Product Liability Litigation Adjuster
Claims adjuster job in Raleigh, NC
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**Position Summary**
As a Product Liability Litigation Adjuster, Risk Management, you will be responsible for managing lawsuits and overseeing outside counsel defending CVS in high exposure, product liability mass tort litigations and general liability cases filed throughout the United States.
Responsibilities include:
+ Developing relationships with internal colleagues for fact-finding and key litigation activities.
+ Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution.
+ Managing all aspects of product liability mass tort litigations and complex general liability cases.
+ Working with outside national counsel and sr. management to develop consistent litigation strategies applicable to mass tort cases filed across the country.
+ Providing reporting to key internal stake holders on case developments and litigation trends for product liability mass torts and other cases.
+ Managing large scale discovery investigations by working with internal custodians, outside counsel and vendors to develop comprehensive procedures for identifying, locating, preserving and producing corporate records.
+ Analyzing case and internal materials and utilizing resources across CVS to discern key issues and identify the litigation strategy in every case assigned.
+ Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working with and overseeing outside counsel.
+ Participating in meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases.
**Required Qualifications**
+ 2+ years of legal experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier.
+ Juris Doctor degree from an ABA accredited university.
+ Ability to travel and participate in legal proceedings, arbitrations, depositions, etc.
**Preferred Qualifications**
+ Experience overseeing or defending product liability claims and litigation.
+ Familiarity or experience with insurance and coverage issues related to litigated claims.
+ Strong attention to detail and project management skills.
+ Experience overseeing and answering written discovery.
+ Ability to work independently and in an environment requiring teamwork and collaboration.
+ Strong written and verbal communication skills.
+ Demonstrated negotiation skills and ability.
+ Ability to articulate and summarize cases with management in a concise, cogent manner.
+ Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure.
+ 3-5 years of legal or claims experience.
+ Familiarity with the rules and procedures applicable to mass tort litigations, class actions, and/or multidistrict litigations.
+ Knowledge and experience navigating attorney-client privilege issues, corporate litigation holds, corporate witness depositions, and e-discovery.
+ Ability to influence and work collaboratively with senior leaders, CVS' in-house legal counsel and outside counsel.
+ Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new software programs and systems.
+ Ability to positively and aggressively represent the company at mediation, arbitration and trial.
+ Ability to navigate difficult situations and communicate effectively with both internal and external groups.
+ Excellent organizational and time management skills and ability to handle a high volume of litigated claims.
+ Experience with and understanding of legal documents (pleadings, discovery, motions and briefs).
**Education**
+ Verifiable Juris Doctor degree
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$46,988.00 - $122,400.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/03/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Claims Adjuster - Liability (REMOTE- BI/Lit exp & licensed in any: NC, SC, VA, FL DE DC DE MD)
Claims adjuster job in Raleigh, NC
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Claims Adjuster - Liability (REMOTE- BI/Lit exp & licensed in any: NC, SC, VA, FL DE DC DE MD)
***Looking for bodily injury/ligation adjuster with auto- trucking claim, product claims, GL premises. Needs to be licensed in NC, SC, VA, FL DE DC DE MD. ***
Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?
+ Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
+ Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.
+ Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
+ Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.
+ Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
+ Enjoy flexibility and autonomy in your daily work, your location, and your career path.
+ Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
**ARE YOU AN IDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
**PRIMARY PURPOSE** **:** To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements..
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
+ Assesses liability and resolves claims within evaluation.
+ Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
+ Manages subrogation of claims and negotiates settlements.
+ Communicates claim action with claimant and client.
+ Ensures claim files are properly documented and claims coding is correct.
+ May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
+ Maintains professional client relationships.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred.
**Experience** :
4 years of Liability claims management experience or equivalent combination of education and experience required.
**TAKING CARE OF YOU**
+ Flexible work schedule.
+ Referral incentive program.
+ Career development and promotional growth opportunities.
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Raleigh NC Regional Daily Claims Adjuster
Claims adjuster job in Raleigh, NC
CENCO Claims is looking for a qualified Daily Property Adjuster to handle residential and commercial property claims in the Raleigh, NC area. This is a field-based position offering steady claim volume, flexible scheduling, and strong team support.
Key Responsibilities:
Conduct on-site inspections to assess property damage
Create detailed estimates using Xactimate
Document findings with clear photos and written reports
Communicate professionally with policyholders and carriers
Submit complete, accurate claim files on time
Requirements:
Proficient in Xactimate
Strong knowledge of property damage and construction
Excellent time management and communication skills
Valid driver's license and dependable transportation
North Carolina or designated home state adjuster license
Preferred: 2+ years of experience as a field property adjuster
What We Offer:
Competitive per-claim compensation
Consistent claim volume in the Raleigh market
Flexible scheduling
Ongoing support from experienced claims managers
Long-term opportunities for growth and continued work
Apply Now
Independent Insurance Claims Adjuster in Apex, North Carolina
Claims adjuster job in Apex, NC
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-ApplyField Claims Adjuster
Claims adjuster job in Raleigh, NC
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.
Field Claims Adjuster - Auto Damage
Claims adjuster job in Chapel Hill, NC
Progressive is dedicated to helping employees move forward and live fully in their careers. Your journey has already begun. Apply today and take the first step to Destination: Progress. As an auto damage claims adjuster, you'll serve as Progressive's point of contact with customers - directing and making decisions regarding the repair process from beginning to end. Managing your own inventory while working independently, you'll work closely with body shops and others to negotiate repair pricing and assess liability. Ideal candidates will possess leadership and conflict management skills, along with strong attention to detail and a passion for providing excellent customer service.
This is a field position with access to a company car and frequent driving within your assigned geographical area. We assess our workload collectively, which means you may cover assignments outside your geographical area. You may also be required to report into an office occasionally.
Duties and responsibilities
* Complete vehicle inspections, write estimates, determine total loss evaluations, and set clear expectations and timelines
* Negotiate repair process with body shops
* Document information related to the claim and make decisions consistent with claims standards and local laws
* Evaluate and handle claim payments and resolution of claims without payments
* Review and determine validity of any supplement requests
Must-have qualifications
* A minimum of four years of relevant work experience with one year appraisal/estimatics or insurance experience
* {OR} Associate's degree and a minimum of three years relevant work experience with one year appraisal/estimatics or insurance experience
* {OR} Bachelor's degree and a minimum of one year appraisal/estimatics or insurance experience
* Valid driver's license, auto insurance, and compliance with Progressive's driving standards and/or policies
Location: Territory is expected to be Chapel Hill, NC and surrounding areas
Compensation
* $65,000-$79,400/year based on experience
* Gainshare annual cash incentive payment up to XX% of your eligible earnings based on company performance
Benefits
* 401(k) with dollar-for-dollar company match up to 6%
* Medical, dental & vision, including free preventative care
* Wellness & mental health programs
* Health care flexible spending accounts, health savings accounts, & life insurance
* Paid time off, including volunteer time off
* Paid & unpaid sick leave where applicable, as well as short & long-term disability
* Parental & family leave; military leave & pay
* Diverse, inclusive & welcoming culture with Employee Resource Groups
* Career development & tuition assistance
Energage recognizes Progressive as a 2025 Top Workplace for: Innovation, Purposes & Values, Work-Life Flexibility, Compensation & Benefits, and Leadership.
Equal Opportunity Employer
For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at ****************************************************************
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Commercial Field Adjuster - Durham, NC
Claims adjuster job in Durham, NC
Job Description
CCMS & Associates is looking for a 1099 Field Adjuster in North Carolina, specifically the Durham 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 claim adjusting 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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Claims Analyst/Lead Claims Analyst/Senior Claims Analyst (Full-Time)
Claims adjuster job in Raleigh, NC
MBP is looking for Claims Analyst/Lead Claims Analyst/Senior Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Highly proficient in Oracle P6 and experienced with one or more of the following: Microsoft Project, Phoenix Project Manager, or similar.
Responsibilities
Main Duties:
Performs review and analysis of construction claims.
Assists with development of contractor claims.
Develops and/or review time extension requests.
Assist with development of expert reports and exhibits.
Qualifications
Education
B.S. in Civil Engineering, Construction Management, or relevant experience which equates to this degree.
P.E. license, Certified Construction Manager, Planning and Scheduling Profession, or similar, certification preferred.
Skills and Abilities
Experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts.
Experience drafting expert reports and deliverables.
Proficient in Oracle P6 required and experienced with Microsoft Project desired.
Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration.
Ability to relate technical knowledge to a non-technical audience.
Proficiency in reading/understanding construction plans and specifications.
Proficiency with Microsoft Office software programs including Word, Excel, and PowerPoint.
Experience providing training, supervision, proposal development, and business development desired.
Occasional overnight travel may be required.
STATUS:
Full-time
BENEFITS:
Competitive compensation with opportunities for semi-annual bonuses
Generous Paid Time Off and holiday schedules
100% Employer paid medical, dental, vision, life, AD&D, and disability benefits (for individual)
Health Savings Account with company contribution
401(k)/Roth 401(k) plan with company match
Tuition Assistance and Student Loan Reimbursement
Numerous Training and Professional Development opportunities
Wellness Program & Fitness Program Reimbursement
Applicants must be authorized to work in the U.S. without sponsorship.
MBP is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Protected veterans and individuals with disabilities are encouraged to apply.
Auto-ApplyClaims Analyst/Lead Claims Analyst/Senior Claims Analyst (Full-Time)
Claims adjuster job in Raleigh, NC
MBP is looking for Claims Analyst/Lead Claims Analyst/Senior Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Highly proficient in Oracle P6 and experienced with one or more of the following: Microsoft Project, Phoenix Project Manager, or similar.
Responsibilities
Main Duties:
Performs review and analysis of construction claims.
Assists with development of contractor claims.
Develops and/or review time extension requests.
Assist with development of expert reports and exhibits.
Qualifications
Education
B.S. in Civil Engineering, Construction Management, or relevant experience which equates to this degree.
P.E. license, Certified Construction Manager, Planning and Scheduling Profession, or similar, certification preferred.
Skills and Abilities
Experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts.
Experience drafting expert reports and deliverables.
Proficient in Oracle P6 required and experienced with Microsoft Project desired.
Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration.
Ability to relate technical knowledge to a non-technical audience.
Proficiency in reading/understanding construction plans and specifications.
Proficiency with Microsoft Office software programs including Word, Excel, and PowerPoint.
Experience providing training, supervision, proposal development, and business development desired.
Occasional overnight travel may be required.
STATUS:
Full-time
BENEFITS:
Competitive compensation with opportunities for semi-annual bonuses
Generous Paid Time Off and holiday schedules
100% Employer paid medical, dental, vision, life, AD&D, and disability benefits (for individual)
Health Savings Account with company contribution
401(k)/Roth 401(k) plan with company match
Tuition Assistance and Student Loan Reimbursement
Numerous Training and Professional Development opportunities
Wellness Program & Fitness Program Reimbursement
Applicants must be authorized to work in the U.S. without sponsorship.
MBP is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Protected veterans and individuals with disabilities are encouraged to apply.
Auto-ApplyCasualty Adjuster - Out-Of-State
Claims adjuster job in Raleigh, NC
About Us At North Carolina Farm Bureau Insurance, we take pride in our strong, community-oriented roots that began right here in North Carolina. In 1953, our company was born out of the need to provide insurance coverage to our farmers and rural communities. Now, with local offices in each of the 100 counties, we provide services to all North Carolinians across the state. Here at NCFB we are a familiar face in the community with a service oriented mindset that truly sets us apart. Guided by our mission, we are deeply committed to both our neighbors and employees. Helping you is what we do best! If you are passionate about making a meaningful impact and value a people-centered culture, we invite you to join us!
About the Role
Our Claims Department provides outstanding individuals with the opportunity for an exciting and rewarding career. Resolving claims combines the excitement of investigations with the reward of helping people through difficult times.
We are seeking motivated and proactive individuals to join our team. As a Casualty Adjuster, you will work directly with policyholders, claimants, and other involved parties to investigate, evaluate, and negotiate settlements of casualty insurance claims.
Education and Experience
Associate's degree or above preferred
Preference given to applicants with extended education and/or training
Mechanical aptitude or ability preferred
Required Skills and Abilities
Present a professional and personable attitude and communicate effectively in stressful situations
Demonstrate exceptional mental resilience and possess strong conflict management skills
Possess strong written, verbal, and interpersonal communication skills
Ability to organize and prioritize your workload to demonstrate effective time management towards meeting deadlines
Demonstrate the strong ability to make decisions and problem solve using logical and analytical skills
Must be reliable and capable of working independently as well with others
Location and Commitments
Full-time office role
Reports to: Out of State District Claims Manager at 5171 Glenwood Ave, Raleigh NC 27612
Must obtain and maintain licensing CE in compliance with N.C. Department of Insurance and N.C. Farm Bureau Mutual Insurance Company requirements
All offers are contingent on a Background Check
Responsibilities of the Role
Provide prompt, timely, and professional communication for insureds and claimants.
Appraise and determine covered damages using provided resources.
Investigate losses, verify coverage, and apply policy coverage.
Determine legal liability for losses and damages.
Authorize or deny claim payments based on policy guidelines.
Evaluate and establish reserves for the possible payout amounts.
Adhere to company policies, procedures, and regulatory guidelines.
Maintain current, accurate, and detailed documentation throughout the claims process.
Ensure the protection and proper maintenance of all company equipment assigned to you.
Participate in industry-related conferences and training programs. *Certain training programs are located at the Corporate Office in Raleigh, NC.
This document is intended to outline the essential responsibilities of the position, and does not limit the tasks that may be assigned or amended by the supervisor.
Management Liability Claims Specialist
Claims adjuster job in Raleigh, NC
IAT Insurance Group has an immediate opening for a Management Liability Claims Specialist that can be located in any of our IAT locations.
This role works a hybrid schedule from an IAT Office. The hybrid schedule reflects our values (thinking and acting like an owner, collaboration, and teamwork) as it requires working from the office with colleagues and other disciplines Monday through Wednesday, with the option of working Thursday and Friday remotely.
Responsibilities:
Responsible for handling Management Liability Claims (EPL, D&O, Fiduciary and Crime) for Private and Non-Profit businesses based on Claim Guidelines
Within authority limit, thoroughly analyze, investigate, negotiate and resolve all levels of severity claims
Selects, directs and manages defense counsel including approval of budgets
Develops litigation/file disposition strategy. Attends mediations, settlement conferences and trials
Verifies/analyzes applicable coverage for the reported claims
Follow operational policies and procedures, including compliance, regulatory and performance and customer service standards
Prepare reports, including Large Loss Reports, to management which accurately reflects loss development, potential/actual financial exposure, coverage issues, claim and recovery strategies
Establishes 24-hour contact and maintain appropriate contact with all involved stakeholders throughout the life of the claim file
Identifies and addresses recovery/contribution/SIU opportunities
Sets accurate/timely loss/expense reserves in compliance with Claim Guidelines.
Drafts correspondence, including but not limited to, coverage letters to stakeholders as required
Support business partners on an as needed basis on various claim and underwriting related issues and marketing meetings
Maintains resident/nonresident adjuster licenses as required
Performs other duties as assigned
Qualifications: Must Have:
Bachelor's Degree with 5+ years of management liability claims experience (including handling employment liability practices, directors & officers' liability and fiduciary liability coverages) or equivalent
Equivalent experience is defined as 9+ years of relevant claims experience, specifically claims involving litigation.
Excellent coverage analysis skills with experience in drafting coverage position correspondence
Experience handling litigated files and direction of defense counsel
Excellent negotiation skills
Must be willing to travel, average 1 day a month
Claims Licensure as required by respective state(s)
Excellent oral and written communication skills
Ability to organize, multi-task and prioritize work
Excellent customer service and interpersonal skills
Ability to analyze data, utilize sound judgment to draw conclusion and make supported decisions
To qualify, applicants must be authorized to work in the United States and must not require, now or in the future, VISA sponsorship for employment purposes
Preferred to Have:
CPCU and other insurance related studies
Our Culture IAT is the largest private, family-owned property and casualty insurer in the U.S. I
nsurance
A
nswers
T
ogether
is how we define IAT, in letter and in spirit. We work together to provide solutions for people and businesses. We collaborate internally and with our partners to provide the best possible insurance and surety options for our customers.
At IAT, we're committed to driving and building an open and supportive culture for all. Our employees propel IAT forward - driving innovation, stable partnerships and growth. That's why we continue to build an engaging workplace culture to attract and retain the best talent.
We offer comprehensive benefits like:
26 PTO Days (Entry Level) + 12 Company Holidays = 38 Paid Days Off
7% 401(k) Company Match and additional Profit Sharing
Hybrid work environment
Numerous training and development opportunities to assist you in furthering your career
Healthcare and Wellness Programs
Opportunity to earn performance-based bonuses
College Loan Assistance Support Plan
Educational Assistance Program
Mentorship Program
Dress for Your Day Policy
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. We maintain a drug-free workplace and participate in E-Verify.
Compensation: Please note, that the annual gross salary range associated with this posting is $60,600 - $95,700. This range represents the anticipated low and high end of the base salary for this position. Actual salaries will vary based on factors such as a candidate's qualifications, skills, competencies, and geographical location related to this specific role. The total compensation will include a base salary, performance-based bonus opportunities, 401(K) match, profit-sharing opportunities, and more.
To view details of our full benefits, please visit **************************************************
Claims Settlement Specialist
Claims adjuster job in Raleigh, NC
Now Hiring: Claims Settlement Specialist - Inspire, Lead, and Create Meaningful Impact!
Are you passionate about leading with purpose, empowering others, and making a lasting impact? We are looking for motivated individuals to join our team as Claims Settlement Specialist, where you'll mentor, inspire, and implement strategies that help individuals achieve financial and personal breakthroughs while building a career that aligns with your values.
Who We're Looking For:
✅ Visionary leaders who are passionate about servant leadership and impact
✅ Entrepreneurs and professionals eager to empower others while scaling success
✅ Licensed & aspiring Life & Health Insurance Agents (We'll guide you through licensing!)
✅ Individuals ready to lead with integrity, purpose, and a strong mission for success
As a Claims Settlement Specialist, you'll help individuals discover their potential, achieve financial independence, and create meaningful change in their lives and communities.
Is This You?
✔ Passionate about mentorship, leadership, and creating impact-driven success?
✔ A strong communicator who thrives on guiding and inspiring others?
✔ Self-driven, disciplined, and committed to personal and professional growth?
✔ Open to mentorship, leadership development, and continuous learning?
✔ Looking for a recession-proof career with unlimited earning potential?
If you answered YES, keep reading!
Why Become a Claims Settlement Specialist?
🚀 Work from anywhere - Build a career aligned with your values and goals.
💰 Uncapped earning potential - Part-time: $40,000-$60,000+/year | Full-time: $70,000-$150,000+++/year.
📈 No cold calling - Work with individuals who have already requested guidance.
❌ No sales quotas, no pressure, no pushy tactics.
🏆 Leadership & Ownership Opportunities - Develop and expand your own team.
🎯 Daily pay & performance-based bonuses - Direct commissions from top carriers.
🎁 Incentives & rewards - Earn commissions starting at 80% (most carriers) + salary.
🏥 Health benefits available for qualified participants.
This is more than just a career-it's an opportunity to lead with purpose, inspire positive change, and build a future that aligns with your mission and impact.
👉 Apply today and take your first step as a Claims Settlement Specialist!
(Results may vary. Your success depends on effort, skill, and commitment to learning and execution.)
Auto-ApplyField Auto Damage Adjuster - Greensboro, NC
Claims adjuster job in Burlington, NC
At Allstate, great things happen when our people work together to protect families and their belongings from life's uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers' evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.
Job Description
As a Field Auto Damage Adjuster, you'll be out in the field every day-writing estimates on-site at customer homes, repair shops, and tow yards. You'll complete hands-on inspections, assess damage in person, and handle a variety of claim types including repairable vehicles, total losses, and virtual reviews. This is a fast-paced, active role where no two days look the same.
Key Responsibilities
The Customer Service Expert
* Support customers through their claim with care, clarity, and empathy.
* Make the process as simple and stress-free as possible by being a reliable partner from start to finish.
The Investigator
* Independently inspect vehicle damage, gather key details, and determine coverage based on policy guidelines.
The Effective Communicator
* Connect with customers through phone, email, or video to guide them through the claims process.
* Adjust your communication style based on customer preference and keep them informed every step of the way.
The Negotiator
* Review estimates and negotiate fair settlements with customers, shops, vendors, and third parties.
* Navigate tough conversations professionally while staying aligned with legal and company standards.
The Problem Solver
* Use estimating tools, resources, and training to make accurate decisions in a fast-moving environment.
* Apply strong critical-thinking skills to resolve issues and move claims forward efficiently.
The Recorder
* Document your work clearly and accurately in the claims system.
* Follow policy guidelines to help protect the company and ensure each claim is handled correctly.
Work Location
* This is a field-based position requiring daily travel to customer homes, repair shops, and tow yards.
* Candidates must reside in or near Greensboro, NC to be considered.
* A company car may be provided, depending on business need.
Notice of Licensing Requirement
* As a condition of employment, you may be expected to obtain an adjuster's license in multiple markets.
* All required licenses will need to be obtained within 60 days of hire.
* You must maintain all licensing required for your role. This includes any continuing education and/or other state-affiliated requirements for licensing renewal.
* This role offers a sign on bonus of $1,000 if you have an active appraiser license or active adjuster license in TX, FL, or your resident state (current employees and candidates who have previously worked for and are seeking to be rehired at Allstate and its family of companies are not eligible for this sign-on bonus).
Experience
* At least 24 months of experience writing auto damage estimates.
* Proficiency with estimating software such as CCC One, Audatex, or Mitchell.
* Valid driver's license.
Functional Skills
* Communication: Clear written and verbal communication to support and guide customers.
* Attention to Detail: Ability to create accurate, thorough, and well-documented estimates.
* Technical Proficiency: Comfortable using estimating tools, mobile apps, and multiple claims platforms.
* Time Management: Able to manage a steady workload, prioritize tasks, and meet deadlines.
* Problem Solving: Uses critical thinking to evaluate damage, resolve issues, and move claims forward.
* Customer Focus: Provides a calm, supportive, and helpful experience during stressful situations.
* Independence: Works confidently in the field with limited supervision while making sound decisions.
Allstate Benefits
Allstate cares about you and your wellbeing. We offer a comprehensive total rewards package that includes pay, benefits, and programs to help you balance work with the rest of your life. You can choose whatever benefits are most important you. Here are some of our offerings:
* Competitive salary based on experience and qualifications
* Medical, dental, and vision coverage
* Allstate pension plan and 401(k) savings plan
* Ayco financial coaching
* Spring Health mental and emotional wellbeing resources
* Paid parental leave
* Adoption reimbursement
* Paid time off
* Tuition reimbursement
* Wellness incentives
* Allstate Foundation donation match and grant opportunities
To learn more about our benefits and programs visit AllstateGoodLife.com
#LI-AP2
Skills
Auto Estimating, CCC ONE, Communication, Customer-Focused, Detail-Oriented, Problem Solving, Results-Oriented, Time Management
Compensation
Compensation offered for this role is 55,500.00 - 93,600.00 annually and is based on experience and qualifications.
The candidate(s) offered this position will be required to submit to a background investigation.
Joining our team isn't just a job - it's an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger - a winning team making a meaningful impact.
Allstate generally does not sponsor individuals for employment-based visas for this position.
Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.
For jobs in San Francisco, please click "here" for information regarding the San Francisco Fair Chance Ordinance.
For jobs in Los Angeles, please click "here" for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance.
To view the "EEO Know Your Rights" poster click "here". This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs.
To view the FMLA poster, click "here". This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.
It is the Company's policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee's ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.
Auto-ApplyAuto Claims Representative
Claims adjuster job in Raleigh, 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
Auto-ApplyRISK CLAIMS ADMININSTRATOR
Claims adjuster job in Chapel Hill, NC
The purpose of this position is to provide professional and technical support to the enterprise risk management program including, workers' compensation, insurance claims administration, and occupational health and safety programs. * THIS POSTING MAY CLOSE WITHOUT NOTICE.*
Essential Functions
Note: This information is intended to be descriptive of the key responsibilities of the position. The list of essential functions below does not identify all duties performed by any single incumbent in this position.
* Coordinates and, administer internal processing of all reportable and lost-time workers' compensation claims, documented injury or incident reports; evaluate and analyze claims data needed to endure regulatory compliance; review claims for compensability, and initiate investigative processes; prepares and maintains state and federal regulatory compliance reports; prepares monthly reports for internal use.
* Works directly with departments and third-party administrators (TPA) on a wide range of risk and safety management subject matters; reviews to ensure that data is timely, accurate and complete; serves as the Town's liaison between claimants, claim adjustors, medical providers, attorneys, and external governmental agencies; may initiate the Towns formal investigative process.
* Validates employee work status, return-to-work process, and provides departments with relevant information to reduce workplace injuries and improve safety; facilitates return-to-work of injured employees through the use of modified duty programs and medical case management; ensures managers are aware of accommodations/work restrictions and comply with restricted work duties; follows up on accident investigations and works closely with the Town's Safety Officer and team to analyze trends and develop strategies for prevention.
* Maintains filing system for all documented workplace incidents/injuries and other risk and safety management data systems; coordinates and administers internal finance process for reconciling workers' compensation deductibles.
* Collects statistical risk and safety management data and other information provided by various internal and external sources. Consolidates loss and safety hazard assessment data into risk management analysis reports. Assists with claims data analysis reports and the development of risk strategies and benchmarking performance.
* Assist in the administration of risk and safety programs, occupational safety and health compliance training, and safety committees; Serves on the Town safety committees or advisory groups.
* Assists with research projects, developing and maintaining policies and procedures, hazard risk exposure plans, emergency preparedness and response plans, committee agendas and munities, business continuity planning, and prepares risk and safety compliance reports.
* Performs all other duties as assigned.
Supervision Exercised:
None
Physical Demands:
The work requires intermittent standing or stooping. The employee uses equipment requiring a high degree of dexterity.
Work Environment:
The work is typically performed in an office environment.
Minimum Qualifications
An equivalent combination of education and experience that provides the required knowledge, skills, and abilities to perform the duties.
Knowledge of:
* Principles, practices and trends of public sector risk management
* Relevant municipal, state and federal laws related to workplace safety compliance
* Records and file management
* Basic bookkeeping and accounting practices
* English grammar, spelling and punctuation
* Principles, practices and trends in customer service
Ability to:
* Investigate claims information and make recommendations
* Communicate orally and in writing effective
* Establish and maintain effective working relationships
* Prepare reports and PowerPoint presentation
* Microsoft word, excel and other required software
* use discretion and maintain work confidentially at all organizational levels
* Research and analyze data and draw sound conclusions
* Promote a culture of workplace safety
* Model behaviors consistent with our values of RESPECT
EDUCATION
A bachelor's degree in risk insurance, business administration, public administration or a related field.
EXPERIENCE
Three years of experience in claims administration.
CERTIFICATION
Possession of or the ability to obtain a valid driver's license in North Carolina.
Claims Investigator - Experienced
Claims adjuster job in Greensboro, NC
Job Description
Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must.
Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments.
If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ******************
The Claims Investigator should demonstrate proficiency in the following areas:
AOE/COE, Auto, or Homeowners Investigations.
Writing accurate, detailed reports
Strong initiative, integrity, and work ethic
Securing written/recorded statements
Accident scene investigations
Possession of a valid driver's license
Ability to prioritize and organize multiple tasks
Computer literacy to include Microsoft Word and Microsoft Outlook (email)
Full-Time benefits Include:
Medical, dental and vision insurance
401K
Extensive performance bonus program
Dynamic and fast paced work environment
We are an equal opportunity employer.
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Claims and Litigations Manager
Claims adjuster job in Chapel Hill, NC
Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Reporting to the Director of Claims & Litigation, the Claims and Litigation Manager is responsible for the investigation of reported claims and the monitoring of incidents that develop into claims against healthcare providers and staff of UNC Health Care System insured by its commercial and self-insurance liability programs. This position handles internal investigation process of claims, including analysis of medical records, interviews with relevant staff and analysis of value of claim. Assists the Director in managing external legal counsel hired to represent liability program insureds and manages the lawsuit through resolution. Attends mediations, negotiates and settles claims and lawsuits within the settlement authority provided. Inputs and manages claims information in the internal database. Assists the Director in other projects related to claims as requested. In addition to professional liability and hospital liability claims, this position also administers general liability, executive liability, employer liability and small claims as needed.
Responsibilities:
1. Manages and conducts claims investigations, gathering data from healthcare providers and employees in a timely manner, researching medical records, protocols, laws, policies and procedures governing the alleged claim. Interviews provide employees, patient, patient family members, and others who are involved with the incident and claim. Obtains internal and expert opinion reviews, prepares case files in orderly, thorough manner; maintains accurate documentation.
2. Defines issues involved in the case and makes recommendations for settlement strategies. Negotiates and settles medical malpractice claims or otherwise assists in defense of those claims. Gathers information and reviews settlement agreements. Authorizes funding for settlement payments. Manages external legal counsel hired to represent insureds and manages litigation through resolution.
3. Attends conferences with attorneys and staff, mediations, and depositions, and arranges meetings, and communicates policies and procedures to all involved in the claims.
4. Inputs all claims and incident information into claims database. Follows through on patient complaints and legal/risk management matters that have potential to result in claims. Interacts as requested with internal and external stakeholders on scheduling of depositions, conducting depositions, coordination of discovery (documents for production and responses to interrogatories), and completion of documentation for claims files.
5. Plans, develops, and presents educational sessions with insured faculty and staff regarding loss prevention and reduction techniques, insurance coverages and exclusions, medical record documentation, legal issues and communication techniques. Provides risk management advice to staff regarding incidents that have occurred or issues that are anticipated.
6. Assists the Director in evaluating claim exposure, preparation of summaries and other risk management reports, and the development of claims and risk management policies and procedures.
Other Information
Other information:
Education Requirements:
● Bachelor's degree in a related field.
Licensure/Certification Requirements:
● No licensure or certification required.
Professional Experience Requirements:
● Five (5) years of experience in risk management, paralegal services, or claims settlement work.
Knowledge/Skills/and Abilities Requirements:
● Ability to analyze and develop solutions to complex problems. Ability to apply judgment and informed decisions. Ability to communicate effectively in written and verbal formats including summarizing data, presenting results. Ability to establish and maintain effective working relationships. Ability to work effectively both as a team player and leader. Knowledge of computer systems and software used in functional area. Knowledge of laws pertaining to professional liability, informed consent, malpractice litigation, and other legal issues. Knowledge of local, state and federal regulatory requirement related to the functional area. Knowledge of medical terms, concepts and practice
Job Details
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: Risk Management
Work Type: Full Time
Standard Hours Per Week: 40.00
Pay offers are determined by experience and internal equity
Work Assignment Type: Hybrid
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: Yes
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.
Operations Associate - Claims Associate
Claims adjuster job in Durham, NC
Full-time Description
:
Aspida is a tech-driven, nimble insurance carrier. Backed by Ares Management Corporation, a leading global alternative asset manager, we offer simple and secure retirement solutions and annuity products with speed and precision. More than that, we're in the business of protecting dreams; those of our partners, our producers, and especially our clients. Our suite of products, available through our elegant and intuitive digital platform, focuses on secure, stable retirement solutions with attractive features and downside protection. A subsidiary of Ares Management Corporation (NYSE: ARES) acts as the dedicated investment manager, capital solutions and corporate development partner to Aspida. For more information, please visit ************** or follow them on LinkedIn.
Who We Are:
Sometimes, a group of people come together and create something amazing. They don't let egos get in the way. They don't settle for the status quo, and they don't complain when things get tough. Instead, they see a common vision for the future and each person makes an unspoken commitment to building that future together. That's the culture, the moxie, and the story of Aspida.
Our business focuses on annuities and life insurance. At first, it might not sound flashy, but that's why we're doing things differently than everyone else in our industry. We're dedicated to developing data-driven tech solutions, providing amazing customer experiences, and applying an entrepreneurial spirit to everything we do. Our work ethic is built on three main tenets: Get $#!+ Done, Do It with Moxie, and Have Fun. If this sounds like the place for you, read on, and then apply at aspida.com/careers.
What We Are Looking For:
The Claims Specialist will be responsible for the evaluation, investigation, and resolution of life and annuity claims, perform diverse duties relating to the intake, processing, review, and adjudication of claims, including reviewing for accuracy, file and claim completeness, reviewing coverage and approving payment or denial. The ideal candidate must be empathetic while assisting individuals that are facing difficult life experiences. The right person for this role has strong organization skills and capacity to recall complex business rules in addition to varied state regulations as they pertain to claims settlements and tax implications. Individuals must have strong communication skills and ability to work with and adjust to all other personality types. This is a fast-paced team that requires dedicated and prompt team members to ensure nothing sits idle without attention for any span of time. Successful analysts will handle a multitude of activities moving from one task to the next in a fast, efficient, and accurate manner. This role reports to the Operations Manager and is required to be onsite 3 days a week at our Durham, NC headquarters.
What You Will Do:
· Evaluate and determine claim coverage for benefits in accordance with policy and/or certificate provisions, and department procedures.
· Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
· Establish claim reserves and authorize payments within authority limits.
· Enter claim payments, reserves, and new claims on various computer programs, inputting concise yet sufficient file documentation.
· Contact and/or interview claimants, doctors, medical specialists, or employers to obtain additional information as needed.
· Manage time adequately to ensure proper turn around for all tasks such as new claims, pending claims, customer service requests, and audit feedback.
· Maintain quality and production standards as defined by procedures and management.
· Communicate with legal counsel on claims requiring litigation.
· Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
· Report overpayments, underpayments, and other irregularities.
· Ability to look at processes and offer suggestions for efficiencies.
· Work with teammates and supervisor to ensure the needs of the claimants are being met.
· Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
· Maintain complete confidentiality of company business.
· Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
What We Provide:
· Hourly Pay
· Full-Time
· Full Benefits Package Available
What We Believe:
Not sure if you meet every qualification? We still encourage you to apply! We value inclusivity, welcoming candidates from diverse backgrounds, including non-traditional paths. Unique experiences enrich our team, and the willingness to dream big makes you an exceptional candidate!
At Aspida Financial Services, LLC, we are committed to creating a diverse and inclusive environment and are proud to be an equal opportunity employer. As such, Aspida does not and will not discriminate in employment and personnel practices on the basis of race, sex, age, handicap, religion, national origin or any other basis prohibited by applicable law. Hiring, transferring and promotion practices are performed without regard to the above listed items.
Requirements
What We Require:
· One year of claims adjudication or equivalent experience.
· NC Producer Life license achieved within 30 days of employment.
· Clear and concise verbal and written communication skills.
· Analytical, problem solving and organizational skills.
· Attention to Detail and Highly Dependable.
· Proficiency with MS Office applications, especially Word and Excel.
· Ability to thrive in a team environment and maintain positive energy in the face of adversity.
· Demonstrate dependability and reliability.
PFML Claim Support Specialist 13944
Claims adjuster job in Cary, NC
Global Operations (Global Ops) focuses on creating positive experiences for MetLife customers and helping the company make the best use of its global resources. We're looking for unique talent with fresh perspectives that can propel innovation. In this role you will provide exemplary customer service by facilitating Multi-State Paid Family Leave (PFL) benefits, Family Medical leave Act (FMLA) and Americans with Disabilities Act (ADA) claim adjudication in a timely and accurate manner.
Location: Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT Cary, NC, Aurora, IL, Bridgewater, NJ, Omaha, NE, Warwick, RI, Clark Summit, PA, San Juan, PR, West Des Moines, IA office
Once a month in office for meetings
How You'll Help Us Build a Confident Future (Key Responsibilities)
* Coaches, coordinates, and develops Multi-State PFL, FML and ADA Claims Specialists.
* Acts as resources for claim-related and technical issues.
* Monitors case managers' work queues to ensure claims team is meeting expectations and applicable performance guarantees.
* Conducts exceeds authority reviews daily, weekly quality audits; resolves escalated phone calls.
* Analyzes trending opportunities to provide ongoing trainings.
* Provides real time coaching to Claims Specialists.
* Provides feedback to Unit Leaders on individuals' and overall team performance.
* Daily and weekly reporting to ensure compliance measures are met.
* Performs other related duties as assigned or required.
What You Need to Succeed (Required Qualifications)
* Positive mindset and willingness to learn.
* 1+ years of Disability Insurance experience.
* Must be able to communicate clearly and effectively, both written and verbal.
* Ability to work with autonomy, minimal direction.
* Strong computer skills (word, excel, manipulating reports, spreadsheets, etc…).
* High School Diploma.
What Can Give You an Edge (Additional Skills)
* 1+ years of Paid Family Leave experience.
* 5+ years of Disability Insurance experience.
* Excellent analytical, decision making and problem-solving skills.
* Highly self-motivated.
The expected salary range for this position is $41,600 - $61,500. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.
Benefits We Offer
Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more!
About MetLife
Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible. Join us!
MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process.
MetLife maintains a drug-free workplace.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.
$41,600 - $61,500
Inventory Claim Specialist
Claims adjuster job in Wendell, NC
Job Description
Inventory Claims Coordinator
Department:
Warehouse Operations - 171032
Reports to:
Inventory Supervisor
Full-time
Status:
Hourly, Non-Exempt
Management Level:
Non-Management
JOB SUMMARY
The Inventory Claims Coordinator serves as a support element and liaison for all distribution centers and the dealer network. This person will be cross trained and gain exposure to many functions including claims processing, inventory investigations, dealer network relationship building and recording claim data.
KEY RESPONSIBILITIES OF JOB
The Inventory Claims Coordinator key responsibilities are outlined below:
Claims:
Resolve and process claim disputes
Technical drawing look-up
Inventory background investigations
Credit and Debit process on claim investigations
Issuing and monitoring call tags
Resolve and process freight claim disputes and tracking reimbursement if applicable
Inventory Management
Provide inventory control reporting and vendor reports
Track claim data and communicate common themes for mitigation
Directly or indirectly locate misplaced parts to help satisfy sale to customer/dealer
Help maintain or relay proper product identification and location accuracy and ability to transfer product to correct location if needed
Other Responsibilities
Determine and record data for KPI's
Promote dealer satisfaction utilizing customer service skills
EDUCATIONAL AND PHYSICAL REQUIREMENTS
High school diploma or GED equivalent required with minimum of 3 years' related experience
Associate or Bachelor degree with a minimum of 1 year experience
1-5 Years of related customer service or inventory experience.
Must be a team player with strong interpersonal communication skills
Good time-management skills and attention to detail
Outstanding written and oral communication skills with the ability to effectively present information
Proficiency in Microsoft programs, including Excel, a plus
SAP experience preferred
SalesForce experience preferred