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Claims adjuster jobs in Albuquerque, NM - 26 jobs

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  • Medical Claims Representative - Workers' Compensation (Albuquerque)

    Cannon Cochran Management 4.0company rating

    Claims adjuster job in Albuquerque, NM

    Workers' Compensation Medical Only Claim Representative Schedule: Monday-Friday, 8:00 a.m. - 4:30 p.m. (37.5 hours per week) Compensation: $20.00 per hour Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job SummaryThe Workers' Compensation Medical Only Claim Representative is responsible for managing medical-only workers' compensation claims for multiple client accounts across various industries. This position focuses on the timely and accurate adjudication of claims in compliance with New Mexico statutes, client expectations, and CCMSI standards. It offers structured training, mentorship, and the opportunity to develop foundational adjusting skills in a collaborative, in-office environment. Responsibilities Adjudicate medical-only workers' compensation claims timely and accurately in accordance with statutory, client, and CCMSI guidelines. Establish and maintain claim reserves within authority levels under direct supervision. Review, approve, and negotiate medical and miscellaneous invoices to ensure appropriate and related charges. Coordinate and monitor medical treatment in compliance with corporate claim standards. Document all claim activity, medical updates, and correspondence in the claim system. Close claim files when appropriate and assist with file maintenance as needed. Provide support to the broader claim team, including client service initiatives and administrative tasks. Maintain compliance with all Corporate Claim Standards and client-specific handling instructions. Qualifications Required: Associate degree or two (2) years of related business experience NM Adjuster's License or ability to obtain within 90 days of hire (must pass state licensing exam and background check) Proficiency in Microsoft Office (Word, Excel, Outlook) Preferred / Nice to Have: Previous workers' compensation or claim handling experience Knowledge of medical terminology is very helpful Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Why You'll Love Working Here 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions Compliance & audit performance - adherence to jurisdictional and client standards Timeliness & accuracy - purposeful file movement and dependable execution Client partnership - proactive communication and strong follow-through Professional judgment - owning outcomes and solving problems with integrity Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #CareerDevelopment #ClaimsTraining #WorkersCompensation #InsuranceCareers #AlbuquerqueJobs #NowHiring #LearnAndGrow #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #AdjusterJobs #BilingualJobs #IND456 #LI-InOfficeWe can recommend jobs specifically for you! Click here to get started.
    $20 hourly Auto-Apply 5d ago
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  • Claims Adjuster I

    New Mexico Mutual Casualty Company 4.0company rating

    Claims adjuster job in Albuquerque, NM

    Job Title: Claims Adjuster I Department: Claims Reports To: Claims Manager This position is responsible for the adjudication of all assigned claims in accordance with the Act, governing rules and regulations, related case law and company procedures. Case complexity assignment is determined by the experience and qualifications of the adjuster. This position will demand quality claim handling expertise, Service Excellence standards, and timely indemnity, medical and expense benefit management. Essential Functions: Evaluate, analyze and determine compensability, causation, offsets and exposures of basic workers compensation insurance claims in accordance with applicable law, corporate policy, best practice and prescribed authorities. Verify claim information including but not limited to: documentation of the claim history; taking recorded statements from workers and witnesses, identify subrogation opportunities, coordination of medical care. Document all activities in the claim management system. Responsible for outside legal counsel assignments, RTW strategies with policyholders, implement medical case management strategies with nurse case managers and all other expert assignments. Upon determination of compensability: Set and monitor reserves according to company policies and the worker's injury, issue benefit checks in accordance to statutory requirements, and demonstrate proficiency in the application of state statutes, related case law and to interpret and comply with company claims standards, policies and procedures. Ensure the timely and accurate statutory/benefit payments within the established time frames and guidelines. Prepare and participate in mediation conferences and other authorized legal or regulatory proceedings before the regulatory agencies and courts of law. Maintain a diary on all open claims. Document all relevant information to provide a clear history of events and a proper audit trail. Set review dates based on claim complexity or standard review criteria. Detect and report reasonable suspicions of insurance fraud by claimants, medical or legal providers, policyholders or other individuals related to claims. Maintain claim records in compliance with applicable law, corporate policies and retention schedules. Requirements Job Qualifications: Education: Bachelor's Degree from an accredited college or university. Experience: A minimum of one year of workers' compensation claims experience is preferred. Additional relevant experience considered in lieu of education. Specialized Knowledge, Licenses, etc.: Demonstrated proficiency in: Related professional certifications preferred State required adjuster's license Values and Mission: Adhere to values and mission by demonstrating Service Excellence, Trust, Ownership, One team and Boldness in thought and action. Positive Attitude: Develops and maintains positive working relationships with team members, customers, co-workers and management by demonstrating effective communication and collaborative skills. Working Conditions: NEW MEXICO MUTUAL maintains general office conditions with light to moderate physical demands, with occasional lifting. Employees of NEW MEXICO MUTUAL adhere to all safety rules and regulations including building security. Employees participate in ensuring safe and efficient operating conditions that safeguard employees and facilities. NEW MEXICO MUTUAL maintains a drug free environment; drug testing prior to employment as well as upon a work related accident. Exposure to VDT screens.
    $44k-52k yearly est. 20d ago
  • Daily Claims Adjuster - Albuquerque, NM Region

    Cenco Claims 3.8company rating

    Claims adjuster job in Albuquerque, NM

    CENCO Claims is a well-established claims services provider, working closely with leading insurance carriers to deliver reliable, efficient claim handling. We are currently expanding coverage in Albuquerque and the greater Southwest region and are seeking Daily Property Claims Adjusters to support ongoing residential and commercial claim activity. This role is well suited for independent adjusters looking for consistent work, flexibility, and strong operational support. What You'll Be Doing Complete field inspections to evaluate property damage from wind, hail, fire, and related losses Document damages thoroughly with clear photos, notes, and measurements Prepare accurate estimates using Xactimate or Symbility Communicate professionally with policyholders, contractors, and carrier partners Manage assignments efficiently while meeting carrier timelines and quality expectations What We're Looking For Active New Mexico adjuster license and applicable Southwest state licensing Experience using Xactimate or Symbility Reliable transportation, ladder, laptop, and standard field inspection equipment Strong organizational skills and the ability to work independently Responsiveness and availability to accept assignments and submit reports promptly Why Work with CENCO Claims Consistent claim volume across a growing regional footprint Competitive compensation with timely payments Supportive back-office team and streamlined workflows Opportunity to build long-term relationships with established carrier partners If you're a dependable adjuster seeking steady daily work in the Albuquerque market, we'd be glad to connect and discuss next steps.
    $44k-54k yearly est. Auto-Apply 60d+ ago
  • Field Claims Adjuster

    EAC Claims Solutions 4.6company rating

    Claims adjuster job in Albuquerque, NM

    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.
    $44k-54k yearly est. Auto-Apply 6d ago
  • Independent Insurance Claims Adjuster in Albuquerque, New Mexico

    Milehigh Adjusters Houston

    Claims adjuster job in Albuquerque, NM

    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.
    $43k-53k yearly est. Auto-Apply 60d+ ago
  • Claims - Field Claims Representative

    Cincinnati Financial Corporation 4.4company rating

    Claims adjuster job in Albuquerque, NM

    Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into action, we're looking for extraordinary people to join our talented team. Our service-oriented, ethical, knowledgeable, caring associates are the heart of our vision to be the best company serving independent agents. We help protect families and businesses as they work to prevent or recover from a loss. Share your talents to help us reach for continued success as we bring value to the communities we serve and demonstrate that Actions Speak Louder in Person. If you're ready to build productive relationships, collaborate within a diverse team, embrace challenges and develop your skills, then Cincinnati may be the place for you. We offer career opportunities where you can contribute and grow. Build your future with us Our Field Claims department is currently seeking field claims representatives to service the territory surrounding: Albuquerque, New Mexico. The candidate is required to reside within the territory. This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure accurate settlements. Be ready to: * complete thorough claim investigations * interview insureds, claimants, and witnesses * consult police and hospital records * evaluate claim facts and policy coverage * inspect property and auto damages and write repair estimates * prepare reports of findings and secure settlements with insureds and claimants * use claims-handling software, company car and mobile applications to adjust loss in a paperless environment * provide superior and professional customer service * once eligible, become a certified and active Arbitration Panelist To be an Entry Level Claims Representative: The pay range for this position is $55,000 - $76,000 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance. Be equipped with: * be available and communicative during your regular business hours * a desire to learn about the insurance industry and provide a great customer experience * the ability to work unsupervised * excellent verbal and written communication skills * strong interpersonal skills * excellent problem-solving, negotiation, organizational and prioritization skills * preparedness to follow-up with others in a timely manner * a valid driver's license Bring education or experience from: * a bachelor's degree * AINS, AIC, or CPCU designations preferred Benefits in addition to compensation include: * company car * company stock options, including Restricted Share Units and Incentive based stock options * paid time off (PTO) * 401K with 6% company match To be an Experienced Claims Representative: The pay range for this position is $62,000 - $90,000 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance. Be equipped with: * be available and communicative during your regular business hours * multi-line claims experience preferred * ability to completely assess auto, property, and bodily injury type damages * capacity to work unsupervised * excellent verbal and written communication skills * strong interpersonal skills * excellent problem-solving, negotiation, organizational, and prioritization skills * preparedness to follow-up with others in a timely manner * a valid driver's license Bring education or experience from: * one or more years of claims handling experience * AINS, AIC, or CPCU designations preferred * bachelor's degree or equivalent experience required Benefits in addition to compensation include: * company car * company stock options, including Restricted Share Units and Incentive based stock options * paid time off (PTO) * 401K with 6% company match Enhance your talents Providing outstanding service and developing strong relationships with our independent agents are hallmarks of our company. Whether you have experience from another carrier or you're new to the insurance industry, we promote a lifelong learning approach. Cincinnati provides you with the tools and training to be successful and to become a trusted, respected insurance professional - all while enjoying a meaningful career. Enjoy benefits and amenities Your commitment to providing strong service, sharing best practices and creating solutions that impact lives is appreciated. To increase the well-being and satisfaction of our associates, we offer a variety of benefits and amenities. Embrace a diverse team As a relationship-based organization, we welcome and value a diverse workforce. We grant equal employment opportunity to all qualified persons without regard to race; creed; color; sex, including sexual orientation, gender identity and transgender status; religion; national origin; age; disability; military service; veteran status; pregnancy; AIDS/HIV or genetic information; or any other basis prohibited by law. All job applicants have rights under Federal Employment Laws. Please review this information to learn more about those rights.
    $62k-90k yearly 56d ago
  • Workers' Compensation Claims Manager

    Integrion Group

    Claims adjuster job in Albuquerque, NM

    Job Title: Workers' Compensation Claims Manager Department: Workers' Compensation Reports to: Director of Operations The Workers' Compensation Claims Manager oversees the Workers' Compensation Insurance Claims Department at Integrion Group. This role ensures that all claims are handled and settled in compliance with applicable laws, industry best practices, and company procedures. The Claims Manager is responsible for maintaining high standards of service, compliance with the New Mexico Workers' Compensation Administration and the Industrial Commission of Arizona, and ensuring that all operations are audit-ready. Essential Functions: Claims Oversight: Assign and review claims, applying technical expertise and interpersonal skills to ensure fair settlements, prompt case resolution, and a reduced loss ratio. Team Leadership: Supervise and mentor Claims Adjusters, Technicians, and support staff. Conduct performance evaluations, set individual goals, and identify training needs to foster professional growth. Process Management: Develop, update, and enforce the claims operations manual and attorney guidelines. Ensure efficient processing and payment of claims. Compliance & Quality Assurance: Conduct regular claim file reviews and audits to ensure adherence to procedures, compliance with special account instructions, and accurate documentation of claim payments, reserves, and new claims. Recruitment & Onboarding: Lead hiring decisions for department staff, oversee new hire orientation, and ensure all team members receive comprehensive training and ongoing professional development. Claims Investigation: Review claims investigated by claims adjusters, verify data, and ensure adjudication aligns with client instructions, company policies, and state statutes. Investigate questionable claims and consult with the Director of Operations and/or legal counsel on litigation matters. Vendor & Cost Management: Review and approve vendor partners, identify cost-saving opportunities for clients, and recommend procurement strategies to executive management. Business Development: Represent Integrion Group at industry conferences and seminars, network with professionals, and identify new business opportunities. Provide recommendations to executive management and marketing on potential profit opportunities. Stakeholder Engagement: Build and maintain relationships with clients, management, vendor partners, and industry professionals. Represent the company in public forums and business meetings. Claims Adjusting: adjust workers' compensation claims as needed. Other Duties: Perform additional responsibilities as assigned by management. Job Qualifications: Education and Experience Requirements: Education: Bachelor's degree in Business Administration or a related field. Equivalent experience may be considered. Experience: Minimum of ten (10) years in insurance claims administration or a related field, including at least three (3) years in a supervisory role. Substitutions or exceptions may be authorized by Integrion management. Current New Mexico adjuster license required (or obtained within first 60 days). Knowledge, Skills and Abilities: Strong knowledge of business and management principles, including strategic planning, resource allocation, and leadership techniques. Familiarity with customer service principles, quality standards, and customer satisfaction evaluation. Proficiency with electronic equipment, computer hardware, and software applications, including word processing and spreadsheets. Analytical skills to identify complex problems, evaluate options, and implement effective solutions. Ability to reconcile differences in claims and make sound decisions considering costs and benefits. Excellent interpersonal, oral, and written communication skills. Proven ability to build and maintain relationships across departments and with external stakeholders. Values and Mission: Demonstrate Integrion Group's core values: Service Excellence, Trust, Ownership, One Team, and Boldness in thought and action. Positive Attitude: Foster positive working relationships with team members, customers, and management through effective communication and collaboration. Working Conditions: General office environment with light to moderate physical demands. Adherence to all safety rules, building security protocols, and participation in maintaining safe and efficient operations. Drug-free workplace, with pre-employment and post-incident drug testing. Regular use of computer monitors and digital workstations. Commitment to Diversity, Equity, and Inclusion: Integrion Group is committed to creating a diverse and inclusive workplace. We encourage applicants from all backgrounds and experiences to apply.
    $52k-95k yearly est. 40d ago
  • Senior Analyst, Claims Research

    Molina Healthcare Inc. 4.4company rating

    Claims adjuster job in Albuquerque, NM

    The Senior Claims Research Analyst provides senior-level support for claims processing and claims research. The Sr. Analyst, Claims Research serves as a senior-level subject matter expert in claims operations and research, leading the most complex and high-priority claims projects. This role involves advanced root cause analysis, regulatory interpretation, project management, and strategic coordination across multiple departments to resolve systemic claims processing issues. The Sr. Analyst provides thought leadership, develops remediation strategies, and ensures timely and accurate project execution, all while driving continuous improvement in claims performance and compliance. Additionally, the Sr. Analyst will represent the organization internally and externally in meetings, serving as a key liaison to communicate findings and resolution plans effectively. Job Duties * Uses advanced analytical skills to conduct research and analysis for issues, requests, and inquiries of high priority claims projects * Assists with reducing re-work by identifying and remediating claims processing issues * Locate and interpret regulatory and contractual requirements * Expertly tailors existing reports or available data to meet the needs of the claims project * Evaluates claims using standard principles and applicable state specific policies and regulations to identify claims processing error * Act as a senior claims subject matter expert, advising on complex claims issues and ensuring compliance with regulatory and contractual requirements. * Leads and manages major claims research projects of considerable complexity, initiated through provider inquiries, complaints, or internal audits. * Conducts advanced root cause analysis to identify and resolve systemic claims processing errors, collaborating with multiple departments to define and implement long-term solutions. * Interprets regulatory and contractual requirements to ensure compliance in claims adjudication and remediation processes. * Develops, tracks, and / or monitors remediation plans, ensuring claims reprocessing projects are completed accurately and on time. * Provides in-depth analysis and insights to leadership and operational teams, presenting findings, progress updates, and results in a clear and actionable format. * Takes the lead in provider meetings, when applicable, clearly communicating findings, proposed solutions, and status updates while maintaining a professional and collaborative approach. * Proactively identifies and recommends updates to policies, SOPs, and job aids to improve claims quality and efficiency. * Collaborates with external departments and leadership to define claims requirements and ensure alignment with organizational goals. Job Qualifications REQUIRED QUALIFICATIONS: * 5+ years of experience in medical claims processing, research, or a related field. * Demonstrated expertise in regulatory and contractual claims requirements, root cause analysis, and project management. * Advanced knowledge of medical billing codes and claims adjudication processes. * Strong analytical, organizational, and problem-solving skills. * Proficiency in claims management systems and data analysis tools * Excellent communication skills, with the ability to tailor complex information for diverse audiences, including executive leadership and providers. * Proven ability to manage multiple projects, prioritize tasks, and meet tight deadlines in a fast-paced environment. * Microsoft office suite/applicable software program(s) proficiency PREFERRED QUALIFICATIONS: * Bachelor's Degree or equivalent combination of education and experience * Project management * Expert in Excel and PowerPoint * Familiarity with systems used to manage claims inquiries and adjustment requests To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $106,214 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $80.2k-106.2k yearly 15d ago
  • Rec Marine Adjuster

    Sedgwick 4.4company rating

    Claims adjuster job in Albuquerque, NM

    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 Rec Marine Adjuster **PRIMARY PURPOSE** **:** To investigate and process marine claims adjustments for clients; to handle complex losses locally unassisted up to $50,000 and assist the department on larger losses. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates the cause and extent of the damages, obtains appropriate documentation, and issues settlement. + Receives and reviews new claims and maintains data integrity in the claims system. + Reviews survey reports and insurance policies to determine insurance coverage. + Prepares settlement documents and requests payment for the claim and expenses. + Assists in preparing loss experience report to help determine profitability and calculates adequate future rates. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Appropriate state adjuster license is required. **Experience** 3 years or more of Marine Adjusting preferred. **Skills & Knowledge** + Strong oral and written communication skills + PC literate, including Microsoft Office products + Good customer service skills + Good organizational skills + Demonstrated commitment to timely reporting + Ability to work independently and 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** **:** + Must be able to stand and/or walk for long periods of time. + Must be able to kneel, squat or bend. + Must be able to work outdoors in hot and/or cold weather conditions. + Have the ability to climb, crawl, stoop, kneel, reaching/working overhead + Be able to lift/carry up to 50 pounds + Be able to push/pull up to 100 pounds + Be able to drive up to 4 hours per day. + Must have continual use of manual dexterity **Auditory/Visual** **:** Hearing, vision and talking 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**
    $50k yearly 49d ago
  • Claims Investigator - Experienced

    Command Investigations

    Claims adjuster job in Albuquerque, NM

    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 RPlQMliA1V
    $36k-49k yearly est. 30d ago
  • 1099 Daily Experienced Licensed Field Adjuster - New Mexico

    Struction Solutions

    Claims adjuster job in Albuquerque, NM

    Struction Solutions, a leading source for commercial and residential claims servicing clients. all over the U.S. We are trying to build our roster in various locations through out the United States for future assignments. The Field Adjuster will be assigned daily claims. Skill Set: Xactimate experience is required. Prefer 3+ years experience handling property field claims. Preferred Commercial Experience. Must have valid state Adjuster Licenses. Excellent customer service, written and verbal communications skills to effectively manage and prepare reports. Be a part of the Solution! View all jobs at this company
    $42k-56k yearly est. 60d+ ago
  • Daily Property Field Adjuster

    Alacrity Solutions

    Claims adjuster job in Albuquerque, NM

    Job Description Alacrity Solutions Independent Contractor Daily Property Field Adjuster Alacrity Solutions is a full end-to-end provider delivering streamlined insurance claims, repair, and recovery solutions. As one of the largest independent providers of insurance claims services in North America, we provide property, auto, heavy equipment, and casualty claims management services. Our staffing capabilities, temporary housing services, managed repair network, and subrogation services support a fully integrated solution for all your needs from first notice of loss through completion of repairs. By assembling the best service providers through strategic acquisitions and relying on the right talent, Alacrity Solutions provides consistent, professional, and scalable services throughout the entire claim handling and resolution process. To learn more, visit ************************** The objective of a Daily Property Field Adjuster is to provide excellent claim handling services for our clients regarding daily claim work within your area which can include multiple perils. Contract Requirements Include: A contract will be issued within 24 hours of accepting your first claim assignment with Alacrity. This IA contract will include pay details and other pertinent information regarding your work as an independent contract with Alacrity. A completed contract is required to issue pay. Skills & Requirements/Licensure: MUST live within 50-100 miles of posted location and willing to travel to location. Minimum 2-3 years property field adjusting experience. Independent adjusting license in your home state (area of work), or a designated home state license if residing in a non-licensing state. Experienced in wind, hail, theft, fire, water losses and other perils preferred. Have reliable transportation, computer, digital camera, ladder, and other miscellaneous items necessary to perform adjuster responsibilities. Willing and able to climb roofs. Computer and Phone System Requirements: Smart Cell Phone able to access to internet. Xactimate and/or Symbility proficient with current subscription Working Laptop computer with reliable high-speed internet Digital camera and other miscellaneous items necessary to perform adjuster responsibilities. Working Conditions / Physical & Mental Demands: The physical demands described here are representative and must be met by the independent contractor to successfully perform this job. 100% travel is required within designated working territory based on the location of assignments received. Normal office or field claims environment. Ability to operate a motor vehicle for up to 8 hours daily, repeatedly entering and exiting the vehicle. Must be able to make physical inspections of auto loss sites. Must be able to work outdoors in all types of weather. Available to work catastrophic loss events. A willingness to work irregular hours and to travel with possible overnight requirements a plus. Why Choose Alacrity? Flexibility: Self-determined Scheduling Diversity Statement Alacrity is an equal opportunity employer and is committed to providing employees with a work environment free of discrimination and harassment. All decisions pertaining to an employee's employment are made without regard to race, color, religion, sex (including sexual orientation, pregnancy, childbirth), gender, gender identity or expression, age, national origin, ancestry, physical or mental disability, medical condition, reproductive health decisions, veteran's status, genetic information, creed, marital status, disability, citizenship status, or any other characteristic protected by applicable law. How Long We Retain Personal Information: We will keep your personal information for as long as necessary to fulfill legitimate business purposes and in accordance with applicable laws. Powered by JazzHR MdlxsbES7g
    $42k-56k yearly est. 15d ago
  • Claims Specialist- Journal Center, (784)

    Tricore Reference Laboratories 4.6company rating

    Claims adjuster job in Albuquerque, NM

    Schedule: Monday-Friday 8:00 AM-5:00PM and other shifts as needed. Responsible for collecting accounts receivables on patient accounts, non-government and contracted insurances government payers and secondary billing. Responsibilities include routine follow-up on accounts, working the Rejection Report for contracted insurances, analyzing aged trial balance report for assigned charge to's, working the Antrim, Rhodes reports and miscellaneous accounts receivable reports. ESSENTIAL FUNCTIONS: 1. Collects outstanding accounts receivables on patient accounts from patient, commercial, non-government, contracted insurances or government payors via phone call to the patient or insurance company or by means of written appeal or reconsideration. 2. Pursues collection activities on assigned accounts from primary and secondary payors until worked to resolution to include claims resubmission, appeal or reconsideration. 3. Works account receivables reports (i.e. aged-trial-balance report), focusing attention on accounts over 60 days. 4. Researches adjustments and pull all necessary backup to support adjustments. 5. Utilizes on-line insurance resources to obtain and maintain current information. 6. Develops and maintains a professional working rapport with internal and external customers to include contacts with insurance company representatives. 7. Identifies trends in payment or non-payment of claims. Communicates findings to leadership and co-workers as appropriate. 8. Customizes reports in Antrim and or Excel to prioritize accounts for collecting. The above statements describe the general nature and level of work being performed by individuals assigned to this classification. This is not intended to be an exhaustive list of all responsibilities and duties required of personnel so classified. MINIMUM EDUCATION: High school diploma or equivalent MINIMUM EXPERIENCE: Must have one of the following: Six (6) months as an Apprentice in the Business Office at TriCore Minimum of one (1) year of laboratory or medical claims follow-up/collections experience Minimum of three (3) years of medical billing or claims processing experience OTHER REQUIREMENTS: Must be able to type 30 words per minute (typing test required) Must have basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows based applications PREFERENCES: Basic knowledge of Excel and Word Knowledge of medical terminology IMMUNIZATION REQUIREMENTS: Prove immunity to Hepatitis B or be immunized or sign a waiver refusing hepatitis immunization. Provide documentation of a PPD test conducted not more than 90 days prior to date of hire or have a PPD test conducted. GENERAL REQUIREMENTS: 1. Proficient in PC/data entry skills 2. Must be able to work independently with little direction and to demonstrate sound judgment and problem solving skills 3. Ability to resolve problems and follow up as needed or appropriate 4. Effective communication skills and telephone skills 5. Ability to deal with difficult clients and patients 6. Strong working knowledge of insurance and reimbursement
    $38k-62k yearly est. 60d+ ago
  • Claims Adjuster Professional Trainee

    New Mexico Mutual Casualty Company 4.0company rating

    Claims adjuster job in Albuquerque, NM

    Job Title: Claims Adjuster Professional Trainee Department: Claims Reports to: Claims Manager This position will be responsible, following the initial training phase, for the adjudication of all assigned claims in accordance with the Act, governing rules and regulations, related case law and company procedures. Case complexity assignment is determined by the responsible claims manager and is guided by the level of training and performance of the claims adjuster trainee candidate. The Claims Professional Trainee position is designed to introduce the individual to the workers' compensation claims function of New Mexico Mutual over a one-year (1) period of time. This candidate will have access to a comprehensive and formal training program under the direct guidance and supervision of our claims training manager, with active participation from other claims management personnel and claims specialists. Essential Functions: This claim training will cover claim investigation, compensability, policy coverage, statutory law, case law, benefits analysis and payment, litigation, medical and claims resolution. Responsibilities include effective and consistent partnership with the employer, injured worker and medical provider, administration of benefits, litigation management and claims resolution. Verify claim information including but not limited to: documentation of the claim history; taking recorded statements from workers and witnesses, coordination of medical care. Document all activities in the claim management system. Responsible for outside legal counsel assignments, RTW strategies & all other expert assignments. Upon determination of compensability: Set and monitor reserves according to company policies and the worker's injury, issue benefit checks in accordance to statutory requirements, and demonstrate proficiency in the application of state statutes, related case law and to interpret and comply with company claims standards, policies and procedures. Make required filings and ensure benefit payments within the established time frames and guidelines. Prepare, attend, and present a majority of all mediations and hearings. Represent the company at trial. Maintain a diary on all open claims. Document all relevant information to provide a clear history of events and a proper audit trail. Set review dates based on claim complexity or standard review criteria. Perform other duties as assigned. Requirements Job Qualifications Education: Bachelor's Degree from an accredited college or university. Experience: No prior claims handling experience is necessary for this position. Specialized Knowledge, Licenses, etc.: MS Office (Word, Advanced Excel, PowerPoint, Outlook) Values and Mission: Adheres to New Mexico Mutual's values and mission by demonstrating Service Excellence, Trust, Ownership, One Team and Boldness in thought and action. Positive Attitude: Develops and maintains positive working relationships with team members, customers, co-workers, and management by demonstrating effective communication and collaborative skills. Working Conditions: NEW MEXICO MUTUAL maintains general office conditions with light physical demands. Employees of NEW MEXICO MUTUAL adhere to all safety rules and regulations including building security. Employees participate in ensuring safe and efficient operating conditions that safeguard employees and facilities. NEW MEXICO MUTUAL maintains a drug free environment; drug testing prior to employment as well as upon a work-related accident. Exposure to VDT screens.
    $44k-52k yearly est. 20d ago
  • Property Claims Adjuster - Daily Albuquerque, NM

    Cenco Claims 3.8company rating

    Claims adjuster job in Albuquerque, NM

    CENCO Claims is seeking a driven Property Claims Adjuster to manage daily residential property inspections in the Albuquerque, NM area. This field position offers dependable claim volume, flexible scheduling, and direct support from an experienced in-house claims team. What You'll Be Responsible For: Conduct on-site residential property inspections to evaluate reported losses Prepare accurate and well-supported estimates using Xactimate Gather detailed photo documentation and complete clear written reports Communicate professionally with policyholders and carrier representatives Submit organized, timely claim files that meet carrier guidelines What We're Looking For: Working knowledge of Xactimate estimating software Strong understanding of residential construction and damage evaluation Excellent organization, communication, and time-management skills Reliable transportation and a valid driver's license Active New Mexico or designated home state adjuster license What We Offer: Competitive per-file compensation Consistent residential claim volume in the Albuquerque market Flexible scheduling with autonomy in the field Dedicated internal support to assist with file handling and questions Apply Today
    $44k-58k yearly est. Auto-Apply 60d+ ago
  • Claims Investigator - Experienced

    Command Investigations

    Claims adjuster job in Albuquerque, NM

    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.
    $36k-49k yearly est. Auto-Apply 60d+ ago
  • Daily Scope Only Property Field Adjuster

    Alacrity Solutions

    Claims adjuster job in Albuquerque, NM

    Alacrity Solutions Independent Contractor Daily Scope Only Property Field Adjuster Alacrity Solutions is a full end-to-end provider delivering streamlined insurance claims, repair, and recovery solutions. As one of the largest independent providers of insurance claims services in North America, we provide property, auto, heavy equipment, and casualty claims management services. Our staffing capabilities, temporary housing services, managed repair network, and subrogation services support a fully integrated solution for all your needs from first notice of loss through completion of repairs. By assembling the best service providers through strategic acquisitions and relying on the right talent, Alacrity Solutions provides consistent, professional, and scalable services throughout the entire claim handling and resolution process. To learn more, visit ************************** The objective of a Daily Scope Only Field Adjuster is to provide excellent scope-only handling services for our clients regarding daily claim work within your area which can include multiple perils. Contract Requirements Include: A contract will be issued within 24 hours of accepting your first claim assignment with Alacrity. This IA contract will include pay details and other pertinent information regarding your work as an independent contract with Alacrity. A completed contract is required to issue pay. Skills & Requirements/Licensure: MUST live within 50-100 miles of posted location and willing to travel to location. Experience as a roofing contractor, installer OR background in construction or building inspections is highly recommended. Well-versed in roofing material options, construction standards, and recurring structural issues. Knowledge of common signs of wear, damage, and potential issues regarding home inspections. Have reliable transportation, computer, digital camera, ladder, and other miscellaneous items necessary to perform adjuster responsibilities. Willing and able to climb roofs. Computer and Phone System Requirements: Smart Cell Phone able to access to internet. Working Laptop computer with reliable high-speed internet Digital camera and other miscellaneous items necessary to perform adjuster responsibilities. Working Conditions / Physical & Mental Demands: The physical demands described here are representative and must be met by the independent contractor to successfully perform this job. 100% travel is required within designated working territory based on the location of assignments received. Normal office or field claims environment. Ability to operate a motor vehicle for up to 8 hours daily, repeatedly entering and exiting the vehicle. Must be able to make physical inspections of auto loss sites. Must be able to work outdoors in all types of weather. Available to work catastrophic loss events. A willingness to work irregular hours and to travel with possible overnight requirements a plus. Why Choose Alacrity? Flexibility: Self-determined Scheduling Diversity Statement Alacrity is an equal opportunity employer and is committed to providing employees with a work environment free of discrimination and harassment. All decisions pertaining to an employee's employment are made without regard to race, color, religion, sex (including sexual orientation, pregnancy, childbirth), gender, gender identity or expression, age, national origin, ancestry, physical or mental disability, medical condition, reproductive health decisions, veteran's status, genetic information, creed, marital status, disability, citizenship status, or any other characteristic protected by applicable law. How Long We Retain Personal Information: We will keep your personal information for as long as necessary to fulfill legitimate business purposes and in accordance with applicable laws.
    $42k-56k yearly est. Auto-Apply 60d+ ago
  • Claims Specialist-Journal Center, (783)

    Tricore Reference Laboratories 4.6company rating

    Claims adjuster job in Albuquerque, NM

    Schedule: Monday-Friday 0800 - 1230 w/ 30 min lunch and other shifts as needed. Responsible for collecting accounts receivables on patient accounts, non-government and contracted insurances government payers and secondary billing. Responsibilities include routine follow-up on accounts, working the Rejection Report for contracted insurances, analyzing aged trial balance report for assigned charge to's, working the Antrim, Rhodes reports and miscellaneous accounts receivable reports. ESSENTIAL FUNCTIONS: 1. Collects outstanding accounts receivables on patient accounts from patient, commercial, non-government, contracted insurances or government payors via phone call to the patient or insurance company or by means of written appeal or reconsideration. 2. Pursues collection activities on assigned accounts from primary and secondary payors until worked to resolution to include claims resubmission, appeal or reconsideration. 3. Works account receivables reports (i.e. aged-trial-balance report), focusing attention on accounts over 60 days. 4. Researches adjustments and pull all necessary backup to support adjustments. 5. Utilizes on-line insurance resources to obtain and maintain current information. 6. Develops and maintains a professional working rapport with internal and external customers to include contacts with insurance company representatives. 7. Identifies trends in payment or non-payment of claims. Communicates findings to leadership and co-workers as appropriate. 8. Customizes reports in Antrim and or Excel to prioritize accounts for collecting. The above statements describe the general nature and level of work being performed by individuals assigned to this classification. This is not intended to be an exhaustive list of all responsibilities and duties required of personnel so classified. MINIMUM EDUCATION: High school diploma or equivalent MINIMUM EXPERIENCE: Must have one of the following: Six (6) months as an Apprentice in the Business Office at TriCore Minimum of one (1) year of laboratory or medical claims follow-up/collections experience Minimum of three (3) years of medical billing or claims processing experience OTHER REQUIREMENTS: Must be able to type 30 words per minute (typing test required) Must have basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows based applications PREFERENCES: Basic knowledge of Excel and Word Knowledge of medical terminology IMMUNIZATION REQUIREMENTS: Prove immunity to Hepatitis B or be immunized or sign a waiver refusing hepatitis immunization. Provide documentation of a PPD test conducted not more than 90 days prior to date of hire or have a PPD test conducted. GENERAL REQUIREMENTS: 1. Proficient in PC/data entry skills 2. Must be able to work independently with little direction and to demonstrate sound judgment and problem solving skills 3. Ability to resolve problems and follow up as needed or appropriate 4. Effective communication skills and telephone skills 5. Ability to deal with difficult clients and patients 6. Strong working knowledge of insurance and reimbursement
    $38k-62k yearly est. 60d+ ago
  • National General Adjuster - Southwest Region

    Sedgwick 4.4company rating

    Claims adjuster job in Albuquerque, NM

    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 National General Adjuster - Southwest Region **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any complex adjustment issue and any medium sized and relatively complex National Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims, and other records to determine insurance coverage. + Administers and reconciles complex catastrophic claims for property. + Interviews, telephones, or corresponds with claimant(s) and witnesses regarding claim. + Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance. + Estimates cost of repair, replacement, or compensation. + Prepares report of findings and negotiates settlement with claimant. + Recommends litigation by legal department when settlement cannot be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probably costs. + Prepares loss experience reports to help determine profitability and calculates adequate future rates. + Interacts with excess carrier to determine coverages, excess insurance levels, and potential reimbursements. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Must have earned the IIA-AIC designation and be actively pursuing another professional insurance designation. **Experience** Five (5) years of related experience or equivalent combination of education and experience required. **Skills & Knowledge** + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong customer service skills + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently or 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 and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: + Ability to stand and/or walk for long periods of time. + Ability to kneel, squat or bend. + Ability to work outdoors in hot and/or cold weather conditions. + Ability to climb, crawl, stoop, kneel, reaching/working overhead. + Ability to lift/carry up to 50 pounds. + Ability to push/pull up to 100 pounds. + Ability to drive up to 4 hours per day. + Must have continual use of manual dexterity. Auditory/Visual: Hearing, vision and talking. 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. 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 77,321.00 - 108,250.00. (Bonus or commission eligibility, if applicable). 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. 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**
    $53k-68k yearly est. 60d+ ago
  • Claims Specialist

    New Mexico Mutual Casualty Company 4.0company rating

    Claims adjuster job in Albuquerque, NM

    Job Title: Claims Specialist Department: Claims Reports To: Claims Manager This position provides expert claim handling services in the areas of coverage, compensability, investigation, evaluation, negotiation, litigation management and resolution of serious and complex workers' compensation insurance claims under applicable law, corporate policy and best practice. Quality claim handling expertise, Service Excellence and indemnity and expense management will also be provided by the position. The claims specialist will also be an expert technical resource to other claims professionals, business partners, policyholders and stakeholders. Essential Functions: Evaluate, analyze and determine compensability, causation, offsets and exposures of serious and complex workers compensation insurance claims in accordance with applicable law, corporate policy, best practice and prescribed authorities Verify claim information including but not limited to: documentation of the claim history; taking recorded statements from workers and witnesses, identify subrogation opportunities, coordination of medical care. Document all activities in the claim management system. Responsible for outside legal counsel assignments, RTW strategies with policyholders, implement medical case management strategies with nurse case managers and all other expert assignments. Upon determination of compensability: Set and monitor reserves according to company policies and the worker's injury, issue benefit checks in accordance to statutory requirements, and demonstrate proficiency in the application of state statutes, related case law and to interpret and comply with company claims standards, policies and procedures. Must have above-average knowledge, understanding and ability to apply case law to claim handling practices. Ensure the timely and accurate statutory/benefit payments within the established time frames and guidelines. Prepare and participate in mediation conferences and other authorized legal or regulatory proceedings before the regulatory agencies and courts of law. Maintain a diary on all open claims. Document all relevant information to provide a clear history of events and a proper audit trail. Set review dates based on claim complexity or standard review criteria. Assess and report claims litigation for significant financial exposure, case law precedent or reputation risk. Identify and recommend claims with potential for full and final settlement and negotiate and/or coordinate with authorized outside legal counsel in full and final settlements. Analyze assigned claims to identify trends and opportunities for improvement of policies, procedures and controls, and prepare related reports. Mentor junior adjusters and provide support to Claims Managers as directed. Detect and report reasonable suspicions of insurance fraud by claimants, medical or legal providers, policyholders or other individuals related to claims. Maintain claim records in compliance with applicable law, corporate policies and retention schedules. Requirements Job Qualifications: Education: Bachelor's Degree from an accredited college or university. Experience: 5+ years of serious workers' compensation claims experience. 10+ claims handling experience. Specialized Knowledge, Licenses, etc.: Demonstrated proficiency in: Related professional certifications preferred State required adjuster's license Values and Mission: Adhere to values and mission by demonstrating Service Excellence, Trust, Ownership, One team and Boldness in thought and action. Positive Attitude: Develops and maintains positive working relationships with team members, customers, co-workers and management by demonstrating effective communication and collaborative skills. Working Conditions: NEW MEXICO MUTUAL maintains general office conditions with light physical demands, with occasional lifting. Employees of NEW MEXICO MUTUAL adhere to all safety rules and regulations including building security. Employees participate in ensuring safe and efficient operating conditions that safeguard employees and facilities. NEW MEXICO MUTUAL maintains a drug free environment; drug testing prior to employment as well as upon a work related accident. Exposure to VDT screens.
    $36k-52k yearly est. 20d ago

Learn more about claims adjuster jobs

How much does a claims adjuster earn in Albuquerque, NM?

The average claims adjuster in Albuquerque, NM earns between $40,000 and $58,000 annually. This compares to the national average claims adjuster range of $40,000 to $64,000.

Average claims adjuster salary in Albuquerque, NM

$48,000

What are the biggest employers of Claims Adjusters in Albuquerque, NM?

The biggest employers of Claims Adjusters in Albuquerque, NM are:
  1. New Mexico Mutual
  2. Work At Home Vintage Experts
  3. Eac Holdings LLC
  4. Reynolds and Reynolds
  5. Cenco
  6. Milehigh Adjusters Houston
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