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Complex Claims Jobs in Ohio (NOW HIRING)

Claims Processor

Mason, OH ยท On-site

$16 - $20.25/hr

Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication. MAJOR DUTIES & RESPONSIBILITIES: โ€ข Processing - Efficiently ...

Claims Processor

Mason, OH ยท On-site

$13.78 - $18.78/hr

Support non-complex claims-related projects and initiatives as needed. * Adapt to processing changes related to new plans and benefit designs. * Collaborate with internal teams to ensure effective ...

Claims Processor

Mason, OH

$16 - $20.25/hr

Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication. Major duties and responsibilities: Processing - Efficiently and ...

Own delivery, performance, and risk outcomes for a large, complex Claims Applied AI portfolio spanning multiple teams, domains, and value streams; translate Claims and enterprise AI priorities into a ...

Partners with Management on complex claims reviews and resolution. * Responsible for reviewing and resolving shared mailbox issues. * Interprets contracts, prepares monthly reports, and attends ...

Partners with Management on complex claims reviews and resolution. * Responsible for reviewing and resolving shared mailbox issues. * Interprets contracts, prepares monthly reports, and attends ...

Partners with Management on complex claims reviews and resolution. * Responsible for reviewing and resolving shared mailbox issues. * Interprets contracts, prepares monthly reports, and attends ...

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Showing results 1-20

Complex Claims information

See Ohio salary details

$32.3K

$68.5K

$112.7K

How much do complex claims jobs pay per year?

As of Jul 27, 2026, the average yearly pay for complex claims in Ohio is $68,548.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,500.00 and $84,600.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Complex Claims Specialist, and why are they important?

To thrive as a Complex Claims Specialist, you need in-depth knowledge of insurance policies, strong analytical skills, and experience in claims investigation, typically supported by a bachelor's degree and relevant industry certifications. Familiarity with claims management systems, legal databases, and specialized software (such as Xactimate or Guidewire) is essential. Exceptional negotiation, critical thinking, and communication skills are crucial for managing sensitive cases and interacting with multiple stakeholders. These skills ensure accurate, fair, and timely resolution of complex claims, minimizing risk and maintaining client trust.

What is the difference between Complex Claims vs Claims Adjuster?

AspectComplex ClaimsClaims Adjuster
Required CredentialsInsurance licenses, certifications in claims handlingInsurance licenses, certifications in claims handling
Work EnvironmentHandling complex, high-value, or specialized claimsAssessing and settling a variety of insurance claims
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent agencies
Common Search & ComparisonComplex Claims vs Claims Adjuster

Complex Claims and Claims Adjusters both require insurance licenses and work within the insurance industry. However, Complex Claims specialists handle high-value, intricate, or specialized claims that demand advanced knowledge and problem-solving skills. Claims Adjusters generally manage a broader range of claims, including straightforward cases. The key difference lies in the complexity and scope of claims managed, with Complex Claims roles focusing on more challenging and detailed cases.

What are the most common challenges faced by professionals handling complex claims, and how can they be managed effectively?

Professionals handling complex claims often encounter challenges such as interpreting intricate policy language, coordinating with multiple stakeholders, and managing large volumes of documentation. To manage these effectively, it's important to develop strong analytical and communication skills, stay organized, and leverage technology for efficient case management. Collaboration with legal teams, underwriters, and external experts is also key to resolving claims accurately and fairly, while ongoing professional development helps keep up with changing regulations and best practices.

What are complex claims?

Complex claims are insurance claims that involve complicated circumstances, multiple parties, or high-value losses, making them more challenging to resolve than standard claims. These claims often require in-depth investigation, specialized expertise, and extended negotiations due to issues like legal disputes, unclear liability, or extensive damages. Handling complex claims typically involves working closely with legal teams, experts, and various stakeholders to ensure a fair and accurate resolution. Insurance companies usually assign experienced adjusters or specialists to manage these types of claims.
Infographic showing various Complex Claims job openings in Ohio as of July 2026, with employment types broken down into 91% Full Time, 7% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $68,548 per year, or $33 per hour.
Complex Claims Consultant - EPL, Private & NFP D&O

Complex Claims Consultant - EPL, Private & NFP D&O

Cna

Westerville, OH โ€ข On-site

$17 - $23.25/hr

Full-time

Posted 11 days ago


Job description

You have a clear vision of where your career can go. And we have the leadership to help you get there.At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.

CNA is one of the premier providers of professional liability insurance. CNA Financial Lines has an opening for a Complex Claims Consultant handling Employment Practice Liability, Private and NFP D&O claims. This individual will work with insureds, attorneys and brokers regarding the handling and/or disposition of mid to high severity claims.
This individual will investigate claims, coordinate discovery, and team with defense counsel on litigation strategy. This individual will be able to utilize claims policies and guidelines, review coverage, determine liability and damages, set financial reserves, secure information to negotiate and settle claims, and present claims to leadership, as needed. Critical to success in this role is the ability to be highly organized, independently motivated and responsive/communicative.
CNA offers a hybrid work environment in one of the following locations: Chicago, Glastonbury, Lake Mary, Wyomissing, NYC area preferred, but candidates near any CNA location will be considered.

JOB DESCRIPTION:

Essential Duties & Responsibilities

Performs a combination of duties in accordance with departmental guidelines:

  • Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.

  • Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information.

  • Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.

  • Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.

  • Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.

  • Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner.

  • Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.

  • Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely.

  • Keeps senior leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct summaries to senior management.

  • Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.

  • Mentors, guides, develops and delivers training to less experienced Claim Professionals.

May perform additional duties as assigned.

Reporting Relationship

  • Typically Director or above


Skills, Knowledge & Abilities

  • Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.

  • Strong communication and presentation skills both verbal and written, including the ability to communicate business and technical information clearly.

  • Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions, and to effectively evaluate and resolve ambiguous, complex and challenging business problems.

  • Strong work ethic, with demonstrated time management and organizational skills.

  • Ability to work in a fast-paced environment at high levels of productivity.

  • Demonstrated ability to negotiate complex settlements.

  • Experience interpreting complex specialty insurance policies and coverage.

  • Ability to manage multiple and shifting priorities in a fast-paced and challenging environment.

  • Knowledge of Microsoft Office Suite and ability to learn business-related software.

  • Demonstrated ability to value diverse opinions and ideas.

Education & Experience

  • Bachelor's Degree or equivalent experience; JD preferred.

  • Typically a minimum of five to seven years of relevant experience, preferably in claim handling

#LI-CP1

#LI-Hybrid

In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $72,000 to $141,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visitcnabenefits.com.


CNAutilizesAI-enabled technology during the recruiting process. For more information, please visitourcareers page.


CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contactleaveadministration@cna.com