Top 32 Senior claims representative Jobs in Ohio

Disability Representative Sr
Sedgwick —Dublin, OH
- Hybrid work
- Writing skills
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
Claims Property Senior Field Representative (Cleveland, OH)- remote
Grange Insurance Company —Cleveland, OH
- Remote
- Clean driving record
- Mid-level
- High school diploma or GED
- Bereavement leave
Content Claim Representative/Senior Claim Representative
Great American Insurance Company —Cincinnati, OH
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Commuter assistance
- Employee stock purchase plan
Quick Apply
Senior Manager, Hospital and Professional Chargemaster - CBO Patient Financial Services - Full Time - Days
The Christ Hospital Health Network —Norwood, OH
- Full-time
- System design
- Finance
- Organizational skills
Senior Claims Representative Bodily Injury -Hybrid
National Interstate —Richfield, OH
- $70,000 - $80,000 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
9d
Ceded Reinsurance Claim Representative/Senior Claims Representative
Great American Insurance Company —Cincinnati, OH
- Full-time
- Writing skills
- Mid-level
- Office
- Commuter assistance
- Employee stock purchase plan
Quick Apply
4d
Senior Claims Adjuster I - Workers Compensation
Liberty Mutual —Columbus, OH
- $67,000 - $126,000 a year
- Full-time
- Office
- 3 years
- Bachelor's degree
Senior Claims Representative Bodily Injury -Hybrid
National Interstate Insurance Company —Richfield, OH
- $70,000 - $80,000 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
Quick Apply
9d
Senior Insurance Follow Up Specialist
University of Toledo Physicians —Toledo, OH
- Writing skills
- Basic math
- HIPAA
- 403(b)
Quick Apply
11d
Senior Claims Representative/Specialist - Bond Division
Great American Insurance Company —Cincinnati, OH
- Full-time
- CPA
- 5 years
- Office
- Commuter assistance
- Employee stock purchase plan
Quick Apply
Liability Senior Claim Representative/Claims Specialist
Great American Insurance Company —Cincinnati, OH
- Full-time
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
Quick Apply
4d
Senior Claims Representative
Mid-Continent Casualty Company —Cincinnati, OH
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
Quick Apply
2d
Third Party Sr. Claims Representative
Fleet Response —Hudson, OH
- $22.00 - $22.50 an hour
- Full-time
- Research
- Analysis skills
- Math
- Disability insurance
- Health insurance
Quick Apply
Commercial Lines Senior Associate Client Representative - Small Business
World Insurance Associates LLC —Columbus, OH
- Full-time
- Mid-level
- Office
- 3 years
- Retirement plan
Quick Apply
3d
Casualty Claims Representative/Sr. Claims Representative-Financial Institution Services Division
Great American Insurance Company —Cincinnati, OH
- Full-time
- Office
- Finance
- Bachelor's degree
- Commuter assistance
- Employee stock purchase plan
Quick Apply
5d
Casualty Claims Representative/Senior Claim Representative-Specialty Human Services
Great American Insurance Company —Cincinnati, OH
- Full-time
- Mid-level
- Office
- 3 years
- Commuter assistance
- Employee stock purchase plan
Quick Apply
Senior Billing Specialist
Ensemble RCM LLC —Columbus, OH
- $18.65 - $20.50 an hour
- Full-time
- No high school diploma
- Mid-level
- Office
- Tuition reimbursement
11d
Senior Patient Access Specialist
Ensemble RCM LLC —Perrysburg, OH
- $18.65 - $19.90 an hour
- Full-time
- Hospital
- Customer service
- Mid-level
- Tuition reimbursement

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Property Claims & Right of Recovery Specialist
Rathbone Group, LLC —Cleveland, OH
This role requires coordination and investigation using sharp analytical skills to recover complex property, right of recovery and other subrogation claims by…
$24 - $26 an hour
Quick Apply
Customer Care Specialist I (Must live in Ohio)
CareSource —Ohio
Maintain complete and accurate documentation of all of telephone and written communications. Resolve member/beneficiaries or provider routine service inquiries;…
$35,900 - $57,300 a year

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Disability Representative Sr
Sedgwick —Dublin, OH
State certification or licensing in statutory leaves is preferred or may be required based on state regulations. High School diploma or GED required.
Senior Claims Adjuster I - Workers Compensation
Liberty Mutual —Columbus, OH
Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally…
$67,000 - $126,000 a year

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Disability Representative Sr

Sedgwick -
Dublin, OH

Apply Now

Job Details

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

High school diploma or GED

Full Job Description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Disability Representative Sr

Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:

Dublin, OH : 5500 Glendon Court Dublin OH 43016

PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Makes independent claim determinations, based on the information received, to approve complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
Reviews and analyzes complex medical information (i.e. attending physician statements, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan.
Oversees additional facets of complex claims including but not limited to comorbidities, concurrent plans, complex ADA accommodations, and claims outside of typical guidelines.
Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians), as needed.
Determines benefits due pursuant to a disability plan, makes timely claims payments/approvals and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets.
Informs claimants of documentation required to process claims, required time frames, payment information and claims status by phone, written correspondence and/or claims system.
Communicates with the claimants’ providers to set expectations regarding return to work.
Medically manages complex disability claims ensuring compliance with duration control guidelines and plan provisions.
Communicates clearly and timely with claimant and client on all aspects of claims process by phone, written correspondence and/or claims system.
Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims.
Evaluates and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities.
Negotiates return to work with or without job accommodations via the claimant’s physician and employer.
Refers cases to team lead and clinical case management for additional review when appropriate.
Maintains professional client relationships and provides excellent customer service.
Meets the organization’s quality program(s) minimum requirements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing
High School diploma or GED required. Bachelor's degree from an accredited university or college preferred. State certification or licensing in statutory leaves is preferred or may be required based on state regulations.

Experience
Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred.

Skills & Knowledge

Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
Knowledge of state and federal FMLA regulations
Working knowledge of medical terminology and duration management
Excellent oral and written communication, including presentation skills
Proficient computer skills including working knowledge of Microsoft Office
Analytical, interpretive, and critical thinking skills
Ability to manage ambiguity
Strong organizational and multitasking skills
Ability to work in a team environment
Ability to meet or exceed performance competencies as required by program
Effective decision-making and negotiation skills
Ability to exercise judgement autonomously within established procedures

WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical : Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required.

Auditory/Visual : Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $23.00 -$25.00 USD Hourly . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Apply Now

Refine Your Search

senior claims representative jobs in ohio

Disability Representative Sr

Claims Property Senior Field Representative (Cleveland, OH)- remote

Content Claim Representative/Senior Claim Representative

Senior Manager, Hospital and Professional Chargemaster - CBO Patient Financial Services - Full Time - Days

Senior Claims Representative Bodily Injury -Hybrid

Ceded Reinsurance Claim Representative/Senior Claims Representative

Senior Claims Adjuster I - Workers Compensation

Senior Claims Representative Bodily Injury -Hybrid

Senior Insurance Follow Up Specialist

Senior Claims Representative/Specialist - Bond Division

Liability Senior Claim Representative/Claims Specialist

Senior Claims Representative

Third Party Sr. Claims Representative

Commercial Lines Senior Associate Client Representative - Small Business

Casualty Claims Representative/Sr. Claims Representative-Financial Institution Services Division

Casualty Claims Representative/Senior Claim Representative-Specialty Human Services

Senior Billing Specialist

Senior Patient Access Specialist

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