CrawlJobs Logo

Claims Case Manager

nttdata.com Logo

NTT DATA

Location Icon

Location:
United States , Lincoln

Category Icon

Job Type Icon

Contract Type:
Employment contract

Salary Icon

Salary:

26.00 USD / Hour

Job Description:

We are seeking a dedicated Claims Case Manager to provide comprehensive claim servicing to our insurance policyholders. This role involves managing the entire claims process from intake to final decision, ensuring frequent status updates to claimants through their preferred communication channels (email, phone, mail, etc.). The ideal candidate will have a strong analytical skill set, a thorough understanding of the claims process, and the ability to communicate with empathy and detail.

Job Responsibility:

  • End-to-End Claim Management: Handle every aspect of the claim process, from intake to final decision
  • Status Updates: Provide frequent updates to claimants through their preferred communication channels
  • Document Review: Thoroughly review medical documents, claim forms, and policy notes
  • Communication: Interact with claimants with empathy and attention to detail
  • Team Collaboration: Work with team members to ensure high-quality service and resolution of issues
  • Record Keeping: Maintain accurate records and reports throughout the claims process
  • Data Analysis: Compile and analyze data to identify trends and perform root cause analysis
  • Claim Initiation: Gather information and initiate claims through various channels
  • Detailed Logging: Log and update pertinent information throughout the claim lifecycle
  • Omni-Channel Correspondence: Communicate required medical records and claim information via email, mail, and phone
  • Proactive Follow-Up: Follow up on pending claims and assist in gathering required medical records
  • Benefit Calculation: Calculate benefit amounts and process payments through the claims system
  • Multitasking: Manage a caseload of active claims and perform end-to-end steps
  • Attention to Detail: Ensure accuracy and organization in logging, tracking, and reviewing claims. Identify and flag potential fraudulent activities
  • Collaboration: Work with management and team members to address service issues and concerns
  • Empathy: Communicate with claimants with empathy and a willingness to help

Requirements:

  • 2 years in an analytical role reviewing medical benefits and claims
  • 2 years of claims adjudication experience, preferably in life, and supplemental products (e.g., critical illnesses such as cancer, stroke, heart attack, kidney disease)
  • 4 years of experience reviewing and assessing medical records
  • Experience articulating claim requirements clearly and concisely
  • Minimum high school diploma or GED
  • At least 1 year of experience working from home with proven productivity and quality
  • Designated quiet area for completing calls
  • Must Pass Drug screen
  • Must Pass a background check with Education check and employment verification check

Nice to have:

  • college degree
  • Any state specific certification related to performing the job duties
What we offer:
  • medical insurance with an employer contribution
  • dental insurance with an employer contribution
  • vision insurance with an employer contribution
  • flexible spending or health savings account
  • life and AD&D insurance
  • short- and long-term disability coverage
  • paid time off
  • employee assistance
  • participation in a 401k program with company match
  • additional voluntary or legally required benefits

Additional Information:

Job Posted:
April 27, 2026

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Claims Case Manager

Case Manager

Step into a role where your resilience and compassion are key to your success. A...
Location
Location
Australia , Charlestown
Salary
Salary:
Not provided
https://www.allianz.com Logo
Allianz
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Extensive experience working as part of a highly resilient team
  • experience in a comparable industry or case management experience is desirable but not essential
  • strong drive and interest in leveraging your customer-focused experience to grow a career in case management
  • known for your empathetic style and customer-focused approach, allowing you to ‘walk beside our customers’
  • ability to handle difficult situations professionally while resolving complex issues
  • ability to work collaboratively in a team environment, providing advice and guidance to other team members.
Job Responsibility
Job Responsibility
  • Build effective working relationships with workers, rehab providers, government agencies, legal providers, and medical professionals to drive successful outcomes
  • make key liability decisions and assess claims for reasonable and necessary treatment
  • assess and manage injury needs, handle correspondence regarding workers compensation benefits, treatment, rehabilitation, and interpret medical reports
  • provide timely and effective responses to customer needs and ensure accurate processing of claims
  • accurately calculate benefits and apply relevant legislative rules and timeframes in managing benefits.
What we offer
What we offer
  • Inclusive Culture: Join a supportive, open-minded team focused on customer outcomes, bringing your authentic self to work every day
  • flexible Work-Life Balance: Enjoy flexible and remote work options and workplace adjustments, with support for your work/life balance
  • career Development: Access mentoring, development and global mobility opportunities for growth and success, including access to over 10,000 learning resources
  • financial and Well-being Perks: Enjoy discounts on Allianz products, retail, tech, and travel, plus financial wellness initiatives and the Employee Share Purchase Program- own a piece of your employer!
  • Fulltime
Read More
Arrow Right

Case Manager

At Allianz, we’re proud to be named one of the Best Workplaces in Australia 2024...
Location
Location
Australia , Brisbane
Salary
Salary:
Not provided
https://www.allianz.com Logo
Allianz
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Insurance Claims experience preferred but not a must
  • Having a genuine customer focused approach
  • Negotiation and conflict resolution skills
  • Ability to work in a high-pressure environment
Job Responsibility
Job Responsibility
  • Managing CTP claims portfolio from lodgement to finalisation
  • Building effective working relationships with a variety of key stakeholders including injured claimants and their solicitors, and rehabilitation advisors and medical professionals, to drive successful rehabilitation and return to work outcomes
  • Assessing claims for reasonable and necessary treatment and rehabilitation requirements
  • Assessing and managing injury needs of claimants, handling correspondence regarding CTP benefits, treatment and rehabilitation, and interpreting medical reports
What we offer
What we offer
  • Inclusive Culture: Join a supportive, open-minded team focused on customer outcomes, bringing your authentic self to work every day!
  • Flexible Work-Life Balance: Enjoy flexible and remote work options and workplace adjustments, with support for your work/life balance.
  • Career Development: Access mentoring, development and global mobility opportunities for growth and success, including access to over 10,000 learning resources.
  • Financial and Well-being Perks: Enjoy discounts on Allianz products, retail, tech, and travel, plus financial wellness initiatives and the Employee Share Purchase Program- own a piece of your employer!
  • Fulltime
Read More
Arrow Right

Case Manager

As a Case Manager in the Critical Support Team, you will help vulnerable custome...
Location
Location
Australia , Charlestown
Salary
Salary:
Not provided
https://www.allianz.com Logo
Allianz
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Experience in a comparable industry (disability support, case management, social services, critical incident response) is desirable but not essential
  • Experience in a similar case management role within personal injury insurance is desirable but not essential
  • Experience in evaluating claims or assessing damages for common law settlements is desirable but not essential
  • Strong drive and interest in leveraging your customer-focused experience to grow a career in case management
  • Known for your empathetic style and customer-focused approach, allowing you to ‘walk beside our customers’
  • Ability to handle difficult situations professionally while resolving complex issues
  • Solid problem-solving and relationship-building abilities
  • Year 12 certificate or equivalent
  • High attention to detail, excellent time management skills, and adaptability to changes
  • Ability to work collaboratively in a team environment, providing advice and guidance to other team members
Job Responsibility
Job Responsibility
  • Build effective working relationships with injured customers, family members, legal providers, and medical professionals to drive successful outcomes
  • Maintain high customer service standards and effective relationships with key stakeholders
  • Focus on strategic collaboration and case management to maximise return to health and work outcomes for customers
  • Make key liability decisions and assess claims for reasonable and necessary treatment
  • Tailor communication skills to suit client interactions, matching voice tone, pace, and style appropriately
  • Assess and manage injury needs, handle correspondence regarding CTP benefits, treatment, rehabilitation, and interpret medical reports
  • Provide timely and effective responses to customer needs and ensure accurate processing of claims.
What we offer
What we offer
  • Inclusive Culture: Join a supportive, open-minded team focused on customer outcomes, bringing your authentic self to work every day
  • Flexible Work-Life Balance: Enjoy flexible and remote work options and workplace adjustments, with support for your work/life balance
  • Career Development: Access mentoring, development and global mobility opportunities for growth and success, including access to over 10,000 learning resources
  • Financial and Well-being Perks: Enjoy discounts on Allianz products, retail, tech, and travel, plus financial wellness initiatives and the Employee Share Purchase Program- own a piece of your employer.
  • Fulltime
Read More
Arrow Right

Case Manager Level 1

At Allianz, we’re proud to be named one of the Best Workplaces in Australia 2024...
Location
Location
Australia , Melbourne
Salary
Salary:
Not provided
https://www.allianz.com Logo
Allianz
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Excellent customer service & ability to engage with multiple stakeholders
  • Ability to achieve outcomes by reviewing medical and factual evidence
  • Proven ability to manage time effectively
  • Excellent team ethos
  • Proven ability to work in a fast-paced environment
Job Responsibility
Job Responsibility
  • Maintaining and improving technical knowledge across all facets of claims management
  • Keeping up to date with legislative amendments and their practical application
  • Managing claims within delegated authority level whilst reviewing medical and like entitlements in line with our legislation and communicating these outcomes to the relevant stakeholders
  • Ensuring that customer service standards are maintained through prompt resolution of enquiries
What we offer
What we offer
  • Inclusive Culture: Join a supportive, open-minded team focused on customer outcomes, bringing your authentic self to work every day!
  • Flexible Work-Life Balance: Enjoy flexible and remote work options and workplace adjustments, with support for your work/life balance.
  • Career Development: Access mentoring, development and global mobility opportunities for growth and success, including access to over 10,000 learning resources.
  • Financial and Well-being Perks: Enjoy discounts on Allianz products, retail, tech, and travel, plus financial wellness initiatives and the Employee Share Purchase Program- own a piece of your employer!
  • Fulltime
Read More
Arrow Right

Claims Management Tracking Officer

Claims Management – Tracking Officer is responsible for tracking all Direct Clai...
Location
Location
Egypt , Cairo
Salary
Salary:
Not provided
https://www.allianz.com Logo
Allianz
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s Degree
  • from 0 to 2 years management experience within Healthcare Industry (TPA, Insurance Companies, Hospitals, Medical Centers or Pharmacies)
  • physically fit to carry out duties
  • legally permitted to work in the country of operations
  • fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.
Job Responsibility
Job Responsibility
  • Checks claim submission for proper completion
  • ensures that standard format for submission is followed such as general statement of account and detailed statement of account
  • adheres to initial check of received physical claims count VS the listed in the statement
  • ensures feedback within set specified time for any corrections, missing information, and any standard format not being followed
  • batching the received claims as per our standards and hand over physical claims to Retrospective team
  • ensures proper documentation, feedback, and endorsement on claims
  • communicates directly with providers for missing information and reports cases where necessary
  • returns claims with incomplete administrative information to the provider
  • directs providers not created on TATSH to MPM team for creation.
What we offer
What we offer
  • Personal and professional development with a large variety of courses and targeted development programs
  • global environment encouraging international mobility and career progression
  • Work Well programs focused on health and wellbeing
  • flexibility in planning for a better work-life balance
  • equal opportunity employer with a focus on inclusivity and diversity.
  • Fulltime
Read More
Arrow Right

Claims Paralegal/Account Manager

Robert Half Legal is partnering with an insurance company located in downtown Ch...
Location
Location
United States , Chicago
Salary
Salary:
85000.00 - 100000.00 USD / Year
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • BA/BS degree required
  • J.D. preferred but not required
  • 5+ years of experience working in a law firm or corporate legal department
  • Prior experience handling complex environmental, asbestos, liability, and/or insurance claims
  • Independent Property and Casualty adjuster’s license a plus but not required
  • Strong research and report writing skills are necessary
  • Excellent negotiation and communication skills
Job Responsibility
Job Responsibility
  • Analyzing, investigating, and evaluating new loss notices and claim tenders
  • Collaborating with policy search teams to find copies of alleged coverage where appropriate
  • Analyzing and positioning claim under applicable primary, umbrella, and excess coverage swiftly
  • Coordinating the retention of defense counsel with internal/external stakeholders
  • Establishing defense strategy with insured, defense counsel, and/or other participating insurance carriers
  • Managing the case resolution process and actively participating in mediations as needed
  • Working with the reinsurance department to provide notice of new accounts, updates on existing accounts, and responding to specific reinsurer inquiries
  • Collaborating with in-house Legal/management to manage declaratory judgment actions, including formation and implementation of resolution strategy, settlement valuation, and obtaining settlement authority
  • Coordinating timely processing of payments including verifying proper allocation of such payments across appropriate policies
  • Managing ALAE through strategic handling and bill review/payment processing in coordination with the billing unit
What we offer
What we offer
  • 5% bonus
  • Full benefits
  • Generous PTO
  • 40-hour work week
  • Fulltime
Read More
Arrow Right

Major Claims Manager

To process claims and to ensure that the departmental strategic initiatives, con...
Location
Location
Malaysia , Kuala Lumpur
Salary
Salary:
Not provided
https://www.allianz.com Logo
Allianz
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's Degree in Insurance, Business, or a related field
  • At least 5 years of experience in claims assessment, preferably in the insurance industry, with a proven track record in handling Major Claims & PA claims
  • Experience in a leadership or supervisory role, particularly managing a team of junior assessors, is an advantage
  • Comprehensive understanding of the Insurance Act 1996, AMLA, Bank Negara Malaysia guidelines, and standard operating procedures
Job Responsibility
Job Responsibility
  • Assessment and approval of Major claims & PA claims within the defined approval authority limit set and committed service level
  • Review processes to propose new guidelines, rules & requirement, procedures and system enhancement for operational efficiency and effectiveness
  • Constantly monitor and review pending claims and appeal within the committed service level and make appropriate revised decision if it is within the authority limit
  • Handle enquiries and provide quality customer service to clients and agents including investigating into customer/agent’s complaints on delay in claims assessment
  • Conduct closed file and open file audit review of junior assessors
  • Liaison with Consultant Doctor and other Insurers to determine validity and liability of the Company
  • Support other section within the dept. to ensure efficiency
  • Assist Superior in the monitoring of Daily TAT, Penders’ File and work performance towards the objectives and goals of the dept
  • Assist to provide training for junior staff and contract staff
  • Clearing of Suspense Account and UMA reporting
  • Fulltime
Read More
Arrow Right

Litigation Paralegal

Join an industry leader! Our manufacturing client is seeking a highly skilled Li...
Location
Location
United States , Bayport
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Associate degree with 2-7 years of experience as a paralegal or in claims management
  • Experience in claims management, litigation, or related roles such as insurance adjustor or customer service representative
  • Strong writing and communication skills with the ability to articulate complex information clearly
  • Excellent organizational and coordination abilities to manage multiple tasks effectively
  • Proven ability to build positive interpersonal relationships and work collaboratively
  • Demonstrated flexibility and adaptability to changing priorities
  • Customer-focused mindset to address claims and negotiate resolutions
  • Proficiency in case management software, Microsoft Office Suite, and other litigation tools such as Relativity and Legal Files
Job Responsibility
Job Responsibility
  • Manage claims and lawsuits related to specific business units or product lines
  • Collaborate with internal teams to gather necessary information and provide updates on litigation progress
  • Partner with insurance providers and adjustors to address claims effectively
  • Collect, analyze, and organize internal and external documents required for legal proceedings
  • Coordinate with outside counsel, witnesses, and experts while aligning with the Legal Manager and Assistant General Counsel
  • Negotiate settlements and prepare relevant documentation
  • Draft responses to inquiries from federal, state, and local agencies
  • Assist with various legal projects based on the department's needs
  • Maintain meticulous records and ensure compliance with legal standards
  • Support the litigation team in trial preparation and case management activities
What we offer
What we offer
  • Medical, vision, dental, and life and disability insurance
  • 401(k) plan
  • Free online training
  • Fulltime
Read More
Arrow Right