Claim Resolution Specialist

7 days ago


Plano, Texas, United States CEF Solutions Inc Full time
Job Title: Claim Operator

Cef Solutions Inc. is a leading provider of consulting services and business process outsourcing solutions. Our team specializes in delivering end-to-end client experiences to multinational companies in the customer service industry.

We are seeking a skilled Claim Operator to join our team. As a Claim Operator, you will be responsible for reviewing new submissions, investigating claims, and communicating with logistics service providers to ensure timely and accurate resolutions.

Key Responsibilities:
  • Review new submissions to ensure all required documentation and claim details are included
  • Investigate and process damage claim submissions based on return authorizations and QA reports
  • Communicate with logistics service providers to ensure a timely and accurate resolution
  • Thoroughly review all claim declinations and communicate the final resolution to customers, if valid
  • Dispute invalid claim resolutions to overturn declination and negotiate claim settlements
  • Analyze data to determine claim validity; evaluate independent reports, including video, written incident reports, valuation estimates, etc.
  • Compile comprehensive claim analyses for monthly reporting to clients
  • Work within company guidelines to analyze contractual agreements of the customer, shipper, consignee or carrier and then assess the physical damage reports and the cargo claims findings
  • Notify involved parties of claim filings and/or rejected claims and clearly communicate with the claimant the best course of action to mitigate loss
  • Escalate high-value declinations with management to discuss possible recourse
Requirements:
  • Required proficiency in Microsoft Excel, including but not limited to, basic reporting functions and formatting, VLOOKUP, and pivot tables
  • 1+ years of freight claims processing experience preferred
  • Excellent verbal and written communication skills
  • Strong critical thinking and creative problem-solving skills
  • Flexibility to work in a fast-paced, team-oriented environment
  • Superior attention to detail, organization, cross-group collaboration, and project management skills
Additional Requirements:
  • Legally authorized to work in the U.S. without any restrictions
  • Okay to work 100% on-site in Plano, TX


  • Plano, Texas, United States Liberty Mutual Group Full time

    Job SummaryThe Bodily Injury Claims Specialist will manage, investigate, and resolve Bodily Injury & Property Damage claims assigned. This role works within a Claims Team, utilizing skills in claims management, investigation, and resolution.Key ResponsibilitiesManage and investigate Bodily Injury & Property Damage claimsResolve claims in a timely and fair...


  • Plano, Texas, United States The LaSalle Group Full time

    Job SummaryThe Insurance Claims Resolution Specialist will be responsible for managing and resolving insurance claims denials, working closely with insurance companies and ensuring that claims are processed and paid accurately. The successful candidate will have extensive experience in denials management, a thorough understanding of denial reasons and the...


  • Plano, Texas, United States CNA Financial Corporation Full time

    Job SummaryWe are seeking a highly skilled Claims Resolution Manager to join our team at CNA Financial Corporation. As a Claims Resolution Manager, you will be responsible for overseeing the work activities of a team of claims professionals and ensuring that claims are effectively handled according to company protocols, quality and customer service standards...


  • Plano, Texas, United States Allen Lund Company, LLC Full time

    Job Title: Claims and Accounting SpecialistWe are seeking a highly skilled Claims and Accounting Specialist to join our team at Allen Lund Company, LLC. This role will support our branch offices and National Accounts Team in evaluating, investigating, and resolving cargo claims.Key Responsibilities:Monitor and resolve claims in customer systemsDistribute...


  • Plano, Texas, United States CEF Solutions Inc Full time

    Job Title: Freight Claims SpecialistCef Solutions Inc. is a leading provider of consulting services and business process outsourcing solutions. Our team is dedicated to delivering exceptional results in the customer service industry.Key Responsibilities:Review new submissions to ensure all required documentation and claim details are included.File and manage...


  • Plano, Texas, United States Crystal Equation Corporation Full time

    Job SummaryWe are seeking a highly skilled Freight Claims Specialist to join our team at Crystal Equation Corporation. As a key member of our logistics team, you will be responsible for processing and resolving freight claims in a timely and accurate manner.Key ResponsibilitiesClaim Processing: Review and process new submissions to ensure all required...


  • Plano, Texas, United States Liberty Mutual Full time

    Job Title: Senior Technical Claims SpecialistLiberty Mutual is seeking a highly skilled Senior Technical Claims Specialist to join our Excess, Coverage and Specialized Claims Unit.Job Summary:We are looking for a seasoned claims professional to handle a book of Commercial Casualty Excess/Umbrella claims, from initial investigation to resolution. The ideal...

  • Claims Adjuster

    3 weeks ago


    Plano, Texas, United States Sedgwick Full time

    Job SummaryWe are seeking a highly skilled and experienced Claims Adjuster - Workers Compensation Specialist to join our team at Sedgwick. As a key member of our claims management team, you will be responsible for analyzing and processing complex workers' compensation claims, ensuring timely and cost-effective resolution.Key ResponsibilitiesAnalyze and...


  • Plano, Texas, United States Crystal Equation Corporation Full time

    Job Summary:Cargo Claims Processor at Crystal Equation CorporationAbout the Role:We are seeking a skilled Cargo Claims Processor to join our team. As a Cargo Claims Processor, you will be responsible for reviewing new submissions, investigating claims, and communicating with logistics service providers to ensure timely and accurate resolutions.Key...


  • Plano, Texas, United States Tokio Marine North America, Inc. Full time

    Claims Specialist II, Commercial AutoAt Tokio Marine North America, Inc., we're seeking a skilled Claims Specialist II to join our team. As a key member of our commercial auto claims team, you'll play a critical role in investigating and resolving complex claims.Key Responsibilities:Screen and thoroughly investigate multi-line/multi-state commercial...


  • Plano, Texas, United States Liberty Mutual Full time

    Job SummaryWe are seeking a highly skilled Senior Technical Claims Specialist to join our Excess, Coverage and Specialized Claims Unit. As a key member of our team, you will be responsible for handling a book of Commercial Casualty Excess/Umbrella claims, from initial investigation to resolution.Key ResponsibilitiesDetermine coverage and investigate complex...


  • Plano, Texas, United States Liberty Mutual Full time

    About the RoleWe are seeking a highly skilled Senior Technical Claims Specialist to join our Excess, Coverage and Specialized Claims Unit. As a key member of our team, you will be responsible for handling a book of Commercial Casualty Excess/Umbrella claims, from initial investigation to resolution.Key ResponsibilitiesDetermine coverage and investigate...


  • Plano, Texas, United States Liberty Mutual Group Full time

    Position OverviewThe Claims Specialist II plays a crucial role in overseeing a portfolio of Workers' Compensation claims, including those related to Texas Non-Subscriber cases. This position is responsible for assessing the validity and liability of claims, ensuring that all evaluations are thorough and accurate.Key ResponsibilitiesEvaluate and manage a...

  • Claims Specialist

    7 days ago


    Plano, Texas, United States Liberty Mutual Insurance Full time

    Job SummaryWe are seeking a highly skilled and detail-oriented Claims Specialist to join our team at Liberty Mutual Insurance. As a Claims Specialist, you will be responsible for investigating and resolving claims in a timely and efficient manner, ensuring that our policyholders receive the best possible service.Key Responsibilities:Investigate new claims by...


  • Plano, Texas, United States Sedgwick Full time

    Job SummaryWe are seeking a highly skilled and experienced Claims Adjuster - Workers Compensation Specialist to join our team at Sedgwick. As a key member of our claims management team, you will be responsible for analyzing and processing complex workers' compensation claims, ensuring timely and cost-effective resolution.Key ResponsibilitiesAnalyze and...


  • Plano, Texas, United States Crystal Equation Corporation Full time

    Job Summary:Candidate will be responsible for reviewing and processing freight claims, investigating damage and shortage claims, and communicating with logistics service providers to ensure timely and accurate resolutions.Key Responsibilities:Review and verify claim submissions to ensure all required documentation is includedInvestigate and process damage...


  • Plano, Texas, United States The Reny Company Full time

    Position: Healthcare Claims Negotiation SpecialistThe Reny Company is in search of a proficient Healthcare Claims Negotiation Specialist to enhance our team. Candidates with relevant qualifications and experience in medical claims negotiation are encouraged to consider this opportunity.Evaluate and negotiate reductions on out-of-network claimsEngage with...


  • Plano, Texas, United States CNA Full time

    Job SummaryCNA is seeking a highly skilled Commercial Claims Specialist to join our team. As a key member of our claims department, you will be responsible for managing commercial claims with moderate to high complexity and exposure.Key ResponsibilitiesClaim Management: Investigate and resolve claims according to company protocols, quality and customer...


  • Plano, Texas, United States The Reny Company Full time

    Job Title: Medical Claim ProcessorThe Reny Company is seeking a professional Medical Claim Processor to fill a key role in our organization. This position requires a candidate with experience in health insurance, medical billing, and a strong focus on providing exceptional service.Key ResponsibilitiesSort and organize medical bills according to client...


  • Plano, Texas, United States Liberty Mutual Group Full time

    Position OverviewThe Claims Specialist II plays a crucial role in overseeing a portfolio of Workers' Compensation claims, including those pertaining to Texas Non-Subscriber cases. This position is essential for assessing the validity and liability of claims, ensuring that all processes align with established protocols and regulatory standards.Key...