Network Adjusters is seeking an experienced General Liability and/or Construction Defect Claims Supervisor to join our third-party administrative insurance handling team. This leadership role is ideal for professionals who thrive in fast-paced claims environments and are passionate about team development, technical excellence, and delivering strong customer service outcomes.
This position offers the opportunity to work within a trusted organization committed to integrity, reliability, and professional development through ongoing training and growth opportunities.
About the Role
General Liability Claims Supervisors oversee the full lifecycle of claims handling while ensuring compliance, service standards, and industry best practices are consistently met. In this role, you will hire, onboard, train, and develop a team of adjusters specializing in general liability and construction defect claims, providing both strategic and technical guidance throughout the claims process.
You will play a key role in maintaining departmental protocols, supporting complex claim resolution, and delivering strong customer service outcomes for carriers, clients, and internal stakeholders. This is a desk-based role.
Responsibilities
Supervise and manage a team of claims adjusters, providing guidance, training, and ongoing support to drive performance and professional development
Hire, onboard, train, and develop staff as needed
Review and analyze coverage, policies, claim forms, and supporting documentation to ensure accurate and compliant claim handling
Oversee the full claims lifecycle, including damage evaluation, loss determination, settlement negotiations, and resolution
Ensure compliance with all regulatory requirements, company guidelines, and industry Best Practices
Implement and monitor quality control standards and QA/QC measures to ensure consistency, accuracy, and efficiency in claims handling
Collaborate with carriers, attorneys, claimants, and internal stakeholders to resolve disputes and provide a positive claims experience
Track and analyze team and departmental performance metrics, establish targets, and implement strategies to meet or exceed goals
Prepare and present reports to senior management and clients, highlighting performance trends, risks, and improvement opportunities
Stay current on industry regulations, case law, statutes, and evolving claims best practices
Qualifications
Minimum 5 years of claims handling experience in General Liability or Construction Defect claims
Minimum 3 years of supervisory or managerial experience, preferably within insurance claims
Strong leadership skills with the ability to mentor, motivate, and develop a team
Superior knowledge of case law, statutes, and procedures impacting claim handling and valuation
Excellent analytical, evaluation, strategic, and negotiation skills
Ability to prioritize workload and manage multiple tasks effectively in a fast-paced environment
Strong problem-solving skills with keen attention to detail
Proficiency in MS Office Suite and other standard business software
Polished written and verbal communication skills
Bachelor's degree in a relevant field or equivalent work experience
Compensation & Benefits
Salary: $110,000-$140,000 annually (based on licensure, certifications, and experience)
Training, development, and career growth opportunities
401(k) with company match and retirement planning
Paid time off and company-paid holidays
Comprehensive medical, dental, and vision insurance
Flexible Spending Account (FSA)
Company-paid life insurance and long-term disability
Supplemental life insurance and optional short-term disability
Strong work/family and employee assistance programs
Employee referral program
Location
📍 Denver, CO
Remote opportunities may be available for experienced candidates who meet all required criteria.
About Network Adjusters
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver, and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
$110k-140k yearly 1d ago
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Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
Stout 4.2
Claim processor job in Denver, CO
At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.
About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include:
Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations.
Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies.
Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic.
Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning.
Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives.
Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support.
Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations.
Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery.
Continue developing technical, analytical, and consulting skills while building credibility with clients.
Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement.
Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team.
What You Bring
Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred.
Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles.
Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance.
Epic Resolute or other hospital billing system experience preferred; Epic certification a plus.
Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required.
Additional certifications such as CHC, CFE, or AHFI preferred.
Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization.
Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred.
Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act.
Willingness to travel up to 25%, based on client and project needs.
How You'll Thrive
Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions.
Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships.
Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time.
Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment.
Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility.
Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions.
Why Stout?
At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life.
We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve.
We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals.
Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.
Learn more about our benefits and commitment to your success.
en/careers/benefits
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job.
Stout is an Equal Employment Opportunity.
All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law.
Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.
A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
$33k-41k yearly est. 5d ago
Workers' Compensation Claim Specialist (CO)
Cannon Cochran Management 4.0
Claim processor job in Greenwood Village, CO
Workers' Compensation Claim Specialist (CO jurisdiction, some UT possible)
Hours: Monday - Friday, 8:00 AM to 4:30 PM
Salary Range: $60,000-$98,000 (experience considered)
Build Your Career With Purpose at CCMSI
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.
The Workers' Compensation Claim Specialist is responsible for the investigation and adjustment of assigned claims. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The Claim Representative is accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.
Important - Please Read Before Applying
This is a true insurance claims adjusting role, not an HR, benefits, safety, consulting, or administrative position. Candidates must have direct experience investigating, evaluating, reserving, negotiating, and resolving claims as an adjuster or adjuster supervisor within a carrier, TPA, or similar claims environment. Applicants without hands-on adjusting experience will not be considered.
Responsibilities
When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems.
Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
Establish reserves and/or provide reserve recommendations within established reserve authority levels.
Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution.
Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
Review and maintain personal diary on claim system.
Assess and monitor subrogation claims for resolution.
Compute disability rates in accordance with state laws.
Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
Provide notices of qualifying claims to excess/reinsurance carriers.
Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
Qualifications What You'll BringRequired
Demonstrated knowledge of workers' compensation claim handling, including indemnity claims
Experience managing multiple client accounts across varied industries
Colorado workers' compensation claim experience
Strong analytical, organizational, and problem-solving skills with consistent attention to detail
Ability to manage competing priorities in a fast-paced claims environment
Excellent written and verbal communication skills with internal and external stakeholders
Strong customer service orientation with a commitment to accurate, compliant claim outcomes
Reliable, predictable attendance during established client service hours
Nice to Have
Experience handling claims in Utah
Professional designations such as AIC, ARM, or CPCU
Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required
Why You'll Love Working Here
4 weeks PTO + 10 paid holidays in your first year
Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
Career growth: Internal training and advancement opportunities
Culture: A supportive, team-based work environment
How We Measure Success
At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
Quality claim handling - thorough investigations, strong documentation, well-supported decisions
• Compliance & audit performance - adherence to jurisdictional and client standards
• Timeliness & accuracy - purposeful file movement and dependable execution
• Client partnership - proactive communication and strong follow-through
• Professional judgment - owning outcomes and solving problems with integrity
• Cultural alignment - believing every claim represents a real person and acting accordingly
This is where we shine, and we hire adjusters who want to shine with us.
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
Visa Sponsorship:
CCMSI does not provide visa sponsorship for this position.
ADA Accommodations:
CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team.
Equal Opportunity Employer:
CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.
Our Core Values
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
Lead with transparency We build trust by being open and listening intently in every interaction.
Perform with integrity We choose the right path, even when it is hard.
Chase excellence We set the bar high and measure our success. What gets measured gets done.
Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
Win together Our greatest victories come when our clients succeed.
We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #WorkersCompensation #HybridWork #ClaimsAdjuster #InsuranceCareers #WorkersCompSpecialist #AdjusterJobs #CareerAdvancement #FlexibleWork #ExperiencedAdjuster #WorkComp #IND123 #LI-Hybrid
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$60k-98k yearly Auto-Apply 35d ago
Senior Construction Claims Analyst
MWH 4.6
Claim processor job in Broomfield, CO
Job Description
MWH is a leading water and wastewater treatment-focused general contractor in the US with a rich history dating back to the 19th century. Fueled by the mission of Building a Better World, our teams are rapidly growing across the nation.
As a company committed to our team's well-being and growth, we offer a supportive work environment, opportunities for advancement, and the chance to contribute to a mission that shapes the future. Your expertise and ambition are valued here.
The work we do matters. The critical systems infrastructure we build changes lives, betters' communities, and improves ecosystems. If you're passionate about this, we want to hear from you!
About the Role
MWH is seeking a remote Senior Construction Claims Analyst. The Analyst will be responsible for evaluating, analyzing, and resolving construction-related claims and disputes. This role requires a strong understanding of construction contracts, project management, and claim resolution processes. This position will also require 50% travel.
Essential Functions
Review and analyze construction claims, including delay, disruption, acceleration, and other impact claims.
Assess the validity and potential impact of claims on project schedules, budgets, and resources.
Prepare detailed claims reports, including cause-effect analysis, quantum assessment, and recommendations for resolution.
Collect, organize, and maintain all necessary documentation related to claims, including contracts, change orders, correspondence, schedules, and cost records.
Ensure all claims documentation complies with contractual, legal, and regulatory requirements.
Work with legal counsel, project managers, and senior leadership to develop and implement strategies for resolution of claims.
Participate in negotiations, mediation, and arbitration processes to resolve claims.
Provide expert testimony and support in legal proceedings, if necessary.
Identify potential claims and disputes early in the project lifecycle and provide proactive advice to mitigate risks.
Assist in developing and implementing best practices for claims management across the organization.
Liaise with project teams, contractors, subcontractors, and external consultants to gather information and support claims analysis.
Communicate findings and recommendations to stakeholders clearly and effectively.
Provide training and guidance to junior staff on claims analysis and management.
Basic Qualifications
Bachelor's degree in Construction Management, Engineering, Law, or a related field.
Master's degree or a professional certification (e.g. CCM, PMP, RICS) is preferred.
Minimum of 8 years' experience in construction claims analysis, with a focus on large-scale infrastructure projects.
Extensive knowledge of construction contracts, claims management, and dispute resolution.
Experience with various construction delivery methods, including Design-Bid-Build (DBB), Design-Build (DB), and CMAR.
Strong analytical and problem-solving skills with the ability to interpret complex data and draw accurate conclusions.
Excellent written and verbal communication skills, with the ability to present findings clearly and persuasively.
Proficiency in construction management software (e.g. Primavera 6, MS Project) and claims analysis tools.
Strong understanding of legal and regulatory aspects of construction claims.
Compensation
The anticipated compensation for this position is $175,000-$225,000/yr depending on previous experience.
Benefits
Group health & welfare benefits including options for medical, dental and vision
100% Company Paid Benefits: Employee Life Insurance & Accidental Death & Dismemberment (AD&D), Spouse and Dependent Life & AD&D, Short Term Disability (STD), Long Term Disability (LTD), Employee Assistance Program and Health Advocate
Voluntary benefits at discounted group rates for accidents, critical illness, and hospital indemnity
Flexible Time Off Program (includes vacation and personal time)
Paid Sick and Safe Leave
Paid Parental Leave Program
10 Paid Holidays
401(k) Plan (company matching contributions up to 4%).
Employee Referral Program
MWH Constructors
is a global project delivery company in heavy civil construction with a focus on water and wastewater treatment infrastructure. With the ultimate goal of delivering maximum value to clients and their local communities,
MWH Constructors
provides single-source, integrated design and construction services through a full range of project delivery methods. Incorporating industry-leading preconstruction and construction services, the Company's multi-disciplined team of engineering and construction professionals delivers a wide range of projects, including new facilities, infrastructure improvement and expansion, and capital construction services.
Equal Opportunity Employer, including disabled and veterans.
Please note that all positions require pre-employment screening, including drug and background check, as a condition of employment.
#LI-SW1
#LI-Onsite
$74k-94k yearly est. 27d ago
Claims & Referral Processor
Sa Technologies Inc. 4.6
Claim processor job in Aurora, CO
SA Technologies Inc. (****************** is a market leader and one of the fastest growing IT consulting firms with operations in US, Canada, Mexico & India. SAT is an Oracle Gold Partner, SAP Services Partner & IBM Certified enterprise.
We guarantee you the best rate for your skills and performance.
Job Description
Description: Title: Claims & Referral Processor II
Location: Aurora, Colorado
Duration: 6 Months c2h
Adjudicates medical claims/bills for payment or denial within contract agreement or guidelines/protocol, using knowledge of medical claim/bill payment processing and medical regulations, verifies and updates relevant data into computerized systems and calculates manually any adjustments needed. Verifies member eligibility and/or Medicare status. Receives daily workflow via Doc-Flo, and incoming phone calls. Interacts with members regarding claims/bills and resolves issues in a courteous and timely manner. Member focus: Making members/patients and their needs a primary focus of one's actions; developing and sustaining productive member/patient relationships. Actively seeks information to understand member/patient circumstances, problems, expectations, and needs. Builds rapport and cooperative relationship with members/patients. Considers how actions or plans will affect members; responds quickly to meet member/patient needs and resolves problems.
Essential Functions:
Receives, and adjudicates medical claims/bills for processing; reviews scanned, EDI, or manual documents for pertinent data on claim/bill for complete and/or accurate information (eg.date of service, provider number s, charged amounts, medical procedure codes, fee codes, etc.).
Researches claims/bills for appropriate support documents and/or documentation. Analyzes and adjusts data, determines appropriate codes, fees and ensures timely filing and contract rates are applied.
Ensures claims/bills meet eligibility, benefit and Medicare requirements. Processes hot provider files within time line. Identifies multiple service, multiple rates and completes claims/bills, pends, voids, refunds, and/or approves for payments.
Processes claims/bills as split claims when appropriate. Forwards complete claims/bills requiring additional authorization to appropriate personnel for approval or denial. Pends claims and receives pend claims for various types of research follow-up amongst other staff members.
Receives calls from members and/or tracks on-line communications, providers, explains reason(s) claims/bills have been denied or pending, by utilizing benefit plan agreement, eligibility, possible coordination of benefits, worker s compensation and policies and procedures. Explains the appeal process if necessary.
Provides one on one customer service in obtaining and providing information to the member and/or provider. Documents and tracks on-line communications.
Responds to and researches vendor and member problems, questions and complaints using on-line systems.
Provides training as assigned to new employees as well as cross training in all phases of claim and referral department processes.
Performs additional assignments such as, special projects related to the claims & referral department.
In addition to defined technical requirements, accountable for consistently demonstrating excellent service behaviors and principles defined by specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to purchasers, contracted providers and vendors.
Basic Qualifications:
Experience
Four (4) years of claims payment experience required.
Experience must be on an automated system, including preparation of payments for medical bills, using medical terminology, CPT, ICD-9 and UB92 coding for both Medicare and non-Medicare claims, and working knowledge of other insurance benefit plans including coordination of benefits, no-fault and workers compensation. May substitute two (2) years of education for two (2) years of experience.
Education
High School graduation or equivalent.
License, Certification, Registration :N/A.
Additional Requirements:
Working knowledge of medical terminology required.
Effective communication skills required, including telephone work.
Personal computer terminal skills.
Demonstrates customer service skills, customer focus abilities and the ability to understand customer needs
Preferred Qualifications:
Personal computer terminal skills; windows based preferred.
There is very high potential for conversion to FTE on this position.
Additional Information
Zishan Khan
************
$34k-50k yearly est. 2d ago
Liability Claims Specialist (Construction Defect)
CNA Financial Corp 4.6
Claim processor job in Littleton, CO
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.
This individual contributor position works under moderate direction, and within defined authority limits, to manage third party liability construction defect commercial claims with moderate to high complexity and exposure. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
JOB DESCRIPTION:
Essential Duties & Responsibilities:
Performs a combination of duties in accordance with departmental guidelines:
* Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
* Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, 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.
* Conducts 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.
* Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
* Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
* Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
* Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
* Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
* Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
* May serve as a mentor/coach to less experienced claim professionals
May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
* Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
* Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
* Demonstrated ability to develop collaborative business relationships with internal and external work partners.
* Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
* Demonstrated investigative experience with an analytical mindset and critical thinking skills.
* Strong work ethic, with demonstrated time management and organizational skills.
* Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
* Developing ability to negotiate low to moderately complex settlements.
* Adaptable to a changing 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.
* Typically a minimum four years of relevant experience, preferably in claim handling.
* Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
* Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
* Professional designations are a plus (e.g. CPCU)
#LI-KP1
#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 $54,000 to $103,000 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 visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
$54k-103k yearly Auto-Apply 21d ago
Bodily Injury Claims Specialist
Auto-Owners Insurance 4.3
Claim processor job in Broomfield, CO
*Applications are accepted on an ongoing basis. An open position may not be available at this time.
We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team.
Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to:
Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss.
Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage.
Follow claims handling procedures and participate in claim negotiations and settlements.
Deliver a high level of customer service to our agents, insureds, and others.
Devise alternative approaches to provide appropriate service, dependent upon the circumstances.
Meet with people involved with claims, sometimes outside of our office environment.
Handle investigations by telephone, email, mail, and on-site investigations.
Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute.
Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials.
Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule.
Assist in the evaluation and selection of outside counsel.
Maintain punctual attendance according to an assigned work schedule at a Company approved work location.
Desired Skills & Experience
A minimum of three years of insurance claims related experience.
The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision.
The ability to effectively understand, interpret and communicate policy language.
The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues.
Benefits
Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent benefits package. Along with a matched 401(k), fully-funded pension plan (once vested), Auto-Owners also offers medical, prescription, dental and vision insurance; associate, spouse and child life insurance; supplemental sick pay; long term disability; health care flexible spending accounts and dependent care flexible spending accounts. Additional benefits include: generous paid time off including holidays, vacation days, personal time, sick leave and parental leave; adoption assistance; discounts on personal insurance; education matching gift program; student loan assistance program, a gym membership and fitness class reimbursement program and a company car. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!
Compensation
Auto-Owners offers a generous compensation package. For this position, the anticipated annualized starting base pay range is: $62,000.00 - $83,200.00. Other components of the compensation package include benefit dollars used to purchase certain benefits and several bonus opportunities.
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.
Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
Applications will be accepted until this opening is filled.
#LI-DNI #IN-DNI
$62k-83.2k yearly Auto-Apply 43d ago
Claims Specialist
PRG 4.4
Claim processor job in Denver, CO
Project Resources Group (PRG) is seeking a Claims Recovery Specialist for our Denver, CO office. Be part of our expanding team focused on recovering third-party property and utility damage claims, primarily in a B2B setting. We're looking for motivated, detail-oriented professionals with strong negotiation skills. Experience in collections or insurance adjusting is highly relevant and transferable. We offer a competitive base salary plus commission. Key Responsibilities
Resolve and negotiate claims recovery of repair and replacement costs on third-party cable/fiber and utility damages across multiple state lines, via phone, email, and letters.
Work directly with liable parties' insurance providers to defend and negotiate claims settlements.
Collaborate with claims departments and management of liable parties, from small businesses to large corporations to municipalities.
Learn, understand, and be able to utilize state dig laws and statutes, 811 excavator requirements, NESC standards, CGA guidelines, etc.
Develop a professional working relationship with damaging parties, on-site field investigators, management, and other personnel.
Conduct 40-50 inbound/outbound calls daily, approximately 2-2.5 hours of total talk time throughout the day.
Enter notes and documentation throughout the recovery process into the company's proprietary Claims Database Tool.
Use a calendar and diary system to coordinate handling claims to be worked twice weekly.
Follow advanced claim handling procedures as detailed by the OPD Claims Manager.
Use photographs, narratives, job costs, site sketches, locate tickets, and other components on-site field investigators provide to visualize and understand the damage scene to defend liability accurately.
Participate in weekly department meetings to discuss individual and team recovery tactics, strategies, and goals.
Maintain a working knowledge of the entire PRG claims recovery process.
Preferred Qualifications
Strong proficiency in Microsoft Word, Outlook, and Excel.
Tech-savvy with the ability to quickly adapt to new software and systems.
Excellent written and verbal communication skills, with an emphasis on professional phone and email correspondence.
Familiarity with the construction, cable, or utility locate industries is advantageous.
Understanding of B2B construction, claims management, recovery, or insurance claim negotiation and settlement processes is preferred.
Ideally, 3-5 years of experience in claims, recovery, and/or the insurance industry.
College education is preferred.
Bilingual in Spanish is a plus.
Compensation and BenefitsWe offer a competitive hourly pay ($20-$24/hour based on experience), plus the potential to earn substantial commissions up to $4,000-$10,000 monthly based on performance. Along with a comprehensive benefits package, including:
Medical, dental, and vision coverage for employees and dependents
401(k) retirement plan, with company match after 1 year
Short-term disability coverage after 1 year
Paid time off and holidays
Additional perks such as company-paid life insurance, and other supplemental insurances available
About PRG
Since 2001, PRG has been a leader in construction management and outside plant damage recovery for the telecommunications and utility industries. With 20+ offices and 800+ employees nationwide, we deliver industry-leading solutions with speed, accuracy, and expertise.
Equal Opportunity EmployerPRG is proud to be an Equal Opportunity Employer. PRG does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, pregnancy-related conditions, and lactation), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, or any other characteristic protected by applicable federal, state, or local law and ordinances.#INDCS
$20-24 hourly Auto-Apply 17d ago
Claims Examiner, General Liability
Arch Capital Group Ltd. 4.7
Claim processor job in Denver, CO
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.
Position Summary
The Claims Division is seeking a team member to join the Shared Services Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of commercial first and third party low complexity General Liability claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence.
Responsibilities:
* Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level
* Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution
* Review and analyze supporting damage documentation
* Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions
* Establish appropriate loss and expense reserves with documented rationale
* Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines
Experience & Qualifications
* Hands-on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint, and Word
* Knowledge of ImageRight preferred
* Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
* Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions
* Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines
* Ability to work well independently and in a team environment
* Texas Claim Adjuster license preferred, but not required for posting. Upon employment candidate would be required to obtain Texas Claim Adjuster license within six months of hire date.
Education
* Bachelor's degree preferred
* 3-5 years' experience handling the process of commercial insurance claims
#LI-SW1
#LI-HYBRID
For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$71,900 - $97,110/year
* Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
* Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
For Colorado Applicants - The deadline to submit your application is:
May 17, 2026
14400 Arch Insurance Group Inc.
$71.9k-97.1k yearly Auto-Apply 2d ago
Senior Construction Claims Analyst
Slayden
Claim processor job in Broomfield, CO
MWH
is
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treatment
focused
general
contractor
in
the
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with
a
rich
history
dating
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19th
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Fueled
by
the
mission
of
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a
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World
our
teams
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rapidly
growing
across
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As
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company
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being
and
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supportive
work environment opportunities for advancement and the chance to contribute to a mission that shapes the future Your expertise and ambition are valued here The work we do matters The critical systems infrastructure we build changes lives betters communities and improves ecosystems If youre passionate about this we want to hear from you About the Role MWH is seeking a remote Senior Construction Claims Analyst The Analyst will be responsible for evaluating analyzing and resolving construction related claims and disputes This role requires a strong understanding of construction contracts project management and claim resolution processes This position will also require 50 travel Essential Functions Review and analyze construction claims including delay disruption acceleration and other impact claims Assess the validity and potential impact of claims on project schedules budgets and resources Prepare detailed claims reports including cause effect analysis quantum assessment and recommendations for resolution Collect organize and maintain all necessary documentation related to claims including contracts change orders correspondence schedules and cost records Ensure all claims documentation complies with contractual legal and regulatory requirements Work with legal counsel project managers and senior leadership to develop and implement strategies for resolution of claims Participate in negotiations mediation and arbitration processes to resolve claims Provide expert testimony and support in legal proceedings if necessary Identify potential claims and disputes early in the project lifecycle and provide proactive advice to mitigate risks Assist in developing and implementing best practices for claims management across the organization Liaise with project teams contractors subcontractors and external consultants to gather information and support claims analysis Communicate findings and recommendations to stakeholders clearly and effectively Provide training and guidance to junior staff on claims analysis and management Basic Qualifications Bachelors degree in Construction Management Engineering Law or a related field Masters degree or a professional certification eg CCM PMP RICS is preferred Minimum of 8 years experience in construction claims analysis with a focus on large scale infrastructure projects Extensive knowledge of construction contracts claims management and dispute resolution Experience with various construction delivery methods including Design Bid Build DBB Design Build DB and CMARStrong analytical and problem solving skills with the ability to interpret complex data and draw accurate conclusions Excellent written and verbal communication skills with the ability to present findings clearly and persuasively Proficiency in construction management software eg Primavera 6 MS Project and claims analysis tools Strong understanding of legal and regulatory aspects of construction claims Compensation The anticipated compensation for this position is 175000 225000yr depending on previous experience Benefits Group health & welfare benefits including options for medical dental and vision100 Company Paid Benefits Employee Life Insurance & Accidental Death & Dismemberment AD&D Spouse and Dependent Life & AD&D Short Term Disability STD Long Term Disability LTD Employee Assistance Program and Health AdvocateVoluntary benefits at discounted group rates for accidents critical illness and hospital indemnity Flexible Time Off Program includes vacation and personal time Paid Sick and Safe LeavePaid Parental Leave Program10 Paid Holidays 401k Plan company matching contributions up to 4Employee Referral ProgramMWH Constructors is a global project delivery company in heavy civil construction with a focus on water and wastewater treatment infrastructure With the ultimate goal of delivering maximum value to clients and their local communities MWH Constructors provides single source integrated design and construction services through a full range of project delivery methods Incorporating industry leading preconstruction and construction services the Companys multi disciplined team of engineering and construction professionals delivers a wide range of projects including new facilities infrastructure improvement and expansion and capital construction services Equal Opportunity Employer including disabled and veterans Please note that all positions require pre employment screening including drug and background check as a condition of employment LI SW1 LI Onsite
$40k-64k yearly est. 60d+ ago
General Liability Claim Representative
Travelers Insurance Company 4.4
Claim processor job in Centennial, CO
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$67,000.00 - $110,600.00
**Target Openings**
1
**What Is the Opportunity?**
Be the Hero in Someone's Story
When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most.
As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner.
In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process.
As of the date of this posting, Travelers anticipates that this posting will remain open until 4/1/2026.
**What Will You Do?**
Provide quality claim handling of General Liability claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations.
Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates.
Determine claim eligibility, coverage, liability, and settlement amounts.
Ensure accurate and complete documentation of claim files and transactions.
Identify and escalate potential fraud or complex claims for further investigation.
Coordinate with internal teams such as investigators, legal, and customer service, as needed.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree.
+ Three years of experience in insurance claims, preferably General Liability claims.
+ Experience with claims management and software systems.
+ Strong understanding of insurance principles, terminology with the ability to understand and articulate policies.
+ Strong analytical and problem-solving skills.
+ Proven ability to handle complex claims and negotiate settlements.
+ Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants.
**What is a Must Have?**
+ One-year bodily injury liability claim handling experience, or one year of liability claim experience, or successful completion of Travelers Claim Representative training program.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
$67k-110.6k yearly 3d ago
Workers' Compensation Claims Specialist
Arcadis Global 4.8
Claim processor job in Highlands Ranch, CO
Arcadis is the world's leading company delivering sustainable design, engineering, and consultancy solutions for natural and built assets. We are more than 36,000 people, in over 70 countries, dedicated to improving quality of life. Everyone has an important role to play. With the power of many curious minds, together we can solve the world's most complex challenges and deliver more impact together.
Role accountabilities:
Case Coordination
* Serve as the main point of contact between the company and the external workers' compensation carrier.
* Track and manage all workers' compensation claims from initial report to resolution.
* Gather, review, and submit all required documentation to the carrier in a timely manner.
* Coordinate with supervisors and injured employees to ensure accurate reporting of workplace injuries.
Communication
* Facilitate clear, timely communication between employees, management, healthcare providers, and the carrier.
* Provide updates to management and affected employees regarding claim status and next steps.
* Educate employees and supervisors on the workers' compensation process and requirements.
Compliance & Documentation
* Ensure all workers' compensation processes adhere to federal, state, and local regulations.
* Maintain confidential and accurate records of all claims, correspondence, and decisions.
* Assist in preparing reports related to claims trends, costs, and outcomes for management review.
Return-to-Work Coordination
* Collaborate with People team, Health & Safety team, management, and healthcare providers to facilitate safe and timely return-to-work plans.
* Monitor work restrictions and accommodations as recommended by medical professionals.
Continuous Improvement
* Identify opportunities to improve claim handling processes and reduce claim costs.
* Participate in safety committees and contribute to workplace injury prevention initiatives.
Qualifications & Experience:
* Bachelor's degree in Legal Studies, Human Resources, Business Administration, or related field (preferred).
* 3+ years of experience in workers' compensation claims management or related field.
* Familiarity with workers' compensation laws and regulations (state and federal).
* Proficiency with case management systems and Microsoft Office Suite.
Why Arcadis?
We can only achieve our goals when everyone is empowered to be their best. We believe everyone's contribution matters. It's why we are pioneering a skills-based approach, where you can harness your unique experience and expertise to carve your career path and maximize the impact we can make together.
You'll do meaningful work, and no matter what role, you'll be helping to deliver sustainable solutions for a more prosperous planet. Make your mark, on your career, your colleagues, your clients, your life and the world around you.
Together, we can create a lasting legacy.
Join Arcadis. Create a Legacy.
Our Commitment to Equality, Diversity, Inclusion & Belonging
We want you to be able to bring your best self to work every day which is why we take equality and inclusion seriously and hold ourselves to account for our actions. Our ambition is to be an employer of choice and provide a great place to work for all our people. We are an equal opportunity and affirmative action employer. Women, minorities, people with disabilities and veterans are strongly encouraged to apply. We are dedicated to a policy of non-discrimination in employment on any basis including race, creed, color, religion, national origin, sex, age, disability, marital status, sexual orientation, gender identity, citizenship status, disability, veteran status, or any other basis prohibited by law.
Arcadis offers benefits for full time and part time positions. These benefits include medical, dental, and vision, EAP, 401K, STD, LTD, AD&D, life insurance, paid parental leave, reward & recognition program and optional benefits including wellbeing benefits, adoption assistance and tuition reimbursement. We offer nine paid holidays and 15 days PTO that accrue per year. The salary range for this position is $65,000 - $85,000. Actual salaries will vary and are based on several factors, such as experience, education, budget, internal equity, project and location.
#LI-CB3
#LI-Hybrid
$65k-85k yearly 14d ago
Billing and Claims Specialist
Rightway 4.6
Claim processor job in Denver, CO
.
WHAT YOU'LL DO:
Determines coverage for medical, dental, and vision procedures by studying provisions of the member's health policy
Extracts additional information as required from outside sources, including claimant, physician, employer, hospital, insurance carriers, and other third partners
Initiates investigation of questionable claims
Resolves medical, dental, and vision claims and billing questions and issues by
examining the summary of benefits
contacting the carrier and/or the provider billing office to ensure the member is not being overcharged
calculating out-of-pocket costs based on benefits
initiating reimbursement requests with the carrier
composing appeal letter
Provides information on year-to-date deductible, copay, and coinsurance activity to team members
Maintains quality customer service by following customer service practices and responding to customer inquiries in a timely manner
Protects claimant information by following HIPAA guidelines
Reports claim status updates in proprietary CRM and provides detailed information on each claim
WHO YOU ARE:
Our Navigation Operations is a fast-paced, dynamic, and growing environment. We are looking for individuals who are passionate about concierge service delivery and changing the healthcare experience for consumers.
Strong communication skills, both written and verbal
Professional experience with both benefit plan interpretation, provider billing practices, and claim adjudication
Strong demonstration of critical thinking and problem-solving skills
Bachelor's degree in health sciences or related field and minimum of 2 years of experience as a medical claims specialist preferred
Expected hourly rate - $22-$25/HR
ABOUT RIGHTWAY:
Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient's care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them.
Since its founding in 2017, Rightway has raised over $130mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. We're headquartered in New York City, with a satellite office in Denver and Dallas. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.
HOW WE LIVE OUR VALUES TO OUR TEAMMATES:
We're seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our following core values:
1) We are human, first
Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to-and hear-each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding.
2) We redefine what is possible
We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems.
3) We debate then commit
We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team.
4) We cultivate grit
Changing healthcare doesn't happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity.
5) We seek to delight
Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members' care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members' success.
Rightway is PROUDLY an Equal Opportunity Employer that believes in strength in the diversity of thought processes, beliefs, background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.
$22-25 hourly Auto-Apply 60d+ ago
Restoration Claims Specialist
Servpro 3.9
Claim processor job in Commerce City, CO
Let's get right to it - work is better when it means something to you; when you know you're making a difference and contributing in tangible ways. And most importantly, when you're with a company that values your voice, your time and your talent. At Servpro of Denver North, we've got just such an opportunity. We're searching for someone to join our team as a Restoration Claims Specialist. If you're ready to dive into intriguing and rewarding work and discover multiple avenues for career development, keep reading and apply today.
What's In It For You?
At Servpro of Denver North, our people come first… and that's not just a company line. Here's a peek at our best-in-class benefits package and top- notch employee culture:
Our Restoration Claims Specialist position pays $21 - $25 per hour, based on experience.
We want our people to succeed, plain and simple. We're all about professional development, continuing education and helping your career grow in a collaborative, inclusive culture where the next big idea can come from anyone… including you!
We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans.
Boring work is the absolute worst. At Servpro of Denver North, you'll work with challenging and unique customer situations every single day - EVERYDAY you will make a difference in our customers' lives.
We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Servpro of Denver North, with accommodating work schedules.
How does a great healthcare benefits package sound? Multiple options are available for individuals and families.
Generous 401K retirement plan with up to 4% company match.
On-call bonus opportunities.
Employee discounts on restoration services, from carpet and duct cleaning to restoration remodels.
We all love to build community and camaraderie where at work - we enjoy an all team monthly happy hour with food and drinks, pool and darts.
We have a full kitchen at the office - and we love to cook!
And what better way to start off your Friday at the office than a yummy breakfast burrito - Yep! Breakfast Burrito Fridays!
With benefits as rich and diverse as our employees, you'll find a plethora of options, giving you the freedom to make the best choices for you and your family.
What You'll Do?
As a Restoration Claims Specialist, you will report to the Office Manager and you will work with our customers, insurance partners and field team throughout your day, ensuring a great customer experience. Your role is critical to our business' success. As the ultimate candidate for the Restoration Claims Specialist, you are a person who makes things happen and is extremely organized and detailed! You are proactive, experienced and truly enjoy providing superior service and taking ownership of your responsibilities.
We are seeking someone who is professional, driven, great on the phone, has excellent analytical skills, is detail-oriented, and is a serious multi-tasker. We are the premier restoration company and are looking for like-minded individuals to represent our brand.
Responsibilities
Scheduling and Dispatching
Monitor job file status
Monitor job file audit status
Maintain customer job files
Monitor and ensure client requirements are followed
Review and validate initial field documentation
Create preliminary estimates
Daily job file coordination
Perform job file backup
Maintain internal and external communications
Prepare job file reports
Complete and review job file documentation for final upload and the audit process
Complete job file audit process
Perform job close-out
Bookkeeping
Collections
Organize office and maintain filing systems
Assist other departments, as needed
Requirements
1+ year(s) of administrative or office-related experience
Experience with writing estimates, job file processes; quality assurance is a plus
Experience in service industry environment is a plus
Outstanding written and verbal communication skills, including proper pronunciation and grammar, and a consistently courteous and professional tone of voice
Polite, confident, and excellent customer service skills, including listening and questioning skills
Ability to remain calm and professional during tense or stressful situations
Excellent organizational skills and strong attention to detail
Very self-motivated and goal-oriented
Ability to multi-task
Capability to work in a fast-paced, team-oriented office environment
Proficiency in Microsoft Office (i.e., Outlook, Word, Excel)
Ability to learn new software, including Xactimate and proprietary software
Minimum of HSD/GED preferred
Ability to successfully complete a background check subject to applicable law
Ability to work 40 hours/ week, flexible to work overtime when required
All employees of a SERVPRO Franchise are hired by, employed by, and under the sole supervision and control of an independently owned and operated SERVPRO Franchise. SERVPRO Franchise employees are not employed by, jointly employed by, agents of, or under the supervision or control of Servpro Industries, Inc., the Franchisor, in any manner whatsoever.
Compensation: $21.00 - $25.00 per hour
Picture yourself here fulfilling your potential.
At SERVPRO , you can make a positive difference in people's lives each and every day! We're seeking self-motivated, proactive, responsible, and service-oriented teammates to join us in our mission of helping customers in their greatest moments of need by repairing and restoring homes and businesses with an industry-leading level of service. With nearly 2,000 franchises all over the country, finding exciting and rewarding SERVPRO career opportunities near you is easy! We look forward to hearing from you.
All employees of a SERVPRO Franchise are hired by, employed by, and under the sole supervision and control of an independently owned and operated SERVPRO Franchise. SERVPRO Franchise employees are not employed by, jointly employed by, agents of, or under the supervision or control of Servpro Franchisor, LLC, in any manner whatsoever.
$21-25 hourly Auto-Apply 60d+ ago
Claims Specialist
Project Resources Group, Inc. 3.5
Claim processor job in Denver, CO
Project Resources Group (PRG) is seeking a Claims Recovery Specialist for our Denver, CO office. Be part of our expanding team focused on recovering third-party property and utility damage claims, primarily in a B2B setting. We're looking for motivated, detail-oriented professionals with strong negotiation skills. Experience in collections or insurance adjusting is highly relevant and transferable. We offer a competitive base salary plus commission.
Key Responsibilities
* Resolve and negotiate claims recovery of repair and replacement costs on third-party cable/fiber and utility damages across multiple state lines, via phone, email, and letters.
* Work directly with liable parties' insurance providers to defend and negotiate claims settlements.
* Collaborate with claims departments and management of liable parties, from small businesses to large corporations to municipalities.
* Learn, understand, and be able to utilize state dig laws and statutes, 811 excavator requirements, NESC standards, CGA guidelines, etc.
* Develop a professional working relationship with damaging parties, on-site field investigators, management, and other personnel.
* Conduct 40-50 inbound/outbound calls daily, approximately 2-2.5 hours of total talk time throughout the day.
* Enter notes and documentation throughout the recovery process into the company's proprietary Claims Database Tool.
* Use a calendar and diary system to coordinate handling claims to be worked twice weekly.
* Follow advanced claim handling procedures as detailed by the OPD Claims Manager.
* Use photographs, narratives, job costs, site sketches, locate tickets, and other components on-site field investigators provide to visualize and understand the damage scene to defend liability accurately.
* Participate in weekly department meetings to discuss individual and team recovery tactics, strategies, and goals.
* Maintain a working knowledge of the entire PRG claims recovery process.
Preferred Qualifications
* Strong proficiency in Microsoft Word, Outlook, and Excel.
* Tech-savvy with the ability to quickly adapt to new software and systems.
* Excellent written and verbal communication skills, with an emphasis on professional phone and email correspondence.
* Familiarity with the construction, cable, or utility locate industries is advantageous.
* Understanding of B2B construction, claims management, recovery, or insurance claim negotiation and settlement processes is preferred.
* Ideally, 3-5 years of experience in claims, recovery, and/or the insurance industry.
* College education is preferred.
* Bilingual in Spanish is a plus.
Compensation and Benefits
We offer a competitive hourly pay ($20-$24/hour based on experience), plus the potential to earn substantial commissions up to $4,000-$10,000 monthly based on performance. Along with a comprehensive benefits package, including:
* Medical, dental, and vision coverage for employees and dependents
* 401(k) retirement plan, with company match after 1 year
* Short-term disability coverage after 1 year
* Paid time off and holidays
* Additional perks such as company-paid life insurance, and other supplemental insurances available
About PRG
Since 2001, PRG has been a leader in construction management and outside plant damage recovery for the telecommunications and utility industries. With 20+ offices and 800+ employees nationwide, we deliver industry-leading solutions with speed, accuracy, and expertise.
Equal Opportunity Employer
PRG is proud to be an Equal Opportunity Employer. PRG does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, pregnancy-related conditions, and lactation), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, or any other characteristic protected by applicable federal, state, or local law and ordinances.
#INDCS
$20-24 hourly Auto-Apply 20d ago
PL CLAIM SPECIALIST
Sedgwick 4.4
Claim processor job in Denver, CO
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
PL CLAIM SPECIALIST
**PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
+ Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
+ Negotiates claim settlement up to designated authority level.
+ Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
+ Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
+ Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
+ Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
+ Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
+ Represents Company in depositions, mediations, and trial monitoring as needed.
+ Communicates claim activity and processing with the client; maintains professional client relationships.
+ Ensures claim files are properly documented and claims coding is correct.
+ Refers cases as appropriate to supervisor and management.
+ Delegates work and mentors assigned staff.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred.
**Experience**
Six (6) years of claims management experience or equivalent combination of education and experience required.
**Skills & Knowledge**
+ In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business
+ Excellent oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Analytical and interpretive skills
+ Strong organizational skills
+ Excellent negotiation skills
+ Good interpersonal skills
+ Ability to work in a team environment
+ Ability to meet or exceed Performance Competencies
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical** **:** Computer keyboarding, travel as required
**Auditory/Visual** **:** Hearing, vision and talking
_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $117,000 - $125,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
$36k-46k yearly est. 7d ago
Claims Specialist
Sonsio 4.2
Claim processor job in Arvada, CO
Who We Are
With a comprehensive lineup of Vehicle Protection plans, Sonsio offers industry-leading programs that cover Tire Road Hazard Protection, Appearance, Parts & Labor Warranties, Mechanical Advisory, and other critical consumer services. These benefits provide vehicle owners with affordable and valuable coverages to keep their vehicles on the road safely, and also maximize the resale value by keeping the appearance of their vehicles like-new.
Sonsio Vehicle Protection is committed to innovation and excellent customer service. Since our inception in 1984, Sonsio has been a leader in the automotive industry-serving more than 74,000 dealerships, F&I service providers, manufacturers, insurance companies, parts suppliers, retail chains, and many independent retailers across all 50 states, Canada, and Puerto Rico.
We understand the challenges and complexities that our partners face when it comes to offering vehicle protection plans. There is no one-size-fits-all. Every business we help is different and has their own set of challenges. That's why, when you partner with Sonsio, we work with you to provide a custom solution designed to improve customer acquisition and retention and increase profitability.
And when it comes to managing claims, you don't have the time or resources to worry about the headaches. Sonsio provides end-to-end support and decades of expertise to give customers the highest quality services with a world-class customer experience.
Base Pay Range:
$18-$19/HR
Position Summary
The Claims Specialist (Level 1) is responsible for accurately and efficiently processing the intake of new claims requests, while providing outstanding customer service to contract holders, dealers, and repair facilities. This role requires strong attention to detail, adherence to company guidelines, and the ability to manage multiple priorities in a fast-paced call center environment. The Claims Specialist ensures claims are set up accurately, customers receive timely support, and all work aligns with company quality and compliance standards.
As a Claims Specialist, your essential job functions will include the following:
Key Responsibilities
Process standard claims accurately and within SLA
Maintain detailed claim documentation, photos, and communication logs
Provide high-quality customer service to contract holders and repair facilities
Accurately enter and update customer information, interactions, and case details in applicable CRM
Collaborate effectively with other teams' members, other departments as well to coordinate customer support efforts and resolve issues
Achieve call, QA, and attendance metrics
Follow established workflows, and escalation processes
Handle and resolve customer complaints in a professional and timely manner.
Develop and maintain a thorough understanding of the company's products, services, policies, and procedures.
Performance Standards
Process and complete claims within 7-10 days, ensuring accuracy, efficiency, and compliance with company policies and regulatory requirements.
QA Score: >85% on the quarterly Quality Assurance scorecard.
Audit Errors:
Attendance: Meets department standards
Adherence% >80%
Position Requirements
Minimum 1-2 years of experience in customer service and/ or claims processing, preferably within a call center environment.
High School Diploma required; Associate or bachelor's degree preferred.
Proficiency in using Salesforce and Microsoft Office Suite; Outlook, Word, Excel.
Ability to efficiently navigate multiple computer systems while assisting customers.
Excellent verbal and written communication skills.
Proven ability to convey complex information clearly, accurately, and concisely.
Strong commitment to providing exceptional customer experiences.
Demonstrated ability to handle inquiries, issues, and complaints with professionalism and care.
Strong time management and multitasking capabilities in a fast-paced environment.
Effective analytical and problem-solving skills to identify and resolve issues efficiently.
High level of accuracy and attention to detail in processing claims and documentation.
Flexible and adaptable to change; able to learn new systems and processes quickly.
Ability to collaborate effectively with team members and cross-functional departments.
Competencies Required
Customer Focus & Empathy
Communication & Collaboration
Attention to Detail & Accuracy
Critical Thinking & Decision-Making
Adaptability & Learning Agility
Results Orientation & Accountability
Time Management & Prioritization
Conflict Resolution & Influence
Physical Job Requirements
Sit for long periods of time.
Continuous viewing from and inputting data to a computer screen.
Drug Policy
Sonsio LLC is a drug-free environment. All applicants being considered for employment must pass a pre-employment drug screening before beginning work.
Please check the box that applies, sign and date upon acceptance of a position with Sonsio LLC.
( ) I can perform all of the essential functions of this position with or without accommodations.
Signature/Date ______________________________________________________
Print Name ______________________________________________________
This position is targeted to be closed on:
Why Sonsio: An amazing opportunity to join a growing organization, built on the efforts of hard working, innovative, and team-oriented people. The compensation offered for this position will depend on qualifications, experience, and geographic location. The total compensation package may also include commission, bonus or profit sharing. We offer a competitive & comprehensive benefit package including: paid time off, medical, dental, vision, and 401k match (50% on the dollar up to 7% of employee contribution). For more information on our benefit offerings, please visit our Dealer Tire Family of Companies Benefits Highlights Booklet.
EOE Statement: Sonsio is an Equal Employment Opportunity (EEO) employer and does not discriminate on the basis of race, color, national origin, religion, gender, age, veteran status, political affiliation, sexual orientation, marital status or disability (in compliance with the Americans with Disabilities Act*), or any other legally protected status, with respect to employment opportunities.
*ADA Disclosure: Any candidate who feels that they may need an accommodation to complete this application, or any portions of same, based on the impact of a disability should contact Sonsio's Human Resources Department to discuss your specific needs. Please feel free to contact us at ************** x6550.
$18-19 hourly Auto-Apply 4d ago
Claims Supervisor
Network Adjusters, Inc. 4.1
Claim processor job in Denver, CO
Network Adjusters is seeking an experienced First-Party Property Damage Claims Supervisor to join our third-party administrative insurance handling team. This leadership role is ideal for professionals who thrive in fast-paced claims environments and are passionate about team development, technical excellence, and delivering strong customer service outcomes.
This position offers the opportunity to work within a trusted organization committed to integrity, reliability, and professional development through ongoing training and growth opportunities.
About the Role
Property Claims Supervisors oversee the full lifecycle of claims handling while ensuring compliance, service standards, and industry best practices are consistently met. In this role, you will hire, onboard, train, and develop a team of adjusters specializing in commercial property losses, providing both strategic and technical guidance throughout the claims process.
You will play a key role in maintaining departmental protocols, supporting complex claim resolution, and delivering strong customer service outcomes for carriers, clients, and internal stakeholders. This is a desk-based role.
Responsibilities
Supervise and manage a team of claims adjusters, providing guidance, training, and ongoing support to drive performance and professional development
Hire, onboard, train, and develop staff as needed
Review and analyze coverage, policies, claim forms, and supporting documentation to ensure accurate and compliant claim handling
Oversee the full claims lifecycle, including damage evaluation, loss determination, settlement negotiations, and resolution
Ensure compliance with all regulatory requirements, company guidelines, and industry Best Practices
Implement and monitor quality control standards and QA/QC measures to ensure consistency, accuracy, and efficiency in claims handling
Collaborate with carriers, attorneys, claimants, and internal stakeholders to resolve disputes and provide a positive claims experience
Track and analyze team and departmental performance metrics, establish targets, and implement strategies to meet or exceed goals
Prepare and present reports to senior management and clients, highlighting performance trends, risks, and improvement opportunities
Stay current on industry regulations, case law, statutes, and evolving claims best practices
Qualifications
Minimum 5 years of claims handling experience, including first-party property claims
Strong leadership skills with the ability to mentor, motivate, and develop a team
Superior knowledge of case law, statutes, and procedures impacting claim handling and valuation
Excellent analytical, evaluation, strategic, and negotiation skills
Ability to prioritize workload and manage multiple tasks effectively in a fast-paced environment
Strong problem-solving skills with keen attention to detail
Proficiency in MS Office Suite and other standard business software
Polished written and verbal communication skills
Bachelor's degree in a relevant field or equivalent work experience
Compensation & Benefits
Salary: $85,000-$110,000 annually (based on licensure, certifications, and experience)
Training, development, and career growth opportunities
401(k) with company match and retirement planning
Paid time off and company-paid holidays
Comprehensive medical, dental, and vision insurance
Flexible Spending Account (FSA)
Company-paid life insurance and long-term disability
Supplemental life insurance and optional short-term disability
Strong work/family and employee assistance programs
Employee referral program
Location
📍 Denver, CO
This role is on-site only; remote or hybrid arrangements are not available.
About Network Adjusters
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver, and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
$85k-110k yearly 1d ago
General Liability Claims Specialist
CNA Financial Corp 4.6
Claim processor job in Littleton, CO
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.
This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
This position enjoys a flexible, hybrid work schedule and is available in any location near a CNA office.
JOB DESCRIPTION:
Performs a combination of duties in accordance with departmental guidelines:
* Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
* Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, 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.
* Conducts 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.
* Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
* Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
* Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
* Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
* Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
* Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
* May serve as a mentor/coach to less experienced claim professionals
May perform additional duties as assigned.
Reporting Relationship
Typically, Manager or above
Skills, Knowledge & Abilities
* Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
* Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
* Demonstrated ability to develop collaborative business relationships with internal and external work partners.
* Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
* Demonstrated investigative experience with an analytical mindset and critical thinking skills.
* Strong work ethic, with demonstrated time management and organizational skills.
* Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
* Developing ability to negotiate low to moderately complex settlements.
* Adaptable to a changing 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.
* Typically, a minimum four years of relevant experience, preferably in claim handling.
* Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
* Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
* Professional designations are a plus (e.g. CPCU)
#LI-LG1
#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 $54,000 to $103,000 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 visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
$54k-103k yearly Auto-Apply 60d+ ago
Workers' Compensation Claims Specialist
Arcadis 4.8
Claim processor job in Highlands Ranch, CO
Arcadis is the world's leading company delivering sustainable design, engineering, and consultancy solutions for natural and built assets.
We are more than 36,000 people, in over 70 countries, dedicated to improving quality of life. Everyone has an important role to play. With the power of many curious minds, together we can solve the world's most complex challenges and deliver more impact together.
Role accountabilities:
Case Coordination
Serve as the main point of contact between the company and the external workers' compensation carrier.
Track and manage all workers' compensation claims from initial report to resolution.
Gather, review, and submit all required documentation to the carrier in a timely manner.
Coordinate with supervisors and injured employees to ensure accurate reporting of workplace injuries.
Communication
Facilitate clear, timely communication between employees, management, healthcare providers, and the carrier.
Provide updates to management and affected employees regarding claim status and next steps.
Educate employees and supervisors on the workers' compensation process and requirements.
Compliance & Documentation
Ensure all workers' compensation processes adhere to federal, state, and local regulations.
Maintain confidential and accurate records of all claims, correspondence, and decisions.
Assist in preparing reports related to claims trends, costs, and outcomes for management review.
Return-to-Work Coordination
Collaborate with People team, Health & Safety team, management, and healthcare providers to facilitate safe and timely return-to-work plans.
Monitor work restrictions and accommodations as recommended by medical professionals.
Continuous Improvement
Identify opportunities to improve claim handling processes and reduce claim costs.
Participate in safety committees and contribute to workplace injury prevention initiatives.
Qualifications & Experience:
Bachelor's degree in Legal Studies, Human Resources, Business Administration, or related field (preferred).
3+ years of experience in workers' compensation claims management or related field.
Familiarity with workers' compensation laws and regulations (state and federal).
Proficiency with case management systems and Microsoft Office Suite.
Why Arcadis?
We can only achieve our goals when everyone is empowered to be their best. We believe everyone's contribution matters. It's why we are pioneering a skills-based approach, where you can harness your unique experience and expertise to carve your career path and maximize the impact we can make together.
You'll do meaningful work, and no matter what role, you'll be helping to deliver sustainable solutions for a more prosperous planet. Make your mark, on your career, your colleagues, your clients, your life and the world around you.
Together, we can create a lasting legacy.
Join Arcadis. Create a Legacy.
Our Commitment to Equality, Diversity, Inclusion & Belonging
We want you to be able to bring your best self to work every day which is why we take equality and inclusion seriously and hold ourselves to account for our actions. Our ambition is to be an employer of choice and provide a great place to work for all our people. We are an equal opportunity and affirmative action employer. Women, minorities, people with disabilities and veterans are strongly encouraged to apply. We are dedicated to a policy of non-discrimination in employment on any basis including race, creed, color, religion, national origin, sex, age, disability, marital status, sexual orientation, gender identity, citizenship status, disability, veteran status, or any other basis prohibited by law.
Arcadis offers benefits for full time and part time positions. These benefits include medical, dental, and vision, EAP, 401K, STD, LTD, AD&D, life insurance, paid parental leave, reward & recognition program and optional benefits including wellbeing benefits, adoption assistance and tuition reimbursement. We offer nine paid holidays and 15 days PTO that accrue per year. The salary range for this position is $65,000 - $85,000. Actual salaries will vary and are based on several factors, such as experience, education, budget, internal equity, project and location.
#LI-CB3
#LI-Hybrid
How much does a claim processor earn in Aurora, CO?
The average claim processor in Aurora, CO earns between $25,000 and $55,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.
Average claim processor salary in Aurora, CO
$37,000
What are the biggest employers of Claim Processors in Aurora, CO?
The biggest employers of Claim Processors in Aurora, CO are: