The Manager, Medicare Claims, oversees end-to-end claims services for provider segments, meeting business goals. This role sets performance targets, manages claims processing and financials, handles submissions, refunds, and recoveries, and ensures claims accounting and reporting. Collaboration with claims leadership ensures alignment with customer needs and contracts.
What You'll Do
Streamline shared processing to reduce management by exception
Set operational process to address market trends, BCBSNC capabilities and customer demand
Manage accounting and financial reporting functions in support of the Finance Division including overseeing the gathering, preparation, analysis, and reconciliation of financial data to ensure compliance with accepted accounting principles and standards.
Participate in projects to improve and/or facilitate claims processing, recovery, and accounting functions.
Manage financial recovery activities including refunds and collections
Manage team leads and staff by efficiently driving work volume to keep high level of utilization and engagement in the group
Resolve complex claims appeal by coordinating with different stakeholders for certain high value claims
Collaborate with Audit and Payment Integrity to sustain a pre-determined level of accuracy and quality
Design and develop tools and techniques for improvements. Identifies needed process and procedural changes which will result in improved customer satisfaction.
Serve as Medicare Claims Subject Matter Expert and single point of contact for performance monitoring and troubleshooting.
Represent Claims Operations on monthly CMS calls with CMS Account manager answering questions, providing status updates and expertise routinely and on demand.
Ability to engage as requested by Compliance with regulatory entities, especially CMS on monthly calls and serve as an internal point of contact to prepare feedback on issues under CMS review.
Use good judgement in understanding issues and work with compliance to prepare for discussions.
Ability to represent claims as a knowledgeable SME.
What You Bring
Bachelor's degree or advanced degree (where required)
8+ years of experience in related field.
In lieu of degree, 10+ years of experience in related field.
Bonus Points
1-2 years of Medicare and Medicaid experience or a highly regulated operational environment - highly preferred
Strong analytical skills with the ability to drive change and manage operations
Ensure risks associated with business activities are effectively identified, measured, monitored and controlled within accordance with compliance policies and procedures
What You'll Get
The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.
Work-life balance, flexibility, and the autonomy to do great work.
Medical, dental, and vision coverage along with numerous health and wellness programs.
Parental leave and support plus adoption and surrogacy assistance.
Career development programs and tuition reimbursement for continued education.
401k match including an annual company contribution
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
*Based on annual corporate goal achievement and individual performance.
$98,092.00 - $156,947.00
Skills
Accounts Receivable (AR), Claims Analysis, Claims Management, Claims Processing, Claims Resolution, Claims Submission, Documentations, Financial Processing, Health Insurance, Insurance Claim Handling, Insurance Claims Processing, Insurance Industry, Medicare Advantage, People Management, Recruiting
$98.1k-156.9k yearly 4d ago
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Workers' Compensation Claims Adjuster - Temp
Argonaut Management Services, Inc.
Claims adjuster job in New Orleans, LA
Argo Group International Holdings, Inc.and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. ("BWS"), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions.
Job Description
Business Title(s):Workers' Compensation ClaimsAdjuster
Employment Type:Contingent Worker
FLSA Status:Non-Exempt
Location:In-Officeor Remote
Summary:
Although Rockwood underwrites general liability insurance and workers' compensation for many types of businesses, ourspecialtyis underwriting workers' compensation insurance for the mining industry, with a focus on the coal-mining industry. Rockwood has become a leading underwriter of workers' compensation for the mining industry by offering workers' compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal. We have never been more committed to our clients to ensure their employees receive excellent medical care if they need it due to a work-related injury or illness. Our passion for outstanding customer focus, combined with our deep industry experience, is what sets up apart from other insurance carriers in this niche market.
We are looking for a highly capable Workers' Compensation ClaimsAdjuster to help us on a temporary assignment through13February2026 and work from anywhere in the continental United States.
If this assignment is filled in one of our following offices, the assignment can be considered temp-to-hire: Albany, Chicago, Los Angeles, New York,Omaha, Richmond (VA), Rockwood (PA), or Springfield (MO). This role willadjudicateindemnity workers' compensation claims of higher technical complexity for our customers in the states of CO, KS, KY, MD, MI, MO, MT, PA, UT, and WV. As this is a temporary assignment, only government-mandated benefits will be provided.
Essential Responsibilities:
Working under technical direction and within significant limits and authority,adjudicateworkers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Resolving issues that are generalized and typically notcomplex butrequire understanding of a broader set of issues.
Reporting to senior management and underwriters onclaimstrends and developments.
Investigating claims promptly and thoroughly.
Analyzing claims forms, policies and endorsements, client instructions, and other records todeterminewhether the loss falls within the policy coverage.
Investigating claims promptly and thoroughly, including interviewing all involved parties.
Managing claims in litigation.
Managing diarytimelyand complete tasks to ensure that cases move to the best financial outcome andtimelyresolution.
Properly setting claim reserves.
Identifying, assigning, and coordinating the assignment and coordination ofexpertiseresources toassistin case resolution.
Preparing reports for file documentation.
Applying creative solutions which result in the best financial outcome.
Negotiating settlements.
Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
Having an appreciation and passion for strong claim management.
Qualifications / Experience Required:
A practical knowledge ofadjudicatingworkers' compensation claims through:
A minimum of two years' experienceadjudicatingindemnity workers'compensation claimsin one or more of the followingjurisdictions: CO, KS, KY, MD, MI, MO, MT, PA, UT, and/or WV.
Bachelor'sdegree from an accredited universityrequired. Two or more insurance designations or fouradditionalyears of related experienceadjudicatingindemnity claims beyond the minimum experiencerequiredabove may be substituted in lieu of a degree.
Must be licensed in KY
Must have good business acumen (i.e.understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable).
A practical knowledge ofadjudicatingworkers' compensation claims through:
Must have excellent communication skills and the ability to build lasting relationships.
Exhibit natural curiosity
Desireto work in a fast-paced environment.
Excellent evaluation and strategic skillsrequired.
Strong claim negotiation skillsa must.
Mustpossessa strong customer focus.
Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
Ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include CEO.
Must work independently anddemonstratethe ability to exercise sound judgment.
Demonstrates inner strength. Has the courage to do the right thing anddemonstratesit on a daily basis.
Intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
Proficient in MS Office Suite and other business-related software.
Polished and professional written and verbal communication skills.
The ability to read and write English fluently isrequired.
Mustdemonstratea desire for continued professional development through continuing education and self-development opportunities.
The base salary range provided below is for hires in those geographic areas only and will becommensuratewith candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.
Colorado outside of Denver metro, Maryland, Nevada, and Rhode Island Pay Ranges:$37.66- $44.33per hour
California outside of Los Angeles and San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Houston metro area, New York State (including Westchester County)and Washington State Pay Ranges:$41.44- $48.79per hour
Los Angeles, New York City and San Francisco metro areas Pay Ranges:$45.12- $53.16per hour
About Working in Claims at Argo Group
Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions andtreateach case as the unique situation it is.
We have a very flat organizational structure, enabling our employeeshavemore interaction with our senior management team, especially when it relates to reviewing large losses.
Our entire claims team works in a collaborative nature to expeditiously resolve claims.We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.
We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.
PLEASE NOTE:
Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.
If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at .
Notice to Recruitment Agencies:
Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions.
We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics.
The collection of your personal information is subject to our HR Privacy Notice
Benefits and Compensation
We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.
$37.7-44.3 hourly 5d ago
Supervisor, Claims (Total Loss)
Turo 4.6
Claims adjuster job in Louisiana
About the team The Total Loss Supervisor is a frontline people leader responsible for overseeing the day-to-day execution, quality, and timeliness of total loss claims. This role owns claim outcomes, associate performance, cost control, and customer experience within a fast-moving, high-exposure claims environment.
What you will do
* Operational Oversight of Total Loss Claims
* Own the end-to-end execution of total loss claims within assigned queues, including total loss determinations, ACV evaluations, settlement negotiations, salvage coordination, and timely resolution in accordance with internal policies and protection plan terms.
* People Leadership & Performance Management
* Directly manage and coach Total Loss Specialists and/or Team Leads by setting clear expectations, conducting regular 1:1s and side-by-sides, reviewing work product, and addressing performance gaps through coaching and documentation as needed.
* Quality Control, Judgment, and Escalation Management
* Serve as the first line of escalation for complex, sensitive, or high-dollar total loss claims.
* Review claims for accuracy, consistency, defensibility, and appropriate documentation, and escalate issues with context and recommended solutions.
* Cost Management & Vendor Coordination
* Actively manage storage exposure, salvage returns, towing, and vendor-related timelines.
* Partner with salvage vendors, inspection partners, and internal stakeholders to resolve bottlenecks and minimize unnecessary cost or delay.
* Metrics, Risk Identification & Continuous Improvement
* Monitor team performance against key metrics such as cycle time, storage cost, quality outcomes, customer experience, and compliance.
* Identify trends, operational risks, and opportunities for process improvement.
* Support pilot initiatives and training enhancements.
Your profile
* Strong supervisory and people leadership skills
* Strong analytical and problem-solving skills with the ability to make sound judgment calls
* Excellent organizational skills and attention to detail
* Ability to manage competing priorities in a high-paced, high-volume environment
* Strong verbal and written communication skills
* Ability to interpret policies, procedures, and protection plan terms
* Ability to identify operational risk and escalate appropriately
* Demonstrates Turo's values through work product and day-to-day team interactions
* 3+ years of auto claims experience, with total loss handling experience strongly preferred
* Prior people leadership, senior, or lead role experience
Bonus if you have
* Bachelors degree
For this role, the target base salary range in Phoenix is $70,000-$87,000 annually. This role is also eligible for equity and benefits. In general, our ranges reflect the market-based target for new hire salaries based on the level and location of the role. Within the range, individual pay is determined by objective factors assessed during the application and interview process, such as job-related skills, experience, and relevant education or training. We encourage you to talk with your recruiter to learn more about the total compensation and benefits available for this role.
Turo highly values having employees working in-office to foster a collaborative work environment and company culture. This role will be in-office on a hybrid schedule - Turists will be expected to work in the office 3 days per week on Mondays, Wednesdays, and Thursdays. Your recruiter can share more information about the various in-office perks Turo offers.
Benefits
* Competitive salary, equity, benefits, and perks for all full-time employees
* Employer-paid medical, dental, and vision insurance (Country specific)
* Retirement employer match
* Learning & Development stipend to invest in your professional development
* Turo host matching program
* Turo travel credit
* Cell phone and internet stipend
* Paid time off to relax and recharge
* Paid holidays, volunteer time off, and parental leave
* For those who are in the office full-time or hybrid we have in-office lunch, office snacks, and fun activities
We are committed to building a diverse team. If you are from a background that's underrepresented in tech, we'd love to meet you.
Aside from an award winning work environment and the opportunity to be part of the world's largest car sharing marketplace, we are also growing the team quickly - join us! Even if you don't meet every qualification, we are looking for people with enthusiasm for what we do and we will consider you for this and other possibilities.
About Turo
Turo is the world's largest car sharing marketplace where you can book the perfect car for wherever you're going from a vibrant community of trusted hosts across the US, UK, Canada, Australia, and France. Whether you're flying in from afar or looking for a car down the street, searching for a rugged truck or something smooth and swanky, Turo puts you in the driver's seat of an extraordinary selection of cars shared by local hosts.
Discover Turo at ***************** the App Store, and Google Play, and check out our blog, Field Notes.
Read more about the Turo culture according to Turo CEO, Andre Haddad.
Turo is an Equal Opportunity Employer and a participant in the U.S. Federal E-Verify program. Women, minorities, individuals with disabilities and protected veterans are encouraged to apply. We welcome people of different backgrounds, experiences, abilities and perspectives.
Turo will consider qualified applicants with criminal histories in a manner consistent with the San Francisco Fair Chance Ordinance, as applicable.
We welcome candidates with physical, mental, and/or neurological disabilities. If you require assistance applying for an open position, or need accommodation during the recruiting process due to a disability, please submit a request to People Operations by emailing ******************.
$70k-87k yearly Auto-Apply 7d ago
Product Liability Litigation Adjuster
CVS Health 4.6
Claims adjuster job in Baton Rouge, LA
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**Position Summary**
As a Product Liability Litigation Adjuster, Risk Management, you will be responsible for managing lawsuits and overseeing outside counsel defending CVS in high exposure, product liability mass tort litigations and general liability cases filed throughout the United States.
Responsibilities include:
+ Developing relationships with internal colleagues for fact-finding and key litigation activities.
+ Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution.
+ Managing all aspects of product liability mass tort litigations and complex general liability cases.
+ Working with outside national counsel and sr. management to develop consistent litigation strategies applicable to mass tort cases filed across the country.
+ Providing reporting to key internal stake holders on case developments and litigation trends for product liability mass torts and other cases.
+ Managing large scale discovery investigations by working with internal custodians, outside counsel and vendors to develop comprehensive procedures for identifying, locating, preserving and producing corporate records.
+ Analyzing case and internal materials and utilizing resources across CVS to discern key issues and identify the litigation strategy in every case assigned.
+ Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working with and overseeing outside counsel.
+ Participating in meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases.
**Required Qualifications**
+ 2+ years of legal experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier.
+ Juris Doctor degree from an ABA accredited university.
+ Ability to travel and participate in legal proceedings, arbitrations, depositions, etc.
**Preferred Qualifications**
+ Experience overseeing or defending product liability claims and litigation.
+ Familiarity or experience with insurance and coverage issues related to litigated claims.
+ Strong attention to detail and project management skills.
+ Experience overseeing and answering written discovery.
+ Ability to work independently and in an environment requiring teamwork and collaboration.
+ Strong written and verbal communication skills.
+ Demonstrated negotiation skills and ability.
+ Ability to articulate and summarize cases with management in a concise, cogent manner.
+ Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure.
+ 3-5 years of legal or claims experience.
+ Familiarity with the rules and procedures applicable to mass tort litigations, class actions, and/or multidistrict litigations.
+ Knowledge and experience navigating attorney-client privilege issues, corporate litigation holds, corporate witness depositions, and e-discovery.
+ Ability to influence and work collaboratively with senior leaders, CVS' in-house legal counsel and outside counsel.
+ Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new software programs and systems.
+ Ability to positively and aggressively represent the company at mediation, arbitration and trial.
+ Ability to navigate difficult situations and communicate effectively with both internal and external groups.
+ Excellent organizational and time management skills and ability to handle a high volume of litigated claims.
+ Experience with and understanding of legal documents (pleadings, discovery, motions and briefs).
**Education**
+ Verifiable Juris Doctor degree
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$46,988.00 - $122,400.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/03/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
$47k-122.4k yearly 60d+ ago
Independent Insurance Claims Adjuster in Lake Charles, Louisiana
Milehigh Adjusters Houston
Claims adjuster job in Lake Charles, LA
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMSADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance ClaimsAdjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed ClaimsAdjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed ClaimsAdjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed ClaimsAdjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claimsadjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claimsadjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claimsadjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed ClaimsAdjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
$40k-49k yearly est. Auto-Apply 60d+ ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claims adjuster job in Lake Charles, LA
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.
$41k-49k yearly est. Auto-Apply 36d ago
Specialty Loss Adjuster
Sedgwick 4.4
Claims adjuster job in Baton Rouge, LA
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
Specialty Loss Adjuster
**Embark on an Exciting Career Journey with Sedgwick Specialty**
**Job Location** **: USA, Mexico, Brazil and strategic locations globally**
**Job Type** **: Permanent**
**Remuneration** **: Salaries can range from** **_$40,000.00USD to $250,000.00USD_** **taking into account skills, experience and qualifications.**
**We have a number of fantastic opportunities for Specialty Loss Adjusters across the US, Mexico and Brazil and a number of key locations**
We are looking for a variety of skill sets at all levels. Whether you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your skills and grow with a company that values innovation, excellence, and employee satisfaction.
Are you ready to be a part of providing a differentiated and best of class proposition to clients whilst working with like-minded colleagues? Sedgwick Specialty is thrilled to announce that we are investing in growth across Natural Resources, Property, Casualty, Technical and Special Risks and Marine. As we expand our operations, we are seeking individuals who are passionate about making a difference to the Adjusting industry.
**As a member of the Specialty platform, you will have the opportunity to:**
+ Work with a wide range of clients across the globe, handling complex cases and claims
+ Collaborate with a talented and supportive team of professionals who are dedicated to delivering exceptional results
+ Utilise state-of-the-art technology and resources to streamline processes and enhance efficiency
+ Receive ongoing training and development opportunities to further enhance your skills and knowledge in the marine industry
+ Enjoy a flexible work arrangement that allows you to maintain a healthy work-life balance while contributing to our global success
**The skills you will have when you apply:**
+ **Qualified** : it is important to us that you are either accredited, on your way to be accredited or qualified by experience
+ **Insurance claims experience:** it is imperative that you have experience working on insurance claims within you respective field. Full claims life cycle experience is a must
+ **Great communicator:** you will be constantly working with policy holders, brokers, carriers and various third parties, so being able to communicate accurately important. Providing an excellent customer service with our clients in mind. Able to approach issues empathetically
+ **Commercially minded:** An understanding of how the industry operates and where the role of a Loss Adjuster fits in. Being able to negotiate. Understanding how to market your services is a big advantage
**What we'll give you for this role:**
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the annual salaries can range from _$40,000.00 to $250,000.00USD._ Bonus eligible role. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always Accepting Applications.
**This isn't just a position, it's a pivotal role in shaping our industry**
At Sedgwick, you won't just build your career; you'll cultivate a team of experts. Our Sedgwick University offering empowers you to excel as well as your team members, with the most comprehensive training program in the industry which includes more than 15,000 courses on demand, training specific to roles, and opportunities to continue formal education.
Together, we're not only reshaping the insurance landscape, we're building a legacy of talent. Come and be a catalyst for change within our industry.
**Next steps for you:**
**Think we'd be a great match? Apply now -** ** we want to hear from you.**
As part of our commitment to you, we are proud to have a zero tolerance policy towards discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex or sexual orientation.
After the closing date we will review all applications and may select some applicants for an interview (which may be virtual, or in-person).
\#LI-HYBRID
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**
$47k-63k yearly est. 60d+ ago
Crop Claims Seasonal Adjuster
Great American Insurance 4.7
Claims adjuster job in Louisiana
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.
The Crop Division of Great American has been helping generations of farmers take control of their risks since 1915. The D ivision is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI policies. With six regional offices throughout the U.S., the teams provide tremendous expertise in the specific needs of farmers and crops.
**********************************
Great American is currently seeking Seasonal Crop Adjusters. These positions are seasonal and may not be eligible for full-time or part-time benefits. Qualified candidates will cover territory in one of the following states:
Alabama
Arkansas
California
Colorado
Florida
Georgia
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
South Carolina
South Dakota
Tennessee
Texas
Washington
Wisconsin
Wyoming
Schedule: Seasonal part-time. Hours fluctuate based on seasonal needs.
As a Crop Adjuster, you will:
Understand and can work claims for all major crops, policy/plan types, in all stages of growth.
Complete field inspections, reviews, and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company Crop insurance policies.
Review and evaluates coverage and/or liability.
Secure and analyze necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims.
Ensure compliant and cost effective application of Crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory requirements.
Accurately document, process and transmit loss information to determine potential.
Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions, or trials as necessary.
May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority.
Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations.
Ensures that claims handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed.
Follow regulatory and company rules, policies, and procedures.
Performs other duties as assigned.
Physical Requirements for employees in the Crop Business Unit/Crop Claims General Adjuster
Requires continuous and prolonged walking and standing.
Requires frequent lifting, carrying, pushing and pulling of objects up to 50 lbs.
Requires frequent climbing grain bins, bending, twisting, stooping, kneeling and crawling.
Requires overhead reaching and grabbing.
Requires regular and predictable attendance.
Requires ability to conduct visual inspections.
Requires work outdoors, in inclement weather conditions.
Requires frequent travel.
May require ability to operate a motor vehicle.
Business Unit:
Crop
Salary Range:
$0.00 -$0.00
Benefits:
Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs.
We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees.
Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.
$40k-48k yearly est. Auto-Apply 44d ago
Daily Claims Adjuster - New Orleans, LA
Cenco Claims 3.8
Claims adjuster job in New Orleans, LA
CENCO is a respected leader in property claims solutions, partnering with top insurance carriers to deliver fast, accurate, and dependable adjusting services. We're currently hiring experienced Daily Property ClaimsAdjusters to handle residential and commercial claims throughout New Orleans and the surrounding Southeast Louisiana region. This position is perfect for adjusters seeking steady assignments and the flexibility of working independently in the field.
Key Responsibilities:
Conduct field inspections for property damage caused by wind, hail, water, fire, and other covered events.
Document findings with detailed written reports and clear, high-quality photos.
Prepare precise estimates using Xactimate or Symbility.
Maintain professional communication with policyholders, contractors, and carrier representatives.
Manage claim files efficiently and complete assignments within required timelines.
Qualifications:
Licensing: Must hold a current Louisianaadjuster license.
Software: Proficiency in Xactimate or Symbility preferred.
Equipment: Reliable transportation, ladder, laptop, and essential field tools.
Work Style: Organized, self-motivated, and able to work independently.
Responsiveness: Must be available to accept assignments and meet reporting deadlines promptly.
Why Choose CENCO?
Consistent claim volume in the New Orleans area
Competitive compensation with timely payments
Supportive team and efficient systems to help you succeed
If you're a skilled adjuster looking for consistent work and an opportunity to grow with a trusted industry partner, we'd love to hear from you!
National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers' evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.
Job Description
Responsible for creating or auditing a comprehensive estimate of damages for 1st and 3rd party material damage claims in either the auto or specialty lines leading to the proper disposition. Responsible for training, mentoring, controlling quality and providing technical assistance on material damage claims.
National General Insurance is seeking an experienced Auto Field Adjuster to join our field estimating team in the Harvey, Gretna, Marrero, Terrytown, Kenner, Metairie and New Orleans metro areas! This is a field-based, territory-specific position covering areas in the New Orleans metro area. We are looking for a professional with experience in auto damage assessment, proficiency in CCC One estimating software, strong negotiation and time management skills, and a customer-focused approach to deliver exceptional service.
Key Responsibilities
• Possesses strong estimating fundamentals in order to create or audit estimates of damages on 1st and 3rd party material damage losses of all severities
• Possesses a deep understanding of the content of all policy types written by the company
• Negotiates settlements, makes settlement payments and documents all activities in the most complex of files across multiple lines
• Evaluates settlement alternatives by reviewing regulatory compliance and fair claims practices; makes decisions on best option
• Builds mastered relationships with both internal and external customers across multiple lines
#LI-SC2
Compensation
Base compensation offered for this role is:
Field Adjuster Cons I: $26.49 - 37.50/hour
Field Adjuster Cons II: $28.03 - 39.42/hour
Field Adjuster Sr. Cons I: $35.82 - 45.58/hour
Compensation is based on experience and qualifications. Total compensation for this role may include additional components, such as incentive pay (for example, commission or bonus), if applicable.
Joining our team isn't just a job - it's an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger - a winning team making a meaningful impact.
Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.
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To view the “EEO Know Your Rights” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs.
To view the FMLA poster, click “here”. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.
It is the Company's policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee's ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.
National General Holdings Corp., a member of the Allstate family of companies, is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A- (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Companies & Partners
Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.
Benefits
National General Holdings Corp. is an Equal Opportunity (EO) employer - Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas. In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at **************.
$26.5-37.5 hourly Auto-Apply 5d ago
Claims Adjuster II, Field Property - National Catastrophe ($5000 Sign-on Bonus)
Nationwide Mutual Insurance 4.5
Claims adjuster job in Louisiana
If you're passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide's Property and Casualty team could be the place for you! At Nationwide , “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we're looking for associates who are passionate about delivering extraordinary care.
This is a field-based role on the National Catastrophe Response Team. This position is responsible for managing property claims in response to catastrophic events across the country. As a field-based adjuster, you will be deployed to areas impacted by large-scale disasters-such as hurricanes, tornadoes, floods, or other major events-to assess damages, support policyholders, and help communities begin the recovery process. The role requires extensive travel (up to 80%), often on short notice, and the ability to work in high-pressure, fast-paced environments for extended periods.
You will regularly engage in direct, and at times, emotionally charged conversations with customers-clearly explaining coverage decisions, setting expectations, and delivering difficult news with empathy and professionalism. The ability to remain composed and compassionate in the face of loss, frustration, or uncertainty is essential. Strong communication skills and emotional resilience are critical, as you'll be guiding customers through some of the most challenging moments of their lives.
In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments. You'll also be responsible for full file ownership, maintaining appropriate reserves, managing claim activity (including supplements and requests for depreciation), ensuring compliance with internal standards and regulatory requirements, and providing proactive communication with external customers throughout each stage of the claim. Collaboration with internal teams such as Special Investigations and Subrogation may be required to identify fraud or recovery opportunities. Staying current on industry repair practices, regional pricing trends, and legal developments is key to success. This is a demanding, customer-facing role that requires a unique blend of technical expertise, critical thinking, and emotional intelligence. Candidates should be comfortable working independently in disaster zones, managing a high volume of claims, working 12 hours a day, up to 21 days in a row, and adapting quickly to evolving priorities. If you're driven by purpose, thrive under pressure, and want to make a meaningful impact during times of crisis, this role offers a challenging and deeply rewarding opportunity.
Ideal candidates will have:
Prior insurance field/property claims handling or adjusting experience
Proficiency with Xactimate
Prior estimate writing experience
Ability to handle claims of varying complexity from start to finish
Prior experience working in on site in a catastrophe environment
Ability to carry a ladder and climb a roof
Strong customer service competency
Strong written and verbal communication skills.
A $5000 SIGN-ON BONUS will be given to all external candidates hired into this role. Half of the bonus will be paid after 3 months of employment and the remainder will be paid after 9 months of employment.
Summary
No two property claims are ever the same and each customer has unique needs. Our team thrives on providing the very best service and building lasting, successful relationships with our customers. If you are confident, curious, driven to learn and grow, and have a desire to help people when they most need it, we want to know more about you!
As a National Catastrophe (NATCAT) Field Claims Specialist primarily supporting our Personal Lines (PL) business, you'll investigate and resolve moderate to severe property damage claims by phone.
Job Description
Key Responsibilities:
Handles all assigned claims promptly and effectively, with little to no direction and oversight. Makes decisions within delegated authority as outlined in company policies and procedures.
Determines proper policy coverages and applies appropriate claims practices to resolve cases in alignment with company guidelines.
Opens, closes, and adjusts reserves according to company practices to ensure reserve adequacy. Adheres to file conferencing notification and authority procedures.
Maintains current knowledge of insurance and applicable product/services; court decisions which may impact the claims function; current guidelines; and policy changes and modifications. This may require attending various seminars and training sessions.
Maintains current knowledge of local industry repair procedures and local market pricing.
Submits severe incident reports, reinsurance reports and other information to claims management as needed.
Partners with Special Investigations Unit and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for lawsuit, trial, or subrogation.
Initiates and conducts follow-ups through proficient use of claims and other related business systems.
Delivers outstanding customer service to all internal, external, current, and prospective Nationwide customers. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service.
May perform other responsibilities as assigned.
Reporting Relationships: Reports to Claims Manager. Individual contributor role.
Typical Skills and Experiences:
Education: Undergraduate degree or equivalent experience.
License/Certification/Designation: State licensing where required. Successful completion of required/applicable claims certification training/classes.
Experience: Three to five years of related property claims experience or comparable job-related experience, or education preferred. Experience in a customer service environment, including flexible work schedules and extended work hours preferred. Commercial claims property experience preferred.
Knowledge, Abilities and Skills: General knowledge of insurance theory and practices, and contracts and their application. Property estimating and automated claims systems. Demonstrated knowledge of the investigation, consultation and settlement activities used to resolve extensive property damage claims. Proven ability to meet customer needs and provide exemplary meaningful service by guiding customers through the claims process and ensuring a positive customer experience. Analytical and problem-solving skills necessary to make decisions and resolve issues related to application of coverages to submitted claims, application of laws of jurisdiction to investigation facts, and application of policy exclusions and exceptions. Ability to establish repair requirements and cost estimates for property losses. Ability to evaluate and successfully advise on property claims. Organizational skills to prioritize work. Command of written and verbal communication skills to effectively communicate with policyholders, claimants, repairpersons, attorneys, agents and the general public. Ability to efficiently operate a personal computer and related claims and business software. Able to provide leadership to less experienced claims associates. Must be able to safely access and inspect rooftops using a ladder. Must be prepared and capable of conducting physical inspections on rooftops, including first and second story roofs with pitches up to 8/12.
Other criteria, including leadership skills, competencies and experiences may take precedence.
Staffing exceptions to the above must be approved by the business unit executive and HR Business Partner.
Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors.
Job Conditions:
Overtime Eligibility: Not Eligible (Exempt)
Working Conditions: Normal office or field claims environment. May require ability to sit and operate phone and personal computer for extended periods of time. Able to make physical inspections of property loss sites; including climb ladders, balance at various heights and rooftops up to 8/12 pitch stoop, bend and/or crawl to inspect vehicles and structures; work outside in all types of weather. Must be willing to work irregular hours and to travel with possible overnight requirements. May be on-call. Must be available to work catastrophes (CAT). Extended and/or non-standard hours as required. Must have a valid driver's license with satisfactory driving record in accordance with Nationwide standards.
ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.
Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process.
We currently anticipate accepting applications until 01/29/2026. However, we encourage early submissions, as the posting may close sooner if a strong candidate slate is identified before the deadline.
Benefits
We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage, paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here.
Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law.
#claims Smoke-Free Iowa Statement: Nationwide Mutual Insurance Company, its affiliates and subsidiaries comply with the Iowa Smokefree Air Act. Smoking is prohibited in all enclosed areas on or around company premises as well as company issued vehicles. The company offers designated smoking areas in which smoking is permitted at each individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air Act, individuals may contact the Smokefree Air Act Helpline at ************.
For NY residents please review the following state law information: Notice of Employee Rights, Protections, and Obligations LS740 (ny.gov) *************************************************************
NOTE TO EMPLOYMENT AGENCIES:
We value the partnerships we have built with our preferred vendors. Nationwide does not accept unsolicited resumes from employment agencies. All resumes submitted by employment agencies directly to any Nationwide employee or hiring manager in any form without a signed Nationwide Client Services Agreement on file and search engagement for that position will be deemed unsolicited in nature. No fee will be paid in the event the candidate is subsequently hired as a result of the referral or through other means.
Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. If a Sales job, Sales Incentives, based on performance goals are possible in addition to this range. Note on Compensation for Part-Time Roles: Please be aware that the salary ranges listed below reflect full-time compensation. Actual compensation may be prorated based on the number of hours worked relative to a full-time schedule.The national salary range for Field Claims Specialist II, National Catastrophe Property - Personal Lines : $62,500.00-$115,500.00The expected starting salary range for Field Claims Specialist II, National Catastrophe Property - Personal Lines : $62,500.00 - $93,500.00
$42k-50k yearly est. Auto-Apply 3d ago
Scope Only Adjusters
Elevate Claims Solutions
Claims adjuster job in Baton Rouge, LA
About Us At Elevate Claims Solutions, we are dedicated to supporting the unique skill sets and career goals of our Independent Adjusters. Our commitment to continuous improvement and meaningful work ensures that you can make a real difference in the lives of those you serve.
What We Offer:
Career Development: We prioritize your growth by seeking your feedback on how we can support your professional journey.
Diverse Opportunities: Work with a variety of carriers, allowing you to expand your skills and network.
Clear Expectations: Benefit from guidelines that clearly outline carrier requirements, ensuring you know what to expect.
Continuous Feedback: Engage in real -time Quality Assurance and formal quarterly coaching sessions to refine your skills and highlight strengths.
Expert Guidance: Collaborate with a team of seasoned industry professionals who provide valuable insights and support.
Job Description
Responsibilities:
Evaluate exterior and minor interior property damage.
Draft detailed damage descriptions, including measurements and materials used.
Fill in basic scope sheets.
Utilize Xactanalysis software effectively.
Requirements:
Current, active Xactimate license with experience writing estimates for both residential and commercial damages.
Flexibility to maintain a non -traditional work schedule to accommodate the needs of insureds and carriers.
Strong written and verbal communication skills, with an emphasis on clear and timely communication.
Proficient in various claims management systems and strong technological skills.
Ability to manage workload independently and exercise good judgment.
Openness to receiving and providing constructive feedback.
Background screening eligibility and current active licenses as required.
Join Us
If you're ready to elevate your career in a supportive and dynamic environment, we want to hear from you! Let's work together to make a meaningful impact.
$40k-54k yearly est. 45d ago
Logistics Claims Representative
AFS Logistics 4.1
Claims adjuster job in Shreveport, LA
Job Description
Purpose/Job Function:
The claims associate will support the filing, tracking, and management of claims for all modes supporting a MTS customer. This role will include working closely with the customer at both corporate offices as well as in the field. There will also be frequent communications with carriers to collect documentation as well as status updates. The data collection and analysis produced in this role will be critical in driving continuous improvements to the customer's service performance.
Essential Functions:
File and manage LTL and Parcel freight claims including freight, shortages, overages, and damages.
Deliver reliable service throughout the entire life cycle of each claim, including but not limited to: prompt contact and timely communication throughout the process until the claim is closed, explaining the process, setting expectations, follow-ups and meeting commitments to achieve optimal outcome on every file.
Assist with client and vendor damage claims.
Develop and grow effective relationships with clients, vendors, and internal business partners.
Update and maintain records
Recognize and request appropriate inspection type based on the details of the loss and coordinate the appraisal process.
Maintain oversight of the repair process and ensure appropriate expense handling, manage approvals per guidelines.
Manage and report weekly review of LTL carrier complaints.
Provide reports to support visibility to claims trends and opportunities to reduce issues.
Run reports and data analysis as needed.
Qualifications/Requirements:
Excellent verbal and written communication in order to respond effectively to sensitive inquiries and complaints
Strong data entry and record keeping skills (may include maintaining records in database/s)
Ability to apply principles of logical thinking to a wide range of practical problems
Strong organizational skills with accurate attention to detail
Aptitude to spot trends in shipment data and detail
Proficient in use of Microsoft Office Suite (use of Excel, Word, Outlook)
Education/Experience:
Highschool diploma or GED
Prior data entry experience preferred
Working Conditions/Physical Demands:
The Claims Associate will sit in front of a computer for long hours at a time responding to emails, communicating with clients, teammates and carriers, and entering financial data. Staring at the computer may cause eye irritation or even muscle strain.
The increased repetitive motions and awkward postures attributed to the use of computer keyboards may also result in cumulative trauma disorders (CTDs).
The job as Claims Associate does not require any strenuous or physical activity.
Customary Work Hours: 8:00 A.M. to 5:00 P.M., Monday through Friday
$26k-32k yearly est. 13d ago
Liability Field Adjuster - New Orleans, LA
CCMS & Associates 3.8
Claims adjuster job in New Orleans, LA
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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$43k-58k yearly est. 4d ago
Loss Claims Specialists/ Project Manager
Puroclean 3.7
Claims adjuster job in Shreveport, LA
About the Role PuroClean of Shreveport is seeking a high-character individual to join our team as a Loss Claims Specialist. This is more than a job-it's a leadership role designed for someone who can take full ownership of a project from start to finish and align with our mission of providing empathetic, efficient, and professional restoration services to our community.
As a Loss Claims Specialist, you will serve in a project manager capacity, overseeing the execution of all services related to water damage, mold, biohazard, contents handling, and reconstruction. This role demands strong organizational skills, technical knowledge, and a commitment to both customer care and team collaboration.
Why Join Us
* Profit Sharing Position - your success is our success
* Annual Draw of $50,000 + laptop + software subscriptions
* Be part of a purpose-driven company that values integrity, excellence, and service
* Opportunities for growth and advancement in a fast-paced industry
What You'll Need
* A personal vehicle and reliable transportation
* A working phone
* A desire to learn and align with our SOPs and company goals
* Willingness to take ownership and be accountable for job outcomes
* Ability to manage multiple claims and ensure timely completion of each project
What You'll Do
* Manage restoration projects from intake through completion
* Coordinate and execute all mitigation and reconstruction services:
* Water Damage
* Mold Remediation
* Biohazard Cleanup
* Contents Pack-Out and Cleaning
* Reconstruction/Build-Back
* Estimate, invoice, and track jobs using software including:
* Xactimate
* Estimate
* Time and Materials platforms
* Learn and apply our internal SOPs with consistency and accuracy
* Meet or exceed quarterly performance goals
Preferred (but not required):
* Prior construction or restoration experience
* Familiarity with insurance claims processes or property loss mitigation
Who We're Looking For
We're looking for someone with more than just technical skills. We value character, accountability, and alignment with our company vision. If you take pride in your work, can lead by example, and are looking to grow in an environment that rewards dedication and results-you may be exactly who we're looking for.
$50k yearly 60d+ ago
1099 Experienced Licensed Field Adjuster
Struction Solutions
Claims adjuster job in Mandeville, LA
Struction Solutions, a leading source for commercial and residential claims servicing clients. all over the U.S.
The Field Adjuster will be assigned daily claims.
Local work in the following:
All over the United States.
TX (Houston, Dallas, Austin, San Antonio), entire states of FL, LA, MS, NC, OK, SC, AL, GA, CA, PA and remaining licensing states.
Skill Set:
• Xactimate experience is required.
Prefer 3+ years' experience handling property field claims
• Must have valid state Adjuster Licenses
• Excellent customer service, written and verbal communications skills to effectively manage and prepare reports
“Be a part of the Solutionâ€
View all jobs at this company
$40k-55k yearly est. 60d+ ago
Claims Representative
Louisiana Workers Compensation Corporation
Claims adjuster job in Baton Rouge, LA
Integral part of helping Louisiana thrive through efficient and consistent handling of injured workers claims. Investigating assigned claims through completion. Provides unparalleled customer experience for all our stakeholders. Major Areas of Accountability
General
Participates in a formal training program to develop the knowledge and skills to handle insurance claims involving work-related accidents. Is responsible for the well-being of hundreds of Louisiana employees who are injured.
Examine claims forms and other records to determine insurance coverage.
Interview or correspond with our policyholders, claimants, witnesses, physicians, or other relevant parties to complete investigation.
Investigate facts of loss to determine extent of injury.
Review and understand police reports, medical treatment records, medical bills, and other insurance documents during the duration of the claim.
Adjust reserves or provide reserve recommendations to establish the value of the claim consistent with corporate policies.
Negotiate claim settlement opportunities.
Confer with legal counsel on claims involving litigation.
Takes initiative and manages personal claim caseload in accordance with processes and procedures with a focus on individual, team and departmental goals.
Seeks opportunities for improvement and continued learning
Maintains required LA Workers' Compensation Adjuster License.
Performs other job duties as needed by the department
Personality/Working Style
Strong character
Alignment with company values, mission, and vision
Trustworthy and honest
Decisive
Curious and persistent
Passion for innovation
Willingness to learn
Adaptive to changing (tolerance for ambiguity)
Desire to collaborate to achieve corporate goals
Strong communicator
Effective communication skills
Empathetic listener and open-minded
Commitment to accountability
Education and Experience
Education Required:
Bachelor's degree and a minimum of 2 years handling of workers' compensation claims, or 4 years of experience as an insurance claimsadjuster. OR High School Diploma/GED with 2 years handling of workers' compensation claims and 4 years of experience as an insurance claimsadjuster.
Active Louisiana Workers' Compensation Adjuster License required prior to start or obtained within seven (7) business days after start date.
Skills Required:
Communication, computer literate, math, judgement and problem-solving skills.
$25k-35k yearly est. 60d+ ago
Claims Specialist II
Blue Cross and Blue Shield of Louisiana 4.1
Claims adjuster job in Baton Rouge, LA
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross. Residency in or relocation to Louisiana is preferred for all positions.
**POSITION PURPOSE**
Duties may include the following responsibilities or functions required to support the claims unit. Accurate processing of claims edits, determining primacy for the Coordination of Benefits (COB), adjusting previously paid claims and initiating procedures to recover funds on overpaid claims. Analyzing, investigating, and resolving problem cases; executing recovery processes; and completing special projects. Accountable for complying with all laws and regulations that are associated with duties and responsibilities.
**NATURE AND SCOPE**
+ This role does not manage people
+ This role reports to this job: SUPERVISOR, CLAIMS OPERATIONS
+ Necessary Contacts: In order to effectively fulfill this position, the Claims Specialist II must be in contact with personnel in other Units:Various internal departments and staff including, but not limited to, Provider Services, Legal, Internal Audit, IT, other Benefits Operations Management and staff, Enrollment and Billing, Administrative Services, and District Offices.Various external entities including, but not limited to, Providers, Members, Lawyers, Groups, Commissioner of Insurance, other insurance companies, and other Plans.
**QUALIFICATIONS**
**Education**
+ High School Diploma or equivalent required
**Work Experience**
+ 2 years in medical claims processing required
+ Coordination of Benefits (COB) processing experience preferred
**Skills and Abilities**
+ Strong analytical ability, that includes strong logical, systemic, and investigates thinking.
+ Strong oral and written communication skills and human relations skills are necessary.
+ Working knowledge of relevant PC software.
+ Ability to prioritize multiple streams of work effectively.
**Licenses and Certifications**
+ None Required
**ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS**
+ Reviews, researches, and makes necessary updates to claims that may include the following: recalculation of benefits to previously processed claims, the processing of claims edits, or initiation of refund requests, according to contractual benefits or provider reimbursement rules, ultimately providing a high degree of customer satisfaction.
+ Achieves and maintains a clear understanding of all systems, applications, and procedures necessary to identify denial codes, edits, and processing codes pertaining to all claims (including our coordination with additional coverage plans) in order to process both coordinated and non-coordinated claims correctly. Requesting of medical records may be required.
+ Communicates, both orally and in writing, with internal and external contacts in order to provide necessary and accurate information for the establishment of sound claim records. This may include, but is not limited to, the coordination of benefits (COB), medical record requests, etc.
+ Review quality audits for correction or routing within 48 hours of receipt following departmental and corporate guidelines to ensure accuracy of claims processing and customer satisfaction.
+ Researches, investigates, and determines the correct order of benefits for payment to be made by the applicable plans and makes necessary corrections to COB records. Communicates to appropriate department(s) when Medicare has determined primacy incorrectly and ensures a letter is generated to notify Medicare. Failure to report discrepancy could result in a daily fine up to $1,000.00.
+ Analyzes, investigates, resolves problem cases (to include COB records, adjusting previously processed claims and requesting refund of overpaid claims). Reviews all previously processed claims to ensure consistency in payments to maximize recovery of overpayments following corporate and departmental guidelines to ensure financial stability.
+ Executes procedures to recover funds from providers, subscribers, or beneficiaries where overpayments have occurred to ensure accuracy of claims processing and financial stability.
+ Steps in and assists in any other capacity as deemed necessary (i.e., training, implementations, and documentation).
+ May complete special projects as assigned by Management due to internal audit findings, multiple provider status changes, and system errors following corporate and departmental guidelines to ensure financial stability and customer satisfaction.
**Additional Accountabilities and Essential Functions**
_The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions_
+ Perform other job-related duties as assigned, within your scope of responsibilities.
+ Job duties are performed in a normal and clean office environment with normal noise levels.
+ Work is predominately done while standing or sitting.
+ The ability to comprehend, document, calculate, visualize, and analyze are required.
**An Equal Opportunity Employer**
**All BCBSLA EMPLOYEES please apply through Workday Careers.**
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**Additional Information**
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
_Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._
_Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results._
**JOB CATEGORY:** **Insurance**
$34k-47k yearly est. 2d ago
Hospital Billing & Claims Appeal Specialist
AMG Integrated Healthcare Management
Claims adjuster job in Lafayette, LA
Job Category: Accounting Job Type: Full-Time Facility Type: Corporate Shift Type (Clinical Positions): Day Shift At AMG we offer our employees much more than just a job in the healthcare industry. We offer unique career opportunities for people who are called to make a difference in the lives of others and desire to be part of a team that contributes to making a difference each day for our patients. We invite you to join our team and share your gifts and talents. In addition to market-competitive pay rates and benefits in the Lafayette market, you will have the opportunity to work for an Employee Stock Ownership Plan (ESOP), as AMG is an employee-owned company!
AMG, Integrated Healthcare Management (AMG Corporate) is seeking a Hospital Billing & Claims Appeal Specialist in Lafayette, Louisiana. This position is crossed trained and is responsible for patient account billing, including monthly statement mail out, and electronic billing submissions. Also responsible for fiscal year end cost reporting. Also providing support for the Billing Specialists and the corporate office team in relation to managing incorrect contracted payments with managed care payors to seek resolution and file necessary appeals. The position will be responsible for assisting the billing specialist with obtaining necessary documentation, writing appeals and following up with appeals as requested by the billing team. The candidate must possess strong communication skills, excellent customer services skills, and be able to work collaboratively with a team. This position requires a strong Hospital Billing and Claim Appeals background with experience in the Post-Acute setting and interpretation of payor contracts for appropriate appeal rights. This is not a remote position.
Join our dynamic team and enjoy a career where you can make a difference with AMG Integrated Healthcare Management!
Apply Now
Job Requirements
* Position located in Lafayette, Louisiana.
* Strong knowledge of MS Word and Excel.
* Requires a strong Claim Appeals background with experience in the Post-Acute setting.
* Requires interpretation of payor contracts for appropriate appeal rights.
* Minimum of 2-3 years hospital billing/collections/accounting experience in health care related field.
* A strong background in Long Term Acute Care (LTAC).
* Must be able to diplomatically articulate communications, interpret and explain complex information, and comprehend written, verbal and electronic communication.
* Strong problem-solving skills with effective time management.
* Strong organizational skills to maintain awareness of appeal timelines.
* Self-starter with strong analytical skills and attention to detai
About Us
AMG is a hospital system committed to our patients, our people, and to the pursuit of healing. As a Top-5 Post-Acute hospital system, we're known for excellence, integrity, community, and compassion.
Our mission is to return patients to their optimal level of well-being in the least restrictive medical environment. We accomplish this through a multi-disciplined approach that includes aggressive clinical and therapeutic interventions, as well as family involvement. Our high staff to patient ratio ensures individualized attention. Our nurses, therapists, and physicians work with each patient to obtain the best possible outcomes.
Acadiana Management Group, LLC is an equal opportunity employer.