in southern Queens County and southwestern Nassau County, New York. With over a century of dedicated service, our 257-bed facility is committed to offering comprehensive preventive,...


  • Jersey City, New Jersey, United States Gainwell Technologies Full time

    Position Overview The Clinical Pharmacy Solutions Specialist plays a pivotal role in advancing clinical pharmacy initiatives, including the formulation of prior authorization criteria and the orchestration of Pharmacy and Therapeutic Committee (P&T) and Drug Utilization Review (DUR) Board meetings. This position is integral in supporting both prospective and...


  • Jersey City, New Jersey, United States Caduceus Inc Full time

    Job SummaryCaduceus Inc is seeking a highly skilled Charge Entry Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for reviewing and clearing claim edits in our system, ensuring timely submission of claims.Key ResponsibilitiesRegistration: Enter demographic information into our Athena system, utilizing...