Claim specialist jobs in Richmond, VA - 40 jobs

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to learn rapidly to develop knowledge and understanding of claims practice Ability to identify, analyze and solve problems Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to meet or exceed performance competencies Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Minimum of 1 year of industry experience and claims management preferred State Certification as an Experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 - $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Kinsale Insurance is an Excess & Surplus lines insurer specializing in hard-to-place, small to medium sized commercial accounts. Kinsale is eligible in all states and writes a variety of Property, Casualty and Specialty lines. Given the experience of our staff and our control over the underwriting and claims processes, Kinsale offers unmatched underwriting flexibility to brokers placing difficult E&S accounts. Kinsale will consider offering terms on a wide range of risks including accounts with new or high hazard operations and businesses that have a poor loss history or that are located in high risk venues. Kinsale Insurance is looking for a full time Claims Examiner to join our growing company and Claims team to work onsite in our new office building in Richmond, VA. Responsibilities: Responsible for handling a wide variety of Casualty claims under the direction of a Claims Supervisor Conducts, coordinates, and directs investigation for all aspects of the claims process Determines liability, evaluates exposure, and negotiates claims to resolution Investigates and analyzes coverage; makes coverage determinations; drafts coverage correspondence; effectively communicates coverage determinations to policyholders and other stakeholders Maintains accurate documentation and information in claim file Manages litigated claims filed against insureds; appoints, directs, and manages defense counsel Proactively drives litigation toward resolution Participates in and attends mediations and/or trials to facilitate fair resolutions of claims Qualifications: A minimum of 2 years of experience handling commercial general liability claims involving bodily injury and property damage Superior written and oral communication skills Strong analytical and problem-solving skills Strong organization and time management skills Ability to work in a collaborative environment Ability to multi-task Strong negotiation skills Proficiency in assigning and directing investigations Experience handling claims in litigation Ability to analyze medical records, contracts including risk transfer provisions, property damage estimates, and litigation documentation to determine applicability to claim resolution Exhibit skills in Microsoft Office products (Word, Outlook, Excel, Power Point) Education and Certifications: Four-year college degree is required Adjuster licenses or other industry designations are desired but not required At Kinsale we offer the following great benefits: Competitive salary with performance-based bonus opportunities Single and Family Health, Dental and Vision Insurance plans with HSA funds contributed Short-Term and Long-Term disability Life Insurance Matching 401(k) Generous Paid Time Off and Holidays Education dollars for training and certifications Kinsale values strong financial responsibility. A credit check will be conducted as a part of the selection process for roles that require sound judgement, trustworthiness, or access to sensitive information.

MBP is looking for Claims Analyst/Lead Claims Analyst/Senior Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Highly proficient in Oracle P6 and experienced with one or more of the following: Microsoft Project, Phoenix Project Manager, or similar. Responsibilities Main Duties: Performs review and analysis of construction claims. Assists with development of contractor claims. Develops and/or review time extension requests. Assist with development of expert reports and exhibits. Qualifications Education B.S. in Civil Engineering, Construction Management, or relevant experience which equates to this degree. P.E. license, Certified Construction Manager, Planning and Scheduling Profession, or similar, certification preferred. Skills and Abilities Experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Experience drafting expert reports and deliverables. Proficient in Oracle P6 required and experienced with Microsoft Project desired. Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration. Ability to relate technical knowledge to a non-technical audience. Proficiency in reading/understanding construction plans and specifications. Proficiency with Microsoft Office software programs including Word, Excel, and PowerPoint. Experience providing training, supervision, proposal development, and business development desired. Occasional overnight travel may be required. STATUS: Full-time BENEFITS: Competitive compensation with opportunities for semi-annual bonuses Generous Paid Time Off and holiday schedules 100% Employer paid medical, dental, vision, life, AD&D, and disability benefits (for individual) Health Savings Account with company contribution 401(k)/Roth 401(k) plan with company match Tuition Assistance and Student Loan Reimbursement Numerous Training and Professional Development opportunities Wellness Program & Fitness Program Reimbursement Applicants must be authorized to work in the U.S. without sponsorship. MBP is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Protected veterans and individuals with disabilities are encouraged to apply.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance PL CLAIM SPECIALIST **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to designated authority level. + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent negotiation skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** **:** Computer keyboarding, travel as required **Auditory/Visual** **:** Hearing, vision and talking _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $117,000 - $125,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

Company Details Berkley Mid-Atlantic Insurance Group is a member of W. R. Berkley Corporation, one of the largest commercial lines property casualty insurance holding companies in the United States. With the resources of a large Fortune 500 corporation and the ability to operate with the closeness and flexibility of a small company, we exclusively work with select independent agents to ensure the future of business. Company URL: *********************** The company is an equal opportunity employer. Responsibilities As a Workers' Compensation Claims Representative, you will play a critical role in maintaining these standards by providing quality claim handling and superior service to our customers, while also engaging in indemnity and expense management. Success in this position will be driven by combining your experience in Workers' Compensation claims management with excellent communication and critical reasoning. Investigate, evaluate, reserve, negotiate and resolve Workers Compensation claims in multiple jurisdictions and in accordance with Best Practices. Promptly manage claims by completing essential functions including contacts, investigations, damages development, evaluation, reserving, and disposition. Regularly handle claims involving complex coverage issues and severe injuries. Develop action plans and handle the claims from assignment to early conclusion. Review incoming mail daily, responding as needed to bring the claim to a prompt fair conclusion and seeking supervision as needed. Work closely with medical management as needed Prepare large loss reports as needed to include updated action plan and recommended reserves. Maintain a current diary on outstanding claims. Provide direction and guidance to defense attorneys and other experts while controlling expenses. Meet or exceed specific objectives for service, quality, and reserving standards and other measurable performance items. Perform other duties as assigned by the Claims Management. Qualifications 5+ years of experience in a workers' compensation claims position CPCU, SCLA or AIC designation is a plus. Working knowledge of current state and local workers' compensation laws preferred Experience in handling multiple jurisdictions is a plus Proven ability to identify and address coverage issues, complete investigations to determine exposure, set timely reserves, and develop detailed action plans. Excellent communication and negotiation skills. Computer proficiency and working knowledge of Microsoft Office products. Experience with Guidewire claims management system is a plus. 4-year college degree or equivalent work experience required. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role

Job Description Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer. Powered by JazzHR ZB3PvDPPZp

CENCO Claims is seeking a dependable and experienced Daily Property Adjuster to handle residential and commercial property claims in the Richmond, Virginia area. This is a field-based position ideal for adjusters who value consistent work, flexible scheduling, and strong internal support. If you're detail-oriented, organized, and confident in the field, we'd love to connect. Key Responsibilities Conduct on-site inspections of residential and commercial properties Assess property damage and determine scope of loss Prepare accurate estimates using Xactimate Document claims with clear photos and detailed reports Communicate professionally with policyholders, contractors, and carriers Maintain organized and compliant claim files Submit complete claim files accurately and on time Requirements Proficiency in Xactimate Excellent written and verbal communication skills Strong time management and organizational abilities Reliable transportation and a valid driver's license Ability to work independently while meeting quality and turnaround expectations Preferred Qualifications Virginia adjuster license or designated home state license 2+ years of property adjusting experience Experience with both residential and commercial claims What We Offer Consistent claim volume in the Richmond area Flexible scheduling Support from experienced claims professionals Long-term opportunities for continued work and growth If you're looking for steady field work with a company that values professionalism and reliability, CENCO Claims is ready to work with you. Apply today.

At Genworth, we empower families to navigate the aging journey with confidence. We are compassionate, experienced allies for those navigating care with guidance, products, and services that meet families where they are. Further, we are the spouses, children, siblings, friends, and neighbors of those that need care-and we bring those experiences with us to work in serving our millions of policyholders each day. We apply that same compassion and empathy as we work with each other and our local communities, Genworth values all perspectives, characteristics, and experiences so that employees can bring their full, authentic selves to work to help each other and our company succeed. We celebrate our diversity and understand that being intentional about inclusion is the only way to create a sense of belonging for all associates. We also invest in the vitality of our local communities through grants from the Genworth Foundation, event sponsorships, and employee volunteerism. Our four values guide our strategy, our decisions, and our interactions: Make it human. We care about the people that make up our customers, colleagues, and communities. Make it about others. We do what's best for our customers and collaborate to drive progress. Make it happen. We work with intention toward a common purpose and forge ways forward together. Make it better. We create fulfilling purpose-driven careers by learning from the world and each other. POSITION TITLE Long Term Care Claims Representative - Payment Servicing POSITION LOCATION This position is available to remote applicants residing in states/locations under Eastern or Central Standard Time: Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, Vermont, West Virginia or Wisconsin. SCHEDULED HOURS During training, your hours will be 8:00 AM-5:00 PM EST. Once training is complete, your regular schedule will be 8:00 AM-5:00 PM EST. Schedule may adjust slightly in the future based on business needs. Candidates are expected to have consistent, reliable and predictable attendance during the duration of virtual classroom training and upon successful completion of training to support the needs of our customers. YOUR ROLE As an Operations team member, you'll play a crucial role in delivering world class customer service and capabilities to our policyholders-now and in the future. Long Term Care Claims is transforming and with transformation comes the potential for constant change. You will support our customer centric culture by proactively providing accurate and timely information to ensure policyholders are fully informed during the claims process. You will, as a member of the Payment Servicing Team, partner closely with the Eligibility and Contact Center teams to provide an extraordinary claims experience for our customers. You will work in a fast -paced environment across multiple products, ensuring claims handling follows policy provisions, internal guidelines, and Compliance requirements and will be responsible for the processing and payment of long-term care claims. We operate daily with integrity and character to achieve outstanding results. WHAT YOU WILL BE DOING To ensure excellence in our relationship with our customer, you will be responsible for incoming and outgoing calls to claimants, caregivers, facilities and other persons or entities involved in the claim to enhance the customer experience. In support of our focus on ‘team' vs ‘individual', you will effectively manage and prioritize a work queue and multiple job responsibilities in a fast-paced environment, frequently with aggressive deadlines. You will be accountable for recognizing and working within a structured environment with clearly defined Standard Operating Procedures, to ensure consistency of claims practices and resolution. You will also be responsible for making complex decisions based on experience and sound judgment for situations not specifically defined in those procedures. Collaboration and effective communication are important; you will seek solutions rather than just identify problems and will partner with teams across sites to achieve common goals. You may occasionally be asked to help deepen others' understanding of our processes and provide support as they grow in their role. This includes, but is not limited to, training/creating training material, side-by-side, group adjudication support, mentoring, and participating in buddy programs. As part of our collaborative organization, you will provide insights, best practices, and share knowledge within Payment Servicing and to departments that support our teams such as QA, IT, Compliance, Eligibility and Contact Center. Ability to handle inbound and outbound calls. To support our customers and our business needs, you may be asked to do work outside of this role for periods of time; training and/or guidance will be provided if so. Through the use of critical thinking and problem solving, you will make claim decisions and process transactions based on the claimant's policy and other information provided. WHAT YOU BRING You will spend the first several months of employment in virtual “classroom” training before beginning to phase into your job responsibilities. You will need to be on camera, actively participate in this training and must successfully complete all training requirements. At Genworth, we are committed to caring for our customers and for the safety of our colleagues. When you are working remotely, or during inclement weather/other circumstances which may make the office inaccessible, high-speed internet (50 mbps) and a distraction-free area is required. A high school diploma or military experience. Excellent written and verbal communication skills with the ability to communicate information concisely and accurately. Excel at customer service (minimum 1 year experience) as evidenced by professional and empathetic demeanor in all interactions Proven ability to understand, interpret and comprehend contract language, disability processes, nursing home licensing and rehabilitative requirements Exhibited competency in critical thinking, problem solving, conflict resolution and collaboration Proficient with Microsoft Office applications (e.g., Word, Excel, Outlook, etc.) Ability to toggle between multiple monitors for optimal and efficient productivity Bachelor's or Associate degree preferred Previous experience in the insurance industry preferred EMPLOYEE BENEFITS & WELL-BEING Genworth employees make a difference in people's lives every day. We're committed to making a difference in our employees' lives. Competitive Compensation & Total Rewards Incentives Comprehensive Healthcare Coverage Multiple 401(k) Savings Plan Options Auto Enrollment in Employer-Directed Retirement Account Feature (100% employer-funded!) Generous Paid Time Off - Including 12 Paid Holidays, Volunteer Time Off and Paid Family Leave Disability, Life, and Long Term Care Insurance Tuition Reimbursement, Student Loan Repayment and Training & Certification Support Wellness support including gym membership reimbursement and Employee Assistance Program resources (work/life support, financial & legal management) Caregiver and Mental Health Support Services ADDITIONAL The base salary pay range for this role starts at a minimum rate of $43,200 up to the maximum of $66,400. In addition to your base salary, you will also be eligible to participate in an incentive plan. The incentive plan is based on performance and the target earning opportunity is 5% of your base compensation. The final determination on base pay for this position will be based on multiple factors at the time of this job posting including but not limited to geographic location, experience, and qualifications to ensure pay equity within the organization.

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.

Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Morton is seeking a Claims Examiner for our client in Richmond, VA. The ideal candidate will be responsible for investigating, evaluating, and settling commercial liability claims. The candidate should have experience with commercial general liability claims handling, which would include reviewing and analyzing coverage, liability and damages. Strong letter writing skills and an interest in handling other lines of business are essential. Responsibilities: Review and analyze coverage, liability and damages Write both coverage and liability position letters Conduct interviews with claimants, witnesses, and other parties involved in the claim. Hire and manage outside vendors such as independent adjusters, defense counsel and other experts as needed Prepare detailed claim reports as needed for upper management Negotiate settlements with claimants and attorneys Maintain accurate notes, records and files Qualifications: Bachelor's Degree - COMPLETED Experience working in the E&S space Experience in commercial casualty claims. Excellent written and verbal communication skills, including letter writing ability. Strong knowledge of commercial liability insurance policies, coverage analysis, and claims handling procedures. Openness to learning and handling other lines of business. Excellent communication, negotiation, and analytical skills. Ability to work independently and as part of a team.

Job Title: Claims Examiner Department: Claims Job Description: We are seeking a skilled and detail-oriented mid-to-senior level Claims Examiner to manage a portfolio of professional liability, management liability and/or allied healthcare liability claims. This role involves evaluating complex coverage scenarios, conducting thorough investigations, and overseeing the resolution of claims in a timely and cost-effective manner. The ideal candidate will have strong analytical and communication skills and a deep understanding of professional liability and/or allied healthcare exposures. While not required, experience working within the specialty insurance market is a plus. Responsibilities: * Investigate, evaluate, and resolve professional liability, management liability and/or allied healthcare claims * Analyze challenging coverage scenarios * Effectively write detailed and complex coverage letters * Handle a diverse caseload with attention to coverage, damages, and liability issues * Manage claims lifecycle, including reserving, negotiation, and settlement strategies * Interface with defense counsel, brokers, and insureds to drive effective resolution * Maintain accurate documentation and produce clear, timely reports for management * Direct and monitor litigation and contribute to strategic resolution planning Qualifications: * Candidates must possess a Bachelor's degree * 5+ years of experience handling professional liability, management liability, and/or allied healthcare claims * Strong knowledge of legal procedures, policy interpretation, and litigation management * Excellent analytical, organizational, and negotiation skills * Strong verbal and written communication abilities * Experience working in the E&S space is a plus Benefits Overview * Medical, Dental, and Vision insurance plans. FSA/HSA plans available. * Basic Life/AD&D/Short Term/Long Term Disability coverage. * 401(k) - Company match of up to 6% * Flexible PTO plan, 11 paid company-wide holidays, plus your birthday off. * Recognized as a Top Workplace by Richmond Times-Dispatch Equal Employment Opportunity (EEO) Richmond National is an equal employment opportunity employer, the Company's employment decisions and practices are not and will not be unlawfully influenced or affected by race, color, creed, age, religion, national origin, sex, disability, genetic information, veteran status, uniformed services, sexual orientation (including transgender status, gender identity or expression), gender, traits historically associated with race, such as hairstyle, pregnancy, childbirth, or related medical conditions or on any other characteristic protected by applicable federal, state, or local law. This policy of equal employment opportunity applies to all policies and procedures relating to recruitment and hiring, compensation, benefits, and all other terms and conditions of employment.

Title: SAFE Examiner State Role Title: Salary Non-Specified Hiring Range: Minimum starting salary $47,003 commensurate with experience Pay Band: UG Agency Website: ****************************** Recruitment Type: General Public - G Does public service appeal to your sense of pride and professional fulfillment? Do you enjoy making a meaningful difference in the lives of others? Does working in a collaborative environment with health care associates interest you? Are you a detail-oriented individual who doesn't mind work of a repetitive nature, but also affords the opportunity to cross train in other departments and perform research? Do you excel at working independently in a mostly telework environment where your colleagues and leaders cheer you on? Are you interested in becoming part of an agency that is evolving, constantly enhancing efficiency, and improving relationships with stakeholders? If you answered yes to these questions, this position may be the perfect fit for you. Job Duties The Criminal Injuries Compensation Fund is seeking a detail-oriented and customer focused SAFE Claims Examiner to join our team. Virginia Workers' Compensation Commission administers the Virginia Compensating Victims of Crime Act through the Criminal Injuries Compensation Fund also known as the Virginia Victims Fund (VVF). The Criminal Injuries Compensation Fund helps victims of violent crime with out-of-pocket expenses including medical bills, prescriptions, funeral expenses, and many other expenses. While money can never erase the scars and painful memories of a crime, our programs may ease some of the financial burdens faced by victims and their families. The SAFE Examiner provides support to the Sexual Assault Forensic Exam Payment Program by processing claims submitted by forensic nurses, reviewing and verifying claim information for eligibility, making claim award determinations, and processing award amounts for completed claims. Additionally, the selected candidate will be responsible for communicating with nurses, billing providers, and other stakeholders by phone and email, maintaining ongoing claims, and ensuring billing information is accurate. The SAFE Examiner is also responsible for reviewing and preparing financial reports based on awards for completeness and accuracy, preparing supporting documentation, and providing training and consultation to allied professionals. VWC Compensation Structure Virginia Workers' Compensation Commission is an independent agency which allows us to have a more competitive and unique pay structure. This position is a pay grade 5 based on a 14 grade pay structure. Our positions are not classified under DHRM's pay bands. Telework Structure Our agency is currently using a hybrid model for teleworking. Our positions at this time are not 100% teleworking. This position is largely telework; however, all candidates would be expected to report to our Headquarters/Regional Office as requested. Telework scheduling is at the discretion of the Manager based on the business needs of the department. Upon hire, candidates should expect to have all training and orientation conducted at the Headquarters Office. Minimum Qualifications Significant experience providing high-volume case management in a fast-paced environment Comprehensive experience with claims examination to include billing and payment determination Experience gathering information and creating and presenting reports Excellent oral and written communication skills to include the ability to interact with a diverse group of professionals and clients Exceptional analytical and logical reasoning and administrative research skills and abilities Strong work ethic, attention to detail, and exceptional customer service skills Strong public speaking and presentation skills Demonstrated ability to work within deadlines in a high volume, fast-paced environment Demonstrated ability and skill in organizing, coordinating and prioritizing work assignments Demonstrated ability to work both independently and as part of a team Ability to travel overnight on occasion Additional Considerations Experience working with the Criminal Injuries Compensation Fund preferred Working knowledge of medical terminology and insurance practices preferred Working knowledge of the Code of Virginia sections relating to the Criminal Injuries Compensation Fund or Sexual Assault Forensic Exam Payment Program preferred Special Instructions You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to “Your Application” in your account to check the status of your application for this position. Contact Information Name: Amy Habel Phone: ************ Email: *********************************** In support of the Commonwealth's commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at ************. Note: Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.

ESIS, Inc. (ESIS) provides sophisticated risk management services designed to reduce claims frequency and loss costs. ESIS, the Risk Management Services Company of ACE USA, provides claims, risk control & loss information systems to Fortune 1000 accounts. ESIS employs more than 1,500 professionals in nine regional centers and 15 major claims offices, as well as local representatives in select jurisdictions. We take our fiduciary responsibilities seriously and are proud to manage over $2.5 billion of customer losses and over 320,000 new claims annually. We specialize in large accounts which have multi-state operations. For information regarding ESIS please visit ************* Summary: ESIS is seeking an experienced Workers' Compensation claims representative for the Glen Allen, VA office. The person in this role will handle and maintain all workers' compensation claims and file reviews under the general supervision of a supervisor and as part of the ESIS team. Minimum Responsibilities: Qualified candidates must possess experience in managing workers' compensation claims investigation/ adjusting, including knowledge of applicable state/local legislation. Experience in a third-party administrator (TPA) environment is a plus. Knowledge of VA, NC, SC, TN, KY, IL, MI, OH and/or WVA Workers' Compensation laws and procedures is a plus. Candidates must have the ability to work independently while assimilating various technical subjects, as evidenced by successful completion of a college degree or equivalent practical work experience. AIC/CPCU is desired but not mandatory, and candidates must also have solid computer software skills (M/S Word, Excel). Ability to work independently while assimilating various technical components, as evidenced by successful completion of college-level curriculum or equivalent related practical work experience. Working knowledge of Worker's compensation Coverage, Compensability, Principles, and Practice. One or more years' experience in handling Lost Time Workers' Compensation Claims. Prior experience working in a TPA environment is strongly preferred. Determine, calculate and issue accurate benefit payments to injured workers, medical providers, and vendors in a timely fashion. Ability to remain calm and professional during peak periods of activity. Ability to organize, prioritize, and complete multiple objectives and effective use of time management skills. Strong computer skills are essential. Self-motivation and self-starting capabilities as well as good communication and interpersonal skills; capable of dealing with accounts, injured workers, attorneys, and associates. Ability to assist with national coordination of accounts. An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

In good company. Hamilton (NYSE: HG) underwrites specialty insurance and reinsurance risks on a global basis through its wholly owned subsidiaries. Its three underwriting platforms: Hamilton Global Specialty, Hamilton Select and Hamilton Re, each with dedicated and experienced leadership, provide access to diversified and profitable business around the world. Headquartered in Bermuda, Hamilton has over 600 employees with key underwriting operations in London, Bermuda, the US and Dublin. We work collaboratively, we share a passion for the service and results we deliver, and we know that what we do each day is meaningful - to our customers and our business. We believe we are ‘In good company.' with everyone we interact with. We're looking for a Claims Technician This is an entry level position based in Richmond, Virginia, and reporting to Claims Management, the successful candidate will join Hamilton's growing Claims Operation. As a Claims Technician, you will play a crucial role in supporting the Claims team by ensuring the timely and accurate execution of administrative functions. Five days in the office required with the possibility of transitioning into a hybrid pattern of 3 days in the office. Hamilton Select is a US-based excess and surplus lines insurer based in Richmond, Virginia, specializing in underwriting hard-to-place accounts in the small and middle-market sectors through an appointed wholesale broker network. What you will do Obtain, organize, prepare, and maintain quarterly audit evidence and reports for Sarbanes-Oxley compliance Collaborate with Internal Audit and Claims Management to ensure controls are updated Assist claims management in testing new systems and automation tools Conduct quality assurance testing on claim files Input claims payment requests into finance applications for claims adjusters Create outgoing exports of claims documents to assist claims employees Review and set up claim files for new incoming losses Provide backup support to the mailroom Associate for processing incoming and outgoing claims mail Participate in additional Claims Operations tasks as needed Conduct Standards You must act with integrity You must act with due skill, care and diligence You must be open and cooperative with regulators You must pay due regard to the interests of customers and treat them fairly You must observe proper standards of market conduct You must act to deliver good outcomes for retail customers What you require for the role Strong written and verbal communication skills Proficiency in typing and data entry with a high level of accuracy and attention to detail Excellent organizational and time management skills Effective team player with a collaborative and supportive approach Ability to work within tight deadlines What you can expect from us At Hamilton, we offer a vibrant, entrepreneurial and collaborative workplace shaped by our values: Be Smart, Be Sensible, Be Open and Be More. Our employees consistently say they would recommend Hamilton as a great place to work - a testament to the inclusive, supportive, and empowering culture we've built together. We embrace individuality, value diverse perspectives, and recognise the unique contribution each person makes to our continued success. Hamilton offers a competitive salary with an annual performance-based target bonus and a comprehensive benefits package, to include: Hybrid working Matching 401K plan Medical, dental, vision, life, disability Generous time off (including parental leave) Continued support for professional development Gym subsidy My day (additional days leave for personal interests/wellness/charity work)

In good company. Hamilton (NYSE: HG) underwrites specialty insurance and reinsurance risks on a global basis through its wholly owned subsidiaries. Its three underwriting platforms: Hamilton Global Specialty, Hamilton Select and Hamilton Re, each with dedicated and experienced leadership, provide access to diversified and profitable business around the world. Headquartered in Bermuda, Hamilton has over 600 employees with key underwriting operations in London, Bermuda, the US and Dublin. We work collaboratively, we share a passion for the service and results we deliver, and we know that what we do each day is meaningful - to our customers and our business. We believe we are 'In good company.' with everyone we interact with. We're looking for a Claims Technician This is an entry level position based in Richmond, Virginia, and reporting to Claims Management, the successful candidate will join Hamilton's growing Claims Operation. As a Claims Technician, you will play a crucial role in supporting the Claims team by ensuring the timely and accurate execution of administrative functions. Five days in the office required with the possibility of transitioning into a hybrid pattern of 3 days in the office. Hamilton Select is a US-based excess and surplus lines insurer based in Richmond, Virginia, specializing in underwriting hard-to-place accounts in the small and middle-market sectors through an appointed wholesale broker network. What you will do * Obtain, organize, prepare, and maintain quarterly audit evidence and reports for Sarbanes-Oxley compliance * Collaborate with Internal Audit and Claims Management to ensure controls are updated * Assist claims management in testing new systems and automation tools * Conduct quality assurance testing on claim files * Input claims payment requests into finance applications for claims adjusters * Create outgoing exports of claims documents to assist claims employees * Review and set up claim files for new incoming losses * Provide backup support to the mailroom Associate for processing incoming and outgoing claims mail * Participate in additional Claims Operations tasks as needed Conduct Standards * You must act with integrity * You must act with due skill, care and diligence * You must be open and cooperative with regulators * You must pay due regard to the interests of customers and treat them fairly * You must observe proper standards of market conduct * You must act to deliver good outcomes for retail customers What you require for the role * Strong written and verbal communication skills * Proficiency in typing and data entry with a high level of accuracy and attention to detail * Excellent organizational and time management skills * Effective team player with a collaborative and supportive approach * Ability to work within tight deadlines What you can expect from us At Hamilton, we offer a vibrant, entrepreneurial and collaborative workplace shaped by our values: Be Smart, Be Sensible, Be Open and Be More. Our employees consistently say they would recommend Hamilton as a great place to work - a testament to the inclusive, supportive, and empowering culture we've built together. We embrace individuality, value diverse perspectives, and recognise the unique contribution each person makes to our continued success. Hamilton offers a competitive salary with an annual performance-based target bonus and a comprehensive benefits package, to include: * Hybrid working * Matching 401K plan * Medical, dental, vision, life, disability * Generous time off (including parental leave) * Continued support for professional development * Gym subsidy * My day (additional days leave for personal interests/wellness/charity work)

Thank you for considering a career at Bon Secours! Scheduled Weekly Hours: 40 Work Shift: Days (United States of America) Bon Secours About Us As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive. Referral & Insurance Specialist - Southside Physicians Network - Endocrinology 2 Job Summary: The Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures/testing. Verifies eligibility/coverage for referral via phone/fax/Internet. Schedule appointments for testing at medical facilities or appointments with physicians. Gathers charge information and enter all pertinent charge and patient demographic information into computer billing system. Post all payments and make daily deposits. Assist patients regarding billing questions and account balance resolution. Promotes a positive and helpful climate for good interpersonal and interdepartmental relationships. Essential Functions: Obtains authorizations from insurance companies for referrals to physicians/medical facilities and/or procedures/testing. Schedules appointments for testing at medical facilities or appointments with physicians. Verifies eligibility/coverage for referral/testing via phone/fax/Internet. Investigates billing problems and denials. Notifies patients of referral process whether authorized or denied in a timely manner. Give patients instructions. Performs data input of patient and/or insurance changes and corrections to ensure current and accurate information in billing system. Answers the telephone, take messages, schedule appointments and greet patients as needed. Prepares patient charge encounter forms for each day and makes new or updates patient chart as needed. Oversees waiting area, coordinate patient movement, and reports problems or irregularities. Screens visitors and respond to routine request for information. Organizes and files progress notes, testing reports, and other forms necessary for chart completion. Assists with appropriate filing of patient charts as needed. Collects patient responsibility balances and copayments as needed. Balance money collected daily. Opens and distributes daily mail as needed Obtains authorizations from insurance carriers or pharmacy benefit managers for medications. Collects all daily charge slips from the physician and reconciles the number of charge slips and their totals Applies all payments to the appropriate patient account by posting each into the computer billing systems Inputs all charge information into the online billing system Assists with coding and error resolution as well as requesting needed information by working with the physician offices Works with patients in resolving billing questions and patient account resolution As applicable, reviews information to make determination on the appropriate course of action for the patient, makes referrals to the local DSS office as appropriate. This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation. Education: High School Diploma or GED (required) Licensure/Certification: None Experience: 2-3 years of experience in a related medical field with experience in processing referrals (preferred) Bon Secours is an equal opportunity employer. As a Bon Secours associate, you're part of a Mission that matters. We support your well-being - personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way. What we offer Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible) Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts Paid time off, parental and FMLA leave, shot- and long-term disability, backup care for children and elders Tuition assistance, professional development and continuing education support Benefits may vary based on the market and employment status. Department: Southside Endocrinology - Richmond Specialty Care It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health- Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email *********************. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at *********************.

Under minimal supervision, the Claims Specialist/Executive Claims Specialist manages a caseload of high complexity commercial insurance claims focused on Allied Health (assisted living and skilled nursing facilities). The Claims Specialist will review claims to analyze land determine applicable coverage, facts, liability, damages, plan and strategy for resolution in accordance with state and company guidelines. The Claims Specialist will function independently and act as a key resource on issues within area of specialty. Duties and Responsibilities Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service Perform coverage, liability, and damage analysis on all claims assignments Investigate allegations, determine facts based on evidence and interviews Draft disclaimers and reservation of rights letters when coverage issues arise Assign limited investigations and appraisals to independent licensed professionals Manage a caseload of high complexity claims with delegated authority Manage litigated files Negotiate settlements, mitigate losses, and control expenses Participate in and attend mediations to facilitate settlements Maintain accurate documentation in claim files Maintain a high level of communication internally with Claims management team and externally with insureds, claimants, attorneys and brokers Act as a consultant providing technical expertise within specialty area to internal stakeholders Provide technical guidance, assistance and training as needed for less experienced Claims professionals Maintain a passing quality assurance score on all audits and QAs Provide exceptional customer service to insureds, claimants, and attorneys, addressing inquiries, concerns, and providing regular updates on claim status Ensure compliance with state regulations, industry standards, and best practices in claims handling, maintaining a high level of professionalism and integrity Handle claims in accordance with established James River Claims Best Practices Other duties as required by management Knowledge, Skills and Abilities Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL) Expert level of expertise in claim handling and suit management Expert knowledge of P&C insurance industry Expert ability to effectively assess risk Proficiency in MS Office (Word, Excel, Outlook) Excellent written and verbal communication skills Advanced analytical and organizational skills Advanced negotiation skills Ability to work independently and take initiative Ability to exercise sound judgement in making critical decisions Research, analysis and problem-solving skills Ability to work in a team environment and accept feedback from Claims management Ability to build effective relationships with business partners Ability to organize complex information and pay close attention to detail Ability to anticipate customer needs and take initiative to meet those needs Ability to train and provide technical guidance to less experienced Claims professionals Ability to successfully obtain the required state adjusters' licenses within six (6) months following the completion of Company-provided licensure training courses and maintain appropriate licensure thereafter Experience and Education Claims Specialist High school diploma required Bachelor's Degree preferred Advanced Degree or Juris Doctorate Degree preferred Minimum of seven years of experience handling primary and excess claims-made and occurrence liability policies and claims. Experienced in coverage, liability, and litigated claims related to health services claims, assisted living and skilled care facilities claims, life sciences (medical devices and products) claims, and professional liability claims. Successful candidate will have strong written, verbal, injury evaluation, and negotiation skills Adjuster license and/or certifications desired preferred Executive Claims Specialist High school diploma required Bachelor's Degree preferred Advanced Degree or Juris Doctorate Degree preferred Minimum of ten years of experience handling primary and excess claims-made and occurrence liability policies and claims. Experienced in coverage, liability, and litigated claims related to health services claims, assisted living and skilled care facilities claims, life sciences (medical devices and products) claims, and professional liability claims. Successful candidate will have strong written, verbal, injury evaluation, and negotiation skills Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL) Project management and process implementation experience preferred #LI-KS1 #LI-Remote

Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer.