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Princeton, New Jersey, United States
Onsite
This is your opportunity to join AXIS Capital – a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the industry.
At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work.
All qualified applicants will receive consideration for employment without regard to any protected characteristic, including age, color, disability, ethnicity, gender identity, marital status, national origin, pregnancy, race, religion, sex, sexual orientation, veteran status, or any basis prohibited by the laws that govern its operations.
AXIS is seeking an experienced Accident & Health Senior Claims Specialist to provide technical claims expertise and oversight across a diverse product portfolio. This role partners with Third-Party Administrators (TPAs), Managing General Underwriters (MGUs), underwriting, actuarial, legal, compliance, and operations to support consistent claims administration, strong partner oversight, and regulatory compliance.
The position is primarily focused on Employer Stop Loss, HMO/Managed Care, Medical Excess, and Provider Excess products, while also supporting the broader Specialty Accident & Health portfolio.
What You'll Do
Serve as a senior claims resource for complex, high-severity, and escalated matters, including appeals and authority referrals.
• Conduct claims and operational audits of TPAs and MGUs, report findings, and monitor corrective actions.
• Support due diligence reviews and onboarding of delegated claims partners.
• Monitor compliance with delegated authority, service standards, and claims handling guidelines.
• Coordinate responses to complaints, regulatory inquiries, attorney correspondence, carrier reviews, and benefit interpretation requests.
• Analyze claims and operational data to identify trends, emerging risks, and improvement opportunities.
• Partner across functions to support product performance, business initiatives, and process improvements.
What You'll Bring
• 4–6 years of relevant Accident & Health claims experience.
• Strong expertise in Employer Stop Loss, HMO/Managed Care, Medical Excess, and Provider Excess products.
• Experience overseeing TPAs, MGUs, delegated claims operations, and claims audits.
• Knowledge of medical claims, provider reimbursement, cost containment, exposure evaluation, and reserving.
• Knowledge of ERISA and applicable state claims handling requirements.
• Strong analytical, problem-solving, communication, and relationship-management skills.
• Bachelor's degree or equivalent industry experience; insurance designation preferred.
The ideal candidate will possess deep expertise in Employer Stop Loss, HMO/Managed Care, Medical Excess, and Provider Excess products, along with working knowledge of Specialty Accident & Health lines, including Leisure Travel, Excess Accident, Pet, Firefighter Line of Duty, Limited Medical Benefits, and Voluntary Benefits.
Work Environment • Hybrid schedule with an expectation of three days per week in the office. • Periodic travel within the U.S. and Canada to support audits and business initiatives.
Compensation & Benefits
The base salary range is $95,000–$130,000, based on experience and location. AXIS also offers incentive compensation and a comprehensive benefits package, including medical, dental, and vision coverage; health and wellness programs; retirement plans; tuition reimbursement; and paid time off. Accident & Health Senior Claims Specialist
Why AXIS?
Join a growing Accident & Health organization where you can influence claims quality, strengthen delegated partner oversight, and contribute across a broad portfolio of products. This role offers meaningful collaboration with experienced business partners and the opportunity to help shape claims practices and operational improvements.
This posting is for an existing vacancy.
