Claims Specialist Jobs in USA with Visa Sponsorship
Claims specialists process insurance claims, investigate fraud, and assess coverage disputes for insurance companies, healthcare organizations, and third-party administrators. Most positions qualify for H-1B sponsorship when they require specialized knowledge in actuarial science, risk management, or healthcare administration, though entry-level claims processing roles may not meet specialty occupation requirements. For detailed occupation requirements, see the O*NET profile.
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INTRODUCTION
At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $2.0B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte. This is a hybrid preferred role to our offices in Charlotte, NC; New Hartford, NY; Buffalo, NY; or Woodbury, Long Island, NY. Depending on location, remote candidates may be considered.
ROLE AND RESPONSIBILITIES
The Specialist will be responsible for the management and effective resolution of higher exposure and complex educational institution claims. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex educational institution claims is required.
Key Responsibilities
- Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex educational institution claims in multiple jurisdictions.
- Manage all claims in accordance with Utica National’s established claim procedures.
- Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level.
- Maintain timely and accurate claim reserves in accordance Utica National’s reserving philosophy.
- Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel’s work product and working with defense counsel to efficiently and fairly resolve claims.
- Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials.
- Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle.
- Achieve the service standard of “excellent” during all phases of claims handling.
- Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction.
- Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling.
BASIC QUALIFICATIONS
- Four year degree or equivalent experience required.
- Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated claims.
- Knowledge of additional insured considerations and complex coverage determinations.
- Proven experience negotiating claims and active participation in alternative dispute resolution practices.
- Multi-state licensing including CT, DE, GA, ME, NC, NH, RI, SC, TX, and/or VT preferred.
Licensing
Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment.
COMPENSATION
- Salary range: $103,300 - $140,000
The final salary to be paid and position within the internal salary range is reflective of the employee’s work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications.
BENEFITS
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following:
- Medical and Prescription Drug Benefit
- Dental Benefit
- Vision Benefit
- Life Insurance and Disability Benefits
- 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)
- Health Savings Account (HSA)
- Flexible Spending Accounts
- Tuition Assistance, Training, and Professional Designations
- Company-Paid Family Leave
- Adoption/Surrogacy Assistance Benefit
- Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance
- Student Loan Refinancing Services
- Care.com Membership with Back-up Care, Senior Solutions
- Business Travel Accident Insurance
- Matching Gifts program
- Paid Volunteer Day
- Employee Referral Award Program
- Wellness programs
- Personal insurance discount
ADDITIONAL INFORMATION
This position is a full time salaried, exempt (non-overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it’s like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy.

INTRODUCTION
At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $2.0B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte. This is a hybrid preferred role to our offices in Charlotte, NC; New Hartford, NY; Buffalo, NY; or Woodbury, Long Island, NY. Depending on location, remote candidates may be considered.
ROLE AND RESPONSIBILITIES
The Specialist will be responsible for the management and effective resolution of higher exposure and complex educational institution claims. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex educational institution claims is required.
Key Responsibilities
- Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex educational institution claims in multiple jurisdictions.
- Manage all claims in accordance with Utica National’s established claim procedures.
- Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level.
- Maintain timely and accurate claim reserves in accordance Utica National’s reserving philosophy.
- Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel’s work product and working with defense counsel to efficiently and fairly resolve claims.
- Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials.
- Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle.
- Achieve the service standard of “excellent” during all phases of claims handling.
- Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction.
- Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling.
BASIC QUALIFICATIONS
- Four year degree or equivalent experience required.
- Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated claims.
- Knowledge of additional insured considerations and complex coverage determinations.
- Proven experience negotiating claims and active participation in alternative dispute resolution practices.
- Multi-state licensing including CT, DE, GA, ME, NC, NH, RI, SC, TX, and/or VT preferred.
Licensing
Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment.
COMPENSATION
- Salary range: $103,300 - $140,000
The final salary to be paid and position within the internal salary range is reflective of the employee’s work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications.
BENEFITS
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following:
- Medical and Prescription Drug Benefit
- Dental Benefit
- Vision Benefit
- Life Insurance and Disability Benefits
- 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)
- Health Savings Account (HSA)
- Flexible Spending Accounts
- Tuition Assistance, Training, and Professional Designations
- Company-Paid Family Leave
- Adoption/Surrogacy Assistance Benefit
- Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance
- Student Loan Refinancing Services
- Care.com Membership with Back-up Care, Senior Solutions
- Business Travel Accident Insurance
- Matching Gifts program
- Paid Volunteer Day
- Employee Referral Award Program
- Wellness programs
- Personal insurance discount
ADDITIONAL INFORMATION
This position is a full time salaried, exempt (non-overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it’s like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy.
How to Get Visa Sponsorship as a Claims Specialist
Target roles requiring specialized expertise
Focus on senior claims specialist, fraud investigator, or complex claims analyst positions. These roles typically require specialized knowledge in insurance law, medical terminology, or actuarial principles that qualify for H-1B sponsorship.
Highlight relevant degree connections
Connect your finance, business administration, or risk management degree directly to claims analysis duties. Emphasize coursework in statistics, healthcare administration, or insurance principles that supports specialty occupation requirements.
Emphasize analytical and investigative skills
Showcase experience with claims software, fraud detection systems, or data analysis tools. Document complex cases you've handled that required specialized judgment beyond routine claims processing to strengthen visa petition.
Consider healthcare-focused positions
Medical claims specialists often have stronger H-1B cases due to specialized knowledge requirements in medical coding, HIPAA compliance, and healthcare regulations. These roles typically require specific educational backgrounds in health administration.
Research company sponsorship history
Large insurance companies like State Farm, Allstate, and Progressive have sponsored H-1B workers for claims roles. Check DOL disclosure data to identify employers with successful sponsorship records for similar positions.
Prepare for specialty occupation documentation
Gather evidence showing your role requires specialized knowledge beyond basic claims processing. Include job descriptions emphasizing complex analysis, regulatory compliance, or technical expertise that supports H-1B specialty occupation requirements.
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Get Access To All JobsFrequently Asked Questions
Do claims specialist positions qualify for H-1B sponsorship?
Senior claims specialist roles typically qualify for H-1B sponsorship when they require specialized knowledge in insurance law, actuarial science, or complex fraud investigation. Entry-level claims processing positions that primarily involve routine data entry and basic coverage verification often don't meet specialty occupation requirements. Focus on roles emphasizing analytical expertise and specialized industry knowledge.
What degree do I need for claims specialist visa sponsorship?
Most sponsored claims specialist positions require a bachelor's degree in business administration, finance, economics, or risk management. Healthcare claims roles may prefer degrees in health administration or healthcare management. The key is connecting your educational background to the specialized knowledge required for complex claims analysis and regulatory compliance in your target role.
Which insurance companies sponsor H-1B workers for claims roles?
Major insurers including Progressive, State Farm, Allstate, and Aetna have sponsored H-1B workers for claims specialist positions. Large third-party administrators and healthcare organizations also sponsor these roles. Check DOL LCA disclosure data to research specific companies' recent sponsorship activity and identify the most promising employers for your background.
How do medical claims specialist roles differ for visa purposes?
Medical claims specialist positions often have stronger H-1B cases because they require specialized knowledge of medical coding, HIPAA regulations, and healthcare reimbursement systems. These roles typically demand specific educational backgrounds in health administration or demonstrated expertise in complex medical claims processing that goes beyond routine administrative work.
What can disqualify a claims specialist role from H-1B sponsorship?
Positions focused primarily on data entry, basic document processing, or routine coverage verification may not qualify as specialty occupations. Job descriptions emphasizing clerical duties over analytical work, or roles that accept any bachelor's degree regardless of field, face higher denial risk. USCIS requires evidence that the position demands specialized knowledge specific to claims analysis or insurance expertise.
What is the prevailing wage requirement for sponsored Claims Specialist jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.
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