Injury Adjuster
Claims adjuster job in Phoenix, AZ
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated Injury Adjuster, you will work within defined guidelines and framework, responsible to adjust non-attorney involved soft tissue bodily injury to include confirming coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations. Accountable for delivering a concierge level of best in class member service through setting appropriate expectations, proactive communications, advice, and compassion.
This hybrid role requires an individual to be in the office 3 days per week. This position will be based in Phoenix, AZ. Relocation assistance is not available for this position.
What you'll do:
Identifies and handles existing and emerging risks that stem from business activities and the job role.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.
Follows written risk and compliance policies, standards, and procedures for business activities.
Adjusts non-attorney involved soft tissue bodily injury claims, as well as all auto physical damage associated with those claims.
Identifies, confirms, and makes coverage decisions on soft tissue claims.
Investigates loss details, determines legal liability, evaluates, negotiates, and arrives at claim settlement within appropriate authority guidelines.
Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.
Provides advice and sets expectations into next steps to members.
Collaborates and supports team members to resolve issues and identify appropriate matters for escalation.
Partners and/or directs vendors and internal business partners to facilitate timely claims resolution.
Supports workload surges and/or Catastrophe Operations as needed.
What you have:
High School Diploma or General Equivalency Diploma.
1 year of injury adjusting or auto liability adjusting experience to include highly complex vehicle physical damage, such as multi-vehicle, non-owned vehicles, or total loss claims.
Working knowledge and understanding of the auto claims contract as well as application of case and state laws and regulations.
Acquisition and maintenance of insurance adjuster license within 90 days and designated number of attempts.
What sets you apart:
2+ years Auto Liability/Casualty adjusting experience to include complex/multi vehicle liability.
1 year auto physical damage or total loss experience.
Ongoing Professional Development with a focus on Insurance.
Bachelors' Degree or higher.
US military experience through military service or a military spouse/domestic partner.
Compensation Range: The salary range for this position is: $57,970 - $103,870.
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Auto-ApplyClaims Representative - Glendale, AZ
Claims adjuster job in Glendale, AZ
Who is Federated Insurance?
At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own.
Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values.
What Will You Do?
Customer-focused, source of knowledge and comfort, desire to help, professional - Does that sound like you? We are seeking someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss.
No previous insurance or claims experience needed! Federated provides an exceptional training program to teach you the fundamentals of claims and will prepare you to assist clients.
This is an in-office position that will work out of our Glendale, AZ office, located at 5701 W. Talavi Blvd. A work from home option is not available.
Responsibilities
Work with policyholders, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair and courteous way.
Explain policy coverage to policyholders and third parties.
Complete thorough investigations and document facts relating to claims.
Determine the value of damaged items or accurately pay medical and wage loss benefits.
Negotiate settlements with policyholders and third parties.
Resolve claims, which may include paying, settling, or denying claims, defending policyholders in court, compromising or recovering outstanding dollars.
Minimum Qualifications
Current pursuing, or have obtained a four-year degree
Experience in a customer service role in industries such as retail, hospitality, logistics, banking, automotive dealerships, vehicle rental, sales or similar fields
Ability to make confident decisions based on available information
Strong analytical, computer, and time management skills
Excellent written and verbal communication skills
Leadership experience is a plus
Salary Range: $63,800 - $78,000
Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information can be discussed with a with a member of the Recruiting team.
What We Offer
We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You.
Employment Practices
All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization.
If California Resident, please review Federated's enhanced Privacy Policy.
Auto-ApplyRisk Claims Supervisor
Claims adjuster job in Phoenix, AZ
As a key member of the Risk Operations team, you#ll lead and support our Risk Specialists while overseeing the management of complex claims data. In this role, you#ll guide investigations and coordinate liability, Workers# Compensation, and property claims to help protect Valleywise Health and the communities we serve. # You#ll work closely with leaders across the organization to ensure effective remediation plans are in place, supervise the collection and analysis of claims data, and play a critical role in insurance renewals and the actuarial process. Because information is often incomplete or difficult to obtain, this position requires strong problem-solving, research, and decision-making skills. # Reporting to the Risk Operations Manager, you#ll bring structure and clarity to complex issues while empowering your team to deliver accurate insights and effective solutions that shape our risk management strategies. # Annual Salary Range: $79,913.60 - $117,873.60 # Qualifications Education: Requires a bachelor#s degree in insurance, Risk Management, Public Administration, Business Administration, Finance, Management, or a closely related field, or an equivalent combination of training and progressively responsible experience that will result in the required specialized knowledge and abilities to perform the assigned work. Experience: Must have three (3) years of Claim Supervisor experience. Preference given for technical training in claims or insurance policies and demonstrated supervisory experience. Knowledge, Skills, and Abilities: Must possess demonstrated experience and expertise in liability and property claims adjusting or auditing. Strong supervisory, organizational, and critical thinking skills, as well as a highly professional attitude and demeanor. Must be self-directed with good time management skills and strong interpersonal skills that will result in working effectively with diverse individuals and groups. Must have the ability to exercise sound judgment and initiative within established guidelines, meet deadlines, and simultaneously handle numerous projects. Will need to be able to work independently and as a team member to attain goals and resolutions through collaboration and negotiation. Must continually strive to improve processes, assigned functions, and functions performed by assigned staff. Requires the ability to read, write and speak effectively in English. #CRP
As a key member of the Risk Operations team, you'll lead and support our Risk Specialists while overseeing the management of complex claims data. In this role, you'll guide investigations and coordinate liability, Workers' Compensation, and property claims to help protect Valleywise Health and the communities we serve.
You'll work closely with leaders across the organization to ensure effective remediation plans are in place, supervise the collection and analysis of claims data, and play a critical role in insurance renewals and the actuarial process. Because information is often incomplete or difficult to obtain, this position requires strong problem-solving, research, and decision-making skills.
Reporting to the Risk Operations Manager, you'll bring structure and clarity to complex issues while empowering your team to deliver accurate insights and effective solutions that shape our risk management strategies.
Annual Salary Range: $79,913.60 - $117,873.60
Qualifications
Education:
* Requires a bachelor's degree in insurance, Risk Management, Public Administration, Business Administration, Finance, Management, or a closely related field, or an equivalent combination of training and progressively responsible experience that will result in the required specialized knowledge and abilities to perform the assigned work.
Experience:
* Must have three (3) years of Claim Supervisor experience.
* Preference given for technical training in claims or insurance policies and demonstrated supervisory experience.
Knowledge, Skills, and Abilities:
* Must possess demonstrated experience and expertise in liability and property claims adjusting or auditing.
* Strong supervisory, organizational, and critical thinking skills, as well as a highly professional attitude and demeanor.
* Must be self-directed with good time management skills and strong interpersonal skills that will result in working effectively with diverse individuals and groups.
* Must have the ability to exercise sound judgment and initiative within established guidelines, meet deadlines, and simultaneously handle numerous projects.
* Will need to be able to work independently and as a team member to attain goals and resolutions through collaboration and negotiation.
* Must continually strive to improve processes, assigned functions, and functions performed by assigned staff.
* Requires the ability to read, write and speak effectively in English.
#CRP
Senior Claim Adjuster
Claims adjuster job in Scottsdale, AZ
Atlantic Casualty Insurance Company (ACIC) is a recognized Excess and Surplus Lines carrier and proud affiliate of the Auto-Owners Insurance Group since 2016. With authority in all 50 states and Washington, D.C., ACIC provides innovative insurance solutions while maintaining a strong financial foundation, reflected in our A.M. Best rating of A+ (Superior).
Our strength comes from our people. For six consecutive years, we've been certified a Great Place to Work and consistently ranked among Fortune's “100 Best Small and Medium Workplaces”. At ACIC, we foster a culture where everyone belongs. We're a team-supporting one another through leadership development, mentorship programs, career certifications, and comprehensive benefits.
Our benefits include:
Health, Dental & Vision plans (HSA & PPO options)
401(k) with company match + financial advisor access
Tuition reimbursement & student loan assistance
Paid parental leave
Counseling and mental wellness support
Flexible work and in-office schedules
Whether you're just starting your career or looking to grow it, Atlantic Casualty is where talent thrives, and teamwork drives success.
Please visit our Careers Page for more information on the benefits and programs you will enjoy by joining the team at Atlantic Casualty Insurance Company.
************************************************
SUMMARY:
The Senior Claims Adjuster will be capable of independently handling claims in states where ACIC writes business. The Senior Claims Adjuster will have a higher authority level than an adjuster and will have full responsibility for claims within that authority. This position has the authority to assign a local independent appraiser / adjuster for fieldwork in the state where the loss occurred. In those cases, they are responsible for controlling the work done by the I/A.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Analyze, review, and interpret policies to assess coverage and liability.
Establish and maintain proper loss and expense reserves on their claims.
Determine what investigation is necessary on more complicated claims in order to bring a claim to an equitable conclusion for all parties involved.
Responsible for controlling the work done by the independent adjuster/appraiser.
Properly document information in the claim file.
Verify and review damages.
Determine applicability of coverage and liability.
Maintain working diary of assigned claims.
Evaluate and settle claims within assigned authority.
Return all phone calls promptly.
Provide excellent customer service.
Recognize and investigate subrogation.
Handle total losses and process salvage returns.
Daily contact with adjusters and/or insureds and/or claimants and/or attorney and/or vendors and/or agents.
Weekly contact with other department managers.
Deal with and have access to information that is important and must be kept confidential.
Handle claims in litigation as assigned.
Assist in training less experienced adjusters.
Perform other similar or related duties as assigned.
REQUIRED EDUCATION/EXPERIENCE:
A four-year degree from an accredited institution or equivalent experience.
5 years' experience handling claims, including advanced skills in coverage, investigation, litigation, negotiation, damage/injury evaluation, salvage and subrogation.
Knowledge of and adherence to the state laws and regulations governing the handling of property and casualty claims.
Basic understanding of claims, mathematics, construction, auto physical damage, medical terms and legal issues.
State adjuster's license where domiciled.
Non-resident adjuster's license where required in the states where we do business.
Be able to demonstrate time management skills; communication skills, verbal and written; strong computer skills.
MENTAL REQUIREMENTS :
Must be able to clearly define systems and operational problems and draw valid conclusions and recommendations as to how to resolve. Must possess ability to interpret and delegate an extensive variety of instructions in written or diagram form. Reasoning; dealing with problems involving a few variables in standard situations. Must also be able interact on personnel matters in a secure and confidential manner.
PHYSICAL REQUIREMENTS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle controls and talk or hear. The employee frequently is required to sit and reach with hands and arms. The employee is occasionally required to stand and walk. The employee may infrequently lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate. Works primarily indoors.
TRAVEL: 5%
Auto-ApplyRisk Claims Supervisor
Claims adjuster job in Phoenix, AZ
As a key member of the Risk Operations team, you'll lead and support our Risk Specialists while overseeing the management of complex claims data. In this role, you'll guide investigations and coordinate liability, Workers' Compensation, and property claims to help protect Valleywise Health and the communities we serve.
You'll work closely with leaders across the organization to ensure effective remediation plans are in place, supervise the collection and analysis of claims data, and play a critical role in insurance renewals and the actuarial process. Because information is often incomplete or difficult to obtain, this position requires strong problem-solving, research, and decision-making skills.
Reporting to the Risk Operations Manager, you'll bring structure and clarity to complex issues while empowering your team to deliver accurate insights and effective solutions that shape our risk management strategies.
Annual Salary Range: $79,913.60 - $117,873.60
Qualifications
Education:
* Requires a bachelor's degree in insurance, Risk Management, Public Administration, Business Administration, Finance, Management, or a closely related field, or an equivalent combination of training and progressively responsible experience that will result in the required specialized knowledge and abilities to perform the assigned work.
Experience:
* Must have three (3) years of Claim Supervisor experience.
* Preference given for technical training in claims or insurance policies and demonstrated supervisory experience.
Knowledge, Skills, and Abilities:
* Must possess demonstrated experience and expertise in liability and property claims adjusting or auditing.
* Strong supervisory, organizational, and critical thinking skills, as well as a highly professional attitude and demeanor.
* Must be self-directed with good time management skills and strong interpersonal skills that will result in working effectively with diverse individuals and groups.
* Must have the ability to exercise sound judgment and initiative within established guidelines, meet deadlines, and simultaneously handle numerous projects.
* Will need to be able to work independently and as a team member to attain goals and resolutions through collaboration and negotiation.
* Must continually strive to improve processes, assigned functions, and functions performed by assigned staff.
* Requires the ability to read, write and speak effectively in English.
#CRP
Share:
Apply Now
Field Claims Adjuster
Claims adjuster job in Phoenix, AZ
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
Independent Insurance Claims Adjuster in Temple, Arizona
Claims adjuster job in Phoenix, AZ
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
Auto-ApplySenior Liability Adjuster
Claims adjuster job in Scottsdale, AZ
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
Competitive compensation
Healthcare benefits package that begins on first day of employment
401K retirement plan with company match
Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
Up to 6 weeks of parental and bonding leave
Hybrid work schedule (3 days in the office, 2 days from home)
Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
Tuition reimbursement after 6 months of employment
Numerous opportunities for continued training and career advancement
And much more!
Responsibilities
The Senior Liability Adjuster is responsible for conducting office investigations and adjusting commercial general liability claims that are largely litigated and exposures up to and over policy limits within our Major Case Unit. The Adjuster is also responsible for, but not limited to:
Handling large and catastrophic losses
Analyzing construction and other contracts
Analyzing policies of insurance
Addressing risk transfer strategies and priority of coverage
Proactive approach towards negotiating claims towards resolution
Investigating losses and identifying coverage issues
Analyzing coverage and identifying covered and uncovered claims
Assigning panel counsel to defend our insured(s)
Working with counsel to develop litigation plan to resolve underlying claim
Obtaining and reviewing evidence, reports, and medical records
Establishing indemnity and expense reserves
Processing payments
Taking statements from insured's, claimants, and witnesses
Qualifications
At least 10 years of prior experience adjusting commercial general liability (CGL) and businessowners' policies (BOP) liability claims
Bachelor's degree required, Attorney license preferred
Able to understand coverage
Ability to analyze policies of insurance and relevant contracts to address priority of coverage and explore risk transfer strategies
Excellent written and verbal communication skills
Strong organizational and computer skills
Excellent time management skills with the ability to prioritize
Able to occasionally travel to hearings, mediations, trials, and conferences
Auto-ApplyWork Comp Claims Adjuster Temporary Assignment
Claims adjuster job in Glendale, AZ
Workers Compensation Claims Adjuster - Temporary Assignment MUST Reside in California & MUST have California Workers Compensation Claims Experience. Workers' Compensation Claims Adjuster - Assist a Dynamic Team in Glendale We're seeking an experienced and motivated Workers' Compensation Claims Adjuster to assist our team in Rocklin. As a Claims Adjuster , you'll work within a team of 7, including 5 Claims Adjusters and 2 Claims to ensure exceptional claim handling and adherence to company standards and regulations.
Our Offer:
Competitive salary and benefits package, including medical, dental, vision, and 401(k)
Opportunity for professional growth and advancement in a dynamic organization
Collaborative work environment with a team dedicated to workers' compensation excellence
Our Mission:
To be the leading third party administrator offering professional and technological resources through pro-active and aggressive claims and managed care solutions in support of our clients' objectives.
Innovative processes and state-of-the-art technology support our people. Competent and experienced individuals provide the human element needed to deliver good service and drives good outcomes.
Our Goal:
To be recognized as the most trusted and innovative partner in providing Claims and Managed Care solutions that are tailored to the specific needs of our clients.
Your Impact:
Provide ongoing coaching, counseling, and feedback to team members to enhance skills and performance
Ensure all claims are handled in accordance with relevant statutes and company guidelines
Address personnel issues promptly and decisively, keeping management informed of corrective action
Foster a collaborative and productive team environment focused on excellence in claim resolution
Our Offer:
Competitive salary and benefits package, including medical, dental, vision, and 401(k)
Opportunity for professional growth and advancement in a dynamic organization
Collaborative work environment with a team dedicated to workers' compensation excellence
Interested? Get in Touch:
To learn more about this exciting opportunity and what Intercare has to offer, please do one of the following:
Apply to this posting
Call me directly at ************
Email [email protected]
We look forward to hearing from you!
“Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.”
Auto-ApplyESIS Claims Representative, WC
Claims adjuster job in Phoenix, AZ
Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!
MAJOR DUTIES & RESPONSIBILITIES:
The ESIS Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines.
Duties may include but are not limited to:
Claims Management: Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies.
Communication: Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.
Investigation: Conduct thorough investigations of claims, including gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability.
Decision-Making: Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on the facts of the case and applicable laws.
Documentation: Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system.
Cost Control: Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while ensuring appropriate reserves are established and maintained.
Compliance: Ensure adherence to state-specific workers' compensation laws, regulations, and reporting requirements.
Customer Service: Provide exceptional service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status.
Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal claim outcomes.
Experience: Minimum of 2-3 years of experience handling workers' compensation claims; prior experience with ESIS or similar third-party administrators is a plus.
Licensing: Knowledge of California Workers Compensation and active adjuster license or ability to obtain licensure within a specified timeframe.
Skills:
Strong analytical and problem-solving abilities.
Excellent verbal and written communication skills.
Proficiency in claims management systems and Microsoft Office Suite.
Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
Knowledge: Familiarity with California workers' compensation laws, medical terminology, and claim handling best practices.
An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.
The pay range for the role is $60,700 to $93,000. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.
ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS' innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients' unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.
Auto-ApplyPatient Claims Specialist - Bilingual Only
Claims adjuster job in Phoenix, AZ
We are united in our mission to make a positive impact on healthcare. Join Us!
South Florida Business Journal, Best Places to Work 2024
Inc. 5000 Fastest-Growing Private Companies in America 2024
2024 Black Book Awards, ranked #1 EHR in 11 Specialties
2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold)
2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara)
Who we are:
We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany.
ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine!
Your Role:
Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections
Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates
Input and update patient account information and document calls into the Practice Management system
Special Projects: Other duties as required to support and enhance our customer/patient-facing activities
Skills & Requirements:
High School Diploma or GED required
Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST
Minimum of 1-2 years of previous healthcare administration or related experience required
Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs)
Manage/ field 60+ inbound calls per day
Bilingual is required (Spanish & English)
Proficient knowledge of business software applications such as Excel, Word, and PowerPoint
Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone
Ability and openness to learn new things
Ability to work effectively within a team in order to create a positive environment
Ability to remain calm in a demanding call center environment
Professional demeanor required
Ability to effectively manage time and competing priorities
#LI-SM2
ModMed Benefits Highlight:
At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits:
India
Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk,
Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees,
Allowances: Annual wellness allowance to support your well-being and productivity,
Earned, casual, and sick leaves to maintain a healthy work-life balance,
Bereavement leave for difficult times and extended medical leave options,
Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave,
Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind.
United States
Comprehensive medical, dental, and vision benefits
401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
Generous Paid Time Off and Paid Parental Leave programs,
Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,
Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.
PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.
Auto-ApplyComplex Liability Adjuster - CGL & BOP Specialist
Claims adjuster job in Scottsdale, AZ
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
Competitive compensation
Healthcare benefits package that begins on first day of employment
401K retirement plan with company match
Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
Up to 6 weeks of parental and bonding leave
Hybrid work schedule (3 days in the office, 2 days from home)
Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
Tuition reimbursement after 6 months of employment
Numerous opportunities for continued training and career advancement
And much more!
Responsibilities
Are you an experienced professional with a sharp eye for detail and a strong background in litigation? Join our team as a Complex Liability Adjuster, where you'll play a crucial role in managing Commercial General Liability (CGL) and Business Owners Policy (BOP) claims with precision and expertise. We're looking for someone who thrives in high-stakes environments, communicates with confidence, and knows how to navigate the legal landscape with precision.
Key Responsibilities:
Conduct thorough investigations of losses, identifying coverage issues and ensuring accurate assessments.
Review and analyze evidence, reports, and medical records to establish damages and reserves.
Interview insureds, claimants, and witnesses to gather essential information and build strong cases.
Collaborate with legal teams to navigate complex litigation processes and defend our insureds effectively.
Manage litigated claims involving CGL and BOP policies, including coordination with defense counsel, litigation strategy development, and resolution planning.
Process payments efficiently, ensuring timely resolution of claims.
Qualifications
Prior experience adjusting Commercial General Liability claims with a proven track record in litigation is required.
Juris Doctorate (JD) preferred, reflecting the value we place on strong legal acumen in managing complex liability claims.
Licensing: Active TX All Lines License, or willingness to obtain one at company's expense.
Exceptional written and verbal communication skills.
Strong organizational and computer skills.
Excellent time management skills with the ability to prioritize tasks effectively.
Auto-ApplySubrogation Adjuster
Claims adjuster job in Phoenix, AZ
Individuals in this role will be responsible for the identification and collection of subrogation recoveries including first party U-Haul equipment damages, third party auto liability damages, commercial general liability damages.
Desired Experience:
Collections and or Adjusting experience.
Heavy phone work required, candidate must possess excellent customer service skills including excellent verbal and written communication abilities.
Must be highly organized and self-motivated.
Follow the structured policy and procedures of subrogation.
Track and monitor payments and payment arrangements.
All other duties as required that ensures compliance with state Department of Insurance (DOI) regulations.
Schedule: Monday-Friday
U-Haul/Repwest Offers:
Full Medical Coverage
Prescription Plans
Dental& Vision Plans
New indoor fitness gym
Gym Reimbursement program
Registered Dietitian Program
Weight Watchers
Onsite Medical clinic for you and your family
Career Stability
Opportunities for advancement
Valuable on-the-job training
Tuition Reimbursement program
Free online courses for personal and professional development at U-Haul University
Business and travel insurance
You Matter Employee Assistance Program
Paid holidays, vacation and sick days
Employee Stock Ownership Plan (ESOP)
401 (k) Savings Plan
Life Insurance
Critical Illness/Group Accident
24-hour physician available for kids
Subsidized gym/membership
Metlaw Legal Program
Metlife auto and home insurance
Mindset App Program
Discounts on Cell Phone plans, hotels and more
Lifelock Identity Theft
Savvy consumer wellness programs-from health care tips to financial wellness
Dave Ramsey's SmartDollar Program
U-Haul Federal Credit Union
Wellness Program
#LI-MM1
U-Haul Holding Company, and its family of companies including U-Haul International, Inc. (“U-Haul”), continually strives to create a culture of health and wellness. Consistent with applicable state law, U-Haul will not hire or re-hire individuals who use nicotine products. The states in which U-Haul will decline to hire nicotine users are: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Pennsylvania, Texas, Utah, Vermont, Virginia, and Washington. U-Haul has observed this hiring practice since February 1, 2020 as part of our commitment to a healthy work environment for our team.
U-Haul is an equal opportunity employer. All applicants for employment will be considered without regard to race, color, religion, sex, national origin, physical or mental disability, veteran status, or any other basis protected by applicable federal, provincial, state or local law. Individual accommodations are available on requests for applicants taking part in all aspects of the selection process. Information obtained during this process will only be shared on a need to know basis.
Auto-ApplyProduct Liability Litigation Adjuster
Claims adjuster job in Phoenix, AZ
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.
Field Claims Representative
Claims adjuster job in Mesa, AZ
Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated and experienced field claims professional to join our team. This job handles insurance claims in the field under general supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job requires mastery of claims-handling skills and requires the person to:
Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability
Handle multi-line property and casualty claims in an assigned territory with an emphasis on property claims
Become familiar with insurance coverage by studying insurance policies, endorsements and forms
Work toward the resolution of claims, and attend arbitrations, mediations, depositions, or trials as necessary
Ensure that claims payments are issued in a timely and accurate manner
Handle investigations by phone, mail and on-site investigations
Desired Skills & Experience
Bachelor's degree or direct equivalent experience handling property and casualty claims
A minimum of 3 years handling multi-line property and casualty claims with an emphasis on property claims
Field claims handling experience is preferred but not required
Knowledge of Xactimate software is preferred but not required
Above average communication skills (written and verbal)
Ability to resolve complex issues
Organize and interpret data
Ability to handle multiple assignments
Ability to effectively deal with a diverse group individuals
Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents)
Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage
Benefits
Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.
*Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
#LI-DNI #IN-DNI
Auto-ApplySenior Claim Adjuster
Claims adjuster job in Scottsdale, AZ
Atlantic Casualty Insurance Company (ACIC) is a recognized Excess and Surplus Lines carrier and proud affiliate of the Auto-Owners Insurance Group since 2016. With authority in all 50 states and Washington, D.C., ACIC provides innovative insurance solutions while maintaining a strong financial foundation, reflected in our A.M. Best rating of A+ (Superior).
Our strength comes from our people. For six consecutive years, we've been certified a Great Place to Work and consistently ranked among Fortune's “100 Best Small and Medium Workplaces”. At ACIC, we foster a culture where everyone belongs. We're a team-supporting one another through leadership development, mentorship programs, career certifications, and comprehensive benefits.
Our benefits include:
Health, Dental & Vision plans (HSA & PPO options)
401(k) with company match + financial advisor access
Tuition reimbursement & student loan assistance
Paid parental leave
Counseling and mental wellness support
Flexible work and in-office schedules
Whether you're just starting your career or looking to grow it, Atlantic Casualty is where talent thrives, and teamwork drives success.
Please visit our Careers Page for more information on the benefits and programs you will enjoy by joining the team at Atlantic Casualty Insurance Company.
************************************************
SUMMARY:
The Senior Claims Adjuster will be capable of independently handling claims in states where ACIC writes business. The Senior Claims Adjuster will have a higher authority level than an adjuster and will have full responsibility for claims within that authority. This position has the authority to assign a local independent appraiser / adjuster for fieldwork in the state where the loss occurred. In those cases, they are responsible for controlling the work done by the I/A.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Analyze, review, and interpret policies to assess coverage and liability.
Establish and maintain proper loss and expense reserves on their claims.
Determine what investigation is necessary on more complicated claims in order to bring a claim to an equitable conclusion for all parties involved.
Responsible for controlling the work done by the independent adjuster/appraiser.
Properly document information in the claim file.
Verify and review damages.
Determine applicability of coverage and liability.
Maintain working diary of assigned claims.
Evaluate and settle claims within assigned authority.
Return all phone calls promptly.
Provide excellent customer service.
Recognize and investigate subrogation.
Handle total losses and process salvage returns.
Daily contact with adjusters and/or insureds and/or claimants and/or attorney and/or vendors and/or agents.
Weekly contact with other department managers.
Deal with and have access to information that is important and must be kept confidential.
Handle claims in litigation as assigned.
Assist in training less experienced adjusters.
Perform other similar or related duties as assigned.
REQUIRED EDUCATION/EXPERIENCE:
A four-year degree from an accredited institution or equivalent experience.
5 years' experience handling claims, including advanced skills in coverage, investigation, litigation, negotiation, damage/injury evaluation, salvage and subrogation.
Knowledge of and adherence to the state laws and regulations governing the handling of property and casualty claims.
Basic understanding of claims, mathematics, construction, auto physical damage, medical terms and legal issues.
State adjuster's license where domiciled.
Non-resident adjuster's license where required in the states where we do business.
Be able to demonstrate time management skills; communication skills, verbal and written; strong computer skills.
MENTAL REQUIREMENTS :
Must be able to clearly define systems and operational problems and draw valid conclusions and recommendations as to how to resolve. Must possess ability to interpret and delegate an extensive variety of instructions in written or diagram form. Reasoning; dealing with problems involving a few variables in standard situations. Must also be able interact on personnel matters in a secure and confidential manner.
PHYSICAL REQUIREMENTS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle controls and talk or hear. The employee frequently is required to sit and reach with hands and arms. The employee is occasionally required to stand and walk. The employee may infrequently lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate. Works primarily indoors.
TRAVEL: 5%
Auto-ApplyPharmacy Claims Representative 2
Claims adjuster job in Mesa, AZ
Essential Functions
Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent's performance objectives as outlined by the incumbent's immediate supervisor or manager.
1. Assist pharmacies with real-time and retrospective claims adjudication. Adjust and correct authorizations in dispensing and PBM systems to ensure timely claims submission. Research and resolve rejected claims by contacting hospices for approvals or updated authorizations.
2. Maintain accuracy of patient profiles, involving authorization status and relatedness indicators.
3. Evaluate and process compound medication claims, ensuring accuracy in ingredients, quantities, and pricing.
4. Research pharmacy invoices and hospice billing issues, reconciling discrepancies as needed.
5. Collaborate with the Customer Service team on complex claims research and resolution.
6. Understand Enclara Pharmacia's standard and custom formularies and differentiate between Per Diem (PD) and Fee-for-Service (FFS) billing models across hospice partners.
7. Contact facilities and pharmacies to verify and collect necessary information for onboarding spreadsheets. Coordinate PBM and billing system verification with facility pharmacies. Maintain and update facility-pharmacy tracking spreadsheets and communicate status with implementation teams.
8. Educate facility pharmacies on billing procedures and contacts for rejected claims.
9. Collect and verify missing or incomplete facility information reported by the Call Center team. Ensure all facilities are correctly linked to their respective hospices in internal systems. Assist with Confirmation Fax reports to validate and update facility-pharmacy relationships and demographics.
10. Complete tasks and special projects assigned by Pharmacy Claims Team Leaders on Pharmacy Claims (Support Services) Manager.
11. Support Call Center leadership in initiatives to streamline processes and improve service outcomes.
Marginal or Additional Functions
1. Performs other duties as assigned or apparent.
Supervisory and Managerial Responsibility
• Supervisory/managerial responsibility is not applicable
Knowledge, Skills & Abilities
Education, Licensure or Certification:
• High school diploma or equivalent required
• CPhT or EXCPT certification required
Work Experience or Related Experience:
• Minimum of six (6) months of pharmacy technician experience.
• Experience with pharmacy claims adjudication is required.
Specialized Knowledge, Skills & Abilities:
• PBM or billing platform experience preferred
• Proficient in Microsoft Office Suite, especially Excel, Word, Outlook, and Access
• Comfortable navigating multiple software systems, including pharmacy dispensing and PBM platforms
• Excellent verbal and written communication skills
• Ability to learn proprietary systems used for claims management and facility tracking.
Equipment
• Working knowledge of a PC, business and communications software (MS Office) and web-based tools are required
Travel Requirements and Conditions
• Travel is not required
Work Environment, Conditions and Demands
• Work is generally performed in a climate-controlled, smoke-free office environment.
Physical Requirements and Demands
• May sit, stand, walk, stoop, or bend intermittently throughout the day.
• May be required to sit for extended periods (7-10 hours/day).
• Occasional lifting of up to 25 pounds may be required.
• Requires manual dexterity to operate office equipment.
• Visual acuity to read fine print and digital screens; must be able to hear and respond to verbal communication.
Additional Position Information
• No additional information is applicable
Specialty Loss Adjuster
Claims adjuster job in Phoenix, AZ
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**
General Liability Claim Representative
Claims adjuster job in Scottsdale, AZ
Claims Representative - CH09CN Associate Claim Representative - CH10DN We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too. Join our team as we help shape the future.
As a General Liability Associate Claims Representative for all business lines, you're at the front lines for our customer. Your primary role is to investigate and manage claim files to help individuals and businesses prevail after a claim. The Hartford will provide you with a robust training and onboarding program, as well as ongoing coaching and development to ensure your success.
Start Date: February 16, 2026
Hours: 8am-5pm, Core Business hours to support either our Eastern or Western region, limited flexibility.
Virtual Training: 8 weeks, core business hours, your local time
This role will have a Hybrid work arrangement, with the expectation of working in an office location : (Hartford, CT / San Antonio, TX / Aurora (Naperville) IL/ Lake Mary, FL/ Scottsdale, AZ ) 3 days a week (Tuesday through Thursday).
Responsibilities:
* Utilize active listening and critical thinking skills to quickly analyze customer needs
* Leverage knowledge and resources to provide the appropriate solutions to requests
* Take ownership to ensure that we go above and beyond in providing customer service
* Utilize every touch point as an opportunity to build value and The Hartford brand
* Commit to learning and developing
* Develop an in depth understanding of Hartford products and business lines
* Act as a liaison with other departments to resolve problems
* Secure essential facts about losses
* Negotiate settlements
* Interpret, understand and explain coverage to policyholders
* Efficiently update and move files to closure
* Manage pending claims to meet company quality criteria
* Ensure payments are processed timely as needed or input payments within authority
* Special assignments or projects as assigned
* May be required to assist in catastrophe situations
* Develop proficiency and capabilities expected during new hire ramp-up period
* Must demonstrate strong customer service focus
* Ability to operate, lead and coach within The Hartford Way management system
Qualifications:
* High School Diploma required; college degree preferred
* Minimum of 1 year of related customer service experience or applicable insurance experience
* Excellent oral, written and interpersonal communication
* Demonstrated capacity to multi-task in a structured work environment
* Ability to utilize multiple systems to handle/process claims
* Problem solving and critical thinking skills are a must
* Strong attention to detail
Additional Information:
* As a condition of your employment, you must obtain and maintain a State Adjuster's License to process Property & Casualty Insurance Claims in the states supported by your office. Continued employment with The Hartford is contingent upon the successful passage of the Licensing exam(s) within 30 business days from the completion of the licensing training.
Compensation
The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford's total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:
$45,280 - $79,320
The posted salary range reflects our ability to hire at different position titles and levels depending on background and experience.
Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age
About Us | Our Culture | What It's Like to Work Here | Perks & Benefits
Auto-ApplyField Property Claims Adjuster
Claims adjuster job in Phoenix, AZ
Join us as a Field Property Claims Adjuster where you'll be responsible for helping our customers navigate the claims process and get back on their feet following damage to the homeowner's property. This is a role where people who love every day to be new, different and exciting, can thrive - you'll be traveling on the road to meet customers in person, providing hands-on assessment of damage and empathetic support.
The Field Property Claims Adjuster will be traveling locally to insured homes within Phoenix, AZ (85041) and surrounding areas. To be successful within the role, candidates should live within or near this area.
Sign-On Bonus Available! We're offering a sign-on bonus for experienced and actively licensed new hires.
What you'll do
* Investigate and evaluate onsite to resolve complex coverage and damage issues to include preparing complete estimates of repair for the covered damages. This may include accessing roofs by ladder, inspecting attics, crawl spaces and basements in search of damage.
* Handle moderate to complex claims independently while managing your workload, from first notice of loss to final closure.
* Be expected to work in a vehicle in the field daily while occasionally handling assignments from the desk.
* Explain coverage of loss, assist policyholders with itemization of damages, emergency repairs and additional living arrangements.
* Work with and coordinate a few vendor services such as contractors, emergency repair, cleaning services and various replacement services.
* May be called upon for catastrophe duty.
Position details
* Territory-based work: Most workdays will be spent in the field within your assigned local territory, giving you the opportunity to work directly with customers and gain hands-on experience.
* Training & support: To set you up for success, you'll participate in a comprehensive 5-month training program, which includes:
* Primarily virtual and on-the-job learning.
* Two short in-person training sessions (Weeks 4 and 7) at our Lewisville, TX office.
* Limited overnight travel for training and team meetings (typically less than 10%).
* Mileage Reimbursement: This role offers mileage reimbursement. You may qualify for a company-provided vehicle once mileage requirements are met. Additional details will be provided if you advance in the selection process.
Qualifications
* Working knowledge of claims handling procedures and operations.
* Proven ability to provide exceptional customer service.
* Effective negotiation skills.
* Ability to effectively and independently manage workload while exhibiting good judgment.
* Strong written/oral communication and interpersonal skills.
* Computer skills with the ability to work with multi-faceted systems.
* The capabilities, skills and knowledge required through a bachelor's degree or equivalent experience and at least 1 year of directly related experience.
* Ability to obtain proper licensing as required.
* The ability to handle multiple competing priorities and organize your day.
* Strong time management and organizational skills.
* Demonstrated understanding of building construction principles.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in
every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive
benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
Auto-Apply