Claims Specialist Position Available In Monmouth, New Jersey

Claims Specialist The Third Group LLC Manalapan, NJ 07726 • Hybrid work Job Summary We are seeking a detail-oriented Claims Specialist to oversee the end-to-end processing of insurance claims. In this role, you will investigate, analyze, and resolve claims in a timely manner, collaborating with internal and external stakeholders to ensure accuracy and regulatory compliance. Responsibilities Investigate, evaluate and adjudicate claims promptly, meeting established SLAs Review policy documents and supporting materials to determine coverage and liability Communicate with policyholders, claimants, adjusters, underwriters, legal counsel, and vendors to collect necessary information Maintain precise claim records and documentation in the claims management system Flag potential fraud or suspicious activity for escalation Provide regular status updates to management and escalate complex issues as needed Recommend settlement options and negotiate resolutions in alignment with company guidelines Qualifications Bachelor’s degree or equivalent experience in insurance, business, or related field Minimum 2 years’ experience in claims processing or a similar insurance role Strong analytical and investigative skills with keen attention to detail Excellent verbal and written communication abilities Proficiency with claims management systems and Microsoft Office Suite Thorough knowledge of insurance regulations and compliance standards Exceptional organizational and time-management skills

Job Type:

Full-time Pay:

$55,000.00 – $60,000.00 per year

Benefits:

Dental insurance Health insurance Paid time off Work from home

Schedule:

8 hour shift

Work Location:

Hybrid remote in Manalapan Township, NJ 07726