Subrogation Investigative Claim Representative II - The Auto Club Group
Reports to: Claim Manager as appropriate
What you will do:Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards. Take statements and establish clear evaluation and resolution plans for claims.
Assist with subrogation investigations. This may include insurance verification, obtaining proofs, taking recorded statements, and hiring experts.
Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim, and initiating documentation in the claim handling system.
Complete an investigation of the facts and determine possible recovery potential.
Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
Evaluate the financial value of the loss.
Approve payments for the appropriate parties accordingly.
Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
Utilize strong negotiating skills.
Supervisory Responsibilities:None
How you will benefit:
A competitive annual salary between $57,500.00 - $85,000.00
ACG offers excellent and comprehensive benefits packages, including:
Medical, dental and vision benefits
401k Match
Paid parental leave and adoption assistance
Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
Paid volunteer day annually
Tuition assistance program, professional certification reimbursement program and other professional development opportunities
AAA Membership
Discounts, perks, and rewards and much more
We're looking for candidates who: Education:
Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states
Experience:One year of experience with:
Negotiating claim settlements
Securing and evaluating evidence
Preparing manual and electronic estimates
Subrogation claims
Resolving coverage questions
Taking statements
Establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Essential Insurance Act (Michigan)
Fair Trade Practices Act as it relates to claims
Subrogation procedures and processes
Intercompany arbitration
Technical knowledge of:
Negligence Law
No-Fault Law
Collision repair shop
Ability to:
Handle claims to the line Claim Handling Standards
Follow and apply ACG and Meemic Claim policies, procedures and guidelines
Work within assigned Meemic Claim systems including basic PC software
Perform basic claim file review and investigations
Demonstrate effective communication skills (verbal and written)
Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
Analyze and solve problems while demonstrating sound decision making skills
Prioritize claim related functions
Process time sensitive data and information from multiple sources
Manage time, organize and plan workload and responsibilities
Research analyze and interpret subrogation laws in various states
Strong negotiating skills
Work Environment
This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.
Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit ***********
Important Note:
ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
$57.5k-85k yearly 1d ago
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Manager, Medicare Claims
Blue Cross and Blue Shield of North Carolina 4.3
Claims adjuster job in Atlanta, GA
The Manager, Medicare Claims, oversees end-to-end claims services for provider segments, meeting business goals. This role sets performance targets, manages claims processing and financials, handles submissions, refunds, and recoveries, and ensures claims accounting and reporting. Collaboration with claims leadership ensures alignment with customer needs and contracts.
What You'll Do
Streamline shared processing to reduce management by exception
Set operational process to address market trends, BCBSNC capabilities and customer demand
Manage accounting and financial reporting functions in support of the Finance Division including overseeing the gathering, preparation, analysis, and reconciliation of financial data to ensure compliance with accepted accounting principles and standards.
Participate in projects to improve and/or facilitate claims processing, recovery, and accounting functions.
Manage financial recovery activities including refunds and collections
Manage team leads and staff by efficiently driving work volume to keep high level of utilization and engagement in the group
Resolve complex claims appeal by coordinating with different stakeholders for certain high value claims
Collaborate with Audit and Payment Integrity to sustain a pre-determined level of accuracy and quality
Design and develop tools and techniques for improvements. Identifies needed process and procedural changes which will result in improved customer satisfaction.
Serve as Medicare Claims Subject Matter Expert and single point of contact for performance monitoring and troubleshooting.
Represent Claims Operations on monthly CMS calls with CMS Account manager answering questions, providing status updates and expertise routinely and on demand.
Ability to engage as requested by Compliance with regulatory entities, especially CMS on monthly calls and serve as an internal point of contact to prepare feedback on issues under CMS review.
Use good judgement in understanding issues and work with compliance to prepare for discussions.
Ability to represent claims as a knowledgeable SME.
What You Bring
Bachelor's degree or advanced degree (where required)
8+ years of experience in related field.
In lieu of degree, 10+ years of experience in related field.
Bonus Points
1-2 years of Medicare and Medicaid experience or a highly regulated operational environment - highly preferred
Strong analytical skills with the ability to drive change and manage operations
Ensure risks associated with business activities are effectively identified, measured, monitored and controlled within accordance with compliance policies and procedures
What You'll Get
The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.
Work-life balance, flexibility, and the autonomy to do great work.
Medical, dental, and vision coverage along with numerous health and wellness programs.
Parental leave and support plus adoption and surrogacy assistance.
Career development programs and tuition reimbursement for continued education.
401k match including an annual company contribution
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
*Based on annual corporate goal achievement and individual performance.
$98,092.00 - $156,947.00
Skills
Accounts Receivable (AR), Claims Analysis, Claims Management, Claims Processing, Claims Resolution, Claims Submission, Documentations, Financial Processing, Health Insurance, Insurance Claim Handling, Insurance Claims Processing, Insurance Industry, Medicare Advantage, People Management, Recruiting
$98.1k-156.9k yearly 22h ago
Workers' Compensation Claims Adjuster - Temp
Argonaut Management Services, Inc.
Claims adjuster job in Charlotte, NC
Argo Group International Holdings, Inc.and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. ("BWS"), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions.
Job Description
Business Title(s):Workers' Compensation ClaimsAdjuster
Employment Type:Contingent Worker
FLSA Status:Non-Exempt
Location:In-Officeor Remote
Summary:
Although Rockwood underwrites general liability insurance and workers' compensation for many types of businesses, ourspecialtyis underwriting workers' compensation insurance for the mining industry, with a focus on the coal-mining industry. Rockwood has become a leading underwriter of workers' compensation for the mining industry by offering workers' compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal. We have never been more committed to our clients to ensure their employees receive excellent medical care if they need it due to a work-related injury or illness. Our passion for outstanding customer focus, combined with our deep industry experience, is what sets up apart from other insurance carriers in this niche market.
We are looking for a highly capable Workers' Compensation ClaimsAdjuster to help us on a temporary assignment through13February2026 and work from anywhere in the continental United States.
If this assignment is filled in one of our following offices, the assignment can be considered temp-to-hire: Albany, Chicago, Los Angeles, New York,Omaha, Richmond (VA), Rockwood (PA), or Springfield (MO). This role will adjudicate indemnity workers' compensation claims of higher technical complexity for our customers in the states of WY, KY, IL, IN, KY, NY, PA, and VA. This temporary role will also adjudicate medical-only and traumatic injury claims. The position supports clients primarily within the coal mining industry, requiring experience adjudicating claims in heavy industrial or mining environments.
As this is a temporary assignment, only government-mandated benefits will be provided.
Essential Responsibilities:
Working under technical direction and within significant limits and authority,adjudicateworkers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Resolving issues that are generalized and typically notcomplex butrequire understanding of a broader set of issues.
Reporting to senior management and underwriters onclaimstrends and developments.
Investigating claims promptly and thoroughly.
Analyzing claims forms, policies and endorsements, client instructions, and other records todeterminewhether the loss falls within the policy coverage.
Investigating claims promptly and thoroughly, including interviewing all involved parties.
Managing claims in litigation.
Managing diarytimelyand complete tasks to ensure that cases move to the best financial outcome andtimelyresolution.
Properly setting claim reserves.
Identifying, assigning, and coordinating the assignment and coordination ofexpertiseresources toassistin case resolution.
Preparing reports for file documentation.
Applying creative solutions which result in the best financial outcome.
Negotiating settlements.
Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
Having an appreciation and passion for strong claim management.
Qualifications / Experience Required:
A practical knowledge ofadjudicatingworkers' compensation claims through:
A minimum of two years' experienceadjudicatingindemnity workers' compensation claims in one or more of the following jurisdictions: IL, IN, KY, NY, PA, and/or VA.
Bachelor'sdegree from an accredited universityrequired. Two or more insurance designations or fouradditionalyears of related experienceadjudicatingindemnity claims beyond the minimum experiencerequiredabove may be substituted in lieu of a degree.
Must be licensed in KYand NY
Must have good business acumen (i.e.understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable).
A practical knowledge ofadjudicatingworkers' compensation claims through:
Must have excellent communication skills and the ability to build lasting relationships.
Exhibit natural curiosity
Desireto work in a fast-paced environment.
Excellent evaluation and strategic skillsrequired.
Strong claim negotiation skillsa must.
Mustpossessa strong customer focus.
Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
Ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include CEO.
Must work independently anddemonstratethe ability to exercise sound judgment.
Demonstrates inner strength. Has the courage to do the right thing anddemonstratesit on a daily basis.
Intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
Proficient in MS Office Suite and other business-related software.
Polished and professional written and verbal communication skills.
The ability to read and write English fluently isrequired.
Mustdemonstratea desire for continued professional development through continuing education and self-development opportunities.
The base salary range provided below is for hires in those geographic areas only and will becommensuratewith candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.
Colorado outside of Denver metro, Maryland, Nevada, and Rhode Island Pay Ranges:$37.66- $44.33per hour
California outside of Los Angeles and San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Houston metro area, New York State (including Westchester County)and Washington State Pay Ranges:$41.44- $48.79per hour
Los Angeles, New York City and San Francisco metro areas Pay Ranges:$45.12- $53.16per hour
About Working in Claims at Argo Group
Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions andtreateach case as the unique situation it is.
We have a very flat organizational structure, enabling our employeeshavemore interaction with our senior management team, especially when it relates to reviewing large losses.
Our entire claims team works in a collaborative nature to expeditiously resolve claims.We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.
We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.
PLEASE NOTE:
Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.
If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at .
Notice to Recruitment Agencies:
Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions.
We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics.
The collection of your personal information is subject to our HR Privacy Notice
Benefits and Compensation
We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.
$37.7-44.3 hourly 1d ago
Claims Specialist - New York Labor Law
James River Management Company 4.7
Claims adjuster job in Richmond, VA
Come grow with James River Insurance!
James River Insurance is an excess and surplus lines segment of James River Group Holdings, Inc. and operates on an approved non-admitted basis in 50 states and Washington, DC. Since 2003, James River has provided thousands of commercial property and casualty customers with innovative and creative solutions for particular insurance needs.
At James River Insurance, we are committed to providing a stable and rewarding work environment supported by our Core Values and Guiding Principles: Integrity, Accountability, Innovation, Customer Service, Communication, and Teamwork. We are proud of being recognized the past 5 years as one of The Top Workplaces USA.
James River Group Holdings, Inc. is a Bermuda-based insurance holding company which owns and operates a group of specialty insurance and reinsurance companies. The Company operates in two specialty property and casualty insurance segments: Excess and Surplus Lines and Specialty Admitted Insurance. The Company tends to focus on accounts associated with small or medium-sized businesses in each of its segments. Each of the Company's regulated insurance subsidiaries are rated "A-" (Excellent) by A.M. Best Company.
Job Summary
Under minimal supervision, the Claims Specialist manages a caseload of moderate to high complexity New York Labor Law commercial insurance claims. The incumbent will review claims to analyze and determine applicable coverage, facts, liability, damages, and plan for resolution in accordance with state and company guidelines. The incumbent will be recognized as having extensive claims handling experience, including the handling of complex high exposure claims.
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 and determine facts based on evidence and interviews
Draft disclaimers and reservation of rights letters when coverage issues arise
Assign limited investigations and appraisals to licensed insurance professionals
Manage a caseload of moderate to 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
Prepare correspondence to all required parties involved in a claim
Provide technical guidance, assistance, and training to Claims Associates and Claims Examiners
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
Maintain a passing quality assurance score on all audits and QAs
Handle claims in accordance with established James River Claims Best Practices
Other duties as required by management
Knowledge, Skills and Abilities
Expertise in claim handling and suit management
Moderate to advanced knowledge of P&C insurance industry
Ability to effectively assess risk
Proficiency in MS Office (Word, Excel, Outlook)
Excellent written and verbal communication skills
Excellent organizational skills
Ability to take direction from management
Ability to work independently and take initiative
Ability to exercise sound judgement in making critical decisions
Research, analysis and problem-solving skills
Strong negotiation skills
Ability to build effective relationships with business partners
Ability to perform effectively as part of a team
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
High school diploma required
Bachelor's Degree preferred
Advanced Degree or Juris Doctorate Degree preferred
Minimum of seven years of New York Labor Law claims handling experience including working with complex coverage issues, handling liability and coverage issues, multi-jurisdictional claims, and negotiating settlements with claimants and attorneys required
Adjuster license and/or certifications desired preferred
#LI-KS1
#LI-Remote
Please note that this position is not eligible for H-1B visa sponsorship. All applicants must be currently authorized to work in the United States on a full-time basis without the need for current or future H-1B sponsorship.
$49k-89k yearly est. 2d ago
Claims Technician - Cyber
Beazley Group
Claims adjuster job in Atlanta, GA
General
Job Title: Claims Technician
Division: Group Claims
Reports To: Claims Product Specialist and/or Claims Focus Group Leader, as per Beazley's organisation chart
Key Relationships: Claims management and staff, underwriters, insureds, brokers and service providers
Job Summary: An entry level claims handler proactively managing low-value/low-complexity claims with support from a line manager to help achieve the Beazley vision of being the highest performing specialist insurer through the proactive management of claims. To support claims management staff in the delivery of projects and improvement initiatives as required. To support claims management to - and work in - a manner that best meets the challenges of our clients. To engage in continuous professional development in claims management.
FLSA: Exempt
Key Responsibilities:
Individual Claims Leadership
* Develop capabilities to independently manage low value/low complexity claims on a proactive basis, with support from line management, from notification to closure, investing the necessary level of involvement required for each claim depending on the nature, category, maturity, type, and quantum of the claim.
* Focus primarily on the management of claims with an expected, Blend estimated, or actual value at or below $100,000 and with limited complexity.
* Escalate claims and issues as appropriate to line management where additional experience of knowledge is required or may be beneficial.
* Adhere at all times to Beazley's Claims Reserving Philosophy and Standards.
* Develop an understanding of Beazley's Conduct Risk Policy.
Claims Portfolio Management
Work alongside and support Assistant Claims Managers and Claims Managers in the management of the claims portfolio to optimise performance including the:
* Review of individual claims within the portfolio on a regular basis and ensuring reserves and records are maintained in a timely manner as required by Beazley's claims controls and standards. Be cognizant of and flag trends identified by Claims team.
Working with Underwriters
* Start to develop working relationships with Underwriters.
* When requested, provide input to Underwriters on existing insured's claims experience under supervision of senior Claims staff.
Authority & Minimum Standards Observance
* Operate within approved claims authorities at all times.
* Maintain a thorough knowledge of industry regulations and minimum standards.
* Ensure compliance with the regulations and Beazley's claims control standards and protocols.
Supporting Senior Claims Handlers
* Support Claims staff with any relevant tasks, projects or initiatives to further develop skills and understanding of the broader organisation.
Operational
* Assist to ensure the management of claims conforms to the agreed standardised processes and use of share service functions as appropriate.
* Contribute to the commitment to and active development of a continuous improvement culture within the overall claims function.
Professional Development
* Proactively enhance professional skills and knowledge in claims management by engaging in continuous learning and development opportunities.
Conflicts of Interest
* Adhere to Beazley's Conflicts of Interest policy, alert the appropriate person to any potential conflicts of interest, and take steps to resolve them promptly.
* Immediately advise your Head of or Group Head of Claims if any Beazley employee seeks to exert undue influence on you or any other team member to act improperly in the management, reserving, or settlement of any claim.
General
It is important that within all your interactions both internally and externally you adhere to Beazley's core values - Being Bold, Striving for Better, and Doing the Right Thing - as they contribute to an internal environment of teamwork and promote a positive brand image and experience to our external customers. We also expect Beazley employees to:
* Comply with Beazley procedures, policies and regulations including the code of conduct which incorporates the FCA and PRA Conduct.
* Undertake training on Beazley policies and procedures as delivered by your line manager, the Culture & People or assurance teams (compliance, risk, internal audit) either directly, via e-learning or the learning management system.
* Display business ethics that uphold the interests of all our customers.
* Ensure all interactions with customers are focused on delivering a fair outcome, including having the right products for their needs.
* Comply with any specific responsibilities necessary for your role as outlined by your line manager, the Culture & People or assurance teams (compliance, risk, internal audit) and ensure you keep up to date with developments in these areas. This may include, amongst others, Beazley's underwriting control standards, Beazley's claims control standards, other Beazley standards and customer relationship management.
* Carry out additional responsibilities as individually notified, either through your objectives or through the learning management system. These may include membership of any Beazley committees or working groups.
Personal Specification:
Education and Qualifications
* Degree Educated / Bachelor's Degree
Skills and Abilities
* Analytical skills: Problem solving (broad-based, analytical, conceptual, creativity), Analysis of financial statements, Financial assessments of claims, Data analysis, Decision-making
* Work management skills: Time and workload management, Self-starter, Planning, Achievement orientation, Productivity focus
* Interpersonal skills: Ability to influence others, Client and broker management skills, Purposeful communication, Flexibility, Active listening
Essential Criteria
* Past claims experience establishing liability and/or settlement resolutions.
* Functional knowledge & understanding: Claims management process, US/RoW Insurance market (general & focus group), US/RoW legal and regulatory environment, Alternative resolution approaches
Aptitude and Disposition
* Outcome focussed, self-motivated, flexible and enthusiastic
* Professional approach to successfully interact with senior management/colleagues/external suppliers
* Diplomatic
Competencies
* Problem-solving
* Decisiveness
* Customer-focused
* Influencing others
* Team work
* Self-starter
* Analytical thinking
* Managing resources effectively
* Technical competency and expertise
Who We Are:
Beazley is a specialist insurance company with over 30 years' experience helping people, communities and businesses to manage risk all around the world. Our mission is to inspire our clients and people with the confidence and freedom to explore, create and build - to enable businesses to thrive. Our clients want to live and work freely and fully, knowing they are benefitting from the most advanced thinking in the insurance market. Our goal is to become the highest performing sustainable specialist insurer.
Our products are wide ranging, from cyber & tech insurance to marine, healthcare, financial institutions and contingency; covering risks such as the weather, film production or protection from deadly weapons.
Our Culture
We have a wonderful mix of cultures, experiences, and backgrounds at Beazley with over 2,000 of us working around the world. Employee's diversity, experience and passion allow us to keep innovating and moving forward, delivering the best. We are proud of our family-feel culture at Beazley that empowers our staff to work from when and where they want, in an adult environment that is big on collaboration, diversity of thought and personal accountability. Our three core values inspire the way we work and how we treat our people and customers.
Be bold
Strive for better
Do the right thing
Upholding these values every day has enabled us to become an innovative and responsive organization in touch with the changing world around us - our ambitious inclusion & diversity and sustainability targets are testament to this.
We are a flexible and innovative employer offering a friendly, collaborative, and inclusive working environment. We actively encourage and expect applications from all backgrounds. Our commitment to fostering a supportive and dynamic workplace ensures that every employee can thrive and contribute to our collective success.
Explore a variety of networks to assist with professional and/or personal development. Our Employee Networks include:
Beazley RACE - Including, understanding and celebrating People of Colour
Beazley SHE - Successful, High potential, Empowered women in insurance
Beazley Proud - Our global LGBTQ+ community
Beazley Wellbeing - Supporting employees with their mental wellbeing
Beazley Families - Supporting families and parents-to-be
We encourage internal career progression at Beazley, giving you all the tools you need to drive your own career here, such as:
Internal Pathways (helping you grow into an underwriting role)
iLearn (our own learning & development platform)
LinkedIn Learning
Mentorship program
External qualification sponsorship
Continuing education and tuition reimbursement
Secondment assignments
The Rewards
The opportunity to connect and build long-lasting professional relationships while advancing your career with a growing, dynamic organization
Attractive base compensation and discretionary performance related bonus
Competitively priced medical, dental and vision insurance
Company paid life, and short- and long-term disability insurance
401(k) plan with 5% company match and immediate vesting
22 days PTO (prorated for 1st calendar year of employment), 11 paid holidays per year, with the ability to flex the religious bank holidays to suit your religious beliefs
Up to $700 reimbursement for home office setup
Free in-office lunch, travel reimbursement for travel to office, and monthly lifestyle allowance
Up to 26 weeks of fully paid parental leave
Up to 2.5 days paid annually for volunteering at a charity of your choice
Flexible working policy, trusting our employees to do what works best for them and their teams
Salary for this role will be tailored to the successful individual's location and experience. The expected compensation range for this position is $70,000-$77,000 per year plus discretionary annual bonus.
Don't meet all the requirements? At Beazley we're committed to building a diverse, inclusive, and authentic workplace. If you're excited about this role but your experience doesn't perfectly align with every requirement and qualification in the job specification, we encourage you to apply anyway. You might just be the right candidate for this, or one of our other roles.
$70k-77k yearly 1d ago
Associate, Wage and Hour - Disputes, Claims & Investigations
Stout 4.2
Claims adjuster job in Arlington, VA
At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.
Associate - DCI (Disputes, Claims & Investigations), Wage & Hour
Stout is seeking an Associate with 2-5 years of experience to join our Disputes, Claims & Investigations (DCI) Wage and Hour practice. This is a full-time role offering comprehensive benefits, a 401(k), and eligibility for annual bonuses.
Stout brings deep expertise supporting clients in high-stakes business litigation and economic consulting matters. Associates work closely with experienced professionals and subject-matter experts to analyze complex data and deliver independent, thoughtful analyses.
Impact You'll Make
This role plays a critical part in delivering high-quality analytical support on complex wage and hour matters. Your work will directly contribute to successful client outcomes and the effectiveness of project teams.
Execute and support complex data analyses related to wage and hour disputes and investigations.
Contribute to the development of sound methodologies and analytical approaches that support defensible conclusions.
Help ensure projects are completed on time, within scope, and with a high standard of quality.
Build strong working relationships across project teams to drive collaboration and efficiency.
Support client-facing deliverables that clearly communicate findings and insights.
What You'll Do
These responsibilities reflect the day-to-day work required to support engagements and achieve project objectives.
Review, organize, and analyze large and complex datasets to support litigation and consulting engagements.
Support multiple concurrent projects, anticipating scope, timing, and budget considerations.
Assist in developing work plans, methodologies, and resource needs to optimize project outcomes.
Collaborate closely with team members to meet deadlines and manage competing client expectations.
Support written analyses, reports, and presentations prepared for clients and other stakeholders.
Apply creative problem-solving techniques to manage risks and address analytical challenges.
What You Bring
This section outlines the qualifications and technical skills needed to succeed in the role.
Bachelor's degree from an accredited college or university, preferably in Economics, Mathematics, or a related field.
2-5 years of experience in wage and hour consulting or a closely related field.
Working knowledge of advanced data management and analytical tools such as SAS, SQL, STATA, R, or similar platforms.
Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, and Access.
Strong written and verbal communication skills with the ability to present complex information clearly.
Demonstrated ability to manage multiple projects simultaneously and work effectively with cross-functional teams.
How You'll Thrive
These competencies and behaviors will help you excel and grow within Stout's collaborative culture.
Maintain flexibility and adaptability in response to changing project requirements and timelines.
Demonstrate strong organizational skills and rigorous attention to detail.
Exhibit intellectual curiosity, self-motivation, and a commitment to quality control.
Collaborate effectively with colleagues while managing competing priorities.
Uphold Stout's core values and deliver Relentless Excellence in both client service and internal teamwork.
Why Stout?
At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life.
We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve.
We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals.
Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.
Learn more about our benefits and commitment to your success.
en/careers/benefits
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job.
Stout is an Equal Employment Opportunity.
All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law.
Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.
A reasonable estimate of the current range is $74,000.00 - $135,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
$31k-36k yearly est. 3d ago
Independent Insurance Claims Adjuster in Asheville, North Carolina
Milehigh Adjusters Houston
Claims adjuster job in Asheville, NC
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMSADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance ClaimsAdjuster? 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 ClaimsAdjuster, 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 ClaimsAdjuster 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 ClaimsAdjuster.
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 claimsadjusting.
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 claimsadjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claimsadjusting 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 ClaimsAdjuster. 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.
$42k-52k yearly est. Auto-Apply 60d+ ago
Auto Claims Representative
Auto-Owners Insurance Co 4.3
Claims adjuster job in Asheville, NC
Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated claims trainee to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company's claims training program for the assigned line of insurance and requires the person to:
* Investigate, evaluate, and settle entry-level insurance claims
* Study insurance policies, endorsements, and forms to develop foundational knowledge on Company insurance products
* Learn and comply with Company claim handling procedures
* Develop entry-level claim negotiation and settlement skills
* Build skills to effectively serve the needs of agents, insureds, and others
* Meet and communicate with claimants, legal counsel, and third-parties
* Develop specialized skills including but not limited to, estimating and use of designated computer-based programs for loss adjustment
* Study, obtain, and maintain an adjuster's license(s), if required by statute within the timeline established by the Company or legal requirements
Desired Skills & Experience
* Bachelor's degree or direct equivalent experience with property/casualty claims handling
* Ability to organize data, multi-task and make decisions independently
* Above average communication skills (written and verbal)
* Ability to write reports and compose correspondence
* Ability to resolve complex issues
* Ability to maintain confidentially and data security
* Ability to effectively deal with a diverse group individuals
* Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents)
* Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage
* Continually develop product knowledge through participation in approved educational programs
Benefits
Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.
* Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
#LI-AT1 #LI-Hybrid
$31k-39k yearly est. Auto-Apply 18d ago
Claims - Field Claims Representative
Cincinnati Financial Corporation 4.4
Claims adjuster job in Asheville, NC
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: Asheville, North Carolina. 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 45d ago
Commercial Field Adjuster - Asheville, NC
CCMS & Associates 3.8
Claims adjuster job in Asheville, NC
Job Description
CCMS & Associates is looking for a 1099 Field Adjuster in North Carolina, specifically the Asheville area. We are answering a call to action to add to our existing roster. We are seeking a commercial field adjuster with at least 8 years of field experience.
Requirements:
Minimum 8 years first-party residential or commercial property adjusting experience
Maintain own current estimating software - Xactimate preferred
Working computer - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
Experience in preparing Statement of Loss & Proof of Loss
North Carolina state adjusters license
Must have a valid drivers license
Responsibilities:
Complete commercial field property inspections utilizing Xactimate software
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses and by interviewing fire, police, or other governmental officials as well as inspecting claimed damages
Recommend claim reserves based on investigation, through well-supported reserve report
Obtain and interpret official reports
Review applicable coverage forms and endorsements, provide a thorough analysis of coverage and any coverage issues in a well-documented initial captioned report to the client
Maintain acceptable product quality through compliance with established best practices
Knowledge and Skills:
In-depth knowledge of property and liability insurance coverage and industry standards
Ability to prepare full-captioned reports by collecting and summarizing required information
Strong verbal and written communications skills
Prompt, reliable, and friendly
Preferred but Not Required:
College degree
AIC, IICRC, HAAG or other professional designations
All candidates must pass a full background check (void in states where prohibited)
CCMS & Associates offers multi-line claimadjusting and third-party administration services dedicated to solving the challenges of the complex claim in the property and casualty insurance industry. We create programs that drive a successful claim life cycle while strategically managing all aspects of the complicated issues carriers and policyholders are facing. Servicing excess and surplus/domestic carriers in the United States.
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$52k-69k yearly est. 6d ago
Auto Damage Adjuster
Geico 4.1
Claims adjuster job in Asheville, NC
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
Experienced Auto Damage Adjuster- Ashville, NC
“*Starting pay $29.51 -$37.65 per hour/$59,000-$75,850
We are looking for talented Auto Damage Adjusters to join our team in Ashville, NC As an experienced Adjuster, you should have a minimum of 12 months of Auto Damage experience and demonstrated a track record of success delivering excellent customer service while promptly and accurately settling claims. The ideal candidate will have the ability to handle complex claims using their technical and industry knowledge.
Qualifications & Skills:
Motor Vehicle Damage Adjuster/Appraiser's License *required*
Valid driver's license (must meet company underwriting guidelines for at least the past 3 consecutive years) and the ability to maintain applicable state and federal certifications and permits
Willingness to be flexible with primary work location - position may require either remote/field/in-office work
Solid computer, mechanical aptitude, and multi-tasking skills
Effective attention to detail and decision-making skills
Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities
Minimum of high school diploma or equivalent
At this time, GEICO will not sponsor a new applicant for employment authorization for this position.
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs.
We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being.
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
$59k-75.9k yearly Auto-Apply 3d ago
Claims Associate (Asheville, NC)
Vaya Health 3.7
Claims adjuster job in Asheville, NC
LOCATION: AshevilleNC - this is an in person, office-based position that operates Monday - Friday from 8:30am-5:00pm EST. The person in this position should live within a reasonable commute to Vaya's Asheville office.
GENERAL STATEMENT OF JOB
Responsible for all accounting functions related to a designated area of physical and behavioral health medical claims processing to ensure that providers receive timely and accurate payment. This position is responsible for managing paper claims. This incumbent will ensure valid paper claims are loaded to the claims adjudication system timely, as well as manage communication back to provider for claims that are unable to be accepted in the system due to missing or invalid claims data. This role will support claims adjudication efforts through continuous monitoring and quality control measures.
ESSENTIAL JOB FUNCTIONS
The Claims Representative II is responsible for (though not limited to):
Paper claims
Keying of valid paper claims to claims adjudication system
Manage invalid claims - return mail to provider
Rejections
Processing of rejections out of Perfect Claims
Return mail or email rejection letters to provider
Reconsideration Letters
Reconsideration letters to be sent regarding Claim appeals received by Vaya.
Customer Service support
Support claims adjudication by finalizing claims processed electronically for payment and reviewing claim adjudication results for both Title XIX and non-title XIX claims, payment, and denial patterns
Ensure adjudication accuracy of keyed claims in the claims processing system by adhering to policy and procedures.
Paper Claim: This position will be responsible for tracking all paper claims. This position will evaluate claims to determine Clean claim vs. Non-clean claim. Clean claims will be loaded to the claim system for adjudication. Non-clean claims will be returned to providers. This position will ensure all mailroom activities are completed within service level agreement timeliness.
Claims Adjudication: This position will be responsible for finalizing keyed claims processed for payment and maintain claims adjudication workflow, reconciliation and quality control measures to meet or exceed prompt payment guidelines. This position is responsible for reconciling provider claims payments through quality control measures, generally accepted accounting principles and Vaya's policies and procedures. This position will assess Title XIX and non-Title XIX claimsadjustments for correction or recoupment and will coordinate the recoupment process to ensure payment is recovered for inappropriately paid claims.
Customer Service: This position will maintain provider satisfaction by being available during regular business hours to handle inquiries; interacting in a professional manner; and providing information and assistance. This position will also answer incoming calls as needed. This position will assist providers in resolving problem claims and system training issues. This position will also serve as a resource for internal staff to resolve eligibility issues, authorization, overpayments, recoupment or other provider issues related to claims payment.
Compliance and Quality Assurance: This position reviews internal bulletins, forms, appropriate manuals and applicable revisions, and fee schedules to ensure compliance with established procedures and processes. Attend and participate in workshops and training sessions to improve technical competence.
Miscellaneous: Other duties as assigned, including coverage of specific functions of other staff to assist the Department as work demands may dictate.
KNOWLEDGE, SKILLS, & ABILITIES
Knowledge of computerized claims systems; organization structure of MCO claims processing, methods and procedures utilized in claims processing, medical terminology (ICD-10/CPT/HCPCS and Revenue codes), third-party reimbursement, and Coordination of benefits (COB).
Ability to adapt to a rapidly evolving work environment, work independently, and communicate with a variety of personnel and providers.
Ability to process moderate to more complex claim issues.
Knowledge of all types of health insurers and coordination of benefits preferred.
Knowledge of Microsoft Office applications, including Excel, Word, and Outlook.
Excellent oral and written communication and interpersonal skills required.
Meticulous and analytical skills.
Self-accountable; scheduled shift, Teams Chats, completion of assigned tasks, etc.
Must be able to work effectively in a team environment with a wide variety of culturally diverse providers.
Must have strong problem-solving, project management, and negotiation skills.
Must have the ability to multi-task; must have effective organizational skills.
Ability to establish and maintain good working relationships with agency personnel, contract agencies.
EDUCATION & EXPERIENCE REQUIREMENTS
High school diploma or GED required. Associate degree in Business Administration, Accounting, Finance or related field preferred.
PHYSICAL REQUIREMENTS
Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
Mental concentration is required in all aspects of work.
RESIDENCY REQUIREMENT : The person in this position should live within a reasonable commute to Vaya's AshevilleNC office.
SALARY: Depending on qualifications & experience of candidate. This position is non-exempt and is eligible for overtime compensation.
DEADLINE FOR APPLICATION: Open Until Filled.
APPLY: Vaya Health accepts online applications in our Career Center, please visit ******************************************
Vaya Health is an equal opportunity employer.
$36k-42k yearly est. Auto-Apply 3d ago
Michigan Homeowners Claim Representative II
The Auto Club Group 4.2
Claims adjuster job in Apex, NC
Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager IWhat you will do:
Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims.
Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system.
Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss.
Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler.
Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential.
Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
Evaluate the financial value of the loss.
Approve payments for the appropriate parties accordingly.
Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
Utilize strong negotiating skills.
Employees assigned to the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update.
Supervisory Responsibilities:
None
How you will benefit:
A competitive annual salary between $64,000 - $72,000
ACG offers excellent and comprehensive benefits packages, including:
Medical, dental and vision benefits
401k Match
Paid parental leave and adoption assistance
Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
Paid volunteer day annually
Tuition assistance program, professional certification reimbursement program and other professional development opportunities
AAA Membership
Discounts, perks, and rewards and much more
We're looking for candidates who:Required Qualifications (these are the minimum requirements to qualify) Education:
Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting
In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states
A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
Experience:
One year of experience or equivalent training in the following:
Negotiating claim settlements
Securing and evaluating evidence
Preparing manual and electronic estimates
Subrogation claims
Resolving coverage questions
Taking statements
Establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Advance knowledge of:
Essential Insurance Act (Michigan)
Fair Trade Practices Act as it relates to claims
Subrogation procedures and processes
Intercompany arbitration
Knowledge of building construction and repair techniques
Ability to:
Handle claims to the line Claim Handling Standards
Follow and apply ACG Claim policies, procedures and guidelines
Work within assigned ACG Claim systems including basic PC software
Perform basic claim file review and investigations
Demonstrate effective communication skills (verbal and written)
Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
Analyze and solve problems while demonstrating sound decision making skills
Prioritize claim related functions
Process time sensitive data and information from multiple sources
Manage time, organize and plan workload and responsibilities
Research, analyze, and interpret subrogation laws in various states
Strong negotiating skills
Ability to work outside normal business hours as needed
Preferred Qualifications:
Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
Xactimate software experience/training or experience in an equivalent software
Claimsadjuster experience specifically in home/property claims preferred
Experience working within a customer service setting
Call center experience or experience handling high volume calls preferred, but not required
Excellent communication skills both oral and written
Experience working within an insurance or claims-based role for one year or more
Full claims cycle experience preferred
Work Environment
This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.
Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit ***********
Important Note:
ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
$64k-72k yearly 2d ago
Workers' Compensation Claims Adjuster - Temp
Argonaut Management Services, Inc.
Claims adjuster job in Charleston, SC
Argo Group International Holdings, Inc.and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. ("BWS"), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions.
Job Description
Business Title(s):Workers' Compensation ClaimsAdjuster
Employment Type:Contingent Worker
FLSA Status:Non-Exempt
Location:In-Officeor Remote
Summary:
Although Rockwood underwrites general liability insurance and workers' compensation for many types of businesses, ourspecialtyis underwriting workers' compensation insurance for the mining industry, with a focus on the coal-mining industry. Rockwood has become a leading underwriter of workers' compensation for the mining industry by offering workers' compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal. We have never been more committed to our clients to ensure their employees receive excellent medical care if they need it due to a work-related injury or illness. Our passion for outstanding customer focus, combined with our deep industry experience, is what sets up apart from other insurance carriers in this niche market.
We are looking for a highly capable Workers' Compensation ClaimsAdjuster to help us on a temporary assignment through13February2026 and work from anywhere in the continental United States.
If this assignment is filled in one of our following offices, the assignment can be considered temp-to-hire: Albany, Chicago, Los Angeles, New York,Omaha, Richmond (VA), Rockwood (PA), or Springfield (MO). This role will adjudicate indemnity workers' compensation claims of higher technical complexity for our customers in the states of WY, KY, IL, IN, KY, NY, PA, and VA. This temporary role will also adjudicate medical-only and traumatic injury claims. The position supports clients primarily within the coal mining industry, requiring experience adjudicating claims in heavy industrial or mining environments.
As this is a temporary assignment, only government-mandated benefits will be provided.
Essential Responsibilities:
Working under technical direction and within significant limits and authority,adjudicateworkers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Resolving issues that are generalized and typically notcomplex butrequire understanding of a broader set of issues.
Reporting to senior management and underwriters onclaimstrends and developments.
Investigating claims promptly and thoroughly.
Analyzing claims forms, policies and endorsements, client instructions, and other records todeterminewhether the loss falls within the policy coverage.
Investigating claims promptly and thoroughly, including interviewing all involved parties.
Managing claims in litigation.
Managing diarytimelyand complete tasks to ensure that cases move to the best financial outcome andtimelyresolution.
Properly setting claim reserves.
Identifying, assigning, and coordinating the assignment and coordination ofexpertiseresources toassistin case resolution.
Preparing reports for file documentation.
Applying creative solutions which result in the best financial outcome.
Negotiating settlements.
Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
Having an appreciation and passion for strong claim management.
Qualifications / Experience Required:
A practical knowledge ofadjudicatingworkers' compensation claims through:
A minimum of two years' experienceadjudicatingindemnity workers' compensation claims in one or more of the following jurisdictions: IL, IN, KY, NY, PA, and/or VA.
Bachelor'sdegree from an accredited universityrequired. Two or more insurance designations or fouradditionalyears of related experienceadjudicatingindemnity claims beyond the minimum experiencerequiredabove may be substituted in lieu of a degree.
Must be licensed in KYand NY
Must have good business acumen (i.e.understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable).
A practical knowledge ofadjudicatingworkers' compensation claims through:
Must have excellent communication skills and the ability to build lasting relationships.
Exhibit natural curiosity
Desireto work in a fast-paced environment.
Excellent evaluation and strategic skillsrequired.
Strong claim negotiation skillsa must.
Mustpossessa strong customer focus.
Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
Ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include CEO.
Must work independently anddemonstratethe ability to exercise sound judgment.
Demonstrates inner strength. Has the courage to do the right thing anddemonstratesit on a daily basis.
Intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
Proficient in MS Office Suite and other business-related software.
Polished and professional written and verbal communication skills.
The ability to read and write English fluently isrequired.
Mustdemonstratea desire for continued professional development through continuing education and self-development opportunities.
The base salary range provided below is for hires in those geographic areas only and will becommensuratewith candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.
Colorado outside of Denver metro, Maryland, Nevada, and Rhode Island Pay Ranges:$37.66- $44.33per hour
California outside of Los Angeles and San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Houston metro area, New York State (including Westchester County)and Washington State Pay Ranges:$41.44- $48.79per hour
Los Angeles, New York City and San Francisco metro areas Pay Ranges:$45.12- $53.16per hour
About Working in Claims at Argo Group
Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions andtreateach case as the unique situation it is.
We have a very flat organizational structure, enabling our employeeshavemore interaction with our senior management team, especially when it relates to reviewing large losses.
Our entire claims team works in a collaborative nature to expeditiously resolve claims.We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.
We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.
PLEASE NOTE:
Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.
If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at .
Notice to Recruitment Agencies:
Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions.
We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics.
The collection of your personal information is subject to our HR Privacy Notice
Benefits and Compensation
We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.
Come grow with James River Insurance!
James River Insurance is an excess and surplus lines segment of James River Group Holdings, Ltd. and operates on an approved non-admitted basis in 50 states and Washington, DC. Since 2003, James River has provided thousands of commercial property and casualty customers with innovative and creative solutions for particular insurance needs.
At James River Insurance, we are committed to providing a stable and rewarding work environment supported by our Core Values and Guiding Principles: Integrity, Accountability, Innovation, Customer Service, Communication, and Teamwork. We are proud of being recognized the past 5 years as one of The Top Workplaces USA.
James River Group Holdings, Ltd. is a Bermuda-based insurance holding company which owns and operates a group of specialty insurance and reinsurance companies. The Company operates in two specialty property and casualty insurance segments: Excess and Surplus Lines and Specialty Admitted Insurance. The Company tends to focus on accounts associated with small or medium-sized businesses in each of its segments. Each of the Company's regulated insurance subsidiaries are rated "A-" (Excellent) by A.M. Best Company.
Job Summary
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
Please note that this position is not eligible for H-1B visa sponsorship. All applicants must be currently authorized to work in the United States on a full-time basis without the need for current or future H-1B sponsorship.
$49k-89k yearly est. 3d ago
Manager, Medicare Claims
Blue Cross and Blue Shield of North Carolina 4.3
Claims adjuster job in Chapel Hill, NC
The Manager, Medicare Claims, oversees end-to-end claims services for provider segments, meeting business goals. This role sets performance targets, manages claims processing and financials, handles submissions, refunds, and recoveries, and ensures claims accounting and reporting. Collaboration with claims leadership ensures alignment with customer needs and contracts.
What You'll Do
Streamline shared processing to reduce management by exception
Set operational process to address market trends, BCBSNC capabilities and customer demand
Manage accounting and financial reporting functions in support of the Finance Division including overseeing the gathering, preparation, analysis, and reconciliation of financial data to ensure compliance with accepted accounting principles and standards.
Participate in projects to improve and/or facilitate claims processing, recovery, and accounting functions.
Manage financial recovery activities including refunds and collections
Manage team leads and staff by efficiently driving work volume to keep high level of utilization and engagement in the group
Resolve complex claims appeal by coordinating with different stakeholders for certain high value claims
Collaborate with Audit and Payment Integrity to sustain a pre-determined level of accuracy and quality
Design and develop tools and techniques for improvements. Identifies needed process and procedural changes which will result in improved customer satisfaction.
Serve as Medicare Claims Subject Matter Expert and single point of contact for performance monitoring and troubleshooting.
Represent Claims Operations on monthly CMS calls with CMS Account manager answering questions, providing status updates and expertise routinely and on demand.
Ability to engage as requested by Compliance with regulatory entities, especially CMS on monthly calls and serve as an internal point of contact to prepare feedback on issues under CMS review.
Use good judgement in understanding issues and work with compliance to prepare for discussions.
Ability to represent claims as a knowledgeable SME.
What You Bring
Bachelor's degree or advanced degree (where required)
8+ years of experience in related field.
In lieu of degree, 10+ years of experience in related field.
Bonus Points
1-2 years of Medicare and Medicaid experience or a highly regulated operational environment - highly preferred
Strong analytical skills with the ability to drive change and manage operations
Ensure risks associated with business activities are effectively identified, measured, monitored and controlled within accordance with compliance policies and procedures
What You'll Get
The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.
Work-life balance, flexibility, and the autonomy to do great work.
Medical, dental, and vision coverage along with numerous health and wellness programs.
Parental leave and support plus adoption and surrogacy assistance.
Career development programs and tuition reimbursement for continued education.
401k match including an annual company contribution
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
*Based on annual corporate goal achievement and individual performance.
$98,092.00 - $156,947.00
Skills
Accounts Receivable (AR), Claims Analysis, Claims Management, Claims Processing, Claims Resolution, Claims Submission, Documentations, Financial Processing, Health Insurance, Insurance Claim Handling, Insurance Claims Processing, Insurance Industry, Medicare Advantage, People Management, Recruiting
$41k-69k yearly est. 22h ago
Casualty Claims Representative
Auto-Owners Insurance Co 4.3
Claims adjuster job in Asheville, NC
We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated and experienced field claims professional to join our team. This job handles insurance claims in the field under general supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job requires mastery of claims-handling skills and requires the person to:
* Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability
* Handle multi-line property and casualty claims in an assigned territory with an emphasis on property claims
* Become familiar with insurance coverage by studying insurance policies, endorsements and forms
* Work toward the resolution of claims, and attend arbitrations, mediations, depositions, or trials as necessary
* Ensure that claims payments are issued in a timely and accurate manner
* Handle investigations by phone, mail and on-site investigations
Desired Skills & Experience
* Bachelor's degree or direct equivalent experience handling property and casualty claims
* A minimum of 3 years handling multi-line property and casualty claims with an emphasis on property claims
* Field claims handling experience is preferred but not required
* Knowledge of Xactimate software is preferred but not required
* Above average communication skills (written and verbal)
* Ability to resolve complex issues
* Organize and interpret data
* Ability to handle multiple assignments
* Ability to effectively deal with a diverse group individuals
* Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents)
* Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage
Benefits
Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.
* Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
$31k-39k yearly est. Auto-Apply 10d ago
Commercial Field Adjuster - Asheville, NC
CCMS & Associates 3.8
Claims adjuster job in Asheville, NC
CCMS & Associates is looking for a 1099 Field Adjuster in North Carolina, specifically the Asheville area. We are answering a call to action to add to our existing roster. We are seeking a commercial field adjuster with at least 8 years of field experience.
Requirements:
Minimum 8 years first-party residential or commercial property adjusting experience
Maintain own current estimating software - Xactimate preferred
Working computer - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
Experience in preparing Statement of Loss & Proof of Loss
North Carolina state adjusters license
Must have a valid drivers license
Responsibilities:
Complete commercial field property inspections utilizing Xactimate software
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses and by interviewing fire, police, or other governmental officials as well as inspecting claimed damages
Recommend claim reserves based on investigation, through well-supported reserve report
Obtain and interpret official reports
Review applicable coverage forms and endorsements, provide a thorough analysis of coverage and any coverage issues in a well-documented initial captioned report to the client
Maintain acceptable product quality through compliance with established best practices
Knowledge and Skills:
In-depth knowledge of property and liability insurance coverage and industry standards
Ability to prepare full-captioned reports by collecting and summarizing required information
Strong verbal and written communications skills
Prompt, reliable, and friendly
Preferred but Not Required:
College degree
AIC, IICRC, HAAG or other professional designations
All candidates must pass a full background check (void in states where prohibited)
CCMS & Associates offers multi-line claimadjusting and third-party administration services dedicated to solving the challenges of the complex claim in the property and casualty insurance industry. We create programs that drive a successful claim life cycle while strategically managing all aspects of the complicated issues carriers and policyholders are facing. Servicing excess and surplus/domestic carriers in the United States.
$52k-69k yearly est. Auto-Apply 60d+ ago
Michigan Homeowners Claim Representative II
The Auto Club Group 4.2
Claims adjuster job in Atlanta, GA
Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager IWhat you will do:
Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims.
Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system.
Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss.
Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler.
Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential.
Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
Evaluate the financial value of the loss.
Approve payments for the appropriate parties accordingly.
Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
Utilize strong negotiating skills.
Employees assigned to the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update.
Supervisory Responsibilities:
None
How you will benefit:
A competitive annual salary between $64,000 - $72,000
ACG offers excellent and comprehensive benefits packages, including:
Medical, dental and vision benefits
401k Match
Paid parental leave and adoption assistance
Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
Paid volunteer day annually
Tuition assistance program, professional certification reimbursement program and other professional development opportunities
AAA Membership
Discounts, perks, and rewards and much more
We're looking for candidates who:Required Qualifications (these are the minimum requirements to qualify) Education:
Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting
In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states
A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
Experience:
One year of experience or equivalent training in the following:
Negotiating claim settlements
Securing and evaluating evidence
Preparing manual and electronic estimates
Subrogation claims
Resolving coverage questions
Taking statements
Establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Advance knowledge of:
Essential Insurance Act (Michigan)
Fair Trade Practices Act as it relates to claims
Subrogation procedures and processes
Intercompany arbitration
Knowledge of building construction and repair techniques
Ability to:
Handle claims to the line Claim Handling Standards
Follow and apply ACG Claim policies, procedures and guidelines
Work within assigned ACG Claim systems including basic PC software
Perform basic claim file review and investigations
Demonstrate effective communication skills (verbal and written)
Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
Analyze and solve problems while demonstrating sound decision making skills
Prioritize claim related functions
Process time sensitive data and information from multiple sources
Manage time, organize and plan workload and responsibilities
Research, analyze, and interpret subrogation laws in various states
Strong negotiating skills
Ability to work outside normal business hours as needed
Preferred Qualifications:
Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
Xactimate software experience/training or experience in an equivalent software
Claimsadjuster experience specifically in home/property claims preferred
Experience working within a customer service setting
Call center experience or experience handling high volume calls preferred, but not required
Excellent communication skills both oral and written
Experience working within an insurance or claims-based role for one year or more
Full claims cycle experience preferred
Work Environment
This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.
Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit ***********
Important Note:
ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
$64k-72k yearly 2d ago
Workers' Compensation Claims Adjuster - Temp
Argonaut Management Services, Inc.
Claims adjuster job in Atlanta, GA
Argo Group International Holdings, Inc.and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. ("BWS"), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions.
Job Description
Business Title(s):Workers' Compensation ClaimsAdjuster
Employment Type:Contingent Worker
FLSA Status:Non-Exempt
Location:In-Officeor Remote
Summary:
Although Rockwood underwrites general liability insurance and workers' compensation for many types of businesses, ourspecialtyis underwriting workers' compensation insurance for the mining industry, with a focus on the coal-mining industry. Rockwood has become a leading underwriter of workers' compensation for the mining industry by offering workers' compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal. We have never been more committed to our clients to ensure their employees receive excellent medical care if they need it due to a work-related injury or illness. Our passion for outstanding customer focus, combined with our deep industry experience, is what sets up apart from other insurance carriers in this niche market.
We are looking for a highly capable Workers' Compensation ClaimsAdjuster to help us on a temporary assignment through13February2026 and work from anywhere in the continental United States.
If this assignment is filled in one of our following offices, the assignment can be considered temp-to-hire: Albany, Chicago, Los Angeles, New York,Omaha, Richmond (VA), Rockwood (PA), or Springfield (MO). This role will adjudicate indemnity workers' compensation claims of higher technical complexity for our customers in the states of WY, KY, IL, IN, KY, NY, PA, and VA. This temporary role will also adjudicate medical-only and traumatic injury claims. The position supports clients primarily within the coal mining industry, requiring experience adjudicating claims in heavy industrial or mining environments.
As this is a temporary assignment, only government-mandated benefits will be provided.
Essential Responsibilities:
Working under technical direction and within significant limits and authority,adjudicateworkers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Resolving issues that are generalized and typically notcomplex butrequire understanding of a broader set of issues.
Reporting to senior management and underwriters onclaimstrends and developments.
Investigating claims promptly and thoroughly.
Analyzing claims forms, policies and endorsements, client instructions, and other records todeterminewhether the loss falls within the policy coverage.
Investigating claims promptly and thoroughly, including interviewing all involved parties.
Managing claims in litigation.
Managing diarytimelyand complete tasks to ensure that cases move to the best financial outcome andtimelyresolution.
Properly setting claim reserves.
Identifying, assigning, and coordinating the assignment and coordination ofexpertiseresources toassistin case resolution.
Preparing reports for file documentation.
Applying creative solutions which result in the best financial outcome.
Negotiating settlements.
Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
Having an appreciation and passion for strong claim management.
Qualifications / Experience Required:
A practical knowledge ofadjudicatingworkers' compensation claims through:
A minimum of two years' experienceadjudicatingindemnity workers' compensation claims in one or more of the following jurisdictions: IL, IN, KY, NY, PA, and/or VA.
Bachelor'sdegree from an accredited universityrequired. Two or more insurance designations or fouradditionalyears of related experienceadjudicatingindemnity claims beyond the minimum experiencerequiredabove may be substituted in lieu of a degree.
Must be licensed in KYand NY
Must have good business acumen (i.e.understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable).
A practical knowledge ofadjudicatingworkers' compensation claims through:
Must have excellent communication skills and the ability to build lasting relationships.
Exhibit natural curiosity
Desireto work in a fast-paced environment.
Excellent evaluation and strategic skillsrequired.
Strong claim negotiation skillsa must.
Mustpossessa strong customer focus.
Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
Ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include CEO.
Must work independently anddemonstratethe ability to exercise sound judgment.
Demonstrates inner strength. Has the courage to do the right thing anddemonstratesit on a daily basis.
Intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
Proficient in MS Office Suite and other business-related software.
Polished and professional written and verbal communication skills.
The ability to read and write English fluently isrequired.
Mustdemonstratea desire for continued professional development through continuing education and self-development opportunities.
The base salary range provided below is for hires in those geographic areas only and will becommensuratewith candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.
Colorado outside of Denver metro, Maryland, Nevada, and Rhode Island Pay Ranges:$37.66- $44.33per hour
California outside of Los Angeles and San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Houston metro area, New York State (including Westchester County)and Washington State Pay Ranges:$41.44- $48.79per hour
Los Angeles, New York City and San Francisco metro areas Pay Ranges:$45.12- $53.16per hour
About Working in Claims at Argo Group
Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions andtreateach case as the unique situation it is.
We have a very flat organizational structure, enabling our employeeshavemore interaction with our senior management team, especially when it relates to reviewing large losses.
Our entire claims team works in a collaborative nature to expeditiously resolve claims.We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.
We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.
PLEASE NOTE:
Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.
If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at .
Notice to Recruitment Agencies:
Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions.
We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics.
The collection of your personal information is subject to our HR Privacy Notice
Benefits and Compensation
We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.
How much does a claims adjuster earn in Asheville, NC?
The average claims adjuster in Asheville, NC earns between $38,000 and $57,000 annually. This compares to the national average claims adjuster range of $40,000 to $64,000.
Average claims adjuster salary in Asheville, NC
$46,000
What are the biggest employers of Claims Adjusters in Asheville, NC?
The biggest employers of Claims Adjusters in Asheville, NC are: