Post job

Claim processor jobs in Sioux Falls, SD - 288 jobs

All
Claim Processor
Claim Specialist
Claims Representative
Claim Processing Specialist
  • Claims Examiner

    Securian 3.7company rating

    Claim processor job in Saint Paul, MN

    ** At Securian Financial, the internal title is Customer Benefit Payments Sr Rep** The Claims team is looking for a highly motivated, energized and positive individual. We work in a fast-paced, ever-changing environment where claim information needs to be processed efficiently and accurately. We take pride in providing high standards of performance to our customers and strive to exceed those standards. If you enjoy assisting people in their time of need, being customer focused and working in a team-oriented environment, then joining our team may be right move for you. Responsibilities include but not limited to: Serves department dedicated to issuing timely, accurate benefit payments to customers and channel partners. Tasks include payment processing, data entry, records management, fraud prevention, and loss or eligibility investigations. Provides effective, customer-centric, and compliant communication to internal and external resources, clients, and partners. Adjudicates payments in compliance with regulatory requirements and applicable law, engaging legal, medical, and investigative resources as necessary. Maintains accurate and complete payment record to improve the customer experience, quality review/audit process, and protect our company in the event of litigation and regulatory investigations. Makes critical risk assessments on behalf of Securian Financial and its clients. May manage or serve as subject matter expert for special projects. Ensures payment practices are efficient and in keeping with our organization's values and the highest ethical standards. Qualifications: Strong analytical skills and attention to detail Good judgment/decision-making skills and organizational skills Strong written and verbal communication skills Willingness to maintain a positive and compassionate attitude in a high volume setting Ability to work independently within a team environment Desire to provide world-class customer service Preferred qualifications: Experience on claims processing systems Financial institution background Demonstrated proficiency with Microsoft Word and Outlook Telephone customer service experience #LI-Hybrid This role requires 2 days onsite a month and for moments that matter. The estimated base pay range for this job is: $18.27 - $31.73 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information on base pay and incentive pay (if applicable) can be discussed with a member of the Securian Financial Talent Acquisition team. Be you. With us. At Securian Financial, we understand that attracting top talent means offering more than just a job - it means providing a rewarding and fulfilling career. As a valued member of our high-performing team, we want you to connect with your work, your relationships and your community. Enjoy our comprehensive range of benefits designed to enhance your professional growth, well-being and work-life balance, including the advantages listed here: Paid time off: We want you to take time off for what matters most to you. Our PTO program provides flexibility for associates to take meaningful time away from work to relax, recharge and spend time doing what's important to them. And Securian Financial rewards associates for their service by providing additional PTO the longer you stay at Securian. Leave programs: Securian's flexible leave programs allow time off from work for parental leave, caregiver leave for family members, bereavement and military leave. Holidays: Securian provides nine company paid holidays. Company-funded pension plan and a 401(k) retirement plan: Share in the success of our company. Securian's 401(k) company contribution is tied to our performance up to 10 percent of eligible earnings, with a target of 5 percent. The amount is based on company results compared to goals related to earnings, sales and service. Health insurance: From the first day of employment, associates and their eligible family members - including spouses, domestic partners and children - are eligible for medical, dental and vision coverage. Volunteer time: We know the importance of community. Through company-sponsored events, volunteer paid time off, a dollar-for-dollar matching gift program and more, we encourage you to support organizations important to you. Associate Resource Groups: Build connections, be yourself and develop meaningful relationships at work through associate-led ARGs. Dedicated groups focus on a variety of interests and affinities, including: Mental Wellness and Disability Pride at Securian Financial Securian Young Professionals Network Securian Multicultural Network Securian Women and Allies Network Servicemember Associate Resource Group For more information regarding Securian's benefits, please review our Benefits page. This information is not intended to explain all the provisions of coverage available under these plans. In all cases, the plan document dictates coverage and provisions. Securian Financial Group, Inc. does not discriminate based on race, color, religion, national origin, sex, gender, gender identity, sexual orientation, age, marital or familial status, pregnancy, disability, genetic information, political affiliation, veteran status, status in regard to public assistance or any other protected status. If you are a job seeker with a disability and require an accommodation to apply for one of our jobs, please contact us by email at , by telephone (voice), or 711 (Relay/TTY). To view our privacy statement click here To view our legal statement click here
    $18.3-31.7 hourly 2d ago
  • Job icon imageJob icon image 2

    Looking for a job?

    Let Zippia find it for you.

  • Michigan Homeowners Claim Representative II

    The Auto Club Group 4.2company rating

    Claim processor job in Saint Paul, MN

    Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager IWhat you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss. Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Employees assigned to the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update. Supervisory Responsibilities: None How you will benefit: A competitive annual salary between $64,000 - $72,000 ACG offers excellent and comprehensive benefits packages, including: Medical, dental and vision benefits 401k Match Paid parental leave and adoption assistance Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays Paid volunteer day annually Tuition assistance program, professional certification reimbursement program and other professional development opportunities AAA Membership Discounts, perks, and rewards and much more We're looking for candidates who:Required Qualifications (these are the minimum requirements to qualify) Education: Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members. Experience: One year of experience or equivalent training in the following: Negotiating claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advance knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Knowledge of building construction and repair techniques Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG Claim policies, procedures and guidelines Work within assigned ACG Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Research, analyze, and interpret subrogation laws in various states Strong negotiating skills Ability to work outside normal business hours as needed Preferred Qualifications: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Xactimate software experience/training or experience in an equivalent software Claims adjuster experience specifically in home/property claims preferred Experience working within a customer service setting Call center experience or experience handling high volume calls preferred, but not required Excellent communication skills both oral and written Experience working within an insurance or claims-based role for one year or more Full claims cycle experience preferred Work Environment This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
    $64k-72k yearly 2d ago
  • Associate Claims Examiner - Equine

    Markel Corporation 4.8company rating

    Claim processor job in Omaha, NE

    What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. Job Responsibilities * Confirms coverage of claims by reviewing policies and documents submitted in support of claims. * Conducts, coordinates and directs investigation into loss facts and extent of damages. * Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure. * Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents. * Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting. Required Qualifications * This role will is responsible for Equine claims; equine knowledge or hands-on experience working with horses is strongly preferred. * Must have or be eligible to receive claims adjuster license. * Successful completion of basic insurance courses or achievement of industry designations. * Ability to be trained in insurance adjusting up to two years of claims experience. * 2-4 years of experience in general liability, construction defect, or related liability lines preferred. * Bachelor's degree preferred * Excellent written and oral communication skills. * Strong organizational and time management skills. #LI-Hybrid US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. * We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. * All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. * We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose 'Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: * All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. * All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.
    $34k-47k yearly est. Auto-Apply 51d ago
  • Experienced Catastrophe Claims Representative

    Auto-Owners Insurance Co 4.3company rating

    Claim processor job in Sioux Falls, SD

    * There are multiple positions open across the 26 states in which we operate. The current locations for which we are seeking CAT Claim Reps are located in the job posting.* Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated claims professional to join our team. The position requires the following, but is not limited to: * Frequent travel up to 21 days at a time and is required upon short notice to location of catastrophe, which would most likely be out of state. * Can meet the physical demands required for the position including carrying and climbing a ladder. * Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses. * Familiar with insurance coverage by studying insurance policies, endorsements and forms. * Work towards the resolution of claims, possibly attending arbitrations, mediations, depositions or trials as necessary. * Ensure that claims payments are issued in a timely and accurate manner. Desired Skills & Experience * Bachelor's degree or equivalent experience * Minimum of 2 years claims handling experience or comparable experience * Field claims experience with multi-line property and casualty claims and wind/hail * Proficient with Xactimate software * Above-average communication skills (written and verbal) * Ability to resolve complex issues * Organize and interpret data * Ability to handle multiple assignments * Possess a valid driver's license * Military experience is considered Benefits Competitive salary, matching 401(k) retirement plans, fully funded pension plan, bonus programs, paid holidays, vacation days, personal days, paid sick leave and a comprehensive health care plan. 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-KC1 #LI-Hybrid
    $35k-43k yearly est. Auto-Apply 60d+ ago
  • Property Claim Representative

    IMT Insurance

    Claim processor job in Sioux Falls, SD

    WHO WE ARE IMT is proud of our heritage and will never forget where our roots are firmly planted. Locally run from its office in West Des Moines, Iowa, IMT has been a Midwest company since it was founded in Wadena, Iowa in 1884. That s over 140 years! Today, IMT continues to offer a strong line of personal and commercial insurance products for which it has always been known, along with exceptional service for a competitive price. Our products are offered through Independent Agents throughout a six-state territory Iowa, Illinois, Minnesota, Nebraska, South Dakota and Wisconsin. PROPERTY CLAIM REPRESENTATIVE IMT Insurance is now taking applications for the position of a Property Claim Representative in Sioux Falls, South Dakota area. This individual will conduct investigations and attempt settlement of claims submitted by policyholders for property losses. The ideal candidate will be an analytical, detailed worker, who can manage time and work on multiple projects while maintaining accuracy and service. IMT Property Claims Representatives investigate and evaluate claims involving personal and commercial property to determine proper policy coverages and apply best claims practices to ensure accurate settlements in accordance with company guidelines. If you're interested in joining our claims department, apply online today! A DAY IN THE LIFE Conduct interviews with insureds, claimants and other interested parties Conduct thorough investigations and examine insurance policies to determine coverage Inspect damages and prepare written estimates of repair or replacement Correspond with insureds, claimants and other interested parties Prepare and report findings and negotiate settlements DESIRED QUALIFICATIONS 0 - 3 years Property claims experience preferred Bachelor's Degree Excellent verbal and written communication skills Excellent problem-solving and negotiation skills Good keyboard/PC skills Excellent organizational and prioritization skills Ability to climb ladder to assess roof damage Ability to lift minimum 30 lbs Must maintain valid driver s license Able to travel/stay overnight for storm claim duty BENEFITS & PERKS IMT Insurance is committed to our employees and their families. When you work for IMT, you earn far more than just a paycheck. The IMT office was new in 2018 and offers a fitness room, game room and a variety of collaboration areas. This position includes learning and development opportunities and more! Below is a list of what IMT offers our employees: Medical, dental, and vision insurance, Life & A D & D insurance, 401K retirement savings accounts, spending accounts, long and short-term disability, profit share, paid vacation & sick time, employee assistant program and additional voluntary benefits. The salary range for this position is $53,000.00 - $99,000.00 Starting salary and level of position will depend on level of experience This position is not eligible for tips or commission but may be eligible for additional bonuses WHAT DEFINES US Our vision is to provide peace of mind in the moments that matter. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant based on race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state or local protected class. Our agents and customers come from all walks of life and so do we. Our goal is to hire great people from a wide variety of backgrounds, because it makes our team stronger. If you share our values and our passion for creating a Worry Free life for others, we want to talk to you!
    $32k-43k yearly est. 60d+ ago
  • Content Claims Specialist - Field - Level I

    Crawford & Company 4.7company rating

    Claim processor job in Sioux Falls, SD

    Start Your Journey in Claims - Join Us in South Dakota! Content Claims Specialist - Field (Level I) What We're Looking For: 6+ months of related experience Strong attention to detail and communication skills Ability to work independently and travel for field inspections
    $42k-51k yearly est. Auto-Apply 7d ago
  • Northland Liability Major Case Claim Specialist

    The Travelers Companies 4.4company rating

    Claim processor job in Saint Paul, MN

    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 $104,000.00 - $171,700.00 Target Openings 1 What Is the Opportunity? Under general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training and serves as an expert technical resource to other claim professionals, business partners, customers, and other stakeholders as appropriate or required. This position does not manage staff. What Will You Do? * Directly handle assigned severe claims. * Full damage value for average claim (without regard to coverage or liability defenses): $500,000 to several million dollars, amounting to a typical inventory of claims with FDV of over a multi-million dollar value. * Provide quality customer service and ensure file quality, timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case. * Work with Manager on use of Claim Coverage Counsel as needed. * Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. * Interview witnesses and stakeholders; take necessary statements, as strategically appropriate. * Complete outside investigation as needed per case specifics. * Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants nurse consultants, and fire or fraud investigators, and other experts. * Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. * Maintain claim files and document claim file activities in accordance with established procedures. * Develop and employ creative resolution strategies. * Responsible for prompt and proper disposition of all claims within delegated authority. * Negotiate disposition of claims with insureds and claimants or their legal representatives. * Recognize and implement alternate means of resolution. * Manages litigated claims. Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers. * Utilize evaluation documentation tools in accordance with department guidelines. * Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. * Utilize diary management system to ensure that all claims are handled timely. At required time intervals, evaluate liability and damages exposure. * Establish and maintain proper indemnity and expense reserves. * Provide guidance to underwriting business partners with respect to accuracy and adequacy of, and potential future changes to, loss reserves on assigned claims. * Recommend appropriate cases for discussion at roundtable. * Attend and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense. * Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others. * Apply the Company's claim quality management protocols, and metrics to all claims; document the rationale for any departure from applicable protocols and metrics with or without assistance. * Apply litigation management through the selection of counsel, evaluation. * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Bachelor's Degree. * 10+ years claim handling experience with 5-7 years experience handling serious injury and complex liability claims. * Extensive working level knowledge and skill in various business line products. * Excellent negotiation and customer service skills. * Advanced skills in coverage, liability and damages analysis with expert understanding of the litigation process in both state and federal courts, including relevant case and statutory law and procedure; expert litigation management skills. * Extensive claim and/or legal experience and thus the technical expertise to evaluate severe and complex claims. * Able to make independent decisions on most assigned cases without involvement of supervisor. * Openness to the ideas and expertise of others and actively solicits input and shares ideas. * Thorough understanding of commercial lines products, policy language, exclusions, ISO forms and effective claims handling practices. * Demonstrated strong coaching, influence and persuasion skills. * Advanced written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise. * Can adapt to and support cultural change. * Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information. * Analytical Thinking - Advanced. * Judgment/Decision Making - Advanced. * Communication - Advanced. * Negotiation - Advanced. * Insurance Contract Knowledge - Advanced. * Principles of Investigation - Advanced. * Value Determination - Advanced. * Settlement Techniques - Advanced. * Litigation Management - Advanced. * Medical Terminology and Procedural Knowledge - Advanced. What is a Must Have? * Four years bodily injury litigation claim handling experience or comparable claim litigation experience. 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 *********************************************************
    $46k-62k yearly est. 6d ago
  • Claims Specialist II - WC

    UFG Career

    Claim processor job in Cedar Rapids, IA

    UFG is currently hiring for a Claims Specialist II to work with our Workers Compensation team. This individual's primarily responsible for verifying applicable coverages, conducting timely and thorough research of the facts of a loss, analyzing compensability and evaluating benefits for reserve and settlement, and negotiating medium to occasional high complexity claims to resolution in accordance with claims best practices. The Claims Specialist II - Workers Compensation role demonstrates a strong desire to learn and grow, promotes a positive work environment, and embraces a strong service-oriented mindset in support of internal and external customers. This role requires strong communication skills, attention to detail, and the ability to handle multiple tasks efficiently and effectively. It also requires the ability to work independently with low to moderate levels of supervision. A strong desire to advance one's professional development is essential to this role. Essential Duties & Responsibilities: Review claim assignments to timely determine policy coverage, compensability of a claimed injury or illness and facilitation of medical, indemnity and other statutory workers' compensation benefits. If a coverage issue is relevant, review facts with a designated leader or mentor to determine a proper plan of action. Make prompt, meaningful contact with insureds and their employees to research facts by conducting interviews; securing, understanding and synthesizing information from relevant documents; identifying other relevant parties to a claim; and proactively supporting all parties with their commitment to outcomes. Establish rapport and an outcome focused relationship with insureds and their employees, as well as other internal and external stakeholders, through consistent on-going contact throughout the recovery process and claim resolution. Request and analyze medical records to determine compensability according to evidence-based causation by jurisdiction. Develop knowledge of how to conduct medical and legal research. Interact with medical providers to clearly define medical causation and establish treatment plans focused on recovery. Promptly and supportively inform insured and employees as well as other stakeholders of coverage and compensability decisions. Support stay-at-work or return-to-work opportunities for insureds and their employees. Propose and facilitate vocational support when appropriate by jurisdiction. Identify subrogation potential and document evidence in support of subrogation. Understand the subrogation mechanism and actively partner with internal and external subrogation partners to achieve outcomes with a goal to achieve global resolution. Identify potential Medicare eligibility and comply with all Medicare Secondary Payor requirements of law. Develop knowledge of Medicare settlement obligations. Assess and periodically re-assess the nature and severity of injury or illness. Design a plan of action focused on recovery and resolution in accordance with claims best practice guidelines by jurisdiction. Identify factors which could impact successful outcomes and collaborate with others on plans of action to mitigate impacts. Assess and periodically re-assess claim file reserves adequacy. This will be achieved through understanding medical diagnoses and care plan developments; thorough analysis of wage information and accurate calculations of indemnity benefits; and by securing and providing job descriptions specific to the employee to medical providers. Promptly identify factors of risk for increased loss and expense costs. Execute all technical claim handling functions such as documenting facts within the claims management system in a consistent, concise and clear manner; make timely decisions and promptly communicate decisions to stakeholders; process accurate benefit payments; and seek opportunities to mitigate claim handling expenses. Proactively seek resolution of claims by defining stakeholder outcome expectations early and often, managing processes focused on outcomes and engaging in direct negotiation, mediation, settlement conferences or hearings according to jurisdiction. Emphasis is placed on seeking opportunities to overcome resolution barriers. Comply with statute specific claims handling practices and reporting requirements. Inform underwriting of increased hazards or unusual circumstances concerning a risk/policy exposure. Participate in internal and external continuing education opportunities to maintain licensure and develop claim handling skills and abilities. Demonstrate a supportive attitude and presence within the team by adapting well to change in process or procedure. Share innovative ideas to improve work product and outcomes. Take initiative to identify and learn about areas of professional development. Proactively seek out opportunities to collaborate with peers. Demonstrate interest in one's own career development and interest in supporting peers with their development. Job Specifications: Education: High school diploma required. Post-Secondary education or Bachelor's degree preferred. Licensing/Certifications/Designations: Meet the appropriate state licensing requirements to handle claims. Within 1 year of hire, complete the Workers' Recovery Professional (WRP) certification program. Within 3 years of hire, complete the Workers' Compensation Law Associate (WCLA) certification program. Willingness to pursue other professional certifications or designations requested. Experience: 3+ years of general work experience. 5+ years of workers' compensation claims handling experience or a combination of workers' compensation claims handling experience and experience in a related field. Knowledge: General knowledge of insurance, medical and legal concepts is required with a high degree of ability to articulate knowledge verbally and in writing. Skills and Abilities: Service-Oriented Mindset Clear and Concise Communication Analytical and Critical Thinking Attitude of Collaboration and Curiosity Proactive Decision-making and Problem-solving Time management and Sense of Service Urgency Demonstrate mentorship within the team Actively demonstrate engagement in executing on claims initiatives Working Conditions: Working remote from home or general office environment. Occasionally the job requires working irregular hours. Infrequent overnight travel and weekend hours may be required. Pay Transparency Statement: UFG Insurance is committed to fair and equitable compensation practices. The base salary range for this position is $59,622 - $78,637 annually, which represents the typical range for new hires in this role. Individual pay within this range will be determined based on a variety of factors, including relevant experience, education, certifications, skills, internal equity, geography and market data. In addition to base salary, UFG Insurance offers a comprehensive total rewards package that includes: Annual incentive compensation Medical, dental, vision & life insurance Accident, critical Illness & short-term disability insurance Retirement plans with employer contributions Generous time-off program Programs designed to support the employee well-being and financial security. This pay range disclosure is provided in accordance with applicable state and local pay transparency laws. The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and skills required. Additional tasks and requirements may be assigned, as necessitated by business need. UFG retains the right to modify the description of this job at any time.
    $59.6k-78.6k yearly 60d ago
  • Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)

    Holmes Murphy 4.1company rating

    Claim processor job in Minnesota

    We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $61k-84k yearly est. Auto-Apply 24d ago
  • Complex Claims Specialist

    Lockton 4.5company rating

    Claim processor job in Minneapolis, MN

    Lockton is currently seeking a Clinical Claims Specialist within our Specialty Practice unit. The objective of this role is to improve and reduce the severity of complex and catastrophic claims, reduce the cost of risk while improving the health of our employer client's employee health plan. * Provide explanation of disease states and associated costs to internal and external stakeholders. * Provide cost-of-care estimates used in the risk assessment of stop loss underwriting. * Consult with and advise underwriting on medical/clinical care approaches, standards of care and research of data for new business and renewals. * Serve as a resource regarding medical necessity issues, standards of care and analysis for the reimbursement of submitted stop loss claims. * Review claims and clinical documents to identify and monitor opportunities to increase member quality of care and overall cost reduction. * Collaborate with various key stake holders to strategize clinical and cost savings strategies and assist on execution of plan. * Coordinate implementation of claims savings solutions with Lockton Client Service Teams, TPAs, and stop loss carriers including regular tracking to measure savings and plan performance. * Manage and organize task lists and open items and cases. * Attend team clinical rounds to discuss cases and strategy solutions.
    $41k-50k yearly est. 22d ago
  • Workers' Compensation Claims Specialist (Remote - MN, SD, WI, PA, IA)

    HMA Group Holdings 3.7company rating

    Claim processor job in Minnesota

    Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers' Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred. Essential Responsibilities: Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves Workers' Compensation claims. Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching coverage issues. Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. Generates checks for indemnity and medical payments daily. Develops and monitors consistency in procedural matters of the claims handling process with CRS. Compiles and interprets Workers' compensation reports on designated accounts, as requested. Ability to adjudicate lost time claims. Participates in claim reviews and attends Risk Control Workshops when requested by agency partners or insureds. These could be in person or by phone. Performs special projects and other duties as requested. Qualifications: Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Willingness and ability to obtain additional state specific licenses during duration of employment as needed. Experience: 2-4 years claims experience with strong background in Workers' Compensation coverage. Technical Competencies: Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Here's a little bit about us: At Creative Risk Solutions, you'll be part of a collaborative, innovative team that values trust, communication, and client focus. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth within the Holmes Murphy family. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! The salary range for this role is $45,800- $78,800. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development. Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $45.8k-78.8k yearly Auto-Apply 23d ago
  • Commercial Lines Claims Specialist

    AAA Mid-Atlantic

    Claim processor job in Lexington, MN

    * Top 100 Agency for 2025 * Best Agencies to Work for in 2024 by the Insurance Journal * Big "I" Best Practices Agency in 2023 * Annual bonus eligibility * No weekends required - great work/life balance * 3+ weeks of Paid Time Off * 8 Paid Company Holidays We are looking for someone who will * Manage the claims reporting process for agency clients. * Report claims to the appropriate carrier and maintain records in the agency management system by documenting claim actions in accordance with established procedures. * Follow up on claim to obtain the specific adjuster and claim number relevant to the reported loss. Notify appropriate parties when a claim is processed with carrier, providing accurate and timely claim information. * Continuously monitor claims until claims are closed by the insurance carrier. Report any potential issues with a claim to the client's Account Manager and Producer, escalating to management as needed. * Prepare reports by collecting and summarizing information as requested by management. Why Join AAA Club Alliance and the Energy Insurance team? * A base rate of $20.00 to $25.00/hour, depending on experience and geographic location. * Annual bonus potential Do you have what it takes? * Minimum of 2 years experience handling claims for Commercial Insurance - general liability, workers compensation, commercial auto, etc. * Strong communication skills (both verbal and written) and attention to detail * Strong time management skills * Ability to obtain property and casualty license within 60 days of hire Full time Associates are offered a comprehensive benefits package that includes: * Medical, Dental, and Vision plan options * Up to 2 weeks Paid parental leave * 401k plan with company match up to 7% * 2+ weeks of PTO within your first year * Paid company holidays * Company provided volunteer opportunities + 1 volunteer day per year * Free AAA Membership * Continual learning reimbursement up to $5,250 per year * And MORE! Check out our Benefits Page for more information ACA is an equal opportunity employer and complies with all applicable federal, state, and local employment practices laws. At ACA, we are committed to cultivating a welcoming and inclusive workplace of team members with diverse backgrounds and experiences to enable us to meet our goals and support our values while serving our Members and customers. We strive to attract and retain candidates with a passion for their work and we encourage all qualified individuals to apply. It is ACA's policy to employ the best qualified individuals available for all positions. Hiring decisions are based upon ACA's operating needs, and applicant qualifications including, but not limited to, experience, skills, ability, availability, cooperation, and job performance. Job Category: Insurance
    $20-25 hourly Auto-Apply 60d+ ago
  • 3A - Process Specialist - Claims

    Infosys 4.4company rating

    Claim processor job in Des Moines, IA

    Process Specialist Claims Examiner In the role of Process Specialist, you will serve as a subject matter expert for the claim team in answering team member questions regarding case specifics and assisting with complicated cases. You will respond to phone and email inquiries related to claims and follow up on any outstanding requirements within a specified timeframe. You will maintain detailed, compliant, and accurate documentation of all claim activity and collaborate with the team to update procedures and develop new procedures as appropriate. Responsibilities: Serve as an SME for claim team in answering team member questions regarding case specifics and assisting with complicated cases. Customer Service Experience - respond to phone and email inquiries related to claims. Follow up on any outstanding requirements within a specified timeframe. Maintain detailed, compliant, and accurate documentation of all claim activity. Collaborate with team to update procedures and develop new procedures as appropriate. Coordinate special projects as assigned. Training in new procedures. Perform quality reviews on claims/letters. Qualifications: Basic High School Diploma or GED Equivalent. Will also consider three years of progressive experience in the specialty in lieu of every year of education. 2 years' experience relevant to the job description Preferred Associate or bachelor's degree 3 years' experience analyzing life claims. Effective written and verbal communication skills Knowledge of the insurance industry or insurance products/procedures through a combination of experience and/or coursework Organizational and follow through skills. Sensitivity to service and quality Ability to work with confidential information. Your responsibilities include but may not be limited to Serve as a SME for claim team in answering team member questions regarding case specifics and assisting with complicated cases. Customer Service Experience - respond to phone and email inquiries related to claims. Follow up on any outstanding requirements within a specified timeframe. Maintain detailed, compliant, and accurate documentation of all claim activity. Collaborate with team to update procedures and develop new procedures as appropriate. Coordinate special projects as assigned. Training on new procedures. Perform quality reviews on claims/letters. Note: Applicants for employment in the U.S. must possess work authorization which does not require sponsorship by the employer for a visa (H1B or otherwise). The job entails sitting as well as working at a computer for extended periods of time. Should be able to communicate by telephone, email or face to face. About Us Infosys McCamish Systems,(*********************************** located in Atlanta, Georgia, is the Life Insurance and Retirement Services subsidiary of Infosys BPM Limited.(******************* Infosys McCamish was started in 1985 as a virtual insurance company and went to market as a commercial services provider in 1995.It has an outstanding business perspective and an exemplary track record that no other outsourcer of business solutions can claim - generating US$16 billion of recurring premium in less than five years as a virtual insurance company. Infosys McCamish has expert technology and outsourcing credentials, along with a proven business model for re-engineering systems and performing back-office services at a reduced cost, while reinforcing accuracy, speed and security. Seven of the top ten US insurers are among Infosys McCamish's many BPM clients. Infosys McCamish has its operations spread across Atlanta GA and Des Moines IA in USA. U.S. citizens and those authorized to work in the U.S. are encouraged to apply. We are unable to sponsor at this time. EOE/Minority/Female/Veteran/Disabled/Sexual Orientation/Gender Identity/Nationality Infosys is an equal opportunity employer, and all qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, spouse of protected veteran, or disability.
    $72k-87k yearly est. 60d+ ago
  • Claims Specialist

    Bell Bank 4.2company rating

    Claim processor job in Bloomington, MN

    The Claims Specialist position will manage the intake, review, processing, and oversight of multi-line insurance claims. This position provides consulting and advocacy on behalf of our clients throughout the process of a claim and the duration of the loss event. This position will play a vital role in our agency supporting fair and timely claims resolution for our clients. Responsibilities Serve as the primary liaison between the client and the insurance carrier during the claims process. Maintain clear, timely, and professional communication with all stakeholders (clients, carriers, internal teams, legal counsel). Document all claim activity, communications, and outcomes accurately in the agency's management system. Adhere to all regulatory, ethical, and internal best practice standards. Protect operations by keeping claims information confidential. Receive initial claim information from clients and ensure timely and accurate reporting to the appropriate insurance carrier. Input new claim data into the claims system, verify information, and maintain high data integrity. Manage correspondence, create claim files, process documentation, and assist the rest of the team with requests as needed. Prepare loss runs requests, basic claim status reports, and assist with reporting requirements. Field general client or carrier inquiries and route complex coverage or resolution issues to experienced colleagues. Participate in training and mentorship opportunities to develop foundational insurance knowledge, including policy language and industry standards. Bell Bank Culture, Policy and Accountability Standards: Know by name and face as many customers and employees as possible, calling them by name as often as possible. Know and practice LOCBUTN, our Golden Rules, and Bell Bank Customer Service Standards. Know, understand, and live the company values and bottom line. Conduct activities consistent with established Bell Bank policies, procedures and systems, the Bell Bank Employee Conduct policies, the Bank Secrecy Act and all applicable state and federal laws and regulations. All employees are responsible for information security, including compliance with policies and standards which protect sensitive information. Prompt and reliable attendance. Perform other duties as assigned. Education, Experience, and Other Expectations Bachelor's degree in business administration or related field. 1-2 years of experience handling multi-line claims. Associate in Claims (AIC) or other related designations is an advantage. Skills and Knowledge Extensive knowledge of insurance-related policies and legislation. Proficient in analytical math. Excellent conflict resolution and organization skills. Strong written and oral communication skills. Accuracy in claim processing and documentation. A growth mindset and ability to work independently but as part of a team environment.
    $28k-37k yearly est. 20h ago
  • Claims Specialist I

    VTI Architectural Products Inc.

    Claim processor job in Holstein, IA

    Job Description Essential Job Functions: Receive, investigate, and maintain reports on production claims and warranty issues for an assigned region of the country with minimal assistance from team lead and manager. Provides Technical Assistance to CSC, Manufacturing, Customers, Sales Representatives and Architects Assist in resolving issues by working through internal processes Resolves claim issues by determining which party is responsible for the claim Coordinates field-fix, credit, or replacement resolution Coordinates the field repair between the repair person and customer Ensures that information and supplies needed for the repair are sent and payment is coordinated Processes warranty claim replacements and involves the sales representative Able to utilize negotiating skills in resolving claim issues Follows up on unresolved claims Maintains excellent communication with production, customer service and the customer Provides customer support by providing LEED documentation, product information, and technical information Has basic knowledge of VT product offering, construction, labeling, and hardware restrictions Provides website support by directing internal and external customer to the location of technical information Sends customers product update information Provides CDN accounting support by processing payment or credit Types letters and other correspondence as required Supports 5S/lean program keeping work area organized Available to work 8 to 10 hours as required, 5 days per week Always observes all safety policies and procedures Participates in team meetings Works individually or with team members as assigned, maintaining a positive work environment Other duties as assigned by supervisor Position Requirements Qualifications: Eager and willing to gain knowledge of door products and processes. Excellent written and verbal communication skills Able to apply common sense understanding to carry out instructions in written, oral, or diagram form Customer service and math skills Self-motivated and able to achieve a high level of performance without immediate supervision Verbally articulate and has excellent written communication skills Be familiar with Excel, Word, PowerPoint, and other computer systems Able to work quickly and multi-task while adhering to tight deadlines for multiple projects Compliant with VT employment policy requirements All team members are expected to follow the Code of Conduct to the highest standards as well as to adhere to the Attendance Policy of VT Industries. Physical Requirements Tolerance for sitting long periods of time. Possess finger dexterity to write, type, and use a calculator. Maintain adequate vision to view small print and computer terminal. Ability to speak and hear, walk throughout facilities with occasional light lifting (25 pounds), stooping, kneeling, crouching, and reaching with hands and arms required. Ability to travel between multiple facilities as required to perform core job duties. The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    $25k-40k yearly est. 17d ago
  • Michigan Homeowners Claim Representative II

    The Auto Club Group 4.2company rating

    Claim processor job in Omaha, NE

    Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager IWhat you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss. Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Employees assigned to the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update. Supervisory Responsibilities: None How you will benefit: A competitive annual salary between $64,000 - $72,000 ACG offers excellent and comprehensive benefits packages, including: Medical, dental and vision benefits 401k Match Paid parental leave and adoption assistance Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays Paid volunteer day annually Tuition assistance program, professional certification reimbursement program and other professional development opportunities AAA Membership Discounts, perks, and rewards and much more We're looking for candidates who:Required Qualifications (these are the minimum requirements to qualify) Education: Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members. Experience: One year of experience or equivalent training in the following: Negotiating claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advance knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Knowledge of building construction and repair techniques Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG Claim policies, procedures and guidelines Work within assigned ACG Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Research, analyze, and interpret subrogation laws in various states Strong negotiating skills Ability to work outside normal business hours as needed Preferred Qualifications: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Xactimate software experience/training or experience in an equivalent software Claims adjuster experience specifically in home/property claims preferred Experience working within a customer service setting Call center experience or experience handling high volume calls preferred, but not required Excellent communication skills both oral and written Experience working within an insurance or claims-based role for one year or more Full claims cycle experience preferred Work Environment This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
    $64k-72k yearly 2d ago
  • Northland Liability Major Case Claim Specialist

    Travelers Insurance Company 4.4company rating

    Claim processor job in Saint Paul, MN

    **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** $104,000.00 - $171,700.00 **Target Openings** 1 **What Is the Opportunity?** Under general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training and serves as an expert technical resource to other claim professionals, business partners, customers, and other stakeholders as appropriate or required. This position does not manage staff. **What Will You Do?** + Directly handle assigned severe claims. + Full damage value for average claim (without regard to coverage or liability defenses): $500,000 to several million dollars, amounting to a typical inventory of claims with FDV of over a multi-million dollar value. + Provide quality customer service and ensure file quality, timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case. + Work with Manager on use of Claim Coverage Counsel as needed. + Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. + Interview witnesses and stakeholders; take necessary statements, as strategically appropriate. + Complete outside investigation as needed per case specifics. + Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants nurse consultants, and fire or fraud investigators, and other experts. + Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. + Maintain claim files and document claim file activities in accordance with established procedures. + Develop and employ creative resolution strategies. + Responsible for prompt and proper disposition of all claims within delegated authority. + Negotiate disposition of claims with insureds and claimants or their legal representatives. + Recognize and implement alternate means of resolution. + Manages litigated claims. Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers. + Utilize evaluation documentation tools in accordance with department guidelines. + Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. + Utilize diary management system to ensure that all claims are handled timely. At required time intervals, evaluate liability and damages exposure. + Establish and maintain proper indemnity and expense reserves. + Provide guidance to underwriting business partners with respect to accuracy and adequacy of, and potential future changes to, loss reserves on assigned claims. + Recommend appropriate cases for discussion at roundtable. + Attend and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense. + Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others. + Apply the Company's claim quality management protocols, and metrics to all claims; document the rationale for any departure from applicable protocols and metrics with or without assistance. + Apply litigation management through the selection of counsel, evaluation. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + 10+ years claim handling experience with 5-7 years experience handling serious injury and complex liability claims. + Extensive working level knowledge and skill in various business line products. + Excellent negotiation and customer service skills. + Advanced skills in coverage, liability and damages analysis with expert understanding of the litigation process in both state and federal courts, including relevant case and statutory law and procedure; expert litigation management skills. + Extensive claim and/or legal experience and thus the technical expertise to evaluate severe and complex claims. + Able to make independent decisions on most assigned cases without involvement of supervisor. + Openness to the ideas and expertise of others and actively solicits input and shares ideas. + Thorough understanding of commercial lines products, policy language, exclusions, ISO forms and effective claims handling practices. + Demonstrated strong coaching, influence and persuasion skills. + Advanced written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise. + Can adapt to and support cultural change. + Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information. + Analytical Thinking - Advanced. + Judgment/Decision Making - Advanced. + Communication - Advanced. + Negotiation - Advanced. + Insurance Contract Knowledge - Advanced. + Principles of Investigation - Advanced. + Value Determination - Advanced. + Settlement Techniques - Advanced. + Litigation Management - Advanced. + Medical Terminology and Procedural Knowledge - Advanced. **What is a Must Have?** + Four years bodily injury litigation claim handling experience or comparable claim litigation experience. **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 ******************************************************** .
    $46k-62k yearly est. 6d ago
  • Workers' Compensation Claims Specialist (MS, LA, TX)

    Holmes Murphy 4.1company rating

    Claim processor job in West Des Moines, IA

    We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $51k-72k yearly est. Auto-Apply 25d ago
  • Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)

    HMA Group Holdings 3.7company rating

    Claim processor job in Iowa

    We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $30k-50k yearly est. Auto-Apply 24d ago
  • Michigan Homeowners Claim Representative II

    The Auto Club Group 4.2company rating

    Claim processor job in Iowa City, IA

    Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager IWhat you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss. Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Employees assigned to the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update. Supervisory Responsibilities: None How you will benefit: A competitive annual salary between $64,000 - $72,000 ACG offers excellent and comprehensive benefits packages, including: Medical, dental and vision benefits 401k Match Paid parental leave and adoption assistance Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays Paid volunteer day annually Tuition assistance program, professional certification reimbursement program and other professional development opportunities AAA Membership Discounts, perks, and rewards and much more We're looking for candidates who:Required Qualifications (these are the minimum requirements to qualify) Education: Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members. Experience: One year of experience or equivalent training in the following: Negotiating claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advance knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Knowledge of building construction and repair techniques Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG Claim policies, procedures and guidelines Work within assigned ACG Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Research, analyze, and interpret subrogation laws in various states Strong negotiating skills Ability to work outside normal business hours as needed Preferred Qualifications: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Xactimate software experience/training or experience in an equivalent software Claims adjuster experience specifically in home/property claims preferred Experience working within a customer service setting Call center experience or experience handling high volume calls preferred, but not required Excellent communication skills both oral and written Experience working within an insurance or claims-based role for one year or more Full claims cycle experience preferred Work Environment This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
    $64k-72k yearly 2d ago

Learn more about claim processor jobs

How much does a claim processor earn in Sioux Falls, SD?

The average claim processor in Sioux Falls, SD earns between $23,000 and $54,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Sioux Falls, SD

$36,000
Job type you want
Full Time
Part Time
Internship
Temporary