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Claim processor jobs in North Carolina - 100 jobs
STD Claims Examiner II
Matrix Absence Management
Claim processor job in Ruth, NC
Job Responsibilities and Requirements Obtains and analyzes information to make claim decisions and payments of Short Term Disability (STD) claims. The goal of the position/role is to consistently pay the accurate amount for each claim in accordance with the contract. Research * Applies knowledge of disability products, policies and contracts. * Interprets and applies contract/policy definitions of disability and relevant provisions, clauses, exclusions, riders and waivers as well as statutory requirements. * Utilizes reference materials and tools regarding medical, vocational and disability issues to identify and evaluate claim information in a fair and objective manner. * Efficient use of applicable disability claims system(s). * Applies routine medical and technical claims skills, practices, and procedures. * Utilizes most efficient means to obtain claim information. Analysis and Adjudication * Fully investigates all relevant claim issues. * Provides payment or denials promptly and in full compliance with department procedures and regulations. * Involves technical resources (Social Security specialist, medical resources, and vocational resources) at appropriate claim junctures. * Determine and implement appropriate return to work strategy for assigned cases. * Applies contract specifics regarding eligibility and pre-existing formulas in reference to specific claim. * Communicates with claimants, policyholders, and physicians to resolve investigations concerns. * Comfortably makes balanced decisions in situations where there are potential adverse consequences. Case Management * Utilizes appropriate intervention for the characteristics of each claim. * Manages assigned case load of 100-110 complex and some simple cases independently. * Collaborates with team members and management in identifying and implementing improvement opportunities. * Manages appropriate volumes, consistently meeting turnaround times, high activity levels, and quality focus on timely claim activities. * Consistently remain within workflow guidelines on diaries and casework & adjust desk management if needed. * Provides clear, concise and accurate information to claimants as well as the claims administrative system. * Serves as a subject matter expert within team, provides some mentor support for newer examiners to assist in their development. Customer Service * Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands. * Establishes, communicates, and manages claimant and policyholder expectations. * Documents claim file actions and telephone conversations appropriately. Required Competencies * 2 years STD claims examiner experience (Short Term Disability) * Associates Degree, Bachelors Preferred * Promptly acknowledges customers' needs, both internal and external. Ensures customers' needs are handled in a timely and appropriate manner. Creates a positive impression. * Demonstrates effective interpersonal and listening skills: takes direction, practices active listening, accepts feedback. Communicate/respond appropriately to varied audiences/tasks. Exhibits teamwork, honors commitments. * Anticipates, analyzes and defines problems. Develops and assesses alternative solutions as necessary. Makes appropriate decisions in a timely manner. Analyzes impact of decisions. * Work is accomplished quickly and accurately. Takes responsibility for actions. Prioritizes work effectively and uses time efficiently. Accomplishes goals and objectives. * Makes/fulfills commitments. Consistently works independently, meets deadlines, and accepts responsibility for his/her actions. Adheres to all attendance requirements. Prompt, well prepared and ready to contribute. * Level I LOMA Designation Preferred Ability to Travel: None The expected hiring range for this position is $23.24 - $29.04 hourly for work performed in the primary location (South Portland, ME). This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future. Work location may be flexible if approved by the Company. What We Offer At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you. That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing. Our Benefits: * An annual performance bonus for all team members * Generous 401(k) company match that is immediately vested * A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account * Multiple options for dental and vision coverage * Company provided Life & Disability Insurance to ensure financial protection when you need it most * Family friendly benefits including Paid Parental Leave & Adoption Assistance * Hybrid work arrangements for eligible roles * Tuition Reimbursement and Continuing Professional Education * Paid Time Off - new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service. * Volunteer days, community partnerships, and Employee Assistance Program * Ability to connect with colleagues around the country through our Employee Resource Group program Our Values: * Integrity * Empowerment * Compassion * Collaboration * Fun EEO Statement Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications. #LI-Remote #LI-MR1$23.2-29 hourly Auto-Apply 4d agoClaims Examiner
Harriscomputer
Claim processor job in North Carolina
Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.$28k-46k yearly est. Auto-Apply 25d agoComplex Liability Claims Specialist - Commercial General Liability
Utica National Insurance Group
Claim processor job in North Carolina
The Company At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an "A" rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier. Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago. What you will do The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in multiple jurisdictions. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex commercial general liability is required. Key responsibilities * Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex liability claims in multiple jurisdictions. * Manage all claims in accordance with Utica National's established claim procedures. * Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level. * Maintain timely and accurate claim reserves in accordance Utica National's reserving philosophy. * Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel's work product and working with defense counsel to efficiently and fairly resolve claims. * Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials. * Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle. * Achieve the service standard of "excellent" during all phases of claims handling. * Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction. * Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling. What you need * Four year degree or equivalent experience preferred. * Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated casualty claims. * Proven experience negotiating claims and active participation in alternative dispute resolution practices. * Experience with general liability, additional insured considerations and complex coverage determinations. Licensing Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment. Salary range: $103,300 - $136,400 The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications. Benefits: We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following: * Medical and Prescription Drug Benefit * Dental Benefit * Vision Benefit * Life Insurance and Disability Benefits * 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results) * Health Savings Account (HSA) * Flexible Spending Accounts * Tuition Assistance, Training, and Professional Designations * Company-Paid Family Leave * Adoption/Surrogacy Assistance Benefit * Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance * Student Loan Refinancing Services * Care.com Membership with Back-up Care, Senior Solutions * Business Travel Accident Insurance * Matching Gifts program * Paid Volunteer Day * Employee Referral Award Program * Wellness programs Additional Information: This position is a full time salaried, exempt (non-overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy. #LI-HL1$42k-64k yearly est. 21d agoClaims Representative II
Berkley
Claim processor job in North Carolina
Company Details With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results. All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong), by S&P. For further information about Key Risk please visit *************** The company is an equal opportunity employer. Responsibilities Key Risk is looking for a Claims Representative who enjoys analysis and management of workers compensation claims. Key functions include but are not limited to the following: Analyzes and processes workers' compensation claims by investigating and gathering information to determine the exposure on the claim. Negotiate settlement of claims up to designated authority level and makes claims payments. Calculates and assigns timely an appropriate reserve to claims and continues to manage reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level. Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution. Prepares necessary state filings within statutory limits. Actively manages the litigation process; ensures timely and cost-effective claims resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. Frequently communicates with all appropriate parties involved with the claim. Maintains professional client relationships. Actively executes appropriate claims activities to ensure consistent delivery of quality claims services. Qualifications BA/BS Degree 2-3 years of workers compensation claims experience Adjuster license strongly desired or ability to obtain license within six months Knowledge of appropriate insurance principles and laws of workers' compensation, preferably jurisdiction specific. Strong verbal and written communication Strong interpersonal, time management and organizational skills. Strong negotiation skills. Proven critical thinking skills that demonstrates analysis/judgment and sound decision making with focus on attention to detail. Ability to perform with a sense of urgency. Ability to work both independently and within a team environment. Ability to travel for business purposes, approximately less than 10%. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. 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. Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.$41k-56k yearly est. Auto-Apply 25d agoBilling Procedure Claims Specialist
Summit Spine and Joint Centers
Claim processor job in North Carolina
Summit Spine and Joint Centers is a rapidly expanding Pain Management Group looking to add an experienced Medical Billing Specialist to our team. With twelve ambulatory surgery centers and twenty-three clinic locations across the State of Georgia, Summit Spine is winning the race to become the largest comprehensive spine and joint care provider in the state. We are looking for a motivated and hard-working Claims Processor who can join our growing team of professionals. Job Duties: Audits and ensure claim information is complete and accurate. claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management. Ensures accurate and timely billing of HCFA 1500 claims. Ensures that files are documented with appropriate information (i.e., date stamped, logged, signed, etc.). Creates logs for providers of pending medical encounters and or encounters with errors. Work directly with other billing staff and management to meet end of month closing deadlines. Able to work with clearinghouse rejections, print, and mail secondaries. Address inquiries from insurance companies, patients, and providers. Understands CPT, ICD10, HCPCS coding and modifiers. Knowledge of third-party payers, HMOs, PPOs, Medicare, Medicaid, Worker's Compensation, etc. Knowledge of ERAs, EOBs Knowledge of payer specific/LCD guidelines Understanding of health plan benefits (deductibles, copays, coinsurance) and eligibility verification Must be proficient with spreadsheets and word processing applications. Qualifications: Minimum of 3 years' experience with medical billing or revenue cycle in a medical setting Experience with Medicare, Medicaid, Commercial insurance plans, Workers' comp, and Personal Injury cases. Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials. Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required. Excellent computer skills and familiarity with Microsoft Office Comfortable working in a growing, dynamic organization and able to navigate change. Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment. Bachelor's degree preferred. Experience using eClinicalWorks preferred. Experience with high level procedure billing and coding for Pain Management preferred The position is full time with competitive salary, PTO, health benefits and 401k match. The ideal candidate will be located in Georgia and able to be present at our administrative office, or near Austin, Texas where other members of the billing team are located.$31k-54k yearly est. 22d agoBodily Injury Claims Specialist
Auto-Owners Insurance Co
Claim processor job in Raleigh, NC
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 compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! 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. #LI-DNI$42k-58k yearly est. Auto-Apply 13d agoClaims Settlement Specialist
The Strickland Group
Claim processor job in Raleigh, NC
Now Hiring: Claims Settlement Specialist - Inspire, Lead, and Create Meaningful Impact! Are you passionate about leading with purpose, empowering others, and making a lasting impact? We are looking for motivated individuals to join our team as Claims Settlement Specialist, where you'll mentor, inspire, and implement strategies that help individuals achieve financial and personal breakthroughs while building a career that aligns with your values. Who We're Looking For: ✅ Visionary leaders who are passionate about servant leadership and impact ✅ Entrepreneurs and professionals eager to empower others while scaling success ✅ Licensed & aspiring Life & Health Insurance Agents (We'll guide you through licensing!) ✅ Individuals ready to lead with integrity, purpose, and a strong mission for success As a Claims Settlement Specialist, you'll help individuals discover their potential, achieve financial independence, and create meaningful change in their lives and communities. Is This You? ✔ Passionate about mentorship, leadership, and creating impact-driven success? ✔ A strong communicator who thrives on guiding and inspiring others? ✔ Self-driven, disciplined, and committed to personal and professional growth? ✔ Open to mentorship, leadership development, and continuous learning? ✔ Looking for a recession-proof career with unlimited earning potential? If you answered YES, keep reading! Why Become a Claims Settlement Specialist? 🚀 Work from anywhere - Build a career aligned with your values and goals. 💰 Uncapped earning potential - Part-time: $40,000-$60,000+/year | Full-time: $70,000-$150,000+++/year. 📈 No cold calling - Work with individuals who have already requested guidance. ❌ No sales quotas, no pressure, no pushy tactics. 🏆 Leadership & Ownership Opportunities - Develop and expand your own team. 🎯 Daily pay & performance-based bonuses - Direct commissions from top carriers. 🎁 Incentives & rewards - Earn commissions starting at 80% (most carriers) + salary. 🏥 Health benefits available for qualified participants. This is more than just a career-it's an opportunity to lead with purpose, inspire positive change, and build a future that aligns with your mission and impact. 👉 Apply today and take your first step as a Claims Settlement Specialist! (Results may vary. Your success depends on effort, skill, and commitment to learning and execution.)$39k-70k yearly est. Auto-Apply 60d+ agoInventory Claim Specialist
Kioti Tractor
Claim processor job in Wendell, NC
Job Description Inventory Claims Coordinator Department: Warehouse Operations - 171032 Reports to: Inventory Supervisor Full-time Status: Hourly, Non-Exempt Management Level: Non-Management JOB SUMMARY The Inventory Claims Coordinator serves as a support element and liaison for all distribution centers and the dealer network. This person will be cross trained and gain exposure to many functions including claims processing, inventory investigations, dealer network relationship building and recording claim data. KEY RESPONSIBILITIES OF JOB The Inventory Claims Coordinator key responsibilities are outlined below: Claims: Resolve and process claim disputes Technical drawing look-up Inventory background investigations Credit and Debit process on claim investigations Issuing and monitoring call tags Resolve and process freight claim disputes and tracking reimbursement if applicable Inventory Management Provide inventory control reporting and vendor reports Track claim data and communicate common themes for mitigation Directly or indirectly locate misplaced parts to help satisfy sale to customer/dealer Help maintain or relay proper product identification and location accuracy and ability to transfer product to correct location if needed Other Responsibilities Determine and record data for KPI's Promote dealer satisfaction utilizing customer service skills EDUCATIONAL AND PHYSICAL REQUIREMENTS High school diploma or GED equivalent required with minimum of 3 years' related experience Associate or Bachelor degree with a minimum of 1 year experience 1-5 Years of related customer service or inventory experience. Must be a team player with strong interpersonal communication skills Good time-management skills and attention to detail Outstanding written and oral communication skills with the ability to effectively present information Proficiency in Microsoft programs, including Excel, a plus SAP experience preferred SalesForce experience preferred$31k-55k yearly est. 28d agoClaims Specialist
Capsigna
Claim processor job in Charlotte, NC
Responsibilities: Processing fast paced inbound customer service calls. Taking inbound calls from clients Providers, Consumers and Insurance companies regarding medical billing. Resubmitting claims, and answering questions regarding benefits Demonstrates excellent customer service skills with the ability to take ownership in assisting, researching and resolving customer issues. Performs other duties as assigned. Requirements Previous Call Center or Customer Service experience preferred. Ability to develop rapport and demonstrate a caring attitude. Clear, distinct oral and written communication skills. Must be detail oriented.$30k-54k yearly est. 60d+ agoClaims Specialist
PRG
Claim processor job in Charlotte, NC
Project Resources Group (PRG) is seeking a Claims Recovery Specialist for our Charlotte, NC 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 ($19-$23/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.$19-23 hourly Auto-Apply 4d agoInsurance Claims Specialist
National Ondemand
Claim processor job in Burlington, NC
National OnDemand, Inc. is a communications and utilities infrastructure provider delivering service solutions to the Fiber, Wireless, Energy and Technology sectors in the United States. Headquartered in Burlington, North Carolina, the Company provides full turnkey infrastructure solutions - on demand, anywhere across its service footprint and has secured and sustained its current standing in the market through the successful completion of mergers and acquisitions, along with demonstrable, steady organic growth. Under the supervision Insurance Claims Manager, coordinate and administer workers' compensation program, automotive, property and casualty claims. Primary Position Duties: * Process and document all worker's compensation claims and property & casualty claims, ensuring compliance with relevant policies, procedures, and legislation. * Serve as liaison with external agencies and regulatory bodies in the claims administration and the care and disposition of claimants. * In coordination with the Insurance Claims Manager, evaluate property and casualty claims to determine liability, damage and exposure. * Elevate to the Insurance Claims Manager larger, more complex claims. * Assist the Insurance Claims Manager, the Senior Director of EHS & Compliance, Human Resources, and Legal, in third-party claims, including negotiations and settlement when required. * Reviews and evaluates all work-related accident reports for completeness and clarity of data; analyzes data, as needed, to ensure compliance with policy and regulatory requirements. * Determines appropriateness and amount of worker's compensation claims; investigates individual claims for eligibility for workers' compensation benefits; ensures that all legal and procedural requirements are met for the processing of claims to ensure proper and timely payment to employees and medical facilities. * Provide authoritative advice and counsel to organizational leadership on interpreting and applying for worker's compensation and property & casualty policies, legislation, regulations, and processes. * Liaison with the organization's insurance broker and providers. * Coordinates and participates in strategic planning aimed at reducing the incidence of worker's compensation-related injuries. * Assembles appropriate medical information and facts regarding claims for cases pending litigation; participates in the Workers' Compensation Administration mediation and formal hearings. * Communicates and interacts with medical professionals, support agencies and others to monitor and assess the progress of rehabilitation efforts and to facilitate either return to work, job restrictions or, depending upon the medical status of the claimant, placement into appropriate alternative positions, ensuring compliance with all appropriate regulations and guidelines. * Updates organizational leadership on employees' return to full duty status. * Prepares all necessary forms, records and documentation, including statistical analyses and reports, for all claims, as required by various regulatory agencies. * Makes recommendations for reducing the frequency and severity of losses using a workers' compensation database and/or other claims data reports; designs and develops databases; performs integrated data analyses and prepares reports. * Process assigned property and casualty claims and performed other job-related duties as assigned. * Claims support during Emergency Events. * Assist EHS & Compliance Administrator as needed. * Assists the Director of EHS & Risk in developing policies and procedures to reduce risk.Performs miscellaneous job-related duties as assigned. Position Requirements: * Access-only office environment with reasonable heating and cooling. * The position will be at a computer workstation much of the time. * Ability to work extended or irregular hours/days (nights and weekends) * Prolonged sitting at a computer workstation performing repetitive tasks. * Ability to occasionally lift, push, or pull up to 25 lbs. * Must have reliable transportation and a valid driver's license. * Ability to travel 10% of the time. Education or Skills: * Bachelor's Degree in Business Administration; at least four years of directly related experience in claims adjusting, investigations, litigation and/or risk management. * Completed degree(s) from an accredited institution. * One or more certifications - Certified Medical Insurance Specialist (CMIS), Certified Risk Insurance Specialist (CRIS), Transportation Risk Insurance Professional (TRIP), Associate in Claims (AIC), or Associate in General Insurance (AINS). * .4 years of experience in risk management handling various claims processes. * Ability to liaison with insurance carriers professionally. * Ability to work independently or with a team at all levels of the organization. * Ability to maintain confidentiality. * Ability to professionally represent the organization. Benefits: This is a full time position with access to our comprehensive benefits which include paid time off (PTO), medical, dental, vision, short- and long-term disability, and life insurance, an Employee Assistance Program (EAP), and 401(k). EQUAL OPPORTUNITY EMPLOYER: NATIONAL OnDemand, Inc. is an equal opportunity employer. The company's policy does not discriminate against any applicant or employee based on race, gender, sex, sexual orientation, gender identity, color, religion, national origin, disability, genetic information, age, veteran status or any other consideration made unlawful by applicable federal, state or local laws. NATIONAL OnDemand, Inc. prohibits harassment of applicants and employees based on any of these protected categories.$31k-54k yearly est. 4d agoInvestigator, Claims
C&S Family of Companies
Claim processor job in Lumberton, NC
Earn $20.00 per hour * Full time First shift ONLY * Grocery (dry goods) - about 50°- 90° 9:00 pm until the works completed Text "CS" to 32543 to learn more about how you can become a part of our legacy. By texting the advertised keyword to 32543 you will opt-in to receive hiring messages from the C&S Family of Companies. Text HELP for help or ******************. Msg & data rates may apply. Msg freq varies. Text STOP to cancel. For terms of use and privacy information, visit ********************************************************************** Job Description Description + This position will report directly to the Claims Manager and conduct detailed investigations by recovering all documentation regarding Customer shortage requests ensuring that all pending claims are researched and processed within the agreed upon time frames. Research will utilize video surveillance as a research tool. + Conduct telephone interviews with store management + Provide documentation packets to warehouse supervision for employee training and or corrective action + Interface with multiple departments to aid in investigations + Travel Required:No Environment + Office : Office Temperature (65F to 75F) Skills + Specialized Knowledge : Knowledge of warehouse operations are essential Knowledge of C&S warehouse and office system applications + Special Skills : + Physical abilities: : Years Of Experience + 0-2 : Relevant experience. Value Propositions (what we offer) + Weekly Pay - (Wednesday) + Paid training provided + Tuition Reimbursement + PTO and Holiday Pay offered + Employee Assistance Program + Career Progression Opportunities + Employee Health & Wellness program + Employee Discounts / Purchasing programs + C&S offers $100 towards the purchase of safety shoes + Benefits available from day 1 (medical, dental, vision, company matched 401k) Qualifications Attendance, General Equivalency Diploma - General Studies, High School Diploma - General Studies, Initiative, Productivity, Quality, Safety, Values Shift 1st Shift (United States of America) Company C&S Wholesale Grocers, LLC About Our Company C&S Wholesale Grocers, LLC is an industry leader in supply chain solutions and wholesale grocery supply in the United States. Founded in 1918 as a supplier to independent grocery stores, C&S now services customers of all sizes, supplying more than 7,500 independent supermarkets, chain stores, military bases and institutions with over 100,000 different products. C&S also proudly operates and supports corporate grocery stores and services independent franchisees under a chain-style model throughout the Midwest, South and Northeast. We are an engaged corporate citizen, supporting causes that positively impact our communities. Working Safely is a Condition of Employment at C&S Wholesale Grocers, LLC. C&S Wholesale Grocers is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or veteran status, or any other applicable state or federal protected class. The Company provides affirmative action in employment for qualified Individuals with a Disability and Protected Veterans in compliance with Section 503 of the Rehabilitation Act and the Vietnam Era Veterans' Readjustment Assistance Act. Company: C&S Wholesale Grocers, LLC Job Area: Quality Assurance Job Family: Finance Job Type: Regular Job Code: JC0324 ReqID: R-265929$20 hourly 3d agoMedical Intake Processer
WN
Claim processor job in Rocky Mount, NC
Temp Medical Intake Processor- is responsible for gathering and processing patient information. This role focuses on initiating the patient's care journey by collecting essential data, verifying insurance, and scheduling appointments. Responsibilities: Gathering Patient Information: This includes collecting demographics, medical history, insurance details, and the reason for the patient's visit. Data Entry and Record Management: Accurately entering patient information into electronic health records systems and ensuring data integrity. Insurance Verification: Confirming patient insurance coverage and benefits to ensure proper billing and payment processes. Appointment Scheduling: Scheduling appointments for consultations, procedures, and follow-up visits based on patient needs and facility availability. Patient Communication: Answering patient inquiries, addressing concerns, and providing information about services and procedures. Paperwork and Documentation: Preparing and managing patient paperwork, including admissions forms, consent forms, and other relevant documents. HIPAA Compliance: Ensuring the confidentiality and privacy of patient information in accordance with HIPAA regulations. Referrals and Coordination: Directing patients to appropriate departments or specialists and coordinating care transitions. Clerical Duties: Performing general office tasks such as filing, copying, and faxing as needed.$33k-42k yearly est. 60d+ agoClaims Examiner II - Absence Management Specialist
Matrix Absence Management
Claim processor job in Ruth, NC
Job Responsibilities and Requirements The Claims Examiner will act as a liaison between client, employee and healthcare provider. In this position, you are responsible for applying appropriate claims management by providing reliable and responsive service to claimants and clients. Description of responsibilities: * Investigates claim issues providing resolution within departmental and regulatory guidelines. * Interprets and administers contract provisions: eligibility and duration * Accurately codes all system fields with correct financial, diagnosis and duration information. * Coordinates with other departments to ensure appropriate claims transition or facilitate timely return to work. * Adheres to compliance, departmental procedures, and Unfair Claims Practice regulations. * Makes determinations to approve, deny or delay and or reach out to additional resources for review, based on medical certification review and management. * Determines the duration associated with the leave and or disability based on the information given by the healthcare provider. * Process medium to high complexity or technically difficult claims. * Develops and manages claims thought well developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution. * Actively contributes to customer service, quality and performance objectives. * Proactively engages in departmental training to remain current with all claim management practices. * Responsible for managing Performance Guarantee clients and meet targeted metrics. * Responsible and accountable for maintaining and protecting personal health information. Must maintain a high level of confidentiality and abide by HIPPA rules and regulations. Qualifications: * High School Diploma or GED (Bachelor's preferred) * Ability to develop proficiency regarding required RSL products, systems and processes related to the effective delivery of new business proposals * Microsoft Office experience * Attention to detail, analytical skills, and the ability to collaborate with others and work independently * Strong organizational skills, including the ability to prioritize work and multi-task * Customer service experience and orientation * Written and verbal communication skills. The expected hiring range for this position is $23.24 - $29.04 hourly for work performed in the primary location (South Portland, ME). This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future. Work location may be flexible if approved by the Company. What We Offer At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you. That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing. Our Benefits: * An annual performance bonus for all team members * Generous 401(k) company match that is immediately vested * A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account * Multiple options for dental and vision coverage * Company provided Life & Disability Insurance to ensure financial protection when you need it most * Family friendly benefits including Paid Parental Leave & Adoption Assistance * Hybrid work arrangements for eligible roles * Tuition Reimbursement and Continuing Professional Education * Paid Time Off - new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service. * Volunteer days, community partnerships, and Employee Assistance Program * Ability to connect with colleagues around the country through our Employee Resource Group program Our Values: * Integrity * Empowerment * Compassion * Collaboration * Fun EEO Statement Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications. #LI-Hybrid #LI-MR1$23.2-29 hourly Auto-Apply 10d agoComplex Liability Claims Specialist - Primarily NY / New York Labor Law
Utica National Insurance Group
Claim processor job in North Carolina
The Company At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an “A” rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier. Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago. What you will do The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in primarily New York venues, inclusive of New York Labor Law claims. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex commercial general liability is required. Key responsibilities Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex liability claims in primarily New York jurisdictions. Manage all claims in accordance with Utica National's established claim procedures. Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level. Maintain timely and accurate claim reserves in accordance Utica National's reserving philosophy. Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel's work product and working with defense counsel to efficiently and fairly resolve claims. Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials. Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle. Achieve the service standard of “excellent” during all phases of claims handling. Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction. Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling. What you need Four year degree or equivalent experience preferred. Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated casualty claims. Proven experience negotiating claims and active participation in alternative dispute resolution practices. Experience with general liability, additional insured considerations and complex coverage determinations. Experience with New York Labor Law Claims strongly preferred. Licensing Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment. Salary range: $103,300 - $136,400 The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications. Benefits: We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following: Medical and Prescription Drug Benefit Dental Benefit Vision Benefit Life Insurance and Disability Benefits 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results) Health Savings Account (HSA) Flexible Spending Accounts Tuition Assistance, Training, and Professional Designations Company-Paid Family Leave Adoption/Surrogacy Assistance Benefit Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance Student Loan Refinancing Services Care.com Membership with Back-up Care, Senior Solutions Business Travel Accident Insurance Matching Gifts program Paid Volunteer Day Employee Referral Award Program Wellness programs Additional Information: This position is a full time salaried, exempt (non-overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy. #LI-HL1$42k-64k yearly est. 32d agoClaims Representative II
Berkley
Claim processor job in High Point, NC
Company Details With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results. All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong), by S&P. For further information about Key Risk please visit *************** The company is an equal opportunity employer. Responsibilities Key Risk is looking for a Claims Representative who enjoys analysis and management of workers compensation claims. Key functions include but are not limited to the following: Analyzes and processes workers' compensation claims by investigating and gathering information to determine the exposure on the claim. Negotiate settlement of claims up to designated authority level and makes claims payments. Calculates and assigns timely an appropriate reserve to claims and continues to manage reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level. Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution. Prepares necessary state filings within statutory limits. Actively manages the litigation process; ensures timely and cost-effective claims resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. Frequently communicates with all appropriate parties involved with the claim. Maintains professional client relationships. Actively executes appropriate claims activities to ensure consistent delivery of quality claims services. Qualifications BA/BS Degree 2-3 years of workers compensation claims experience Adjuster license strongly desired or ability to obtain license within six months Knowledge of appropriate insurance principles and laws of workers' compensation, preferably jurisdiction specific. Strong verbal and written communication Strong interpersonal, time management and organizational skills. Strong negotiation skills. Proven critical thinking skills that demonstrates analysis/judgment and sound decision making with focus on attention to detail. Ability to perform with a sense of urgency. Ability to work both independently and within a team environment. Ability to travel for business purposes, approximately less than 10%. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. 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. Sponsorship Details Sponsorship not Offered for this Role$42k-56k yearly est. Auto-Apply 60d+ agoInventory Claim Specialist
Kioti Tractor
Claim processor job in Wendell, NC
Inventory Claims Coordinator Department: Warehouse Operations - 171032 Reports to: Inventory Supervisor Location: Wendell, NC Position Status: Full-time Status: Hourly, Non-Exempt Management Level: Non-Management JOB SUMMARY The Inventory Claims Coordinator serves as a support element and liaison for all distribution centers and the dealer network. This person will be cross trained and gain exposure to many functions including claims processing, inventory investigations, dealer network relationship building and recording claim data. KEY RESPONSIBILITIES OF JOB The Inventory Claims Coordinator key responsibilities are outlined below: Claims: Resolve and process claim disputes Technical drawing look-up Inventory background investigations Credit and Debit process on claim investigations Issuing and monitoring call tags Resolve and process freight claim disputes and tracking reimbursement if applicable Inventory Management Provide inventory control reporting and vendor reports Track claim data and communicate common themes for mitigation Directly or indirectly locate misplaced parts to help satisfy sale to customer/dealer Help maintain or relay proper product identification and location accuracy and ability to transfer product to correct location if needed Other Responsibilities Determine and record data for KPI's Promote dealer satisfaction utilizing customer service skills EDUCATIONAL AND PHYSICAL REQUIREMENTS High school diploma or GED equivalent required with minimum of 3 years' related experience Associate or Bachelor degree with a minimum of 1 year experience 1-5 Years of related customer service or inventory experience. Must be a team player with strong interpersonal communication skills Good time-management skills and attention to detail Outstanding written and oral communication skills with the ability to effectively present information Proficiency in Microsoft programs, including Excel, a plus SAP experience preferred SalesForce experience preferred$31k-55k yearly est. Auto-Apply 60d+ agoBodily Injury Claims Specialist
Auto-Owners Insurance Co
Claim processor job in Asheville, NC
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 compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! 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. #LI-DNI$40k-54k yearly est. Auto-Apply 13d agoClaims Processing Expert
The Strickland Group
Claim processor job in Raleigh, NC
Join Our Dynamic Insurance Team - Unlock Your Potential! Are you ready to take control of your future and build a career in one of the most stable and lucrative industries? We are seeking driven individuals to join our thriving insurance team, where you'll receive top-tier training, support, and unlimited income potential. NOW HIRING: ✅ Licensed Life & Health Agents ✅ Unlicensed Individuals (We'll guide you through the licensing process!) We're looking for our next leaders-those who want to build a career or an impactful part-time income stream. Is This You? ✔ Willing to work hard and commit for long-term success? ✔ Ready to invest in yourself and your business? ✔ Self-motivated and disciplined, even when no one is watching? ✔ Coachable and eager to learn? ✔ Interested in a business that is both recession- and pandemic-proof? If you answered YES to any of these, keep reading! Why Choose Us? 💼 Work from anywhere - full-time or part-time, set your own schedule. 💰 Uncapped earning potential - Part-time: $40,000 - $60,000 /month | Full-time: $70,000 - $150,000+++/month. 📈 No cold calling - You'll only assist individuals who have already requested help. ❌ No sales quotas, no pressure, no pushy tactics. 🧑 🏫 World-class training & mentorship - Learn directly from top agents. 🎯 Daily pay from the insurance carriers you work with. 🎁 Bonuses & incentives - Earn commissions starting at 80% (most carriers) + salary 🏆 Ownership opportunities - Build your own agency (if desired). 🏥 Health insurance available for qualified agents. 🚀 This is your chance to take back control, build a rewarding career, and create real financial freedom. 👉 Apply today and start your journey in financial services! ( Results may vary. Your success depends on effort, skill, and commitment to training and sales systems. )$27k-34k yearly est. Auto-Apply 60d+ agoComplex Liability Claims Specialist - Commercial General Liability
Utica National Insurance Group
Claim processor job in North Carolina
The Company At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an “A” rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier. Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago. What you will do The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in multiple jurisdictions. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex commercial general liability is required. Key responsibilities Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex liability claims in multiple jurisdictions. Manage all claims in accordance with Utica National's established claim procedures. Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level. Maintain timely and accurate claim reserves in accordance Utica National's reserving philosophy. Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel's work product and working with defense counsel to efficiently and fairly resolve claims. Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials. Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle. Achieve the service standard of “excellent” during all phases of claims handling. Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction. Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling. What you need Four year degree or equivalent experience preferred. Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated casualty claims. Proven experience negotiating claims and active participation in alternative dispute resolution practices. Experience with general liability, additional insured considerations and complex coverage determinations. Licensing Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment. Salary range: $103,300 - $136,400 The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications. Benefits: We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following: Medical and Prescription Drug Benefit Dental Benefit Vision Benefit Life Insurance and Disability Benefits 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results) Health Savings Account (HSA) Flexible Spending Accounts Tuition Assistance, Training, and Professional Designations Company-Paid Family Leave Adoption/Surrogacy Assistance Benefit Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance Student Loan Refinancing Services Care.com Membership with Back-up Care, Senior Solutions Business Travel Accident Insurance Matching Gifts program Paid Volunteer Day Employee Referral Award Program Wellness programs Additional Information: This position is a full time salaried, exempt (non-overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy. #LI-HL1$42k-64k yearly est. 32d ago
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