H-1B Visa Claims Representative Jobs
Claims Representative jobs with H-1B visa sponsorship sit at the intersection of insurance, legal analysis, and regulatory compliance. Sponsoring employers typically structure these roles around bachelor's-level duties in business, finance, or a related field to meet the specialty occupation standard. Expect a certified LCA for each worksite and an initial three-year H-1B status period.
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Get Access To All JobsINTRODUCTION
This individual is responsible for the accurate detection and in-depth investigation of potentially fraudulent insurance activity, ranging from complex medical and staged accident claims to simpler application fraud issues. Investigative activities will include in-person interviews and recorded statements. Prepares and presents reports of impartial results to management for decision-making. Performs field work as needed and coordinates efforts with industry fraud units, claim personnel, counsel, law enforcement and regulatory agencies. May provide evidence and testimony in cases where law enforcement agencies pursue prosecution. May conduct fraud awareness training and/or investigative research. The individual will work remotely and will be provided a company issued computer, phone and vehicle. Applicants must live in New Jersey preferably in either Middlesex or Monmouth County.
Responsibilities
- Prioritize and handle multiple tasks simultaneously. Adjust to fluctuating workload.
- Good file analysis/decision making when reviewing file documentation.
- Maintain diary to meet requirements for status reports on all investigations.
- Successfully completes investigation addressing all referral issues.
- Will obtain nine hours of formal training per year.
- Will participate in conducting fraud awareness training to company associates.
- Network with law enforcement and other investigators within the SIU Industry.
- Adhere to privacy guidelines.
- Cover large geographic areas.
- Complete accurate monthly reports and submit to supervisor timely.
- On occasion, complete assignments in other parts of NY or NJ based on business need.
QUALIFICATIONS
Must meet the following qualifications:
- Bachelor's Degree
- Minimum of 7 years of insurance industry experience or five years of law enforcement experience involving investigation of insurance related crimes.
- Valid Driver's License
- Strong Computer Skills (Microsoft Excel, Word, Access and Outlook)
- Strong verbal and writing skills
- Working knowledge of Home and Auto Policies/Claims
- Understanding of Underwriting and Premium Fraud investigations.
- Knowledge of medical terminology and treatment plans
- Bi-lingual in Spanish would be preferred.
SALARY RANGE
The pay range for this position is $84,000 to $109,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
PERKS & BENEFITS
- 4 weeks accrued paid time off + 9 paid national holidays per year
- Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
- Annual 401(k) Employer Contribution
- Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
- Robust health and wellness program and fitness reimbursements
- Various Paid Family leave options including Paid Parental Leave
- Tuition Reimbursement
ABOUT THE COMPANY
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
LI-DNI
INTRODUCTION
This individual is responsible for the accurate detection and in-depth investigation of potentially fraudulent insurance activity, ranging from complex medical and staged accident claims to simpler application fraud issues. Investigative activities will include in-person interviews and recorded statements. Prepares and presents reports of impartial results to management for decision-making. Performs field work as needed and coordinates efforts with industry fraud units, claim personnel, counsel, law enforcement and regulatory agencies. May provide evidence and testimony in cases where law enforcement agencies pursue prosecution. May conduct fraud awareness training and/or investigative research. The individual will work remotely and will be provided a company issued computer, phone and vehicle. Applicants must live in New Jersey preferably in either Middlesex or Monmouth County.
Responsibilities
- Prioritize and handle multiple tasks simultaneously. Adjust to fluctuating workload.
- Good file analysis/decision making when reviewing file documentation.
- Maintain diary to meet requirements for status reports on all investigations.
- Successfully completes investigation addressing all referral issues.
- Will obtain nine hours of formal training per year.
- Will participate in conducting fraud awareness training to company associates.
- Network with law enforcement and other investigators within the SIU Industry.
- Adhere to privacy guidelines.
- Cover large geographic areas.
- Complete accurate monthly reports and submit to supervisor timely.
- On occasion, complete assignments in other parts of NY or NJ based on business need.
QUALIFICATIONS
Must meet the following qualifications:
- Bachelor's Degree
- Minimum of 7 years of insurance industry experience or five years of law enforcement experience involving investigation of insurance related crimes.
- Valid Driver's License
- Strong Computer Skills (Microsoft Excel, Word, Access and Outlook)
- Strong verbal and writing skills
- Working knowledge of Home and Auto Policies/Claims
- Understanding of Underwriting and Premium Fraud investigations.
- Knowledge of medical terminology and treatment plans
- Bi-lingual in Spanish would be preferred.
SALARY RANGE
The pay range for this position is $84,000 to $109,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
PERKS & BENEFITS
- 4 weeks accrued paid time off + 9 paid national holidays per year
- Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
- Annual 401(k) Employer Contribution
- Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
- Robust health and wellness program and fitness reimbursements
- Various Paid Family leave options including Paid Parental Leave
- Tuition Reimbursement
ABOUT THE COMPANY
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
LI-DNI
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Get Access To All JobsTips for Finding H-1B Visa Sponsorship in Claims Representative
Align your degree to specialty occupation criteria
Claims Representative roles qualify as a specialty occupation when the employer requires a bachelor's degree in business, finance, risk management, or a directly related field. Pull the O*NET profile for your specific SOC code and confirm the listed education requirement matches your credential before applying.
Verify prevailing wage tier before negotiating
Your employer's LCA must certify a wage at or above the DOL prevailing wage for your location and job title. Run the OFLC Wage Search using your SOC code and intended work city to know your wage tier before the offer conversation starts.
Target employers with active LCA filing history
Search Migrate Mate's verified sponsor database to identify insurers, TPAs, and healthcare systems with recent H-1B LCA filings for claims roles. Filing history shows real sponsorship intent, not just a checkbox on a job posting.
Confirm a separate LCA for each worksite
If the role involves hybrid work across multiple office locations, each worksite needs its own DOL-certified LCA before you can legally work there. Ask the recruiter whether multi-site arrangements are built into the petition before you accept an offer.
Time your application around cap selection changes
H-1B cap selection rules have changed recently, affecting when registrations open and how employers prioritize filings. Check USCIS for current registration timelines and confirm your employer is prepared to file within the active cap-subject window.
Document claims-specific credentials for the I-129
USCIS adjudicators scrutinize specialty occupation petitions for claims roles. Gather degree transcripts, any state adjuster licenses, continuing education records, and a detailed employer support letter linking your specific job duties to your degree field before the I-129 is drafted.
H-1B Visa Claims Representative: Frequently Asked Questions
Does a Claims Representative role qualify as a specialty occupation for H-1B purposes?
Not automatically. The role qualifies when the employer structures it to require a bachelor's degree or higher in a specific field such as business administration, finance, risk management, or a related discipline. Generic claims processing roles that accept any degree or no degree at all won't satisfy the specialty occupation standard. The employer's job description and internal requirements drive the determination, not the job title alone.
Which employers sponsor H-1B visas for Claims Representative positions?
Large insurers, managed care organizations, third-party administrators, and workers' compensation carriers are the most consistent sponsors, particularly for claims roles that require actuarial, financial, or regulatory analysis. Browse Migrate Mate to see which companies have active LCA filings for claims titles in your target city and industry segment.
How long does H-1B status last for a Claims Representative job?
USCIS grants initial H-1B status for up to three years, with one extension available to reach a six-year maximum. After six years, continued H-1B status requires an approved I-140 immigrant petition or a pending green card application that meets specific filing-date thresholds under AC21 portability rules.
What happens to my H-1B if I transfer to a different claims office in another state?
Each worksite requires its own certified LCA from DOL before you begin working there. If your employer moves you to a new office in a different metropolitan area, they must file a new LCA reflecting the prevailing wage for that location. Working at an unlisted site before the LCA is certified creates a compliance violation for the employer and a status risk for you.
Can I switch employers while on H-1B sponsorship for a Claims Representative role?
Yes. Under H-1B portability, you can start working for a new sponsoring employer once they file a cap-exempt transfer petition with USCIS, provided your current status is valid and in good standing. The new employer must file their own LCA and I-129 petition for the specific claims role and worksite before your first day.