Sr. Claims Technical Specialist
Claims adjuster job in Houston, TX
Company Details
Berkley Oil & Gas, (a W.R. Berkley Company) is an insurance underwriting manager providing unique property and casualty products and risk services to customers engaged in the energy sector. Our customers recognize the importance of the expertise we provide and appreciate the opportunity to work with professionals who understand their business. We are in turn committed to delivering innovative products and exceptional service to them, our valued agents and brokers, Berkley Oil & Gas is dedicated in its efforts to be well-informed of the changing dynamics of the industry; support industry efforts to minimize and mitigate risks and hazards in the ‘oil patch', and to constantly seek ways to improve our products and services to meet customer needs.
Company URL: ***************************
The company is an equal opportunity employer.
Responsibilities
The Sr. Technical Claims Specialist position will be responsible for handling, negotiating and resolving third party commercial general liability and automobile bodily injury and property damages claims to conclusion. This would include coverage verification, policy interpretation, contract interpretation, liability investigation and evaluation and negotiation of claims consistent with company policies and state regulations.
Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant external parties.
Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution.
Demonstrate understanding of medical terms, medical treatment and injury descriptions
Demonstrate collaborative efforts in managing the litigation process with outside defense counsel
Recognition and evaluation of potential exposures under the policy to establish timely, adequate reserves
Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant external parties.
Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution.
Demonstrate understanding of medical terms, medical treatment and injury descriptions
Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws
Recognition and evaluation of potential exposures under the policy to establish timely, adequate reserves
Manage the claim authorization process and negotiate claims with significant complexity
Negotiation and settlement skills.
May be deposed or testify in claims negotiations or trials
Ability to follow detailed procedures and ensure accuracy in documentation and data.
Excellent written and verbal communications; with ability to listen well.
Uphold a high standard of customer service.
Ability to use a win-win approach to resolve controversy.
Recognizes differences in opinions and misunderstandings and encourages open discussion while working towards resolution.
Accepts individual responsibility for all actions taken. Holds self and others accountable to the organization and stakeholders.
Strong computer proficiency necessary.
Multi-jurisdictional experience preferred.
Qualifications
15+ years of multi-line experience including high severity bodily injury claims.
Must possess a current Texas claims adjuster license; additional licenses a plus.
Litigation experience required
Education Requirement
Bachelor's Degree required or equivalent work experience.
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role
Auto-ApplyDaily Claims Adjuster
Claims adjuster job in Houston, TX
CENCO is a leading provider of claims solutions, partnering with top insurance carriers to deliver reliable and efficient claims handling. We are looking for Daily Claims Adjusters to assist with residential and commercial property claims across the Southwest region. This role is ideal for adjusters seeking steady assignments and the flexibility of independent work.
What You'll Do:
- Inspect and assess property damage, including wind, hail, and fire-related losses.
- Document findings with detailed reports and high-quality photos.
- Prepare accurate estimates using Xactimate or Symbility.
- Communicate with policyholders, contractors, and carriers professionally and effectively.
- Manage claims efficiently to meet deadlines and carrier expectations.
What We're Looking For:
- Licensing: Must hold an active adjuster license in applicable Southwest states.
- Technology Skills: Familiarity with Xactimate or Symbility.
- Equipment: Reliable vehicle, ladder, laptop, and standard adjusting tools.
- Work Ethic: Organized, self-motivated, and able to work independently.
- Availability: Must be able to respond to assignments promptly and meet reporting deadlines.
Why Work with CENCO?
- Consistent claim volume in a high-demand region.
- Competitive pay and timely compensation.
- Supportive team and streamlined processes to help you succeed.
If you're looking for steady daily claims work and the opportunity to grow with a trusted industry leader, we want to hear from you!
Field Claims Adjuster
Claims adjuster job in Houston, TX
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
Independent Insurance Claims Adjuster in Houston, Texas
Claims adjuster job in Houston, TX
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-ApplyLicensed Public Adjuster Houston, Texas
Claims adjuster job in Houston, TX
Job DescriptionSalary:
About Us
Rockwall National Public Adjusters is one of the most established public adjusting firms in the region. For more than 15 years, we have successfully advocated for property owners, supported by leadership with over 20 years of experience in the insurance claims industry.
We pride ourselves on our longevity, high retention, and reputation for excellence. Many of our adjusters and office staff have been with us for over 10 years, reflecting our supportive culture and commitment to long-term careers.
At Rockwall, our mission is simple: level the playing field, fight for our clients rights, and secure the settlements they deserve. By joining our team, you will become part of a well-respected firm with proven processes, unmatched administrative support, and a collaborative environment that fosters professional growth.
The Role
We are seeking a motivated and Licensed Public Adjuster in the Houston area to join our team in a hybrid, commission-based role.
As a Public Adjuster, you will represent policyholders throughout the insurance claims process, guiding them through stressful property damage losses and securing fair settlements. You will play a vital role in soliciting referral business, signing clients, evaluating damages, preparing and negotiating claims, and advocating for clients best interests.
This position is designed to support all levels of experience:
Newly licensed adjusters benefit from structured training, mentorship, and back-office support.
Experienced adjusters gain access to qualified leads, advanced systems, and a trusted brand with a long-standing reputation.
Key Responsibilities
Collaboratively solicit residential and commercial new claims and referral partners
Sign, inspect, evaluate, and document property damage for residential and commercial claims
Prepare, submit, and negotiate insurance claims on behalf of policyholders
Communicate with clients, insurance carriers, contractors, and stakeholders to advance claims efficiently
Advocate for clients best interests and ensure fair settlements are achieved
Maintain accurate records, reports, and claim documentation
Deliver exceptional customer service while educating clients on the claims process
Generate new business and efficiently close provided leads
Required Qualifications
Active Texas Public Adjuster license (or ability to obtain one)
Prior experience in insurance adjusting, construction, restoration, or a related field preferred, but not required
Strong negotiation and communication skills
Organized, detail-oriented, and able to manage multiple claims simultaneously
Professional demeanor with a client-focused mindset
Valid drivers license and reliable transportation for field inspections
Compensation & Benefits
Commission-based structure with unlimited earning potential
Training and ongoing professional development
Career growth opportunities within a supportive and collaborative team
Hybrid work flexibility (field + office)
Full administrative and office support (contracts, compliance, claims, invoicing, mortgage company payments)
The Rockwall Difference
At Rockwall, we provide unmatched support at every stage of the claims process, allowing our adjusters to focus on serving clients and building careers.
Key Advantages:
Comprehensive adjuster onboarding and mentorship programs
Professional ongoing sales training to close contracts faster and expand referral networks
Proprietary lead generation sources and affiliate networks
Automated client onboarding to reduce paperwork
Access to advanced claims management software for streamlined workflows
Hands-on field training for residential and commercial claims
Xactimate training and estimate reviews to ensure complete assessments
Seamless invoicing and fee collection support
Regular updates on case law, legislation, and industry trends
A collaborative team environment that promotes growth and shared knowledge
Why Join Rockwall NPA
20+ years of insurance industry expertise
15+ years as a trusted, established firm
Strong reputation and high staff retention
Proprietary lead generation sources and long-standing affiliate networks
Full support systems that empower adjusters to succeed
A company culture built on professionalism, advocacy, and results
Total Loss Adjuster
Claims adjuster job in Houston, TX
Job DescriptionBenefits:
401(k)
Dental insurance
Health insurance
Vision insurance
The Total Loss Adjuster plays a critical role in evaluating insurance claims involving the complete loss of vehicles or properties. This position requires thorough investigation, analysis, and communication to ensure accurate assessment, fair settlement, and compliance with policy terms.
Key Responsibilities:
Conduct in-depth investigations of total loss claims for insured properties.
Collect and analyze pertinent documentation and information to determine the extent of loss.
Evaluate policy terms to confirm coverage eligibility for claims.
Calculate equitable settlement values based on findings and industry standards.
Negotiate settlements with claimants, policyholders, and other stakeholders.
Prepare detailed, accurate reports outlining evaluations and decisions.
Ensure timely and precise processing and resolution of claims.
Qualifications:
Comprehensive understanding of insurance policies, coverage nuances, and claims assessment procedures.
Proficient communication and negotiation skills for effective interaction with claimants and stakeholders.
Strong investigative and analytical abilities to evaluate total losses accurately.
Exceptional attention to detail for meticulous review of documentation and policy specifics.
Outstanding organizational and time management skills to manage multiple claims concurrently.
Proven experience in insurance claims adjusting or a related field.
Possession of a Multi-line Texas Adjuster's License.
Liability Field Adjuster - Houston, TX
Claims adjuster job in Houston, TX
Job Description
CCMS & Associates is looking for 1099 Field Liability Adjusters. We are answering a call to action to add to our existing roster. The time is now to get on with our innovative team! We are seeking auto/homeowners/general liability field adjusters with at least 5 years of field experience.
Requirements:
Minimum 5 years auto and/or premise liability adjusting experience
Working computer/laptop - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
State adjusters license (where applicable)
Must have a valid drivers license
Responsibilities:
Conduct in-depth investigations into liability claims to gather facts regarding the loss
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses, and by interviewing fire, police, or other government officials as well as inspecting claimed damages
Inspect damage to property and obtain personal injury information to assist in determining liability
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 communication skills
Prompt, reliable, and friendly
Detail-oriented individual to accurately gather and analyze information to avoid errors
Preferred but Not Required:
College degree
Professional designations and certifications
All candidates must pass a full background check (void in states where prohibited)
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Bodily Injury Adjuster at CONSTITUTION (CMGA) INSURANCE
Claims adjuster job in Houston, TX
Investigates, evaluates, negotiates and resolves claims of moderate to high complexity through effective research, negotiation and interaction with insured's and claimants in accordance with established claims procedures and state regulations.
Qualifications:
Minimum of 2 years previous auto liability claim handling experience or minimum 1 year bodily injury claims experience preferred.
Multi-line Texas Adjuster's license
Excellent verbal and written communication
Strong interpersonal skills
Proficient in use of Microsoft Office software and other business-related software
Able to type own reports and other correspondence'
Responsibilities:
Investigating Claims:
This may involve speaking with witnesses, medical experts, legal professionals, and or law enforcement to gather evidence and review medical records.
Assessing Damages:
This may include determining the cost of medical bills, lost wages, and other expenses related to the injury.
Negotiating Settlements
: Adjusters are responsible for negotiating settlements with the injured party or legal representative,
Communicating with Clients
: This includes regular communication with clients regarding the status of the claim and answering any questions they may have.
Documenting Claims and Following Legal Procedure:
Adjusters must document all aspects of a claim, including the investigation, assessment of damages, and settlement negotiations. They must ensure all claims are processed in accordance with legal and regulatory requirements.
We are looking forward to reading your application.
Available shifts and compensation: We have available shifts all days of the week. Compensation depends on your experience.
About CONSTITUTION (CMGA) INSURANCE: BE A PART OF CONSTITUTION GENERAL AGENCY We have a great team, all based in Texas, and a diverse company culture. We offer a comprehensive benefits package to all our full-time employees: - Medical Insurance - Vision Insurance - Dental Insurance - Life Insurance - Extensive PTO (paid time off) opportunities Contact us for more information.
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Auto Liability Inside Claim Representative - Houston, TX
Claims adjuster job in Houston, TX
ATTENTION MILITARY AFFILIATED JOB SEEKERS
- Our organization works with partner companies to source qualified talent for their open roles. The following position is available to
Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers
. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps.
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Compensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range
$67,000.00 - $110,600.00
Target Openings
2
What Is the Opportunity?
**Potential for Sign-On Bonus**
Be the Hero in Someone's Story
When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most.
As a Claim Representative, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner.
In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process.
Travelers offers a hybrid work location model that is designed to support flexibility.
What Will You Do?
Provide quality claim handling of Auto Liability claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations.
Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates.
Determine claim eligibility, coverage, liability, and settlement amounts.
Ensure accurate and complete documentation of claim files and transactions.
Identify and escalate potential fraud or complex claims for further investigation.
Coordinate with internal teams such as investigators, legal, and customer service, as needed.
Insurance License: In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
Perform other duties as assigned.
Additional Qualifications/Responsibilities
What Will Our Ideal Candidate Have?
Bachelor's Degree.
Three years of experience in insurance claims, preferably Auto claims.
Experience with claims management and software systems.
Strong understanding of insurance principles, terminology with the ability to understand and articulate policies.
Strong analytical and problem-solving skills.
Proven ability to handle complex claims and negotiate settlements.
Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants.
What is a Must Have?
High School Degree or GED with a minimum of one year bodily injury liability claim handling experience or successful completion of Travelers Claim Representative training program is required.
What Is in It for You?
Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
Liability/Claims Specialist
Claims adjuster job in Houston, TX
Job Details Houston, TXJob Posting Date(s) 07/17/2025Description
For over 31 years, RCA's employees have been dedicated advocates for hospitals and the patients they serve. We are looking to add to our superior team with our opening of a Liability/Claim Specialist position. The ideal candidate will provide the highest quality of service to our client partner by using Third Party Liability Claims to file hospital liens in connection with Motor Vehicle accidents.
Qualifications
Under the supervision of the Supervisor of Liens and the Director of Operations, the Liability/Claim Specialist's job responsibilities will include, but are not limited to:
Investigate and verify all details related to a MVA including making sure the patient received medical treatment within the 72 hour required timeframe.
Initiate and complete the lien process. This includes creating the Notice of Claim of Lien, having the lien notarized, and filing the lien at the county courthouse of the claimant's hospital and recording the docket number
Notify appropriate insurance companies and/or attorneys of any lien filed and/or released. This will include sending all interested parties' copies of the lien filing
Maintain constant communication with insurance companies, attorneys, adjusters, patients and other interested parties to help ensure maxim reimbursement.
Ensure any reimbursement payments received correspond to the balances shown
Qualifications:
Bachelor's Degree preferred but will accept equivalent experience
Experience in an office environment, preferably a healthcare or legal setting
Strong Customer Skills, including both face-to-face interaction and phone skills
A desire to commit to the growth of not only your career but this company.
Must be reliable and dependable
Must be adaptable and able to quickly change processes if requested
Ability to take on multiple tasks at once
Looking for great benefits?
In addition to competitive salary, RCA offers one of the best benefits packages in the business, including compensated time off, six paid holidays, medical, dental and vision benefits. Also offered is 401K, flexible spending accounts, life insurance and many other supplemental policy options for you to choose from!
RCA employees also enjoy the following perks:
Teladoc - Free 24/7 access to on-demand doctors for non-emergency consultations for employees and their immediate family members.
Verizon Wireless customer? RCA employees are eligible for a 22% discount through Verizon Wireless.
Travel discounts through our affiliated partners.
Discounted insurance rates through Liberty Mutual
Access to discount offers for movie tickets, theme parks, sporting events, shows and much more!
Pharmacy Claims Adjudication Specialist
Claims adjuster job in Houston, TX
We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Houston, TX. This will be a Full-Time position. This position must be located within driving distance to our pharmacy, with a hybrid work style. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $20.00 an hour and up Sign-On Bonus: $5,000 for employees starting before January 1, 2026. We offer a variety of benefits including:
Medical; Dental; Vision
401k with a match
Paid Time Off and Paid Holidays
Tuition Reimbursement
Company paid benefits - life; and short and long-term disability
Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360...
Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information..
Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim.
Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays
Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible)
Manages all funding related adjudications and works as a liaison to Onco360 Advocate team.
Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment.
Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable.
Document and submit requests for Patient Refunds when appropriate.
Pharmacy Adjudication Specialist Qualifications and Responsibilities...
Education/Learning Experience
Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication
Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience
Work Experience
Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience
Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience
Skills/Knowledge
Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills
Desired: Knowledge of Foundation Funding, Specialty pharmacy experience
Licenses/Certifications
Required: Registration with Board of Pharmacy as required by state law
Desired: Certified Pharmacy Technician (PTCB)
Behavior Competencies
Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills
#Company Values: Teamwork, Respect, Integrity, Passion
Technical Claims Specialist
Claims adjuster job in Houston, TX
Company Details
Berkley Oil & Gas, (a W.R. Berkley Company) is an insurance underwriting manager providing unique property and casualty products and risk services to customers engaged in the energy sector. Our customers recognize the importance of the expertise we provide and appreciate the opportunity to work with professionals who understand their business. We are in turn committed to delivering innovative products and exceptional service to them, our valued agents and brokers, Berkley Oil & Gas is dedicated in its efforts to be well-informed of the changing dynamics of the industry; support industry efforts to minimize and mitigate risks and hazards in the ‘oil patch', and to constantly seek ways to improve our products and services to meet customer needs.
Company URL: ***************************
The company is an equal opportunity employer.
Responsibilities
The Technical Claims Specialist position will be responsible for handling, negotiating and resolving first and third party commercial general liability, property, Inland Marine and automobile bodily injury and property damage claims to conclusion. This position may also handle worker's compensation claims. This would include coverage verification, policy interpretation, contract interpretation, liability investigation and evaluation and negotiation of claims consistent with company policies and state regulations.
Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant internal and external parties.
Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution.
Demonstrate understanding of medical terms, medical treatment and injury descriptions.
Recognition and evaluation of potential damages related to injuries.
Manage the claim authorization process.
Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence.
Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction.
Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements.
Verify, analyze, and correctly apply coverage.
Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures.
Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law.
Keep policyholders, underwriting and agents advised of file status and other matters as required.
Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues.
Successfully complete relevant continuing education as required.
Qualifications
Minimum of 7 years of multi-line experience
Must possess a current Texas claims adjuster licenses; additional licenses a plus.
Multi-jurisdictional experience preferred.
Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws
Ability to follow detailed procedures and ensure accuracy in documentation and data.
Excellent written and verbal communications; with ability to listen well.
Recognizes differences in opinions and misunderstandings and encourages open discussion while working towards resolution.
Accepts individual responsibility for all actions taken. Holds self and others accountable to the organization and stakeholders.
Excellent organizational skills; ability to prioritize workload
Ability to think critically and solve problems, including the ability to interpret related documentation
Strong negotiation skills leading to best claim outcomes
Demonstrate proficiency in computer programs, such as Microsoft Word, Outlook and Excel
Education Requirement
Bachelor's Degree required or equivalent work experience.
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include:
• Base Salary Range: $90,000 - $140,000
• Eligible to participate in annual discretionary bonus.
• Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
The application window for this role is estimated to be open through January 30, 2026, but may be extended, if necessary, please submit your application as soon as possible prior to January 30, 2026. Sponsorship Details Sponsorship not Offered for this Role
Auto-ApplySubrogation Adjuster
Claims adjuster job in Houston, TX
Job DescriptionBenefits:
Life Insurance
Dental insurance
Health insurance
Paid time off
Vision insurance
The Subrogation Adjuster will be responsible for identifying subrogation opportunities, investigating liability, and pursuing recoveries from at-fault parties or their insurers. The ideal candidate has hands-on experience with non-standard auto claims, understands complex liability scenarios, and is comfortable negotiating to maximize recoveries.
Key Responsibilities
Review claim files to identify subrogation potential and establish recovery strategies
Investigate liability by obtaining police reports, witness statements, and other relevant evidence
Communicate with policyholders, claimants, other insurers, and attorneys to pursue recoveries
Negotiate settlements with adverse carriers and uninsured parties
Document all activity accurately and in a timely manner within claim systems
Collaborate with litigation teams when legal action is required to support recovery efforts
Handle deductible reimbursements in accordance with company policy and state regulations
Maintain productivity and recovery goals in alignment with department metrics
Qualifications
2+ years of subrogation or claims adjusting experience, preferably within non-standard auto insurance
Solid understanding of auto liability, comparative negligence, and subrogation principles
Excellent negotiation, communication, and investigative skills
Strong organizational skills and attention to detail
Ability to manage a high-volume caseload efficiently
Familiarity with arbitration forums (e.g., AF) and relevant state regulations is a plus
Proficiency in claims management systems and Microsoft Office
Pay
Pay is negotiable based on experience
THIS IS AN IN PERSON POSITION
Independent Insurance Claims Adjuster in Rosenberg, Texas
Claims adjuster job in Rosenberg, TX
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 450+ 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-ApplyLiability Field Adjuster - Houston, TX
Claims adjuster job in Houston, TX
CCMS & Associates is looking for 1099 Field Liability Adjusters. We are answering a call to action to add to our existing roster. The time is now to get on with our innovative team! We are seeking auto/homeowners/general liability field adjusters with at least 5 years of field experience.
Requirements:
Minimum 5 years auto and/or premise liability adjusting experience
Working computer/laptop - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
State adjusters license (where applicable)
Must have a valid drivers license
Responsibilities:
Conduct in-depth investigations into liability claims to gather facts regarding the loss
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses, and by interviewing fire, police, or other government officials as well as inspecting claimed damages
Inspect damage to property and obtain personal injury information to assist in determining liability
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 communication skills
Prompt, reliable, and friendly
Detail-oriented individual to accurately gather and analyze information to avoid errors
Preferred but Not Required:
College degree
Professional designations and certifications
All candidates must pass a full background check (void in states where prohibited)
Auto-ApplyProperty Desk Adjuster
Claims adjuster job in Houston, TX
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 Auto Adjuster - Sugar Land, TX
Claims adjuster job in Sugar Land, TX
ATTENTION MILITARY AFFILIATED JOB SEEKERS
- Our organization works with partner companies to source qualified talent for their open roles. The following position is available to
Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers
. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Unless specifically stated otherwise, this role is "On-Site" at the location detailed in the job post.
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
Join Our Team as a Field Auto Adjuster - Where Every Day Brings a New Challenge!
Are you someone who enjoys being on the move, solving problems, and making a real impact for customers? As a Field Auto Adjuster, you'll be at the forefront of our claims process-meeting customers where they are, whether it's at their home, a repair shop, or a tow yard.
You'll take the lead in writing estimates and guiding customers through the repair or total loss process, using a mix of in-person visits, virtual inspections, and written communication. No two days are the same-whether you're evaluating damage on-site or collaborating with body shops and service providers, you'll enjoy a fast-paced, hands-on role that keeps you engaged and on your toes.
If you're looking for a career that blends technical know-how, customer service, and the freedom of field work, this is your chance to thrive in a role where your expertise truly matters.
Additional Qualifications/Responsibilities
Preferred Qualifications
You have 18 months+ experience in auto collision estimating using CCC or Mitchell.
Proficient written and verbal communication skills to effectively interact with customers.
Strong attention to detail and ability to write precise and comprehensive estimates.
Comfortable with utilizing technology and various platforms for claims processing.
Excellent time management and organizational skills to manage multiple assignments effectively.
Valid driver's license and willingness to travel as part of the job requirements.
Key Responsibilities
A day in the life of the Field Auto Damage Adjuster, and what it takes to do the job!
The Customer Service Expert - you'll live into Allstate's Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each Casualty claim. You lead with empathy, always.
The Investigator - you'll confidently and independently investigate casualty (and applicable LOB (line of business)) claims by performing detailed reviews of damage and interpreting policies to determine coverage.
The Effective Communicator - you'll use phone, emails and sometimes even video chat with customers to help them through a fast, fair, and easy claims process. You'll also incorporate a specific approach to claim handling to offer the customer their preference of communication to efficiently discuss their claim needs and keep them updated on the claim progress.
The Negotiator - You will evaluate and negotiate claims settlements with customers, vendors, third party carriers and claimants, in accordance with all legal and business standard methodologies. With negotiations, you will incorporate tactics in handling challenging and complex situations.
The Problem Solver - you'll utilize multiple tools to get the job done in a fast-paced environment, including estimate tools, job aids, and additional settlement platforms, all while using your sharp critical thinking skills.
The Recorder - Your Eye for Detail Keeps Everything on Track
In this role, you'll ensure claims are documented accurately and in line with policy agreements. As you handle each case, you'll maintain clear, timely records in our claims system (which we'll train you on). Your attention to detail helps keep the process smooth, organized, and transparent from start to finish.
Work Location
This position is a field-based role. To be eligible for this role, you must be located in the following locations: Sugar Land, TX.
This position is eligible for a monthly internet stipend of $80 to offset the costs of internet expenses
Company Car
Based on our Company Car Guidelines, this role may qualify for a company car. Our leadership team determines this based on annual work mileage for this location. You may be required to use your personal vehicle until these guidelines are met. We offer mileage reimbursements for personal vehicle usage during work.”
“Please note, you may be required to attend 1-week of training that will take place in Wheeling, IL.”
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)
Independent Insurance Claims Adjuster in Channelview, Texas
Claims adjuster job in Channelview, TX
"Join MileHigh Adjusters Houston! Become a claims adjuster in just 10 days. Expert training. Rewarding career. Apply now!"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-ApplyNon-Standard Bodily Injury Adjuster
Claims adjuster job in Houston, TX
Benefits:
Life Insurance
401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance
Job description: We are seeking a skilled Bodily Injury Adjuster to independently handle both attorney-represented and non-represented BI claims. In this role, youll evaluate liability, coverage, and damages, negotiate settlements, and work directly with attorneys to bring claims to fair and timely resolution. Youll enjoy the support of a collaborative, growth-driven team while maintaining ownership of your caseload.
Key Responsibilities:
Analyze coverage and determine liability for assigned claims.
Negotiate settlements with claimants and their legal representatives.
Establish reserves and process settlements in alignment with company standards.
Estimate medical treatment costs and compensation related to injuries.
Review medical records and coordinate with all involved parties to ensure efficient claim resolution.
Gather information through interviews with claimants, attorneys, agents/brokers, police, and other sources.
Document and manage each step of the claims process accurately and thoroughly.
Qualifications:
Strong background in handling represented BI claims and litigation.
Active Texas All-Lines Adjuster License required.
At least 2 years of experience in non-standard auto insurance.
Exceptional negotiation, communication, and interpersonal skills.
Ability to produce clear, well-structured reports and correspondence independently.
THIS IS AN IN OFFICE POSITION.
Salary:
Salary expectations are negotiable and can be discussed based on experience.
Property Desk Adjuster
Claims adjuster job in Katy, TX
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.