Senior Personal Property Adjuster - Field
Claims adjuster job in Philadelphia, PA
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 Senior Property Adjuster, you will work within defined guidelines and framework, investigate, evaluate, negotiate and settle complex property insurance claims presented by or against our members. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory requirements. You will recognize and empathize with members' life events, as appropriate.
Field Property Adjusters focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses within your locally assigned territory. Field Adjusters may travel outside of their local territory to respond to claims in other regions when needed. This is an hourly, non-exempt position with paid overtime available.
We have a positions available for an experienced Senior Field Property Adjusters with large loss specializing in Contents for the Philadelphia, PA area.
This is a field-based role for Philadelphia, PA. Also, candidate has to live withing 1 hour from the international airport. Candidates currently living in this location or willing to self-relocate are encouraged to apply.
What you'll do:
Proactively manages assigned claims caseload comprised of claims with moderate complexity damages that require commensurate knowledge and understanding of claims coverage.
Partners with vendors and internal business partners to facilitate moderate complexity claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance.
Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics.
Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing investigation information involving moderate complexity policy terms and contingencies.
Determines and negotiates moderate complexity claims settlement. Develops recommendations and collaborates with management for determining settlement amounts outside of authority limits and accurately manages claims outcomes.
Maintains accurate, thorough, and current claim file documentation throughout the claims process.
Applies proficient knowledge of estimating technology platforms and virtual inspection tools; Utilizes platforms and tools to prepare claims estimates to manage moderate complexity property insurance claims.
Applies working knowledge of industry standards of inspection, damage mitigation and restoration techniques.
Serves as an informal resource for team members.
Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations.
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.
2 years relevant property adjusting and/or claims adjusting experience handling moderately complex claims or construction related industry/insurance experience.
Developing knowledge of residential construction.
Working knowledge of estimating losses using Xactimate or similar tools and platforms.
Demonstrated negotiation, investigation, communication, and conflict resolution skills.
Working knowledge of property claims contracts and interpretation of case law and state laws and regulations.
Proficient in prioritizing and multi-tasking, including navigating through multiple business applications.
May need to travel up to 50% of the year (local & non-local) and/or work catastrophe duty when needed.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
What sets you apart:
Prior experience adjusting property claims using virtual technologies such as ClaimsXperience.
Prior advanced knowledge of Xactcontents.
Prior experience handling Contents only in higher severity/complex Large Loss claims
Bachelor's degree
Industry designations such as CPCU, AIC, SCLA
Currently reside within or have the ability to self-relocate within 1 hour driving distance from Philadelphia, PA International Airport
Currently hold an active Adjuster License
US military experience through military service or a military spouse/domestic partner
Physical Demand Requirements:
May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces.
May need to meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver's license.
May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car.
May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics.
Compensation range: The salary range for this position is: $63,590.00 - $121,530.00
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.
Auto-ApplySenior Liability Adjuster
Claims adjuster job in Philadelphia, PA
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 Senior Liability Adjuster is responsible for conducting office investigations and adjusting commercial general liability claims that are largely litigated and exposures up to and over policy limits within our Major Case Unit. The Adjuster is also responsible for, but not limited to:
Handling large and catastrophic losses
Analyzing construction and other contracts
Analyzing policies of insurance
Addressing risk transfer strategies and priority of coverage
Proactive approach towards negotiating claims towards resolution
Investigating losses and identifying coverage issues
Analyzing coverage and identifying covered and uncovered claims
Assigning panel counsel to defend our insured(s)
Working with counsel to develop litigation plan to resolve underlying claim
Obtaining and reviewing evidence, reports, and medical records
Establishing indemnity and expense reserves
Processing payments
Taking statements from insured's, claimants, and witnesses
Qualifications
At least 10 years of prior experience adjusting commercial general liability (CGL) and businessowners' policies (BOP) liability claims
Bachelor's degree required, Attorney license preferred
Able to understand coverage
Ability to analyze policies of insurance and relevant contracts to address priority of coverage and explore risk transfer strategies
Excellent written and verbal communication skills
Strong organizational and computer skills
Excellent time management skills with the ability to prioritize
Able to occasionally travel to hearings, mediations, trials, and conferences
Auto-ApplyIndependent Insurance Claims Adjuster in Camden, New Jersey
Claims adjuster job in Camden, NJ
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-ApplyComplex Liability Adjuster
Claims adjuster job in Conshohocken, PA
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-ApplySenior Liability Adjuster
Claims adjuster job in Conshohocken, PA
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 Senior Liability Adjuster is responsible for conducting office investigations and adjusting commercial general liability claims that are largely litigated and exposures up to and over policy limits within our Major Case Unit. The Adjuster is also responsible for, but not limited to:
* Handling large and catastrophic losses
* Analyzing construction and other contracts
* Analyzing policies of insurance
* Addressing risk transfer strategies and priority of coverage
* Proactive approach towards negotiating claims towards resolution
* Investigating losses and identifying coverage issues
* Analyzing coverage and identifying covered and uncovered claims
* Assigning panel counsel to defend our insured(s)
* Working with counsel to develop litigation plan to resolve underlying claim
* Obtaining and reviewing evidence, reports, and medical records
* Establishing indemnity and expense reserves
* Processing payments
* Taking statements from insured's, claimants, and witnesses
Qualifications
* At least 10 years of prior experience adjusting commercial general liability (CGL) and businessowners' policies (BOP) liability claims
* Bachelor's degree required, Attorney license preferred
* Able to understand coverage
* Ability to analyze policies of insurance and relevant contracts to address priority of coverage and explore risk transfer strategies
* Excellent written and verbal communication skills
* Strong organizational and computer skills
* Excellent time management skills with the ability to prioritize
* Able to occasionally travel to hearings, mediations, trials, and conferences
Auto-ApplyField Claims Adjuster
Claims adjuster job in Philadelphia, PA
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.
Indemnity Claims Adjuster
Claims adjuster job in Norristown, PA
Insight Global is looking for a Senior Indemnity Adjuster to join our client's team. Responsibilities will include managing complex workers' compensation claims, ensuring fair and efficient resolution while maintaining compliance with state regulations. The ideal candidate will have extensive experience handling indemnity claims, negotiating settlements, and collaborating with medical and legal professionals. This candidate will handle a desk with at least 50-70% litigation and would only have a small amount of med only files. Claims total would be around 135.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: ****************************************************
Skills and Requirements
Indemnity Claims Experience; specifically litigation claims
Minimum 3 years of Complex Claims Experience
Experience with NJ, PA and DE Claims
Claims Representative, Casualty
Claims adjuster job in Mount Laurel, NJ
The Casualty Claim Representative will be responsible for the handling of First- and Third-Party Bodily Injury and Physical Damage claims in a Personal Lines /Commercial environment for the Plymouth Rock Operation. The candidate must have the skills listed below and be able to perform the following duties:
RESPONSIBILITIES
* Initiate prompt contact of all insureds/claimants/witnesses on all new claim assignments to conduct thorough coverage and liability/injury investigations. These investigations might require the representatives take in depth recorded statements to investigate coverage and liability/injury claims.
* Analyze, review and interpret policies to assess coverage and liability. Provide advice to Excess and Primary coverage issues.
* Willing to conduct investigations, interviews with insureds, witnesses and claimants while maintaining a pending of represented claimant cases.
* Manage and direct outside vendors (Field/Counsel/Surveillance, Etc..) to determine what investigation is necessary and give them direction to bring a claim to conclusion. Ensure only necessary work is completed.
* Investigate cases timely so that reserves are established and maintained at proper levels. Revise reserves timely based on developments in the course of the claim.
* Investigate the validity of bodily injury claims being presented by individual insureds/claimants or attorneys representing insureds/claimants. Be aware of certain "Red Flags" to identify potential fraudulent claims. Refer to SIU for investigation timely.
* Have advanced skills in coverage, investigation, litigation/ legal issues, negotiations, evaluations, medical terminology, and subrogation. Handle more complex claims to include coverage issues, UM/UIM, etc.. Also, must have prior litigation handling.
* Recognize and investigate subrogation potential.
* Negotiate both 1st and 3rd party claims directly with injured parties or their attorneys.
* Exercises proper judgment and decision making to analyze exposure, determine the proper course of action and make recommendations for final resolution.
* Attend litigation proceedings to either represent the company or participate in arbitrations/depositions/settlement conferences/ mediations/ trials.
* Attend all internal and external training events as required.
* Participate in proactive team activities to achieve departmental and company objectives. May be asked to participate in special projects, committees or assignments from management.
* Possess strong organizational skills, able to demonstrate time management, has the ability to prioritize multiple tasks/duties, and be proficient in the utilization of all claims systems, Excel, Word and social media search engines.
* Have strong communication skills both verbal and written. Provide strong customer service. Prepare case summary for significant reserve increase and/or trial alerts. Participate in roundtables.
* Capable of working independently without close supervision, high level of self motivation, effectively manage workload while maintaining diary and focus on claims quality.
* Ability to handle multiple responsibilities and be adept at conflict resolution while working in a team environment. Work well under pressure. Able to think strategically, solve problems, set priorities, make the necessary decisions to resolve complex/regular issues/claims.
* Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.
* Adhere to departmental internal control requirements. Comply with Plymouth Rock's standards, best practices and ethical guidelines, adhere to Plymouth Rock's culture
QUALIFICATIONS
* A bachelor's degree (B.A.) from an accredited four year college or university.
* 3 - 5 years' experience handling liability and/or Personal Injury Protection claims.
* 1 year of experience handling bodily injury or casualty claims.
* Some litigation experience and knowledge of the New Jersey court system is preferred.
* Knowledge of PA, CT or NY claims handling would be beneficial.
* Currently holds and/or can readily obtain an out of State License(s) (i.e. - CT, Delaware, Florida, etc.) is preferred
SALARY RANGE
The pay range for this position is $58,000 to $76,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity. Candidates with more senior-level experience may be considered for an elevated salary range, depending on qualifications and fit.
PERKS & BENEFITS
* 4 weeks accrued paid time off + 8 paid national holidays per year, and 2 floating holidays
* Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
* Annual 401(k) Employer Contribution
* Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
* Robust health and wellness program and fitness reimbursements
* Various Paid Family leave options including Paid Parental Leave
* Tuition Reimbursement
ABOUT THE COMPANY
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of "A-/Excellent".
#LI-DNI
#BICLMT
Auto-ApplySenior Health Claims Analyst - Large Claims Expert
Claims adjuster job in Philadelphia, PA
Highlight Health is a mission-driven company that protects consumer rights and controls healthcare costs exclusively for self-funded employers and their stop loss carriers. We are a profitable, fast-growing company without private equity investors.
We are looking for a health coverage large and complex claims analysis expert - an expert who has scrutinized hospital and other claims with millions of dollars of charges, knows where the medical billing and pricing skeletons are found, and is tired of business as usual. Your deep knowledge has likely been developed over decades of diverse work with a claims repricing organization, a claims audit department or organization, special investigations unit (SIU), and/or an Office of the Inspector General (OIG).
Highlight Health engineers new ways to protect consumer rights and control healthcare costs for self-funded employers. Nearly every American has felt the pain of the skyrocketing cost of healthcare. Highlight Health brings them solutions. We use our subject-matter expertise to reduce costs for employers and relieve ordinary Americans of burdensome medical costs. Highlight Health is proud of its inclusive workplace that brings together highly skilled leadership and employees from all walks of life. Our company is headquartered in two cities along the Northeast Corridor with an affordable cost of living: Philadelphia, PA and Newark, NJ.
If you are experienced in and passionate about fighting fraud, waste, and abuse in medical billing, this is the job for you. We are seeking a motivated and hard-working individual to guide and optimize the most crucial department of our business-claims analysis and resolutions. In addition to an extensive background in medical billing and claims analysis, this role requires strong communication skills, both written and verbal, and organizational aptitude. The ability to prioritize and satisfy deadlines in this position is a must.
Essential Duties and Responsibilities
Analyze large and complex claims that need special attention
Comprehensively review claims for fraud, waste, abuse, and overpayment
Manage ad hoc Medicare pricing using APC
Read, understand, and analyze comprehensive medical records and itemized bills
Make and present claim resolution recommendations to manager or executive leadership
Complete the claims resolution process
Help Highlight Health improve claims analysis and resolution processes
Requirements
Typical Backgrounds
Claims repricing organization
Claims audit department or organization
SIU unit
OIG
Required Experience/Knowledge
Cynicism of our current healthcare finance system and a willingness to challenge the status quo
More than 10 years of hands-on claims review experience
More than 5 years of hands-on hospital (facility) claim review experience - both inpatient and outpatient
More than 2 years of hands-on large facility claim review experience
More than 2 years of hands-on commercial claims experience (Medicare/Medicaid experience is not sufficient)
In depth knowledge of commercial price structures
In depth knowledge of facility claims coding
In depth knowledge of hospital billing rules and claim edits
Insights into hospital fraud, waste, abuse, and overbilling as experienced by commercial payers
Medical literacy
Advanced Excel skills and understanding of advanced Excel functions including VLOOKUP, pivot tables, etc.
Report writing skills
Nice to have
Clinical credentials
Claim coding certificates (AHIMA, AAPC, ACDIS, etc.)
Database query skills
Medicare and/or Medicaid claims experience
Experience managing ERISA appeals
NSA IDR experience
Team/department management experience
Professional claim experience, particularly related to hospital care and J-code drugs
Benefits
Compensation and Benefits
Salary Range: $110,000+
Highlight Health offers an attractive benefits package, with healthcare cost reimbursement, paid time off, commuting benefits, short term disability, an employer 401(k) contribution, and bonuses
After 90 days of employment, you may work from home 1 day/week
Location and Hours
North New Jersey or Philadelphia areas preferred, but remote work is possible for a highly qualified applicant.
Full-time employee relationship preferred but will consider flexible hours or contract work for a highly qualified applicant.
How to Apply
Submit your resume
Include a MANDATORY cover letter that also includes a story of your role in identifying and stopping or recovering a hospital overpayment. (Please de-identify any HIPAA information.)
Auto-ApplyPublic Adjuster Solicitor
Claims adjuster job in Philadelphia, PA
Department
Insurance & Financial Services
Employment Type
Full Time
Location
Pennsylvania
Workplace type
Hybrid
Compensation
$70,000 - $95,000 / year
Key Responsibilities Skills, Knowledge and Expertise Benefits About The Misch Group Stone Hendricks Group is a direct-hire search firm that brings together years of experience and a diverse range of talent to connect businesses with exceptional job candidates. With a focus on timely and effective recruitment, we understand the power of a well-formed employee base in helping businesses achieve their goals. We offer our services to businesses of all sizes, providing qualified candidates for blue- and grey-collar roles, as well as white-collar and executive positions. The success of our direct-hire search process is driven by our advanced training, proprietary technology, and extensive network across industries. At Stone Hendricks Group, we value integrity and prioritize connectedness, commitment, and candor in our interactions with both employers and job seekers. Our clients consider us trusted advisors, relying on the highly personalized service we provide and our ability to find candidates that are an ideal fit for their unique needs. Choose Stone Hendricks Group for unsurpassed direct-hire search services that match successful organizations with talented job candidates.
Senior Claims Examiner, Commercial Property & Entertainment
Claims adjuster job in Philadelphia, PA
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.
Position Summary
Arch Insurance, AIGI has an opening within our Claims Division on MidCorp Entertainment team as a Senior Claims Examiner, Entertainment to manage a wide range of complex claims across film, television, live events, motorsports, and more. This role involves investigating, evaluating, and resolving claims related to property, equipment, contingency, and third-party damage, while ensuring compliance with internal guidelines. You'll collaborate with underwriters, brokers, and external adjusters, drive subrogation and salvage efforts, and support new business onboarding
Responsibilities
* Proactively investigate, evaluate, negotiate and resolve Entertainment claims including Real Property and Business Personal Property, Time Element, Contingency, Miscellaneous Equipment, Theater, Third Party Property Damage and Props Sets & Wardrobe.
* Entertainment claims include Motion Picture Film and Television, Commercial productions, Touring, Motorsports, Live Events, Theater.
* Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis
* Develop and implement strategy related to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
* Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures
* Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary
* Investigate claims and review the insureds' materials, pleadings, and other relevant documents
* Identify and review each jurisdiction's applicable statutes, rules, and case law
* Review litigation materials including depositions and expert's reports
* Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
* Retain counsel when necessary and direct counsel in accordance with resolution strategy
* Analyze coverage, liability and damages for purposes of assessing and recommending reserves
* Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves
* Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter
* Negotiate resolution of claims
* Select and utilize structure brokers
* Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims
Experience & Required Skills
* 5-7+ years of work experience at an insurance company and/or insurance claims loss adjustment service provider managing property claims process supporting commercial accounts
* Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
* Strong time management and organizational skills
* Demonstrated ability to take part in active strategic discussions
* Demonstrated ability to work well independently and in a team environment
* Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
* Willing and able to travel 10%
* Multi-lingual is a plus
Education
* Bachelor's degree required.
* Proper & active adjuster licensing in all applicable states
#LI-SW1
#LI-HYBRID
For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$97,100 - $131,130/year
* Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
* Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
14400 Arch Insurance Group Inc.
Auto-ApplyField Property Claims Adjuster
Claims adjuster job in Marlton, NJ
Join us as a Field Property Claims Adjuster where you'll be responsible for helping our customers navigate the claims process and get back on their feet following damage to the homeowner's property. This is a role where people who love every day to be new, different and exciting, can thrive - you'll be traveling on the road to meet customers in person, providing hands-on assessment of damage and empathetic support.
The Field Property Claims Adjuster will be traveling locally to insured homes within the Marlton, NJ (08053) and surrounding areas. To be successful within the role, candidates should live within or near this area.
Sign-On Bonus Available! We're offering a sign-on bonus for experienced and actively licensed new hires.
What you'll do
Investigate and evaluate onsite to resolve complex coverage and damage issues to include preparing complete estimates of repair for the covered damages. This may include accessing roofs by ladder, inspecting attics, crawl spaces and basements in search of damage.
Handle moderate to complex claims independently while managing your workload, from first notice of loss to final closure.
Be expected to work in a vehicle in the field daily while occasionally handling assignments from the desk.
Explain coverage of loss, assist policyholders with itemization of damages, emergency repairs and additional living arrangements.
Work with and coordinate a few vendor services such as contractors, emergency repair, cleaning services and various replacement services.
May be called upon for catastrophe duty.
Position details
Territory-based work: Most workdays will be spent in the field within your assigned local territory, giving you the opportunity to work directly with customers and gain hands-on experience.
Training & support: To set you up for success, you'll participate in a comprehensive 5-month training program, which includes:
Primarily virtual and on-the-job learning.
Two short in-person training sessions (Weeks 4 and 7) at our Lewisville, TX office.
Limited overnight travel for training and team meetings (typically less than 10%).
Mileage Reimbursement: This role offers mileage reimbursement. You may qualify for a company-provided vehicle once mileage requirements are met. Additional details will be provided if you advance in the selection process.
Qualifications
Working knowledge of claims handling procedures and operations.
Proven ability to provide exceptional customer service.
Effective negotiation skills.
Ability to effectively and independently manage workload while exhibiting good judgment.
Strong written/oral communication and interpersonal skills.
Computer skills with the ability to work with multi-faceted systems.
The capabilities, skills and knowledge required through a bachelor's degree or equivalent experience and at least 1 year of directly related experience.
Ability to obtain proper licensing as required.
The ability to handle multiple competing priorities and organize your day.
Strong time management and organizational skills.
Demonstrated understanding of building construction principles.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
California
Los Angeles Incorporated
Los Angeles Unincorporated
Philadelphia
San Francisco
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Auto-ApplyTrainee Field Property Adjuster
Claims adjuster job in Philadelphia, PA
Requirements
Requires a high school diploma; advanced education beyond high school preferred or an equivalent combination of education and experience.
Previous experience as a claims adjuster or must complete Capstone specified adjuster training if no experience.
If previous adjuster experience, working knowledge of Xactimate is preferred.
Must be licensed, or have the ability to obtain license(s), as required by state and local jurisdictions to adjust insurance claims.
Must have valid driver's license.
Skills and Competencies:
Ability to work in a high volume, fast paced environment managing multiple tasks.
Ability to provide excellent service to policyholders and clients.
Ability to efficiently operate a computer and related claims and business software.
Effective analytical and problem-solving skills necessary to make decisions and resolve conflict
Good verbal and written communication skills.
Good attention to detail.
Strong analytical and mathematical ability.
Ability to work independently in a virtual environment when required.
Good organizational and time management skills.
Physical Demand Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this position, auto travel is required.
Ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a vehicle. Ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics. Ability to work in a confined or restricted area. Kneeling, crouching, crawling, standing, sitting, walking, pushing, pulling, etc. as is required to inspect claims. Ability to work outdoors, exposed to all weather conditions.
Adjuster
Claims adjuster job in Philadelphia, PA
is located in Central Pennsylvania.
Essential Job Duties and Responsibilities:
To accept, contract, and handle claims as assigned.
Work as many claims as possible.
Assist in resolving complaints from policy holder relative to claims.
Assist in investigating more complex claims.
Complete Quality Control functions as assigned.
Assists with other duties as necessary.
Knowledge, Skills, and Abilities:
Knowledge of or the ability to learn the agricultural industry, including an understanding of the kinds of crops produced in the territory; agricultural issues.
Knowledge of or the ability to learn Rain and Hail's products, services and systems.
Knowledge of and the ability to learn the underwriting and claim adjustment rules and regulations associated with the Multiple Peril Crop Insurance program, crop-hail program and the other insurance products offered by the company.
Ability to organize and prioritize multiple tasks.
Ability to work in a team oriented environment.
Ability to effectively communicate and maintain business relationships with Company personnel, outside resources and customers.
Ability to use the Company's terminology, procedures and systems.
Ability to use department equipment.
Ability to perform basic and complex mathematical calculations.
Ability to drive a vehicle and maintain a valid drivers license.
Ability to remain calm and professional during peak periods of activity.
Ability to work from oral and written communication.
Ability to maintain confidentiality.
Ability to work independently.
Ability to travel away from home for extended periods of time and on short notice.
Willingness to relocate to another division if requested.
Ability to assist in other work-related areas as required.
Qualifications
High School or GED required, baccalaureate degree in Agricultural Business or related field preferred with 1-3 years of experience.
Auto-ApplyLitgations Claims Manager
Claims adjuster job in Philadelphia, PA
Pennsylvania Lumbermens and Indiana Lumbermens Mutual Insurance Company
Litigations Claims Manager Department: Claims
Reports To: Vice President, Claims
The Claim Manager is responsible for the overall results of their assigned claim unit through appropriate management of their team members and external partners. This position facilitates, coordinates and expedites the immediate handling of claims in assigned business unit, controlling and critiquing large exposure cases and resolving claims in a prompt, fair and equitable manner.
Essential Functions and Responsibilities:
1. Provide direct management to assigned staff to ensure a consistent work product in all areas.
2. Approve settlement and reserve increases for claims in excess of assigned adjustors' authority.
3. Provide senior management with regular status reports on all large and potentially large losses.
4. Maintain an active diary on those claims that exceed the claim adjustors' authority and/or require special expertise. Provide direct management on specific claims on his/ her diary.
5. Perform periodic claim file, reserve and subrogation reviews to identify improvement areas and employee training needs and implement action plans based upon review findings.
6. In conjunction with Claim VP's, develop quality, service and expense goals for the unit. Provide leadership by training, developing and positioning people to attain unit goals.
7. Actively seek and evaluate candidates for present or future employment at PLM/ILM.
8. Build and maintain excellent relationships with policyholders and brokers. Develop and measure actions to improve customer service and ease of doing business.
9. Monitor legislative and regulatory changes related to the lines of business handled; attend public hearings as necessary and appropriate.
10. Perform other duties as assigned.
Knowledge and Skills:
1. 10 years' experience in appropriate claim lines of business.
2. Prior supervisory experience.
3. Basic knowledge of various applicable state law systems.
4. Strong litigation skills.
5. Above average reading comprehension and math skills.
6. Ability to deal with a variety of personalities and situations with professional courtesy.
7. Experience controlling expenses.
8. Proficient negotiation skills.
9. Strong oral and written communication skills.
10. Strong analytic skills and ability to pay close attention to detail.
11. Strong customer service skills.
12. Participate in training/education as approved by the VP of Claims.
13. Computer proficiency and working knowledge of Microsoft Office products
14. Obtain adjuster's license where applicable.
15. College degree strongly preferred. Law degree desirable.
Physical Requirements:
1. Frequently operates a computer and other office productivity machinery, such as a calculator, copy machine, printer, and telecommunication device.
2. Frequently communicates with both internal personnel and external contacts. Must be able to exchange accurate, clear information in these situations.
3. Ability to stay in a stationary position for extended periods of time.
4. This position occasionally needs to move about inside an office environment.
Rec Marine Adjuster
Claims adjuster job in Philadelphia, PA
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Rec Marine Adjuster
**PRIMARY PURPOSE** **:** To investigate and process marine claims adjustments for clients; to handle complex losses locally unassisted up to $50,000 and assist the department on larger losses.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Investigates the cause and extent of the damages, obtains appropriate documentation, and issues settlement.
+ Receives and reviews new claims and maintains data integrity in the claims system.
+ Reviews survey reports and insurance policies to determine insurance coverage.
+ Prepares settlement documents and requests payment for the claim and expenses.
+ Assists in preparing loss experience report to help determine profitability and calculates adequate future rates.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Appropriate state adjuster license is required.
**Experience**
3 years or more of Marine Adjusting preferred.
**Skills & Knowledge**
+ Strong oral and written communication skills
+ PC literate, including Microsoft Office products
+ Good customer service skills
+ Good organizational skills
+ Demonstrated commitment to timely reporting
+ Ability to work independently and in a team environment
+ Ability to meet or exceed Performance Competencies
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical** **:**
+ Must be able to stand and/or walk for long periods of time.
+ Must be able to kneel, squat or bend.
+ Must be able to work outdoors in hot and/or cold weather conditions.
+ Have the ability to climb, crawl, stoop, kneel, reaching/working overhead
+ Be able to lift/carry up to 50 pounds
+ Be able to push/pull up to 100 pounds
+ Be able to drive up to 4 hours per day.
+ Must have continual use of manual dexterity
**Auditory/Visual** **:** Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Claims Specialist - Workers Compensation - CA
Claims adjuster job in Blue Bell, PA
As a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.
Responsibilities:
* Promptly investigates all assigned claims with minimal supervision, including those of a more complex nature
* Determines coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)
* Alerts Supervisor and Special Investigations Unit to potentially suspect claims
* Ensures timely denial or payment of benefits in accordance with jurisdictional requirements
* Within granted authority, establishes appropriate reserves with documented rationale, maintains and adjusts reserves over the life of the claim to reflect changes in exposure
* Negotiates claims settlements within granted authority
* Establishes and implements appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition
* Works collaboratively with PMA nurse professionals to develop and execute return to work strategies
* Selects and manages service vendors to achieve appropriate balance between allocated expense and loss outcome
* Maintains a working knowledge of New York jurisdictional requirements and applicable case law for each state serviced
* Demonstrates technical proficiency through timely, consistent execution of best claim practices
* Communicates effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues
* Provides a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions
* Authorizes treatment based on the practiced protocols established by statute or the PMA Managed Care department
* Assists PMA clients by suggesting panel provider information in accordance with applicable state statutes.
* Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
#LI-Remote
* Bachelor's degree and/or four or more years of equivalent work experience required in an insurance related industry required
* CA experience is required; AZ experience is a plus
* Associate in Claims (AIC) Designation or similar professional designation desired
* License required or ability to obtain license within 90 days of employment in mandated states
* Familiarity with medical terminology and/or Workers' Compensation
* Working knowledge of Workers Compensation regulations, preferably jurisdiction-specific
* Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously
* Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details
* Strong verbal, written communication skills and customer service skills gained through previous work experience
* Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint
* Ability to travel for business purposes, approximately less than 10%.
Commercial Field Adjuster - Philadelphia, PA
Claims adjuster job in Philadelphia, PA
CCMS & Associates is looking for a 1099 Field Adjuster in Pennsylvania, specifically the Philadelphia 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
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.
Auto-ApplyClaims Manager
Claims adjuster job in Blue Bell, PA
**The Best Teams are Created and Maintained Here.** At BrightView, the best teams are created and maintained here. If you are searching for your next fulfilling career, picture yourself on a best-in-class team where you can grow to be your brightest. We're looking for a Quality Assurance Analyst. Can you picture yourself here?
**Hybrid Schedule:** 4 Days Onsite in Blue Bell, PA
No Agency Resumes At This Time
**Job Summary**
+ The Claims Manager is a key leader in the Risk Management team, responsible for overseeing all claims-related activities across Auto Liability, Workers' Compensation, and General Liability. This position manages a team of claims professionals, providing strategic oversight, TPA performance management, process improvement leadership, and claims outcome optimization. The role requires proven expertise in large deductible programs, high-volume claims management, complex and litigated claims, and workers' compensation enhancements. The Claims Manager serves as a subject matter expert and change agent, ensuring BrightView achieves strong financial results while fostering positive experiences for employees.
**Duties and Responsibilities:**
+ Lead, mentor, and develop a team of six claims professionals, establishing performance goals and accountability measures
+ Oversee the end-to-end claims process for Auto, Workers' Compensation, and General Liability claims, with a focus on large claim volumes and consistent quality
+ Monitor and guide Third-Party Administrator (TPA) performance, ensuring alignment with BrightView's standards and cost-effectiveness
+ Provide expert oversight of large, complex, and litigated claims, including strategy development, reserving, and settlement approvals
+ Support communication and reporting with excess insurers on significant or catastrophic claims
+ Analyze claim trends and loss drivers to identify opportunities to improve outcomes and reduce claim frequency/severity
+ Develop and refine claim intake and reporting processes for field employees, improving accuracy, timeliness, and ease of use
+ Implement and manage change initiatives to strengthen claims oversight, efficiency, and employee outcomes
+ Collaborate with legal, brokers, operations, HR, and external vendors to support claim resolution and risk mitigation strategies
+ Ensure reserve adequacy and data integrity throughout claim lifecycles; prepare and deliver regular reporting to stakeholders
+ Build and maintain strong relationships with TPAs, defense counsel, brokers, and internal departments
+ Oversee vendor performance, including attorneys, investigators, and medical professionals, to ensure quality and cost-effectiveness
**Education and Experience:**
+ Bachelor's degree in Business, Risk Management, or related field; Juris Doctor preferred.
+ Minimum 5 years of claims management experience, including Auto, GL, and Workers' Compensation
+ Prior Management experience overseeing a claims team
+ Experience in construction, landscaping, or related industries
+ Demonstrated expertise in large deductible programs, high-volume claim handling, complex/litigated claims, and TPA oversight
+ Proven record of improving workers' compensation claim outcomes for employees
+ Strong background in change management and process improvement, including improving field-level claim intake processes
+ Excellent communication and leadership skills
+ Advanced organizational and analytical capabilities with strong attention to detail.
+ Bilingual (Spanish)
**Physical Demands/Requirements:**
+ Constant operation of a computer and other office productivity machinery, such as a calculator, photocopier, and computer printer
+ Position is sedentary; must be able to remain in a stationary position for a majority of the time
+ Operates in an office environment and requires in-person presence
**Work Environment:**
+ Work is conducted in a professional office environment, with a collaborative and dynamic team setting, and requires in-person presence
**_BrightView Landscapes, LLC is an Equal Opportunity and E-Verify Employer._**
**_This job description is subject to change at any time._**
**_BrightView offers a suite or health, wellness, and financial benefits to full-time team members. Benefits offerings for full-time team members include medical, dental, and vision insurance, ancillary and voluntary products, a 401k savings plan with employer contributions, and 6 to 9 company paid holidays per year. Employees may also be eligible to receive paid time off for vacation and/or sick leave, tuition reimbursement, and/or potential variable pay opportunities based on position and performance. A detailed benefits package will be provided during the interview process_** _._
_It's Not Just a Team. It's One BrightView._
Claims Investigator - Experienced
Claims adjuster job in Philadelphia, PA
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.
Auto-Apply