Claim specialist jobs in Maine - 25 jobs

Responsibilities & Duties:Claims Processing and Assessment: * Evaluate incoming claims to determine eligibility, coverage, and validity. * Conduct thorough investigations, including reviewing medical records and other relevant documentation. * Analyze policy provisions and contractual agreements to assess claim validity. * Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: * Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. * Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. * Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: * Ensure compliance with company policies, procedures, and regulatory requirements. * Maintain accurate records and documentation related to claims activities. * Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: * Identify opportunities for process improvement and efficiency within the claims department. * Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. * Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: * Generate reports and provide data analysis on claims trends, processing times, and outcomes. * Contribute to the development of management reports and presentations regarding claims operations.

At OneAmerica, we deliver on promises when customers need us most. We believe the best way to serve our customers is to know that every individual, employee, family and business we work with has unique personal and financial goals. We keep our promises, so we can help them achieve their goals and realize their definition of financial success. Job Summary The STD Claims Examiner is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our client companies and the Claims department. This individual will be responsible for managing appropriate adjudication of short-term disability claims in accordance with policy provisions. The STD Claims Examiner will initiate and facilitate case management as well as other ancillary services to assure optimum outcomes. We are currently seeking Level I & II Representative experience. KEY RESPONSIBILITIES: * Promote a positive customer service image through prompt, accurate and courteous responses to customer information needs * Consistently adhere to the documented workflow guidelines and established procedures. * Maintain required levels of confidentiality * Demonstrate competency in all modules of training program. Remain abreast of industry standards via internal/external continuing education * Promptly and thoroughly investigate and evaluate claims within departmental and regulatory guidelines * Interpret and administer contract provisions including, but not limited to, eligibility, covered weekly earnings, definition of Total Disability, verification of applicable offsets and pre-existing investigations * Calculate benefit and identify other income replacement benefits. Processes financial activities, including, but not limited to, payment adjustments, stop payments, voids and check reissues, other income adjustments, reimbursement checks, and final benefits. Processes overpayments in accordance with established procedures * Assist in the subrogation process to recover money from third parties * Work in coordination with an LTD Examiner to ensure an appropriate transition from the STD claim to LTD * Document claim file actions and telephone conversations appropriately * Refer claim activity outside authority level to Supervisor/Manager for review * Proactively communicate with claimants, policyholders and physicians to resolve investigations issues * Establish, communicate and manage claimant and policyholder expectations * Utilize most efficient means to obtain claim information * Fully investigates all relevant claim issues, provides payment or denials promptly and in full compliance with departmental procedures and Unfair Claims Practice regulations * Respond to customer service issues within required timeframes * Involve technical resources (Social Security Specialist, medical resources and vocational resources) at appropriate claim junctures * Support relationships with technical resources to achieve appropriate outcomes * Meet or exceed departmental service, quality and production objectives * Collaborate with team members and management in identifying and implementing improvement opportunities. Informs Supervisor of any trends noted within specific client companies * All other duties as assigned REQUIREMENTS: * BA/BS or equivalent combination of education and experience * 0-2+ years of experience in managing Short Term Disability claims with first pay authority * Ability to fluently speak and write Spanish a plus * Excellent customer service skills * Excellent math and calculation skills * Good decision-making skills * Ability to analyze complex claim information * Working knowledge of Microsoft Excel and Word * High School Diploma required, or any combination of education and experience which would provide an equivalent background. Salary Band: 3C #LI-SC1 This selected candidate will be expected to work hybrid in Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: * Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim * The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions * Maintain claim block and meet departmental production and quality metrics * An awareness of industry claim practices * Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records * Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. * Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process * Establish cooperative and productive relationships with professional resources What you will bring with you: * Bachelor's degree preferred * A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing * Demonstrated ability to work as part of a cohesive team * Strong written and verbal communication skills * Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in negotiation, persuasion, and solutions-based underwriting * Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism * Overall knowledge of health care industry * Proficiency using the Microsoft Office suite of products * Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAs a Product Liability Litigation Adjuster, Risk Management, you will be responsible for managing lawsuits and overseeing outside counsel defending CVS in high exposure, product liability mass tort litigations and general liability cases filed throughout the United States. Responsibilities include:Developing relationships with internal colleagues for fact-finding and key litigation activities. Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. Managing all aspects of product liability mass tort litigations and complex general liability cases. Working with outside national counsel and sr. management to develop consistent litigation strategies applicable to mass tort cases filed across the country. Providing reporting to key internal stake holders on case developments and litigation trends for product liability mass torts and other cases. Managing large scale discovery investigations by working with internal custodians, outside counsel and vendors to develop comprehensive procedures for identifying, locating, preserving and producing corporate records. Analyzing case and internal materials and utilizing resources across CVS to discern key issues and identify the litigation strategy in every case assigned. Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working with and overseeing outside counsel. Participating in meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. Required Qualifications2+ years of legal experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. Juris Doctor degree from an ABA accredited university. Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. Preferred QualificationsExperience overseeing or defending product liability claims and litigation. Familiarity or experience with insurance and coverage issues related to litigated claims. Strong attention to detail and project management skills. Experience overseeing and answering written discovery. Ability to work independently and in an environment requiring teamwork and collaboration. Strong written and verbal communication skills. Demonstrated negotiation skills and ability. Ability to articulate and summarize cases with management in a concise, cogent manner. Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. 3-5 years of legal or claims experience. Familiarity with the rules and procedures applicable to mass tort litigations, class actions, and/or multidistrict litigations. Knowledge and experience navigating attorney-client privilege issues, corporate litigation holds, corporate witness depositions, and e-discovery. Ability to influence and work collaboratively with senior leaders, CVS' in-house legal counsel and outside counsel. Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new software programs and systems. Ability to positively and aggressively represent the company at mediation, arbitration and trial. Ability to navigate difficult situations and communicate effectively with both internal and external groups. Excellent organizational and time management skills and ability to handle a high volume of litigated claims. Experience with and understanding of legal documents (pleadings, discovery, motions and briefs). EducationVerifiable Juris Doctor degree Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/03/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more. Position Summary Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days. Applicants must be currently authorized to work in the United States on a full-time basis. Principle Duties and Responsibilities: Claims Management * Manage caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations. * Monitor and ensure timely execution of all statutory deadlines or legal filings as needed. * Analyze facts of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines. * Identify fraud indicators and actively pursue subrogation opportunities. * Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks. * Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers. Financial Impact Administration * Manage book of claims business (up to $ 2million) with authority to settle/negotiate a single claim within their authority of up to $25,000. * Communicate ongoing causes of incidents to Safety and Brands. * Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications. Basic Qualifications: * Licensed adjuster (as appropriate by jurisdiction) * Bachelor's degree or experience handling General Liability claims or equivalent expertise. * Thorough knowledge of rules, regulations, statutes, and procedures pertaining to general liability claims. * Knowledge of medical terminology involved in complex claims * Negotiates resolution of claims of various exposure and complexity Skills and Abilities: * Demonstrates relationship building and communication skills, both written and verbal. * Highly self-motivated, goal oriented, and works well under pressure. * Customer focused solid understanding of legal procedures, processes, practices and standards in the handling of general liability claims * Ability to identify problems and effectuate solutions * Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail * Able to apply critical thinking when solving problems and making decisions. ME/NC/PA/SC Salary Range: $63,440-$95,160 IL/MA/MD/NY Salary Range: $72,880 - $109,320 Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws. #LI-SM1 #LI-Hybrid At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent. Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies. Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work. We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.

This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements. **ESSENTIAL RESPONSIBILITIES** + Coordinate, analyze, and interpret the benefits and claims processes for the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties. + Investigate benefit/claim information and provide technical guidance to clinical and claims staff regarding the final adjudication of complex claims. Research and investigate conflicting benefit structures in multi-payor situations. + Provide prompt, thorough and courteous replies to written, electronic and telephonic inquiries from internal/external customers (e.g., clinical, sales/marketing, providers, vendors, etc.) Follow-up on all inquiries in accordance with corporate and regulatory standards and timeframes. + Must have the ability to apply knowledge about the business operations of the area within the defined scope of the job. Assess benefit limitations in accordance with Medical Policy Guidelines. + Monitor and identify claim processing inaccuracies. Bring trends to the attention of management. + Assist with handling inbound calls and strive to resolve customer concerns received via telephone or written communication. + Work independently of support, frequently utilizing resources to resolve customer inquiries. + Collaborate with Clinical Strategy, Sales/Client Management and other areas across the enterprise to respond to client questions and concerns about care/case management and high-cost claimants. + Gather information and develop presentation/training materials for support and education. + Other duties as assigned or requested. **EDUCATION** **Required** + High School or GED **Substitutions** + None **Preferred** + Associate's degree in or equivalent training in Business or a related field **EXPERIENCE** **Required** + 3 years of customer service, health insurance benefits and claims experience. + Working knowledge of Highmark products, systems (e.g., customer service and clinical platforms, knowledge resources, etc.), operations and medical policies + PC Proficiency including Microsoft Office Products + Ability to communicate effectively in both verbal and written form with all levels of employees **Preferred** + Working knowledge of medical procedures and terminology. + Complex claim workflow analysis and adjudication. + ICD9, CPT, HPCPS coding knowledge/experience. + Knowledge of Medicare and Medicaid policies **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services + Knowledge of administrative and clerical procedures and systems such as managing files and records, designing forms and other office procedures + The ability to take direction, to navigate through multiple systems simultaneously + The ability to interact well with peers, supervisors and customers + Understanding the implications of new information for both current and future problem-solving and decision-making + Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate and not interrupting at inappropriate times + Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems + Ability to solve complex issues on multiple levels. + Ability to solve problems independently and creatively. + Ability to handle many tasks simultaneously and respond to customers and their issues promptly. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $21.53 **Pay Range Maximum:** $32.30 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273827

Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.

At OneAmerica, we deliver on promises when customers need us most. We believe the best way to serve our customers is to know that every individual, employee, family and business we work with has unique personal and financial goals. We keep our promises, so we can help them achieve their goals and realize their definition of financial success. Job Summary The STD Claims Examiner is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our client companies and the Claims department. This individual will be responsible for managing appropriate adjudication of short-term disability claims in accordance with policy provisions. The STD Claims Examiner will initiate and facilitate case management as well as other ancillary services to assure optimum outcomes. We are currently seeking Level I & II Representative experience. KEY RESPONSIBILITIES: Promote a positive customer service image through prompt, accurate and courteous responses to customer information needs Consistently adhere to the documented workflow guidelines and established procedures. Maintain required levels of confidentiality Demonstrate competency in all modules of training program. Remain abreast of industry standards via internal/external continuing education Promptly and thoroughly investigate and evaluate claims within departmental and regulatory guidelines Interpret and administer contract provisions including, but not limited to, eligibility, covered weekly earnings, definition of Total Disability, verification of applicable offsets and pre-existing investigations Calculate benefit and identify other income replacement benefits. Processes financial activities, including, but not limited to, payment adjustments, stop payments, voids and check reissues, other income adjustments, reimbursement checks, and final benefits. Processes overpayments in accordance with established procedures Assist in the subrogation process to recover money from third parties Work in coordination with an LTD Examiner to ensure an appropriate transition from the STD claim to LTD Document claim file actions and telephone conversations appropriately Refer claim activity outside authority level to Supervisor/Manager for review Proactively communicate with claimants, policyholders and physicians to resolve investigations issues Establish, communicate and manage claimant and policyholder expectations Utilize most efficient means to obtain claim information Fully investigates all relevant claim issues, provides payment or denials promptly and in full compliance with departmental procedures and Unfair Claims Practice regulations Respond to customer service issues within required timeframes Involve technical resources (Social Security Specialist, medical resources and vocational resources) at appropriate claim junctures Support relationships with technical resources to achieve appropriate outcomes Meet or exceed departmental service, quality and production objectives Collaborate with team members and management in identifying and implementing improvement opportunities. Informs Supervisor of any trends noted within specific client companies All other duties as assigned REQUIREMENTS: BA/BS or equivalent combination of education and experience 0-2+ years of experience in managing Short Term Disability claims with first pay authority Ability to fluently speak and write Spanish a plus Excellent customer service skills Excellent math and calculation skills Good decision-making skills Ability to analyze complex claim information Working knowledge of Microsoft Excel and Word High School Diploma required, or any combination of education and experience which would provide an equivalent background. Salary Band: 3C #LI-SC1 This selected candidate will be expected to work hybrid in Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.

Job Description At OneAmerica, we deliver on promises when customers need us most. We believe the best way to serve our customers is to know that every individual, employee, family and business we work with has unique personal and financial goals. We keep our promises, so we can help them achieve their goals and realize their definition of financial success. Job Summary The STD Claims Examiner is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our client companies and the Claims department. This individual will be responsible for managing appropriate adjudication of short-term disability claims in accordance with policy provisions. The STD Claims Examiner will initiate and facilitate case management as well as other ancillary services to assure optimum outcomes. We are currently seeking Level I & II Representative experience. KEY RESPONSIBILITIES: Promote a positive customer service image through prompt, accurate and courteous responses to customer information needs Consistently adhere to the documented workflow guidelines and established procedures. Maintain required levels of confidentiality Demonstrate competency in all modules of training program. Remain abreast of industry standards via internal/external continuing education Promptly and thoroughly investigate and evaluate claims within departmental and regulatory guidelines Interpret and administer contract provisions including, but not limited to, eligibility, covered weekly earnings, definition of Total Disability, verification of applicable offsets and pre-existing investigations Calculate benefit and identify other income replacement benefits. Processes financial activities, including, but not limited to, payment adjustments, stop payments, voids and check reissues, other income adjustments, reimbursement checks, and final benefits. Processes overpayments in accordance with established procedures Assist in the subrogation process to recover money from third parties Work in coordination with an LTD Examiner to ensure an appropriate transition from the STD claim to LTD Document claim file actions and telephone conversations appropriately Refer claim activity outside authority level to Supervisor/Manager for review Proactively communicate with claimants, policyholders and physicians to resolve investigations issues Establish, communicate and manage claimant and policyholder expectations Utilize most efficient means to obtain claim information Fully investigates all relevant claim issues, provides payment or denials promptly and in full compliance with departmental procedures and Unfair Claims Practice regulations Respond to customer service issues within required timeframes Involve technical resources (Social Security Specialist, medical resources and vocational resources) at appropriate claim junctures Support relationships with technical resources to achieve appropriate outcomes Meet or exceed departmental service, quality and production objectives Collaborate with team members and management in identifying and implementing improvement opportunities. Informs Supervisor of any trends noted within specific client companies All other duties as assigned REQUIREMENTS: BA/BS or equivalent combination of education and experience 0-2+ years of experience in managing Short Term Disability claims with first pay authority Ability to fluently speak and write Spanish a plus Excellent customer service skills Excellent math and calculation skills Good decision-making skills Ability to analyze complex claim information Working knowledge of Microsoft Excel and Word High School Diploma required, or any combination of education and experience which would provide an equivalent background. Salary Band: 3C #LI-SC1 This selected candidate will be expected to work hybrid in Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

Job Description Our role as a Field Claims Representative will be responsible for the investigation, evaluation and settlement of assigned claims involving 1st Party Homeowner and Commercial Property claims. This role is a field-based position and will require travel to loss sites to evaluate the damages. This also includes special investigation activities with an emphasis on investigating possible fraudulent activity. This is a field based position, travel will be required within Southern Maine, with occasional travel to other areas as required. Responsibilities Field appraise losses of all types for both personal lines and commercial lines claims Take loss reports directly from insureds and/or claimants and/or their representatives. Appropriately handle incoming correspondence on assigned claim files. Investigate assigned claims - confirm coverage - verify damages. Effectively handle portions of claim investigations principally through on-site investigations, as warranted. Evaluate and settle assigned claims based upon the results of the investigation. A strong ability to work independently. Other related duties as assigned by supervisor including but not limited to aiding during CATs or other unusual spikes in claim volume. Requirements Bachelor's degree preferred or several years of direct experience 5-7 years of experience handling Property Claims; Commercial Lines experience a plus. Strong understanding of personal and commercial lines policy forms and coverage analysis. Multi-line adjuster's license as required in our operating territories. Demonstrated proficiency in writing detailed structural cost of repair/replacement estimates in Xactimate estimating system and proficient in PC Windows environment. Demonstrated proficiency in investigating, evaluating and settling contents claims. Excellent understanding and skill level of claim handling and customer service. Possess or has ability to timely secure and maintain required multiline adjuster licenses. Knowledge of policy contracts, insurance laws, regulations, and the legal environment in which we operate. Outside/Field Adjusters - ability to view damages and prepare estimates based on their inspection of the damaged property. Benefits At The Concord Group, we're proud to offer a comprehensive benefits package designed to support the wellbeing of our associates. This includes medical, vision, dental, life insurance, disability insurance, and a generous paid time off program for vacation, personal, sick time, and holiday pay. Additional benefits include parental leave, adoption assistance, fertility treatment assistance, a competitive 401(k) plan with company match, gym member/fitness class reimbursement, and additional resources and programs that encourage professional growth and overall wellness. Why Concord Group Insurance Since 1928, The Concord Group has been protecting families and small businesses across New England with trusted, personal insurance solutions. The Concord Group is a member of The Auto Owners Group of Companies and is recognized as a leading insurance provider through the independent agency system. Rated A+ (Superior) by AM Best, the company is represented by more than 550 of the best local independent agents throughout Maine, Massachusetts, New Hampshire, and Vermont. At Concord Group, we believe in more than just insurance, we believe in our people. Our associates thrive in a supportive, collaborative workplace where community involvement, professional growth, and shared values drives everything we do. Starting your career with The Concord Group means joining a team that values people first and gives you the opportunity to grow, give back, and make a lasting difference in the lives of those we serve. Compensation We are dedicated to fair and competitive total compensation package that supports the wellbeing and success of our associates. In addition to this, we offer other components like bonus opportunities. Equal Employment Opportunity The Concord Group is an equal opportunity employer and hires, transfers, and promotes based on 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. The Concord Group participates in E-Verify

Department Insurance & Financial Services Employment Type Full Time Location Maine Workplace type Hybrid Compensation $90,000 - $170,000 / year Key Responsibilities Skills, Knowledge and Expertise Benefits About The Misch Group Stone Hendricks Group is a direct-hire search firm that brings together years of experience and a diverse range of talent to connect businesses with exceptional job candidates. With a focus on timely and effective recruitment, we understand the power of a well-formed employee base in helping businesses achieve their goals. We offer our services to businesses of all sizes, providing qualified candidates for blue- and grey-collar roles, as well as white-collar and executive positions. The success of our direct-hire search process is driven by our advanced training, proprietary technology, and extensive network across industries. At Stone Hendricks Group, we value integrity and prioritize connectedness, commitment, and candor in our interactions with both employers and job seekers. Our clients consider us trusted advisors, relying on the highly personalized service we provide and our ability to find candidates that are an ideal fit for their unique needs. Choose Stone Hendricks Group for unsurpassed direct-hire search services that match successful organizations with talented job candidates.

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: + Award-winning culture + Inclusion and diversity as a priority + Performance Based Incentive Plans + Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% 401(k) employer contribution + Mental health support + Career advancement opportunities + Student loan repayment options + Tuition reimbursement + Flexible work environments **_*All the benefits listed above are subject to the terms of their individual Plans_** **.** And that's just the beginning... With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! **General Summary:** Summary Minimum starting hourly rate is $22.12- $24.04 Training start date: Jan 2026 We are looking for candidates to fill various roles related to managing leave requests and disability claims. When you apply, you'll be considered for positions such as Integrated Paid Leave Specialist, STD Benefits Specialist Trainee, Associate Leave Specialist, Eligibility Specialist and Associate Life Event Specialist. Your placement will depend on your qualifications and role availability. These positions help ensure that our company complies with leave laws and policies while providing top-notch service to our customers. Each of these roles comes with a comprehensive training program, ensuring you gain all the knowledge and expertise needed. These roles are perfect for those who have strong analytical skills, like to learn, and want to help the working world thrive. Join us to make a meaningful impact and grow your career. This is a main campus based position, applicants will work in the Chattanooga, TN or Portland, ME office 3-5 days a week in office required. **Principal Duties and Responsibilities** + Handle leave, short-term disability (STD), or paid leave claims efficiently and accurately. + Determine if employees are eligible for different types of leave, such as FMLA, PFML, and corporate-paid plans. + Have an advanced understanding of compliance and regulations and use this to make fair decisions about eligibility and benefits. + Create necessary communications to comply with federal, state, and company leave policies. + Review medical certifications and other documents, consulting with internal teams as needed. + Stay updated on changes in leave laws and industry practices. + Maintain good relationships with employer contacts, HR administrators, and employees. + Answer questions and resolve issues for employees and employers promptly. + Work with other departments to ensure smooth operations. + Meet standards for accuracy, quality, and service in managing claims and leaves. + Provide excellent customer service by processing claims promptly and addressing inquiries quickly. **Job Specifications** + A 4-year degree or relevant experience is preferred. + Experience in medical, disability claims, or leave management is a plus. + Strong decision-making, analytical, and problem-solving abilities. + Ability to use independent judgment and think critically in making decisions. + Excellent interpersonal and communication skills (phone, email, and written). + Proficiency with Windows and basic computer skills (Word, Excel, Access). + Detail-oriented with strong organizational skills. + Ability to perform in a fast-paced environment while managing multiple tasks and priorities + Ability to make fair decisions quickly and efficiently. + Self-motivated and able to work independently and as part of a team. ~IN2 \#LI-JH1 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $36,000.00-$62,400.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Representative (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.

Department: Loan Servicing Reports to: Commercial Loan Servicing Manager FLSA: Non-Exempt Last Modified: 12.10.25 The Insurance and Escrow Specialist is responsible for administering all insurance and escrow functions across the commercial and retail loan portfolios. This includes monitoring and managing property, flood, hazard, private mortgage, and life/disability insurance; conducting escrow analyses; administering escrow tax and insurance disbursements; and coordinating lender-placed insurance. The role ensures timely and accurate servicing while maintaining compliance with federal and state regulations, agency and investor requirements, and internal bank policies. The position works closely with borrowers, insurance agents, vendors, and internal partners - including Compliance - to mitigate risk and support a high-quality customer experience. Essential Functions: Insurance Administration Monitor and manage property, hazard, flood and life/disability insurance coverage for commercial and retail loan portfolios. Ensure required insurance coverage remains current and meets bank, regulatory, and investor/insurer guidelines (FHA, FNMA, FHLMC, GNMA, VA, USDA, FHLB). Track private mortgage insurance (PMI) requirements, terminations, renewals, and annual reviews in accordance with investor and regulatory rules. Review insurance documentation for accuracy, sufficiency, and compliance; follow up with borrowers and agents on deficiencies. Administer lender-placed insurance including monitoring notices, coordinating placement/cancellations, posting premiums, and maintaining accurate records. Complete monthly premium payments for life/disability insurance, file claims as necessary. Escrow Administration Set up, maintain, and monitor escrow accounts for both commercial and retail loans. Process escrow disbursements for taxes and insurance, ensuring timely, accurate payments. Conduct annual escrow analysis in accordance with RESPA and internal policy. Resolve escrow shortages, overages, and deficiencies; communicate escrow changes to borrowers. Process customer requests to cancel escrow accounts ensuring compliance with required notification timelines. Customer, Vendor, and Internal Coordination Serve as the primary point of contact for insurance agents, carriers, escrow vendors, and force-placed insurance providers. Provide courteous and professional service to borrowers, loan officers, internal departments, auditors, and investors. Coordinate with the Compliance Officer on insurance-related regulations (flood, PMI, RESPA escrow standards) and assist with audits, exams, and reporting needs. Prepare transfers, GL entries, and reconciliations for escrow and insurance transactions. Compliance and Reporting Maintain accurate, records and documentation. Prepare routine and ad-hoc reports for management, Compliance, and Risk. Participate in audits and exams related to insurance and escrow. Stay current with federal/state regulations, including Flood Disaster Protection Act, RESPA, PMI requirements, and applicable investor servicing guidelines. Assist with testing, vendor updates, and system enhancements related to escrow or insurance modules. Other Responsibilities: Participate in department training, meetings, and cross-functional projects. Provide support during year-end processes and regulatory change implementations. Perform other duties as assigned. Skills, Experience, and Training: High School Diploma or equivalent required. 1 or more years of experience in mortgage servicing, escrow administration, or insurance operations. Working knowledge of mortgage and commercial real estate loan servicing practices. Knowledge of federal/state insurance and escrow regulations (Flood, RESPA, PMI rules). Proficiency with mortgage loan servicing software; strong MS Office skills. Excellent communication, organizational, and problem-solving skills. Ability to manage multiple priorities and adapt to evolving business needs. Physical Requirements and Working Conditions: Office environment is generally pleasant and comfortable. Minimal physical effort required; work is primarily desk-based with occasional movement and handling of light materials and supplies. Handling of moderately heavy materials (up to 20 pounds).

Adjuster II / III, Workers' Compensation US-ME-Bath Type: Regular Full-Time Remaining Positions: 1 Salary Grade: C/D Shift: 1st Provide Workers' Compensation (WC) claims adjusting in support of BIW's self-insured/self-administered WC program and provide guidance to injured employees. Effectively and efficiently manage a book of claims by reviewing open claims at a regular cadence and documenting medical management with internal and external providers. Timely review new claims for compensability determinations and processing qualified claimants in accordance with strict regulatory agency rules and regulations; and accurately file State and Federally mandated forms in accordance with strict agency rules and regulations. Operating under the BIW Business Operating System (BOS), the (Adjuster II/II) ensures compliance with safety, quality, and performance standards while coordinating with other key stakeholders to meet overall milestones. Key Responsibilities Safety Leadership: Identify and report out any and all opportunities for prevention or mitigation of injuries during the review of claims and related data & reports. Project Execution: Participate in the analysis of compliance reports and provide feedback as required.Assist in the process of internal and external financial and claim audits as required.Provide assistance and back-up for internal and external reporting, including quarterly CMS (Centers for Medicare & Medicaid Services) reconciliation reports.Evaluate claim exposure, establish case reserves, negotiate and resolve claims. Work closely with defense counsel on litigated claims to develop litigation plan. Attend mediation and hearings as necessary.Review for reasonableness and approval of medical invoices in accordance with treatment plans. Training and Development: Keep up to date on State and Federal laws as well as Medicare reporting requirements.Assist and educate employees and supervisors/managers on respective roles and responsibilities in managing WC claims.Team Collaboration and Communication: Work closely with Medical Dept., Operations, Human Resources, Labor Relations, and other functional areas to promote early return to work Other administrative duties as assigned by the Director of Risk Management.Continuous Improvement: Regular participation in process improvement and/or change management activities within the department and as part of larger teams. Identify opportunities for continuous process improvement and work closely with team members toward achieving same.Interact with State and Federal agencies to provide claim data and answer questions. Responsibilities * Bachelor's Degree in Business Administration or equivalent combination of education and experience required. Qualifications * 2 years of experience with casualty claims management, or similar responsibilities required; experience in Workers' Compensation claims administration preferred. * Advanced knowledge of MS Office required. * Experience in process improvement and/or change management a plus. * Experience with PeopleSoft, WFM, and ATS Claim System a plus. * Knowledge of Federal and State regulatory compliance requirements a plus. * Strong organizational, interpersonal, and communication skills. * Self-motivated & team-oriented. * High attention to detail required. * Able to maintain confidentiality of highly sensitive information. * Must have, or obtain, adjuster license within one year.

Provide Workers' Compensation ("WC") claims adjusting in support of BIW's self-insured/self-administered WC program and provide guidance to injured employees. Effectively and efficiently manage a book of claims by reviewing open claims at a regular cadence and documenting medical management with internal and external providers. Timely review new claims for compensability determinations and processing qualified claimants in accordance with strict regulatory agency rules and regulations; and accurately file State and Federally mandated forms in accordance with strict agency rules and regulations. Operating under the BIW Business Operating System (BOS), the (Adjuster II/II) ensures compliance with safety, quality, and performance standards while coordinating with other key stakeholders to meet overall milestones. Key Responsibilities Safety Leadership: * Identify and report out any and all opportunities for prevention or mitigation of injuries during the review of claims and related data & reports. Project Execution: * Participate in the analysis of compliance reports and provide feedback as required. * Assist in the process of internal and external financial and claim audits as required. * Provide assistance and back-up for internal and external reporting, including quarterly CMS (Centers for Medicare & Medicaid Services) reconciliation reports. * Evaluate claim exposure, establish case reserves, negotiate and resolve claims. Work closely with defense counsel on litigated claims to develop litigation plan. Attend mediation and hearings as necessary. * Review for reasonableness and approval of medical invoices in accordance with treatment plans. Training and Development: * Keep up to date on State and Federal laws as well as Medicare reporting requirements. * Assist and educate employees and supervisors/managers on respective roles and responsibilities in managing WC claims. Team Collaboration and Communication: * Work closely with Medical Dept., Operations, Human Resources, Labor Relations, and other functional areas to promote early return to work * Other administrative duties as assigned by the Director of Risk Management. Continuous Improvement: * Regular participation in process improvement and/or change management activities within the department and as part of larger teams. * Identify opportunities for continuous process improvement and work closely with team members toward achieving same. * Interact with State and Federal agencies to provide claim data and answer questions. Required/Preferred Education/Training * Bachelor's Degree in Business Administration or equivalent combination of education and experience required. Required/Preferred Experience * 2 years of experience with casualty claims management, or similar responsibilities required; experience in Workers' Compensation claims administration preferred. * Advanced knowledge of MS Office required. * Experience in process improvement and/or change management a plus. * Experience with PeopleSoft, WFM, and ATS Claim System a plus. * Knowledge of Federal and State regulatory compliance requirements a plus. * Strong organizational, interpersonal, and communication skills. * Self-motivated & team-oriented. * High attention to detail required. * Able to maintain confidentiality of highly sensitive information. * Must have, or obtain, adjuster license within one year.

Job DescriptionDescriptionQUICK FACTS: Must have Public Adjuster License Must have experience with Xactimate Must have network of Condo, Apartment, Property Management partners Must be able to physically examine all buildings top to bottom (roofs as well W2, Base Salary 70K+, and industry leading commission package We are looking for a results-oriented Outside Sales Representative with a strong background in direct-to-consumer (D2C) or business-to-business (B2B) sales. This role requires a motivated self-starter who thrives in building and maintaining client relationships while working in a fast-paced, competitive environment. Key ResponsibilitiesKey Responsibilities: Identify and pursue new business opportunities with homeowners, contractors, and referral partners. Educate prospective clients on our services and guide them through the insurance claims process. Develop and maintain a pipeline of leads through prospecting and networking efforts. Conduct presentations and training sessions to build brand awareness and establish partnerships. Provide exceptional customer service to existing clients, ensuring their satisfaction and retention. Work closely with internal teams to optimize the sales process and improve closing rates. Maintain accurate records of sales activities and client interactions. Skills, Knowledge and ExpertiseQualifications & Experience: 3+ years of proven sales experience as a licensed Public Adjuster Strong ability to generate leads, manage relationships, and close deals. Bachelor's degree in Business, Marketing, Communications, or equivalent experience. Familiarity with CRM tools, Microsoft Office Suite, and digital communication platforms. Highly organized with strong follow-through skills in a fast-paced environment. Public Adjuster license BenefitsWhat We Offer: Extensive training and support to help you succeed. Flexible work environment with opportunities for growth and career advancement. A team-oriented culture with strong leadership and professional development opportunities. If you're a highly motivated sales professional looking for a rewarding career with a company that makes a difference, apply today!