Claims Adjusters, Examiners, and Investigators
Claims adjuster job in Surprise, AZ
**Role Overview**Mercor is collaborating with a top-tier AI research group to model real-world claims workflows for property and casualty insurance. We are seeking experienced independent contractors-particularly claims adjusters, examiners, and investigators-to execute and evaluate a wide range of P&C insurance tasks.
This project supports the development of AI systems capable of understanding, simulating, and automating complex insurance operations.
It is a short-term, high-impact engagement ideal for professionals with strong technical and compliance knowledge.
**Key Responsibilities** - Execute full-cycle claims tasks including FNOL intake, coverage verification, reserve setting, and liability determination - Simulate real-world workflows using structured tools and mock systems such as Guidewire ClaimCenter and Xactimate - Review and synthesize third-party documentation including police reports, medical records, and vendor estimates - Draft structured outputs such as coverage memos, repair estimates, and liability assessments - Identify inconsistencies or red flags in claim statements and documentation - Evaluate claim compliance, document regulatory deadlines, and assess communication quality - Flag fraud indicators and recommend SIU referrals where applicable - Document all work clearly for auditability and quality review **Ideal Qualifications** - 5+ years handling property, auto, bodily injury, or general liability claims - Familiarity with systems such as Guidewire, Duck Creek, Xactimate, Hyland OnBase, or FileNet - Deep understanding of coverage interpretation, state compliance standards, and claims file documentation - Experience reviewing third-party documentation (e.
g.
, police reports, medical summaries, contractor estimates) - Strong written communication and analytical skills **More About the Opportunity** - Remote and asynchronous - control your own work schedule - **Expected commitment: min 30 hours/week** - **Project duration: ~6 weeks** **Compensation & Contract Terms** - $100-150/hour - Independent contractor arrangement - Paid weekly via Stripe Connect **Application Process** - Submit your resume followed by domain expertise interview and short form **About Mercor** - Mercor is a talent marketplace that connects top experts with leading AI labs and research organizations - Our investors include Benchmark, General Catalyst, Adam D'Angelo, Larry Summers, and Jack Dorsey - Thousands of professionals across domains like insurance, law, engineering, and research partner with Mercor to shape the next era of AI
Injury Adjuster- FPI
Claims adjuster job in Phoenix, AZ
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated Injury Adjuster- FPI, you will responsible to adjust non-attorney involved soft tissue bodily injury or auto PIP/MP medical claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy.
This hybrid role requires an individual to be in the office 3 days per week. This position can be based in one of the following locations: San Antonio, TX, Phoenix, AZ, Colorado Springs, CO, C Chesapeake, VA or Tampa, FL. Relocation assistance is not available for this position.
Training Schedule: Must be available to attend mandatory training for 5 weeks. PTO will not be permitted during these time frames.
Work Schedule: Must be open and available to work any schedule assigned between Monday - Friday 7:00a.m - 7:30 p.m.
What you'll do:
Adjusts soft tissue, moderately complex and complex 1st party PIP/MP medical claims.
Identifies, confirms, and makes coverage decisions on soft tissue claims.
Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes.
Provides advice and sets expectations into next steps to members.
Collaborates and supports team members to resolve issues and identify appropriate matters for escalation.
Partners with and/or directs vendors and internal business partners to facilitate timely claims resolution.
Delivers a best-in-class member service experience through setting appropriate expectations and proactive communication.
Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
May be assigned CAT deployment travel with minimal notice during designated CATs.
Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.
What you have:
High School Diploma or General Equivalency Diploma.
1 year of injury adjusting or auto liability adjusting experience to include highly complex vehicle physical damage, such as multi-vehicle, non-owned vehicles, or total loss claims.
Working knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations.
Demonstrated negotiation, investigation, communication, and conflict resolution skills.
Proven investigatory, prioritizing, multi-tasking, and problem-solving skills.
Exercise sound financial judgment and discretion in handling insurance claims.
Knowledge of coverage evaluation, loss assessment, and loss reserving.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
What sets you apart:
2+ years Auto Liability/Casualty adjusting experience to include complex/multi vehicle liability.
3+ years PIP/MedPay coverage handling experience.
Ongoing Professional Development with a focus on Insurance.
Bachelors Degree or higher.
Compensation range: The salary range for this position is: $57,970 - $97,820.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Claims Representative - Glendale, AZ
Claims adjuster job in Glendale, AZ
Who is Federated Insurance?
At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own.
Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values.
What Will You Do?
Customer-focused, source of knowledge and comfort, desire to help, professional - Does that sound like you? We are seeking someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss.
No previous insurance or claims experience needed! Federated provides an exceptional training program to teach you the fundamentals of claims and will prepare you to assist clients.
This is an in-office position that will work out of our Glendale, AZ office, located at 5701 W. Talavi Blvd. A work from home option is not available.
Responsibilities
Work with policyholders, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair and courteous way.
Explain policy coverage to policyholders and third parties.
Complete thorough investigations and document facts relating to claims.
Determine the value of damaged items or accurately pay medical and wage loss benefits.
Negotiate settlements with policyholders and third parties.
Resolve claims, which may include paying, settling, or denying claims, defending policyholders in court, compromising or recovering outstanding dollars.
Minimum Qualifications
Current pursuing, or have obtained a four-year degree
Experience in a customer service role in industries such as retail, hospitality, logistics, banking, automotive dealerships, vehicle rental, sales or similar fields
Ability to make confident decisions based on available information
Strong analytical, computer, and time management skills
Excellent written and verbal communication skills
Leadership experience is a plus
Salary Range: $61,700 - $75,400
Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information can be discussed with a with a member of the Recruiting team.
What We Offer
We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You.
Employment Practices
All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization.
If California Resident, please review Federated's enhanced Privacy Policy.
Auto-ApplyCasualty Claims Adjuster Tier III
Claims adjuster job in Scottsdale, AZ
Company Details
Berkley One is a modern insurance provider for a modern generation of affluence. We serve clients who live dynamic, adventurous lives and expect their insurance experience to match. Our mission is to deliver highly personalized risk and claims management through a blend of expert independent agents, cutting-edge digital tools, and the strength of the Berkley brand.
Why Join Us?
At Berkley One, you'll be part of a forward-thinking team that's reimagining personal insurance. We're building solutions that are as sophisticated and agile as the clients we serve-individuals and families who value innovation, simplicity, and exceptional service. You'll collaborate with passionate professionals, leverage modern technology, and help shape the future of our industry.
What We Value
A client-first mindset with a passion for delivering exceptional experiences
Curiosity, creativity, and a drive to challenge the status quo
Collaboration across disciplines to build smarter, more intuitive solutions
Integrity, expertise, and a commitment to excellence
Join us in creating a new standard in personal insurance-where protection meets possibility.
This role will be based in our Phoenix, AZ or Wilmington, DE office. We offer a hybrid work schedule with 4 days in the office; and 1 day remote where it makes sense to do so.
#LI-AV1 #LI-HYBRID
The Company is an equal employment opportunity employer.
Responsibilities
The Casualty Claims Adjuster is a key contributor to the Berkley One brand. The position requires Liability, Injury and Auto Physical Damage claim technical, organizational and time management skills, along with self-direction and exceptional customer service. This position is responsible for quality, timely handling and resolution of moderately complex claims in a professional manner.
What you can expect:
Culture of innovation, teamwork, supportive colleagues and leaders willing to invest in talent
Internal mobility opportunities
Visibility to senior leaders and partnership with cross functional teams
Opportunity to impact change
Benefits - competitive compensation, paid time off, comprehensive wellness benefits and programs, employer funded health savings account, profit sharing, 401k, paid parental leave, employee stock purchase plan, tuition assistance and professional continuing education
We'll count on you to:
Handle first and third-party personal lines auto, homeowner liability, bodily injury, first party medical/PIP, and auto physical damage claims of moderate complexity.
Appropriately manage claims through coverage analysis, investigation, reserving and resolution
Identify and address coverage issues, complete investigation to determine cause & exposure, set timely reserves and develop detailed action plans
Negotiate claim settlements with attorneys and unrepresented claimants
Establish validity of claims submitted for payment through coverage research and contact with policyholders, claimants and outside parties
Research and locate additional information and documentation to investigate, evaluate and properly resolve claims
Write denial letters, reservation of rights, coverage disclaimers and other correspondence
Work with defense counsel and coverage counsel as needed.
Maintain an effective diary system and document claim file activities in accordance with established procedures
Pro-actively manage file inventory to ensure timely resolution of cases
Deliver exceptional customer service to meet the needs of the insured, agent and all internal and external customers
Perform administrative functions such as expense accounts and time off reporting as required
Qualifications
Bachelors degree or equivalent work experience
Minimum 3 years of experience handling injury insurance claims with an emphasis in working with High Net Worth customers and experience with automated claims systems
You will also actively participate on CAT duty when needed
Broad knowledge of auto, bodily injury, UM/UIM, and first party injury claims.
Agile learner who can quickly absorb information and apply it to current business situations.
Incredible empathy and understanding of the needs of customers, both insureds and their agents alike. You will be an excellent, pro-active advocate for Berkley One customers and are passionate about their brand experience
Exceptional oral and written communication skills. Your communication style is flexible to the situation. You communicate clearly and with a purpose
Calm under pressure. You have excellent organizational and negotiation skills, integrity, and great follow-through on tasks. You are comfortable challenging norms while working collaboratively with colleagues at all levels of the organization
You have a strong sense of accountability, fun and adventure
Natural curiosity. You love learning how things work and you are always looking for innovative improvements
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Sponsorship Details Sponsorship not Offered for this Role
Auto-ApplyInsurance Claims Adjuster- Litigation
Claims adjuster job in Phoenix, AZ
At American Express, our culture is built on a 175-year history of innovation, shared values and Leadership Behaviors, and an unwavering commitment to back our customers, communities, and colleagues. As part of Team Amex, you'll experience this powerful backing with comprehensive support for your holistic well-being and many opportunities to learn new skills, develop as a leader, and grow your career.
Here, your voice and ideas matter, your work makes an impact, and together, you will help us define the future of American Express.
How will you make an impact in this role?
AMEX Assurance Company provides insurance protection for American Express Card Members through implicit card benefits, and fee/add-on insurance products to both Card Members and non-Card Members. This role will reside in the Claim and Servicing Operations department of AAC, whose primary responsibilities include enrollment, servicing, and adjudication of insurance policies and claims; this role provides an exciting opportunity in handling Litigated Claims for all claims within the AMEX Assurance Company Insurance portfolio, Including but not limited to Travel and Medical claims within the highly complex suite of Specialty Lines products.
Duties include but not limited to:
* Investigation/research by using tools available and making outbound calls to settle claims
* Communication via written and/or direct phone interaction with the customer, to ensure timely decisions
* Communication and partnership with our legal teams and leadership
* Decision making of claims for these products
* Contract and policy interpretation
* Maintaining state compliance
To be considered for this position you must reside in Arizona. This is a hybrid position and will require the successful candidate to be in office a minimum of 3 days per week.
Minimum Qualifications:
* 2 years of Customer Service experience
* 2 years Insurance experience, preferably in claims
* Customer First Principles demonstrated through excellent verbal, written and interpersonal communication skills
* Passion for exceptional service
* Strong phone skills
* Ability to adapt to multiple demands, shifting priorities and rapid changes in workflow
* Ability to demonstrate initiative with minimal supervision to drive results
* Strong problem-solving skills, time management and organizational skills
* Superior level of accuracy and attention to detail.
* Strong proficiency in PC skills, including MS Word and Excel
Preferred Qualifications:
* Travel and Medical Claims experience
* Auto Insurance Experience
* Litigation claims handling experience
* Insurance or Travel Industry experience
A current Claims Adjuster License
If a license is not currently held, the applicant must be able to obtain the necessary license during the time frame allowed prior to training. Upon hiring, candidate will have 2 attempts to pass the Arizona Licensing exam. If the exam, to obtain your license, cannot be passed within 2 attempts, employment will be terminated.
Salary Range: $26.20 to $43.87 hourly + bonus + benefits
The above represents the expected hourly pay range for this job requisition. Ultimately, in determining your pay, we'll consider your location, experience, and other job-related factors.
We back you with benefits that support your holistic well-being so you can be and deliver your best. This means caring for you and your loved ones' physical, financial, and mental health, as well as providing the flexibility you need to thrive personally and professionally:
* Competitive base salaries
* Bonus incentives
* 6% Company Match on retirement savings plan
* Free financial coaching and financial well-being support
* Comprehensive medical, dental, vision, life insurance, and disability benefits
* Flexible working model with hybrid, onsite or virtual arrangements depending on role and business need
* 20+ weeks paid parental leave for all parents, regardless of gender, offered for pregnancy, adoption or surrogacy
* Free access to global on-site wellness centers staffed with nurses and doctors (depending on location)
* Free and confidential counseling support through our Healthy Minds program
* Career development and training opportunities
For a full list of Team Amex benefits, visit our Colleague Benefits Site.
American Express is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law. American Express will consider for employment all qualified applicants, including those with arrest or conviction records, in accordance with the requirements of applicable state and local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance for Employers, and the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance. For positions covered by federal and/or state banking regulations, American Express will comply with such regulations as it relates to the consideration of applicants with criminal convictions.
We back our colleagues with the support they need to thrive, professionally and personally. That's why we have Amex Flex, our enterprise working model that provides greater flexibility to colleagues while ensuring we preserve the important aspects of our unique in-person culture. Depending on role and business needs, colleagues will either work onsite, in a hybrid model (combination of in-office and virtual days) or fully virtually.
US Job Seekers - Click to view the "Know Your Rights" poster. If the link does not work, you may access the poster by copying and pasting the following URL in a new browser window: ***************************
Employment eligibility to work with American Express in the U.S. is required as the company will not pursue visa sponsorship for these positions.
Daily Claims Adjuster - Phoenix, AZ
Claims adjuster job in Phoenix, AZ
CENCO is a leading provider of property claims solutions, collaborating with top insurance carriers to deliver accurate, timely, and dependable adjusting services. We are currently seeking experienced Daily Property Claims Adjusters to manage residential and commercial claims throughout Phoenix and the surrounding areas of Arizona. This role is perfect for adjusters looking for consistent assignments and the flexibility of independent fieldwork.
Key Responsibilities:
Conduct thorough inspections of property damage caused by wind, hail, fire, water, and other covered perils.
Document damages with detailed reports and clear, high-quality photos.
Prepare accurate repair estimates using Xactimate or Symbility.
Maintain professional communication with policyholders, contractors, and insurance carriers.
Manage claims efficiently to meet all deadlines and carrier requirements.
Requirements:
Licensing: Active Arizona adjuster license required.
Software: Experience with Xactimate or Symbility preferred.
Equipment: Reliable vehicle, ladder, laptop, and standard inspection tools.
Work Style: Self-motivated, organized, and able to work independently.
Availability: Able to accept assignments promptly and complete reports on schedule.
Why Work with CENCO?
Steady claim volume in Phoenix and surrounding communities
Competitive pay with reliable, on-time compensation
Supportive team and streamlined workflows
If you're a skilled adjuster seeking steady daily work and the opportunity to grow with a trusted industry partner, we want to hear from you!
Field Claims Adjuster
Claims adjuster job in Phoenix, AZ
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
Independent Insurance Claims Adjuster in Laveen, Arizona
Claims adjuster job in Phoenix, AZ
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
Auto-ApplyPatient Claims Specialist
Claims adjuster job in Phoenix, AZ
ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine!
Your Role:
* Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections
* Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates
* Input and update patient account information and document calls into the Practice Management system
* Special Projects: Other duties as required to support and enhance our customer/patient-facing activities
Skills & Requirements:
* High School Diploma or GED required
* Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST
* Minimum of 1-2 years of previous healthcare administration or related experience required
* Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs)
* Manage/ field 60+ inbound calls per day
* Bilingual a plus (Spanish & English)
* Proficient knowledge of business software applications such as Excel, Word, and PowerPoint
* Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone
* Ability and openness to learn new things
* Ability to work effectively within a team in order to create a positive environment
* Ability to remain calm in a demanding call center environment
* Professional demeanor required
* Ability to effectively manage time and competing priorities
#LI-SM2
Auto-ApplyPharmacy Claims Representative 2
Claims adjuster job in Mesa, AZ
Essential Functions
Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent's performance objectives as outlined by the incumbent's immediate supervisor or manager.
1. Assist pharmacies with real-time and retrospective claims adjudication. Adjust and correct authorizations in dispensing and PBM systems to ensure timely claims submission. Research and resolve rejected claims by contacting hospices for approvals or updated authorizations.
2. Maintain accuracy of patient profiles, involving authorization status and relatedness indicators.
3. Evaluate and process compound medication claims, ensuring accuracy in ingredients, quantities, and pricing.
4. Research pharmacy invoices and hospice billing issues, reconciling discrepancies as needed.
5. Collaborate with the Customer Service team on complex claims research and resolution.
6. Understand Enclara Pharmacia's standard and custom formularies and differentiate between Per Diem (PD) and Fee-for-Service (FFS) billing models across hospice partners.
7. Contact facilities and pharmacies to verify and collect necessary information for onboarding spreadsheets. Coordinate PBM and billing system verification with facility pharmacies. Maintain and update facility-pharmacy tracking spreadsheets and communicate status with implementation teams.
8. Educate facility pharmacies on billing procedures and contacts for rejected claims.
9. Collect and verify missing or incomplete facility information reported by the Call Center team. Ensure all facilities are correctly linked to their respective hospices in internal systems. Assist with Confirmation Fax reports to validate and update facility-pharmacy relationships and demographics.
10. Complete tasks and special projects assigned by Pharmacy Claims Team Leaders on Pharmacy Claims (Support Services) Manager.
11. Support Call Center leadership in initiatives to streamline processes and improve service outcomes.
Marginal or Additional Functions
1. Performs other duties as assigned or apparent.
Supervisory and Managerial Responsibility
• Supervisory/managerial responsibility is not applicable
Knowledge, Skills & Abilities
Education, Licensure or Certification:
• High school diploma or equivalent required
• CPhT or EXCPT certification required
Work Experience or Related Experience:
• Minimum of six (6) months of pharmacy technician experience.
• Experience with pharmacy claims adjudication is required.
Specialized Knowledge, Skills & Abilities:
• PBM or billing platform experience preferred
• Proficient in Microsoft Office Suite, especially Excel, Word, Outlook, and Access
• Comfortable navigating multiple software systems, including pharmacy dispensing and PBM platforms
• Excellent verbal and written communication skills
• Ability to learn proprietary systems used for claims management and facility tracking.
Equipment
• Working knowledge of a PC, business and communications software (MS Office) and web-based tools are required
Travel Requirements and Conditions
• Travel is not required
Work Environment, Conditions and Demands
• Work is generally performed in a climate-controlled, smoke-free office environment.
Physical Requirements and Demands
• May sit, stand, walk, stoop, or bend intermittently throughout the day.
• May be required to sit for extended periods (7-10 hours/day).
• Occasional lifting of up to 25 pounds may be required.
• Requires manual dexterity to operate office equipment.
• Visual acuity to read fine print and digital screens; must be able to hear and respond to verbal communication.
Additional Position Information
• No additional information is applicable
Complex Liability Adjuster - CGL & BOP Specialist
Claims adjuster job in Scottsdale, AZ
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
* Competitive compensation
* Healthcare benefits package that begins on first day of employment
* 401K retirement plan with company match
* Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
* Up to 6 weeks of parental and bonding leave
* Hybrid work schedule (3 days in the office, 2 days from home)
* Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
* Tuition reimbursement after 6 months of employment
* Numerous opportunities for continued training and career advancement
* And much more!
Responsibilities
Are you an experienced professional with a sharp eye for detail and a strong background in litigation? Join our team as a Complex Liability Adjuster, where you'll play a crucial role in managing Commercial General Liability (CGL) and Business Owners Policy (BOP) claims with precision and expertise. We're looking for someone who thrives in high-stakes environments, communicates with confidence, and knows how to navigate the legal landscape with precision.
Key Responsibilities:
* Conduct thorough investigations of losses, identifying coverage issues and ensuring accurate assessments.
* Review and analyze evidence, reports, and medical records to establish damages and reserves.
* Interview insureds, claimants, and witnesses to gather essential information and build strong cases.
* Collaborate with legal teams to navigate complex litigation processes and defend our insureds effectively.
* Manage litigated claims involving CGL and BOP policies, including coordination with defense counsel, litigation strategy development, and resolution planning.
* Process payments efficiently, ensuring timely resolution of claims.
Qualifications
* Prior experience adjusting Commercial General Liability claims with a proven track record in litigation is required.
* Juris Doctorate (JD) preferred, reflecting the value we place on strong legal acumen in managing complex liability claims.
* Licensing: Active TX All Lines License, or willingness to obtain one at company's expense.
* Exceptional written and verbal communication skills.
* Strong organizational and computer skills.
* Excellent time management skills with the ability to prioritize tasks effectively.
Auto-ApplyClaims Representative CO & AZ
Claims adjuster job in Phoenix, AZ
Job DescriptionJob Profile Job Title: Claims RepresentativeLocation: Remote anywhere in the US with CO & AZ experience Hire Type: Contingent Pay Range: $40 - $44/hr. Work Model: RemoteWork Shift: Monday-Friday 8 am - 4:30 pm Recruiter Contact: Sean Craft I sean@marykraft.com I 443-345-3305 Nature & Scope:Positional OverviewWe are seeking an experienced Workers' Compensation Claims Representative to handle and adjudicate low-level workers' compensation claims. The ideal candidate will have at least 2 years of direct WC claim-handling experience, with proficiency in Colorado jurisdiction and Arizona licensure or certification preferred. This position involves determining compensability, administering benefits, managing return-to-work efforts, and ensuring compliance with company standards and state regulations-all while delivering high-quality customer service to claimants and clients.Role & Responsibility:Tasks That Will Lead to Your Success
Process and manage low-level workers' compensation claims, determining compensability and benefits due.
Monitor reserve accuracy and file required documentation with state agencies.
Develop and coordinate claim action plans focused on resolution and return-to-work outcomes.
Approve and issue claim payments within established authority levels.
Handle subrogation of claims and negotiate settlements as appropriate.
Communicate effectively with claimants, clients, and internal partners regarding claim actions and updates.
Maintain accurate and compliant claim documentation and coding.
Process lifetime and/or defined-period medical claims, including state filings and utilization review decisions.
Foster and maintain positive client and claimant relationships.
Support the organization's quality programs and continuous improvement efforts.
Skills & ExperienceQualifications That Will Help You Thrive
High School Diploma or GED required; bachelor's degree preferred.
Colorado WC jurisdiction proficiency required; Arizona license/certification a plus.
Minimum 2 years of direct workers' compensation claim-handling experience, or equivalent combination of education and experience.
Prior experience managing indemnity and medical-only claims preferred.
Working knowledge of state-specific workers' compensation laws and procedures.
Strong analytical, interpretive, and problem-solving skills.
Excellent written and verbal communication skills.
Proficient in Microsoft Office Suite and claims management systems.
Strong organizational and interpersonal abilities.
Ability to work independently and collaboratively to meet performance standards.
Complex Liability Adjuster
Claims adjuster job in Scottsdale, AZ
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
Competitive compensation
Healthcare benefits package that begins on first day of employment
401K retirement plan with company match
Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
Up to 6 weeks of parental and bonding leave
Hybrid work schedule (3 days in the office, 2 days from home)
Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
Tuition reimbursement after 6 months of employment
Numerous opportunities for continued training and career advancement
And much more!
Responsibilities
Are you an experienced professional with a sharp eye for detail and a strong background in litigation? Join our team as a Liability Adjuster, where you'll play a crucial role in managing Complex commercial general liability claims with precision and expertise.
Key Responsibilities:
Conduct thorough investigations of losses, identifying coverage issues and ensuring accurate assessments.
Review and analyze evidence, reports, and medical records to establish damages and reserves.
Process payments efficiently, ensuring timely resolution of claims.
Interview insureds, claimants, and witnesses to gather essential information and build strong cases.
Collaborate with legal teams to navigate complex litigation processes and defend our insureds effectively.
Qualifications
Juris Doctor (JD) degree preferred or Bachelor's degree with prior experience adjusting liability claims and a proven track record in litigation.
Licensing: Active TX All Lines License, or willingness to obtain one at company's expense.
Exceptional written and verbal communication skills.
Strong organizational and computer skills.
Excellent time management skills with the ability to prioritize tasks effectively.
Auto-ApplyAuto Adjuster
Claims adjuster job in Phoenix, AZ
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated Auto Adjuster you will proactively handle the complete end to end claims process. Taking statements, policy and coverages, determination of liability and complete services needed.
Within defined guidelines and framework, responsible to adjust moderately complex auto insurance claims presented by or against our members to include the end-to-end claims process and settling claims in compliance with state laws and regulations. Accountable for delivering best in class service, through setting appropriate expectations, proactive communications, advice, and compassion.
We offer a flexible work environment that requires an individual to be in the office 3 days per week, after completing 6 months in office. This position is based in the Phoenix, AZ location. Relocation assistance is not available for this position.
What you'll do:
Investigates liability and applies appropriate coverage, evaluates, negotiates, and settles moderately complex auto claims.
Negotiates liability for comparative negligence (claimant or adverse carrier).
Identifies coverage concerns, reviews prior loss history, determines, and creates Special Investigation Unit (SIU) referrals, when appropriate.
Interacts with multiple parties to gather information needed to determine liability (police reports, recorded statements, witness statements).
Resolves claims through proactive problem solving and decision making, within authority guidelines and under moderate supervision, overcoming obstacles, and effectively prioritizing the workload.
Clearly documents thought process including damage evaluation, investigation, negotiation, and settlement decisions
Collaborates and sets expectations with external and internal business partners to facilitate claims resolution.
Supports members, business partners, and claimants, through use of varying communication channels to include utilization of digital tools to drive timely and effective resolutions through exceptional service.
Applies developing knowledge of P&C insurance industry products, services, to include P&C insurance policy contracts, coverages and internal claims handling process and procedures.
Applies intermediate knowledge of Auto Physical Damage to adjust claims.
Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
May be assigned CAT deployment travel with minimal notice during designated CATs.
Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
What you have:
High School Diploma or General Equivalency Diploma.
1 year of customer service experience.
Progressive experience handling low complexity auto non injury liability claims.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
Developing knowledge and understanding of auto claims contracts as well as application of case law and state laws and regulations.
Demonstrated negotiation, investigation, communication, and conflict resolution skills.
Proficient in prioritizing and multi-tasking, including navigating through multiple business applications.
Successful completion of a job-related assessment may be required.
What sets you apart:
One or more years of auto liability claims experience managing claims from initial contact through resolution
Minimum one year of experience managing a pending inventory with demonstrated organization and prioritization skills
At least two years of customer service experience, demonstrating strong communication and problem-solving skills
Proven experience with comparative negligence and shared liability determinations
Strong analytical and communication skills with the ability to interpret policy language, assess coverages, and make sound decisions
Proficiency with Guidewire or similar claims management systems
Bachelor's degree or industry designation (e.g., AIC, CPCU)
Military experience through service or as a military spouse
Compensation range: The salary range for this position is: $51,370 - $86,680.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Casualty Claims Adjuster Tier II
Claims adjuster job in Scottsdale, AZ
Company Details
Berkley One is a modern insurance provider for a modern generation of affluence. We serve clients who live dynamic, adventurous lives and expect their insurance experience to match. Our mission is to deliver highly personalized risk and claims management through a blend of expert independent agents, cutting-edge digital tools, and the strength of the Berkley brand.
Why Join Us?
At Berkley One, you'll be part of a forward-thinking team that's reimagining personal insurance. We're building solutions that are as sophisticated and agile as the clients we serve-individuals and families who value innovation, simplicity, and exceptional service. You'll collaborate with passionate professionals, leverage modern technology, and help shape the future of our industry.
What We Value
A client-first mindset with a passion for delivering exceptional experiences
Curiosity, creativity, and a drive to challenge the status quo
Collaboration across disciplines to build smarter, more intuitive solutions
Integrity, expertise, and a commitment to excellence
Join us in creating a new standard in personal insurance-where protection meets possibility.
#LI-AV1 #LI-HYBRID
This role will be based in our Phoenix, AZ or Wilmington, DE office. We offer a hybrid work schedule with 4 days in the office; and 1 day remote where it makes sense to do so.
The Company is an equal employment opportunity employer.
Responsibilities
This Auto/Multi-Line Claims Adjuster is a key contributor to the Berkley One brand. The position requires Property, Liability, Injury and Auto Physical Damage claim technical, organizational and time management skills, along with self-direction and exceptional customer service. The Multi-Line Claims Adjuster is responsible for quality, timely handling and resolution of moderately complex claims in a professional manner.
What you can expect:
Culture of innovation, teamwork, supportive colleagues and leaders willing to invest in talent
Internal mobility opportunities
Visibility to senior leaders and partnership with cross functional teams
Opportunity to impact change
Benefits - competitive compensation, paid time off, comprehensive wellness benefits and programs, employer funded health savings account, profit sharing, 401k, paid parental leave, employee stock purchase plan, tuition assistance and professional continuing education
We'll count on you to:
Handle first and third-party personal lines auto and homeowners, liability, first party medical/PIP, third party BI and auto physical damage claims of moderate complexity as assigned
Appropriately manage claims through coverage analysis, investigation, reserving and resolution
Identify and address coverage issues, complete investigation to determine cause & exposure, set timely reserves and develop detailed action plans
Negotiate and convey claim settlements within authority limits
Establish validity of claims submitted for payment through coverage research and contact with policyholders, claimants and outside parties
Research and locate additional information and documentation to investigate, evaluate and properly resolve claims
Write denial letters, Reservation of Rights and other correspondence
Maintain an effective diary system and document claim file activities in accordance with established procedures
Pro-actively manage file inventory to ensure timely resolution of cases
Deliver exceptional customer service to meet the needs of the insured, agent and all internal and external customers
Perform administrative functions such as expense accounts and time off reporting as required
Qualifications
Capable of participating on CAT duty when needed
Broad knowledge of the auto liability claim handling process
Agile learner who can quickly absorb information and apply it to current business situations.
Minimum 2 years of experience handling auto liability insurance claims with an emphasis in working with High Net Worth customers and experience with automated claims systems
Incredible empathy and understanding of the needs of customers, both insureds and their agents alike. You will be an excellent, pro-active advocate for Berkley One customers and are passionate about their brand experience
Exceptional oral and written communication skills. Your communication style is flexible to the situation. You communicate clearly and with a purpose
Calm under pressure. You have excellent organizational and negotiation skills, integrity, and great follow-through on tasks. You are comfortable challenging norms while working collaboratively with colleagues at all levels of the organization
You have a strong sense of accountability, fun and adventure
Natural curiosity. You love learning how things work and you are always looking for innovative improvements
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role
Auto-ApplyField Claims Adjuster
Claims adjuster job in Queen Creek, AZ
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
Patient Claims Specialist
Claims adjuster job in Phoenix, AZ
We are united in our mission to make a positive impact on healthcare. Join Us!
South Florida Business Journal, Best Places to Work 2024
Inc. 5000 Fastest-Growing Private Companies in America 2024
2024 Black Book Awards, ranked #1 EHR in 11 Specialties
2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold)
2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara)
Who we are:
We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany.
ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine!
Your Role:
Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections
Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates
Input and update patient account information and document calls into the Practice Management system
Special Projects: Other duties as required to support and enhance our customer/patient-facing activities
Skills & Requirements:
High School Diploma or GED required
Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST
Minimum of 1-2 years of previous healthcare administration or related experience required
Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs)
Manage/ field 60+ inbound calls per day
Bilingual a plus (Spanish & English)
Proficient knowledge of business software applications such as Excel, Word, and PowerPoint
Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone
Ability and openness to learn new things
Ability to work effectively within a team in order to create a positive environment
Ability to remain calm in a demanding call center environment
Professional demeanor required
Ability to effectively manage time and competing priorities
#LI-SM2
ModMed Benefits Highlight:
At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits:
India
Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk,
Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees,
Allowances: Annual wellness allowance to support your well-being and productivity,
Earned, casual, and sick leaves to maintain a healthy work-life balance,
Bereavement leave for difficult times and extended medical leave options,
Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave,
Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind.
United States
Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution,
401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
Generous Paid Time Off and Paid Parental Leave programs,
Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,
Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.
PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.
Auto-ApplyProfessional Liability Adjuster
Claims adjuster job in Scottsdale, AZ
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
Competitive compensation
Healthcare benefits package that begins on first day of employment
401K retirement plan with company match
Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
Up to 6 weeks of parental and bonding leave
Hybrid work schedule (3 days in the office, 2 days from home)
Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
Tuition reimbursement after 6 months of employment
Numerous opportunities for continued training and career advancement
And much more!
Responsibilities
The Professional Liability Adjuster is responsible for conducting office investigations and adjusting Professional Liability and Error & Omission (E&O), Employment Practices Liability Insurance (EPLI), and Directors & Officers (D&O) Liability claims. The Adjuster is also responsible for, but not limited to:
Investigating losses and identifying coverage issues across Professional Liability, E&O, EPLO, and D&O lines
Obtaining and reviewing evidence, reports, and medical records
Establishing damages and reserves
Processing payments
Taking statements from insured's, claimants, and witnesses
Participating in Mediations
Qualifications
Active attorney license with at least 5 years of professional liability experience
Prior experience adjusting Professional Liability, E&O, EPLI, and D&O claims
Experience with Legal Malpractice preferred
Active Adjuster license is preferred
Strong understanding of employment law and corporate governance as it relates to EPLI and D&O exposures
Excellent written and verbal communication skills
Strong organizational and computer skills
Excellent time management skills with the ability to prioritize
Auto-ApplySr. Injury Adjuster (Sign-On Bonus)
Claims adjuster job in Phoenix, AZ
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated Sr. Injury Adjuster, you will work within defined guidelines and framework, responsible to adjust attorney involved moderately complex bodily injury to include confirming coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations. Accountable for delivering a concierge level of best in class member service through setting appropriate expectations, proactive communications, advice, and compassion.
This role is remote eligible in the Central, Mountain, or Pacific time zones, with occasional business travel. However, individuals residing within a 60-mile radius of a USAA office will be expected to work on-site three days per week.
For new hires starting, we are offering a signing bonus of $2,500. Bonus will be paid in one lump sum (minus applicable taxes) after 45 days of employment.
What you'll do:
Identifies and manages existing and emerging risks that stem from business activities and the job role.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.
Follows written risk and compliance policies, standards, and procedures for business activities.
Adjusts attorney-involved moderately complex bodily injury claims with demonstrable injuries (e.g. torn meniscus, broken bones, disc herniations), as well as all auto physical damage associated with those claims.
Identifies, confirms, and makes coverage decisions on moderately complex bodily injury claims.
Investigates loss details, determines legal liability, evaluates, negotiates, and arrives at claim settlement within appropriate authority guidelines.
Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.
Prioritizes and manages assigned claims workload to keep members and other involved parties informed, provides timely claims status updates.
Collaborates and supports team members to resolve issues and identify appropriate matters for escalation.
Partners and/or directs vendors and internal business partners to facilitate timely claims resolution.
Supports workload surges and/or Catastrophe Operations as needed.
May act as an informal resource for team members with less experience.
What you have:
High School or General Equivalency Diploma.
1 year of injury adjusting experience.
2 years of auto liability claims adjusting experience.
Deep knowledge and understanding of the auto claims contract as well as application of case law and state laws and regulations.
Proficient negotiation, investigation, communication, and conflict resolution skills.
Demonstrated time-management and decision-making skills.
Proven investigatory, prioritizing, multi-tasking, and problem-solving skills.
Proficient knowledge of human anatomy and medical terminology associated with bodily injury claims.
Ability to exercise sound financial judgment and discretion in handling insurance claims.
Proficient knowledge of coverage evaluation, loss assessment, and loss reserving.
Acquisition and maintenance of insurance adjuster license within 90 days and designated number of attempts.
What sets you apart:
4 or more years auto liability/casualty adjusting experience.
1yr Medical experience to include coding and billing or EMT.
Ongoing Professional Development with a focus on Insurance
Bachelors degree or higher.
US military experience through military service or a military spouse/domestic partner.
Compensation Range: The salary range for this position is: $63,590 - $117,990.
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Senior Property Claims Adjuster
Claims adjuster job in Scottsdale, AZ
Company Details
Berkley One is a modern insurance provider for a modern generation of affluence. We serve clients who live dynamic, adventurous lives and expect their insurance experience to match. Our mission is to deliver highly personalized risk and claims management through a blend of expert independent agents, cutting-edge digital tools, and the strength of the Berkley brand.
Why Join Us?
At Berkley One, you'll be part of a forward-thinking team that's reimagining personal insurance. We're building solutions that are as sophisticated and agile as the clients we serve-individuals and families who value innovation, simplicity, and exceptional service. You'll collaborate with passionate professionals, leverage modern technology, and help shape the future of our industry.
What We Value
A client-first mindset with a passion for delivering exceptional experiences
Curiosity, creativity, and a drive to challenge the status quo
Collaboration across disciplines to build smarter, more intuitive solutions
Integrity, expertise, and a commitment to excellence
Join us in creating a new standard in personal insurance-where protection meets possibility.
#LI-AV1 #LI-HYBRID
This role will be based in our Phoenix, AZ office. We offer a hybrid work schedule with 4 days in the office; and 1 day remote where it makes sense to do so.
The Company is an equal employment opportunity employer.
Responsibilities
As a Senior Property Claims Adjuster, you'll be a key contributor to the Berkley One brand, requires proven claim technical, organizational and time management skills, self-direction, leadership and the ability to provide exceptional quality customer service. The Senior Property Desk Adjuster is responsible for quality handling and resolution of property claims including both volume and complex, high exposure claims in a timely, professional manner with emphasis on providing quality service. The ideal candidate will have experience in handling all manner and size of personal lines property claims from the desk. We'll trust you to provide service while assuring proper claim outcomes and expense management.
What you can expect:
Culture of innovation, teamwork, supportive colleagues and leaders willing to invest in talent
Internal mobility opportunities
Visibility to senior leaders and partnership with cross functional teams
Opportunity to impact change
Benefits - competitive compensation, paid time off, comprehensive wellness benefits and programs, employer funded health savings account, profit sharing, 401k, paid parental leave, employee stock purchase plan, tuition assistance and professional continuing education
We'll count on you to:
Appropriately manage assigned first party claims through coverage analysis, virtual desk adjusting, oversight of independent adjusters, other experts, reserving and resolution
Identify and address coverage issues, complete investigation to determine cause & exposure, set timely reserves and develop detailed action plans
Manage all experts and vendors assigned on claims including quality, service and expense.
Write fair and equitable estimates in Symbility on appropriate losses
Negotiate and convey claim settlements within authority limits
Establish validity of claims submitted for payment through investigation, research and contact with policyholders, claimants and outside parties for additional information and documentation to evaluate and properly resolve claims
Write denial letters, Reservation of Rights and other correspondence
Maintain an effective diary system and document claim file activities in accordance with established procedures
Pro-actively manage file inventory to ensure timely resolution of cases
Deliver exceptional customer service to meet the needs of the insured, agent and all internal and external customers
Perform administrative functions such as expense accounts and time off reporting as required
Manage Independent Adjusters and experts on select claims
Assist with the training of other internal and external adjusters on Berkley One best practices
Catastrophe duty as needed
Establish relationships within the broker community to promote our brand
Perform other duties as assigned
Qualifications
What you need to have:
Bachelors degree or equivalent industry experience
Minimum 5 years of experience handling property insurance claims with an emphasis in working with High Net Worth customers
Experience with automated claims systems
Collaborative, you will coordinate with lead adjusters and managers on pending claim files requiring additional investigation and confirming coverage on our largest claims. You will also actively participate on CAT duty when needed and assist in overseeing the contractor referral program including re-inspections and quality reviews
Pro-active, you will manage preferred vendors in order to drive continuous quality improvement
What makes you stand out:
Broad knowledge of construction, estimating and estimating systems, Symbility preferred
Incredible empathy and understanding of the needs of customers, both insureds and their agents alike. You will be an excellent, pro-active advocate for Berkley One customers and are passionate about their brand experience.
Exceptional oral and written communication skills. Your communication style is flexible to the situation. You communicate clearly and with a purpose.
Calm under pressure. You have excellent organizational and negotiation skills, integrity, and great follow-through on tasks. You are comfortable challenging norms while working collaboratively with colleagues at all levels of the organization.
You have a strong sense of accountability, fun and adventure.
Natural curiosity. You love learning how things work and you are always looking for innovative improvements.
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role
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