Senior Claims Representative, Bodily Injury
Claims adjuster job in Parsippany-Troy Hills, NJ
The Casualty Claim Representative will be responsible for the handling of First- and Third-Party Bodily Injury claims in a Personal Lines/Commercial environment for the Plymouth Rock Operation.
RESPONSIBILITIES
Initiate prompt contact of all insureds/claimants/witnesses on all new claim assignments to conduct thorough coverage and liability/injury investigations. These investigations might require the representatives take in depth recorded statements to investigate coverage and liability/injury claims.
Analyze, review and interpret policies to assess coverage and liability. Provide advice to Excess and Primary coverage issues.
Conduct field investigations, interviews with insureds, witnesses and claimants while maintaining a pending of represented and unrepresented claimant cases.
Manage and direct outside vendors (Field/Counsel/Surveillance, etc.) to determine what investigation is necessary and give them direction to bring a claim to conclusion. Ensure only necessary work is completed.
Investigate cases timely so that reserves are established and maintained at proper levels. Revise reserves timely based on developments in the course of the claim.
Investigate the validity of bodily injury claims being presented by individual insureds/claimants or attorneys representing insureds/claimants. Be aware of certain “Red Flags” to identify potential fraudulent claims. Refer to SIU for investigation timely.
Handle complex claims to include coverage issues, UM/UIM, TNC, Commercial, Umbrella etc. Also, must have prior litigation handling.
Recognize and investigate subrogation potential.
Negotiate both 1st and 3rd party claims directly with injured parties and/or their attorneys.
Exercises proper judgment and decision making to analyze exposure, determine the proper course of action and make recommendations for final resolution.
Attend litigation proceedings to either represent the company or participate in arbitrations/depositions/settlement conferences/ mediations/ trials.
Attend all internal and external training events as required.
Participate in proactive team activities to achieve departmental and company objectives. May be asked to participate in special projects, committees or assignments from management.
Utilize all claims systems, Excel, Word and social media search engines.
Prepare case summary for significant reserve increase and/or trial alerts. Participate in roundtable discussions.
Effectively manage workload while maintaining diary and focus on claims quality.
Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.
Adhere to departmental internal control requirements. Comply with Plymouth Rock's standards, best practices and ethical guidelines, adhere to Plymouth Rock's culture.
QUALIFICATIONS
A bachelor's degree (B.A.) from an accredited four-year college or university.
5 - 10 years' experience handling liability commercial, homeowners, UM/UIM, Excess/Umbrella.
In-depth knowledge of litigation, arbitration and trial process, handle out of state claims, and/or Personal Injury Protection claims.
Currently holds and/or can readily obtain an out of State License(s) (i.e. - CT, Delaware, Florida, etc.). Professional designation such as IIA, AEI, Senior Claim Law Associate (SCLA) or Chartered Property Casualty Underwriting (CPCU) or be actively working towards a designation, preferred.
High level of self-motivation.
Have advanced skills in coverage, investigation, litigation/ legal issues, negotiations, evaluations, medical terminology, and subrogation.
Strong communication, organizational, customer service and time management skills.
Excellent problem solving skills.
Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.
SALARY RANGE
The pay range for this position is $88,00 to $112,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
PERKS & BENEFITS
4 weeks accrued paid time off + 9 paid national holidays per year
Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
Annual 401(k) Employer Contribution
Free onsite gym at our Woodbridge Location
Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
Robust health and wellness program and fitness reimbursements
Various Paid Family leave options including Paid Parental Leave
Tuition Reimbursement
ABOUT THE COMPANY
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
General Liability Claims Representative
Claims adjuster job in Parsippany-Troy Hills, NJ
Berkley Luxury is seeking a Senior Claims Specialist to join our growing team in our new Parsippany, NJ office.
In this role, you'll manage a wide range of commercial lines casualty claims, including litigated matters, while delivering exceptional customer service and collaborating with a high-performing team.
What you'll do:
Conduct thorough investigations and analyze coverage, liability, and damages
Manage litigated claims and work closely with defense counsel
Negotiate resolutions through mediation and arbitration
Prepare reports and ensure compliance with regulations
What we're looking for:
5-7 years of experience handling commercial general liability claims
Strong litigation management and negotiation skills
Bachelor's degree (JD a plus)
This is a fantastic opportunity to join a company that values accountability, collaboration, and continuous learning.
If you're interested in learning more, let's connect!
Forensic Construction Claims Manager
Claims adjuster job in New York, NY
New York, New York
This role is Hybrid.
Interested in the legal/dispute side of construction projects? CPMI is seeking Financial Forensic Claims Managers and Senior Managers. These team members will work closely with Principals of the firm in preparation and evaluation of financial construction claims on a variety of construction projects. Responsibilities include developing conclusions/opinions for contract dispute analysis and resolution, as well as technical research and oversight of team members.
Capital Project Management, Inc. (CPMI) is an independent consulting firm that specializes in the analysis, resolution, and prevention of complex construction disputes with an emphasis on schedule/delay/disruption analyses and related damages calculations. CPMI has been successfully serving the construction industry for 25 years handling more than a thousand projects in virtually every type of capital construction, worldwide. Our professionals regularly address complicated multipart claims in all sectors of the construction industry - from commercial buildings, stadiums, and industrial plants to environmental projects, public works, and defense contracts. We thoroughly evaluate technical, scheduling, cost, quality, and other critical issues, develop dispute resolution strategies, assist in settlement negotiations and mediation, and provide concise, credible expert witness testimony if the case goes to trial. (*****************
Responsibilities
Analyze documents, identifying issues, developing chronologies, and histories.
Conduct detailed technical and legal research as required.
Utilize project records, including financial records to identify project costs, project overruns, or sub-activity costing.
Develop databases for equipment, material, labor, change orders, etc., from project records. Utilize databases to support or contradict various project assumptions.
Evaluate financial records, including financial statements, claims, and project cost records.
Prepare summaries, including charts and graphics to present findings.
Summarize efforts and findings in narratives, including proper grammar with minimal edits.
Prepare documents, exhibits and reports for trial.
Assist clients with document production, depositions and trial preparation as required.
Organize, index and maintain project documents.
Develop and utilize document databases.
Education/Qualifications:
Undergraduate degree
A CPA and/or CFE certification is preferred, but others will be considered with relevant experience.
Preferred Skills:
Excellent communication (written and verbal), mathematical, and organizational skills
Proficient knowledge of PC environment and related software including Microsoft applications such as Word, PowerPoint, and Excel
Proficient in developing and analyzing dynamic spreadsheets
Ability to work in a team as well as independently
Ability to produce high quality work product under strict deadlines
Ability to work in a high-paced, multi-task environment with attention to detail
Flexibility in handling assigned tasks and engagements due to deadline and task priority changes
High level of interpersonal skills
High level of quantitative and qualitative research and analytical skills
Hard working, eager to learn, and motivated to succeed
Fluency in English required and other languages considered as a plus
Benefits/Perks
401k plan with company contribution
Comprehensive medical insurance
Competitive market salary with performance bonus
Continuing education reimbursement opportunities
Capital Project Management, Inc. is an Equal Opportunity Employer. All eligible candidates are invited to apply. For more information, please visit our website at *****************
Complex Claims Adjuster, Specialty
Claims adjuster job in Iselin, NJ
Job Description
The Complex Claims Adjuster, Specialty will independently review, investigate, evaluate and resolve complex Commercial Casualty claims, while maintaining effective contact with agents, insureds, and company personnel.
Minimum Qualifications:
Bachelor's degree or equivalent professional education or experience required.
At least 3 years' experience handling Commercial General Liability claims, New York Labor Law.
Excess Liability claims, or relevant experience preferred.
Skills & Competencies Required:
Ability to establish close business relationships.
Excellent communication skills.
Analytical, decision-making and resource management skills.
Strong commitment to superior client service.
Strong negotiating skills.
Additional Information:
Full benefit package including medical, dental, life, vision, company paid short/long term disability, 401(k), tuition assistance and more.
The anticipated salary for this position is $100,000 - $150,000 per year, based on qualifications and experience.
#LI-Onsite
Independent Insurance Claims Adjuster in Newark, New Jersey
Claims adjuster job in Newark, NJ
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
Auto-ApplyAuto Claim Representative, I
Claims adjuster job in Morristown, NJ
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$55,200.00 - $91,100.00
**Target Openings**
4
**What Is the Opportunity?**
This role is eligible for a sign on bonus up to $10,000
Be the Hero in Someone's Story
When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most.
As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner.
In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process.
**What Will You Do?**
+ Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations.
+ Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates.
+ Determine claim eligibility, coverage, liability, and settlement amounts.
+ Ensure accurate and complete documentation of claim files and transactions.
+ Identify and escalate potential fraud or complex claims for further investigation.
+ Coordinate with internal teams such as investigators, legal, and customer service, as needed.
+ Insurance License: In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree.
+ Three years of experience in insurance claims, preferably Auto claims.
+ Experience with claims management and software systems.
+ Strong understanding of insurance principles, terminology with the ability to understand and articulate policies.
+ Strong analytical and problem-solving skills.
+ Proven ability to handle complex claims and negotiate settlements.
+ Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants.
**What is a Must Have?**
+ High School Diploma or GED required.
+ A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Daily Claims Adjuster - Staten Island, NY
Claims adjuster job in New York, NY
CENCO is a leading provider of property claims solutions, trusted by top insurance carriers for delivering efficient, accurate, and responsive adjusting services. We are currently seeking experienced Daily Property Claims Adjusters to handle residential and commercial property claims across Staten Island and the surrounding New York City area. This opportunity is ideal for adjusters seeking steady claim volume and the flexibility of independent field work.
Key Responsibilities:
Conduct on-site inspections of property damage from perils such as wind, water, fire, and vandalism.
Document damages thoroughly with detailed written reports and clear photographs.
Prepare accurate repair estimates using Xactimate or Symbility.
Maintain clear and professional communication with policyholders, contractors, and carriers.
Manage each claim from inspection through submission, meeting all required deadlines.
Requirements:
Licensing: Must hold an active New York adjuster license.
Software: Experience with Xactimate or Symbility is preferred.
Equipment: Reliable vehicle, ladder, laptop, and standard field tools.
Work Style: Self-driven, organized, and capable of working independently.
Responsiveness: Must be available to accept and complete assignments promptly.
Why Work with CENCO?
Consistent daily claim volume in Staten Island and surrounding boroughs
Competitive pay with reliable, on-time compensation
Supportive internal team and efficient workflows
If you're a qualified adjuster looking for regular work in Staten Island and want to be part of a respected industry team, we'd love to hear from you!
Claims Adjusters, Examiners, and Investigators
Claims adjuster job in New York, NY
Job Description
Role Overview Mercor is collaborating with a top-tier AI research group to model real-world claims workflows for property and casualty insurance. We are seeking experienced independent contractors-particularly claims adjusters, examiners, and investigators-to execute and evaluate a wide range of P&C insurance tasks. This project supports the development of AI systems capable of understanding, simulating, and automating complex insurance operations. It is a short-term, high-impact engagement ideal for professionals with strong technical and compliance knowledge.
Key Responsibilities
Execute full-cycle claims tasks including FNOL intake, coverage verification, reserve setting, and liability determination
Simulate real-world workflows using structured tools and mock systems such as Guidewire ClaimCenter and Xactimate
Review and synthesize third-party documentation including police reports, medical records, and vendor estimates
Draft structured outputs such as coverage memos, repair estimates, and liability assessments
Identify inconsistencies or red flags in claim statements and documentation
Evaluate claim compliance, document regulatory deadlines, and assess communication quality
Flag fraud indicators and recommend SIU referrals where applicable
Document all work clearly for auditability and quality review
Ideal Qualifications
5+ years handling property, auto, bodily injury, or general liability claims
Familiarity with systems such as Guidewire, Duck Creek, Xactimate, Hyland OnBase, or FileNet
Deep understanding of coverage interpretation, state compliance standards, and claims file documentation
Experience reviewing third-party documentation (e.g., police reports, medical summaries, contractor estimates)
Strong written communication and analytical skills
More About the Opportunity
Remote and asynchronous - control your own work schedule
Expected commitment: min 30 hours/week
Project duration: ~6 weeks
Compensation & Contract Terms
$100-150/hour
Independent contractor arrangement
Paid weekly via Stripe Connect
Application Process
Submit your resume followed by domain expertise interview and short form
About Mercor
Mercor is a talent marketplace that connects top experts with leading AI labs and research organizations
Our investors include Benchmark, General Catalyst, Adam D'Angelo, Larry Summers, and Jack Dorsey
Thousands of professionals across domains like insurance, law, engineering, and research partner with Mercor to shape the next era of AI
Liability Claims Adjuster III - Medical Malpractice
Claims adjuster job in New York, NY
This is a dynamic claims and account management position. In accordance with applicable statutes and in keeping with company rules, regulations, client guidelines and established performance objectives, this role is responsible for effectively managing to conclusion an assigned inventory of medical professional and general liability claim files that may include cases of extreme complexity or with unique or unusual issues.
This position is multifaceted and includes the following primary areas of focus:
Culture - Every member of the Intercare team is responsible for nurturing and promoting a healthy culture. Our culture is the most important element of our success. Intercare's culture is defined by our Core Values:
• INTEGRITY: Reinforces our commitment to transparency
• COLLABORATION: Strengthens our passion for customer service
• ACCOUNTABILITY: Supports our actions
• RESPECT: Inspires us to do the right thing
• EXCELLENCE: Drives our outcomes
Claims Management - This teammate will be directly responsible for claim and account management. Expectations regarding claim and account management are best described by our mission:
Mission: To be the leading third-party administrator offering professional and technological resources through proactive and aggressive claims, risk and managed care solutions in support of our clients' objectives. Innovative processes and state-of-the-art technology support our people. Exceptional individuals provide the human element needed to deliver excellent service and drive excellent outcomes.
Quality - The leader works closely with every member of the Intercare team to carry out our vision to promote growth:
Vision: 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.
Essential Duties and Responsibilities:
• Maintain a culture of positivity, respect, supportiveness, collaboration, patience, accountability and excellence.
• Assist with team building ideas and events.
• Lead by example and through service.
• Develop and maintain strong and collaborative client relationships.
• Establish prompt contact on all new losses within 24 hours of receipt of the claim, including the insured, claimant, or claimant representative, to document relevant facts surrounding the incident and obtain information relevant to analysis of liability and damages.
• Thoroughly and accurately evaluate coverage on a timely basis, document coverage analysis, identify coverage issues and draft appropriate coverage letters.
• Thoroughly and accurately investigate all claims and document ongoing case facts and relevant information necessary for establishing liability and damages. Perform and document ongoing analysis and evaluation and what is being done to move the case toward closure.
• Litigation management - Direct, manage and control the litigation process for nationwide programs.
• Assure that all assigned claims are maintained on an active 30-45-day diary and have an up-to-date plan of action outlining activities and actions anticipated for ultimately resolving the claim.
• Obtain consultant and/or expert reviews for early evaluation.
• Aggressively pursue contribution on multiple defendant cases or where provided by employment or independent contractor agreements and apportionment when there is shared liability.
• Assure that the claim file is handled in accordance with applicable statutes, in-force service contracts and company guidelines.
• Establish, monitor and adjust claim reserves in strict accordance with assigned authority levels and client claim-handling instructions.
• Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company and client.
• Respond to telephone messages and inquiries within 24 hours of receipt and to written inquiries within one week of receipt.
• Travel for mediations, trials, client meetings and/or industry-related conferences.
• Requires a working knowledge of medical terminology and various jurisdictional issues.
• Handle other duties and tasks as deemed appropriate by the Supervisor or Manager.
Competency:
To perform the job successfully, an individual should demonstrate the following:
• An open mind, eagerness to learn, positive attitude and healthy curiosity.
• Strong communication skills, including being open and respectful of everyone, regardless of their position or role.
• Flexibility and the ability to adapt to change quickly, including switching efficiently between program needs and personalities multiple times throughout the day.
• Problem solving, change and conflict management, including developing workable implementation plans and recommendations, communicating changes effectively, building commitment, overcoming resistance and supporting those affected.
• Leadership by example and service, including instilling confidence in yourself and others, inspiring and motivating others to perform well ethically, positively influencing others, inspiring respect and trust, accepting and growing from feedback, providing vision and inspiration, recognizing others appropriately, displaying passion and optimism, and mobilizing others to fulfill the vision.
• Exceptional customer service, always going above and beyond, searching for ways to expand services, soliciting client feedback, promptly responding to requests and ensuring compliance with client contracts and service instructions.
• Strong business acumen, being well spoken, poised, presenting with balanced confidence and humility, taking initiative, sparking innovation, understanding business implications, displaying profitability orientation, knowing the market and aligning work with strategic goals.
• Discipline in all aspects of the position with a focus on accuracy, thoroughness and continuous improvement.
• Project management skills, including developing plans, coordinating projects, staying on task, communicating changes and completing projects on time and within budget.
Qualification Requirements:
To perform this job successfully, an individual must, at a minimum, be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience:
JD and/or RN preferred. Bachelor's degree from a four-year college or university; at least seven years of related experience and/or training; or an equivalent combination of education and experience. Requires a high degree of claims handling expertise, including at least five years managing medical professional liability cases, many with complex litigation or high potential value.
Language Skills:
Ability to read, analyze and interpret insurance policies, statutes, legal opinions, business periodicals, professional journals, technical procedures and governmental regulations. Ability to write complex coverage letters, reports, business correspondence, procedure manuals and correspondence to clients, colleagues and industry peers. Ability to effectively present information verbally and in writing and respond to questions from groups of managers, clients, customers and the general public. Fluent spoken and written English is required.
Math Skills:
Ability to add, subtract, multiply and divide in all units of measure using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent and to draw and interpret bar graphs.
Reasoning Ability:
Requires strong problem-solving and analytical skills. Ability to apply common-sense understanding to carry out instructions in written, oral or diagram form, and to deal with problems involving several concrete variables in standardized situations.
Computer Skills:
Proficiency in Word, Excel, Outlook, PowerPoint, RMIS software, RingCentral, Zoom, TEAMS, WebEx, GoToMeeting and other tele-video conferencing software and apps.
Certificates and Licenses:
JD and/or RN licensure preferred. Appropriate jurisdictional adjuster license required.
Physical Demands:
The physical demands described here are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.
• Regularly required to sit.
• Frequently required to use hands to finger, handle, feel, type, collate, file or lift.
• Required to stand and walk.
• Some lifting may exceed 10 pounds, such as luggage, collateral materials or claim files.
• Required to travel by vehicle, airplane, subway and train.
• Required to spend nights in hotels for out-of-town travel.
Work Environment:
The work environment characteristics described here are representative of those encountered while performing essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions. The noise level in the work environment is usually moderate.
Auto-ApplyNo-Fault Claims Adjuster
Claims adjuster job in New York, NY
Job DescriptionSalary: $55k-$65k
No-Fault Claims Adjuster
Our legal team is committed to providing each client with quality counsel, innovative solutions, and personalized service. Founded in 2000, the firm offers the legal expertise of its 115+ attorneys, who have accumulated experience and problem-solving skills over decades of practice.
We are a vibrant, busy, and growing full-service law firm looking to increase its talented ranks of support staff by adding a No-Fault Claims Adjuster with a demonstrated interest and experience of 2-3 years working on no-fault claims in the state of New York.
Successful Candidate
The successful candidate must have an understanding and experience of Regulation 68 with an emphasis on regulatory time frames. Understanding of New York, No-Fault Arbitration, and the No-Fault Claims process. Must be a true team player genuinely interested in working in a supportive, collaborative team environment.
The candidate must be proficient in inputting and identifying information that pertains to new claims in a timely and accurate manner. The duties of the candidate will include working with insurance companies directly to process data entry of claims, medical records, and vendor bills, process insurance claims, and refund/claim checks, and perform daily administrative functions such as answering the phone photocopying, filing, and scanning.
What you'll need to have:
Expertise with the ADR providers online dispute resolution platform
Ability to understand medical reports and medical terminology
Ability to understand legal concepts and legal terminology
Understanding of worker compensation fee schedule
Exceptional organizational skills
Demonstrate ability to work under tight deadlines
Demonstrate ability to adapt to new and changing business needs
Adjuster License a PLUS
Additional Information:
Salary Range: $55k-$65k
Benefits: Medical, Dental, 401K, PTO & Life Insurance
Location: On-site in Brooklyn
Executive Claims Specialist - Gig Economy
Claims adjuster job in Morristown, NJ
Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.
Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.
C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: **************
Job Description
S&S Transportation & Sharing Economy is seeking an experienced Executive Claims Specialist to join our dynamic team. In this role, you will provide expert oversight of Bodily Injury (BI); Property Damage (PD) and Personal Injury Protection (PIP) claims managed by Third-Party Administrators (TPAs), specifically arising from rideshare-related incidents. The ideal candidate will possess substantial expertise in complex injury claims, with a strong background in the rideshare sector.
What you will do for C&F:
TPA Oversight: Provide technical supervision and guidance for BI and PIP claims handled by TPAs, ensuring adherence to program standards and best practices.
Claims Management: Apply advanced knowledge to oversee rideshare claims, including coverage analysis and litigation management.
Technical Excellence: Drive optimal claim outcomes by controlling indemnity, expense, and litigation costs through timely reserving, trial preparation, and resolution strategies.
Auditing: Conduct regular audits of TPA-managed claims to ensure accuracy, timeliness, and compliance with established procedures.
Data Analysis: Review claims data, reserve adequacy, and performance metrics to identify trends and recommend process improvements.
Industry Awareness: Stay informed on evolving rideshare regulations, policy changes, and litigation developments.
Additional Duties: Perform other related tasks as assigned.
What you will bring to C&F:
Experience: Minimum 6-8 years handling complex bodily injury and litigated claims, with direct experience in rideshare claims required.
Expertise: In-depth knowledge of BI and PIP claim procedures; experience with high-value BI, PIP, and Property Damage exposures related to rideshare incidents.
Jurisdictional Knowledge: Extensive claims handling experience in Pennsylvania and New York preferred.
Education: Bachelor's degree required; law degree, professional designations, or insurance coursework a plus.
Licensing: Ability to obtain and maintain required state licenses.
Communication: Excellent verbal and written communication skills, with the ability to interact effectively at all organizational levels.
Technical Skills: Proficiency in Microsoft Office suite.
Travel: Occasional travel may be required.
Risk Transfer: Understanding of claims policy language and coverage necessary to evaluate Risk Transfer with PAP carriers.
What C&F will bring to you
Competitive compensation package
Generous 401K employer match
Employee Stock Purchase plan with employer matching
Generous Paid Time Off
Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing
A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
A dynamic, ambitious, fun and exciting work environment
We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
At C&F you will BELONG
If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know
For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information.
Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $64,700.00 to a maximum of $121,600.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.
#LI-AV1
#LI-Remote
Auto-ApplyTrucking Claims Specialist
Claims adjuster job in New York, NY
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
Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service.
Key Responsibilities
* Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures.
* Review and interpret policy language to determine coverage and consult with coverage counsel when needed.
* Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies.
* Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information.
* Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts.
* Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards.
* Participate in file reviews, team meetings, and ongoing training to support continuous learning.
Salary Range
$95,000.00-$145,000.00 USD
The successful candidate is expected to work in one of our offices 3 days per week and also be available for travel as required. The annual base salary range posted represents a broad range of salaries around the U.S. and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training.
Qualifications
* Minimum of 3 years of trucking industry experience.
* Experience with bodily injury and/or cargo exposures.
* Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices.
* Strong analytical and negotiation skills, with the ability to manage multiple priorities.
* Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism.
* Possession of applicable state adjuster licenses.
* Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.
Auto-ApplyGeneral Adjuster
Claims adjuster job in Morristown, NJ
Company Details
Berkley One exists to insure and protect the lifestyles of a modern generation of affluence. We seek clients that are sophisticated individuals and families who require world-class risk and claims management customized to their needs, a team of select expert independent agents and innovative digital tools to keep it simple and easy. We'll blend our partners, products and capabilities with all that is Berkley, generating a modern solution for the customers we serve.
Our culture is one of innovation, creativity and teamwork. Our team is highly motivated, passionate about our business, and deeply experienced in developing and delivering product and service solutions in the personal insurance marketplace.
#LI-AV1 #LI-Remote
This role will require a colleague to travel to cover the NYC boros, Northern NJ and/or Westchester county, NY.
The company is an equal opportunity employer.
Responsibilities
As a Property General Adjuster, you will be responsible for quality handling and resolution of property claims including complex, high exposure claims in a timely, professional manner with emphasis on providing quality service. We'll trust you to handle all manner and size of personal lines property claims - most often for high net worth customers.
What you can expect:
Culture of innovation, teamwork, supportive colleagues and leaders willing to invest in talent
Internal mobility opportunities
Visibility to senior leaders and partnership with cross functional teams
Opportunity to impact change
Benefits - competitive compensation, paid time off, comprehensive wellness benefits and programs, employer funded health savings account, profit sharing, 401k, paid parental leave, employee stock purchase plan, tuition assistance and professional continuing education
We'll count on you to:
Appropriately manage assigned first party claims through coverage analysis, on site investigation, reserving and resolution
Identify and address coverage issues, complete investigation to determine cause & exposure, set timely reserves and develop detailed action plans
Write fair and equitable estimates in a software program
Negotiate and convey claim settlements within authority limits
Establish validity of claims submitted for payment through investigation, research and contact with policyholders, claimants and outside parties for additional information and documentation to evaluate and properly resolve claims
Write denial letters, Reservation of Rights and other correspondence.
Maintain an effective diary system and document claim file activities in accordance with established procedures
Pro-actively manage file inventory to ensure timely resolution of cases
Deliver exceptional customer service to meet the needs of the insured, agent and all internal and external customers
Qualifications
What you need to have:
5+ years experience handling property insurance claims with an emphasis in working with High Net Worth customers preferred and experience with automated claims systems
Broad knowledge of construction, estimating and estimating systems, Symbility preferred
Pro-active, you will manage preferred vendors in order to drive continuous quality improvement
Collaborative, you will coordinate with lead adjusters and managers on pending claim files requiring additional investigation and confirming coverage on our largest claims; you will also actively participate on CAT duty when needed and assist in overseeing the contractor referral program including re-inspections and quality reviews
Incredible empathy and understanding of the needs of customers, both insureds and their agents alike; you will be an excellent, pro-active advocate for Berkley One customers and are passionate about their brand experience
Valid drivers license
What makes you stand out:
Experience working with High Net Worth customers
Symbility systems exoerience
Excellent oral and written communication skills
Calm under pressure; you have excellent organizational and negotiation skills, integrity, and great follow-through on tasks
You have a strong sense of accountability, fun and adventure
Natural curiosity; you love learning how things work and you are always looking for innovative improvements
Additional Company Details We do not accept any unsolicited resumes from external recruiting firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees including:
• Base Salary Range: $130,000 - $145,000
• Eligible to participate in annual discretionary bonus
• Benefits include: Company Fleet Vehicle, Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and profit-sharing plans
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role
Auto-ApplySmall Commercial Field Property Adjuster
Claims adjuster job in Parsippany-Troy Hills, NJ
Property Adjusters investigate commercial property claims, evaluate damages, determine coverage, set accurate loss cost estimates, control the insured's exposures and losses, manage consultants, and achieve a prompt, fair and equitable settlement according to fair claims handling requirements. Negotiate settlement of claims with varying complexity and perils.
Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory.
This role is open to both Grades 12 to 13.
Responsibilities:
Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin, and extent of loss. Reviews and utilizes financial statements to adjust moderately sized business interruption losses.
Conduct on-site appraisal or direct independent adjuster to determine facts relevant causation, damages and exposure.
Engages and manages consultants and independent adjusters as required. Monitors the costs to ensure they are reasonable and necessary.
Establishes and maintains accurate loss cost estimates and reserves for each claim for reporting, financial records, and other purposes.
Keeps the Insured and others informed about the claim's status with clear, timely and accurate written/oral communications. Effectively communicates in writing on moderately complex coverage issues with minimal review and coaching. Determines depreciation of claim.
Affirms or denies coverage of the claim based on the facts and the policy terms and conditions. Develops information necessary to make advance, partial and final payments when appropriate.
Meet time requirements of the policy and fair claims handling practices.
Effectively negotiate settlement of claims of varying complexity and perils. Achieves a prompt, fair and equitable settlement of a claim, where there is policy liability.
Keeps the electronic claim file properly documented with accurate, clear and timely information and reports that reflect the adjustment activities and substantiate any payments made.
May participate in quality assurance file review sessions and serve as a technical resource for less experienced claims personnel.
Will be called upon for catastrophe duty.
Qualifications
Knowledge of property insurance; commercial property claims; coverage evaluation; claims investigation, loss assessment, evaluation and reserves; financial analyses; insurance regulations.
Negotiation and settlement of moderate to high complexity claims.
Other skills required include a focus on customers; decision making; results oriented; spoken communication; and adaptability.
An ability to build relationships, listen (i.e., comprehend nuances and acknowledge others' viewpoints), mentoring and training less experienced team members, write business correspondence, produce accurate work, manage projects and vendors.
Use core applications/spreadsheets.
As normally acquired through a bachelor's degree or equivalent; successful completion of required internal training programs and AIC (Associate in Claims) modules 33 and 35.
Prefer designations such as AIC, SCLA, CPCU, etc, and at least 2-3 year of progressively responsible experience.
Ability and willingness to travel to the site of catastrophe for assignments that may last several weeks.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
California
Los Angeles Incorporated
Los Angeles Unincorporated
Philadelphia
San Francisco
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Auto-ApplyProperty Desk Adjuster
Claims adjuster job in New York, NY
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.
Transactional Risk Claims Specialist
Claims adjuster job in New York, NY
Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries.
People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden.
* Classification: Exempt/Full-time
* Reports to: Head of Claims for Transactional Risk
* Travel: 0-15%
* Salary: $150,000.00-$215,000.00
Role overview
DUAL North America is seeking a Transactional Risk Claims Specialist for the Claims team.
The Transactional Risk Claims Specialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice.
This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time.
Role responsibilities
* Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion.
* Assist with entering claim data into operational systems.
* Assist with quality control and performance management, to ensure high-quality claim handling.
* Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers.
* Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices.
* Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners.
* Perform other duties as assigned.
Key requirements
* Bachelor's degree required and law degree preferred.
* Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable.
* Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions.
* Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives.
* Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint).
* Ability to manage multiple competing priorities.
* Ability to adapt to evolving regulatory and legal environments.
* Complete assigned tasks correctly, on time and able to learn quickly.
* Self-motivated and demonstrating attention to detail.
* Be able to work independently for extended periods.
* Excellent written and verbal communication skills as well as general business understanding.
* Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment.
* If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team.
What do we offer in return?
A career that you define.
Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more.
What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community.
Our culture: people first
Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world.
The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key.
Diversity and inclusion
At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances.
What do we offer in return?
A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us:
* Our successes have all come from someone brave enough to try something new
* We support each other in the small everyday moments and the bigger challenges
* We are determined to make a positive difference at work and beyond
Reasonable adjustments
We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*.
If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require.
* Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more.
Permanent
Auto-ApplyClaims Specialist
Claims adjuster job in New York, NY
We are seeking a highly skilled and detail-oriented Claims Specialist with expertise in handling No-Fault, Worker's Compensation and all other medical insurance claims. The ideal candidate must have 3+ years experience and will have a thorough understanding of regulatory requirements and processes associated with these types of claims, along with excellent communication and problem-solving skills. Must be available for employment Monday-Friday for 9a-5p employment.
Responsibilities:
Manage and process No-Fault insurance claims, including reviewing claim submission, verifying coverage, and ensuring compliance with regulatory guidelines.
Handle Worker's Compensation claims from initial filling through resolution, including investigating incidents, gathering relevant documentation, and coordinating with legal counsel as needed.
Conduct through investigation into claim validity, including medical records, and other relevant documentation.
Communicate effectively with claimants, insurance adjuster, and other stakeholders to facilitate the claims process and resolve issues in a timely manner.
Maintain accurate and up-to-date claim files and documentation, ensuring compliance with internal policies and regulatory requirements.
Obtain and verify insurance information for patients, including primary and secondary coverage, policy numbers, group numbers, and policy holder information.
Liase with insurance companies and third-party payers to confirm coverage details, policy benefits, and pre-authorization requirements.
Collaborate with medicalbillingteam to ensure accurate timely submission of claims and pre-authorizations.
Resolve insurance related issues and discrepancies, including denials and rejections, through effective communication and follow-up with insurance carriers.
Educate patients on insurance benefits, coverage limitations, and financial responsibilities, providing assistance with insurance inquiries and concerns.
Verify patient insurance coverage and eligibility.
Assist patients with insurance-related inquiries, explaining coverage details, copays, deductibles, and out-of-pocket expenses.
Prepare and submit insurance claims and billing statements.
Maintain confidentiality of patient information and ensure compliance with HIPAA regulations in all administrative activities.
Qualifications:
3+ years experience with medical insurance claims
Thorough understanding of regulatory requirements and processes
Excellent communication and problem-solving skills
Claims Specialist
Claims adjuster job in New York, NY
SourceProSearch is seeking a Claims Specialist with 1-2 years of experience to work in our New York office. The ideal candidate should be comfortable with technology and platforms. This position requires at least 2 days per week in the office.
Job Responsibilities:
Format documents and communications for clients.
Liaise between third-party vendors and the firm.
Review documents (release/document verification) for production to defense counsel for quality control.
Calendaring and entry of case info into the database.
Perform intake and initial filtering of client inquiries.
Preparation of submissions involving large volumes of individual claims.
Run and analyze client data reports.
Organize documents and communications with clients.
Ensure that case documents accurately reflect a client's individual information.
Keep track of communications or developments relating to client cases and deadlines that may be applicable to individual clients.
Prepare and send client communications.
Communicate with clients telephonically, on occasion.
Work with attorneys to plan data gathering and settlement update workflows.
Analyze and summarize client inquiries to identify trends and patterns requiring further action.
Assist with the development of processes and technological systems for addressing large volumes of client interactions.
Skills/Requirements:
Proficient in the use of Microsoft Word and Excel.
Familiarity with Filesite preferred.
Familiarity with client management systems or databases preferred.
Strong technical skills and ability to quickly learn new litigation support software.
Strong written and oral communication skills and strong interpersonal skills.
Must possess great attention to detail.
Must possess analytical and critical thinking skills.
Strong organizational and time-management skills.
Ability to work independently while understanding the importance of teamwork.
Ability to manage workload consisting of multiple tasks.
The work shift for this position is 9:30 am-5:30 pm, five days a week, but the applicant must be willing and available to work overtime, both evening and weekends, when necessary.
****************************
Claims Specialist
Claims adjuster job in Newark, NJ
Job Title: Remote Claims Specialist
Hourly Pay: $22 -$27/hour
We are looking for a skilled Claims Specialist to join our work-from-home team. In this role, you will assist in processing and reviewing insurance claims, ensuring all necessary information is gathered, and helping resolve claims efficiently. If you have strong attention to detail and enjoy supporting customers through the claims process, this is a great opportunity for you.
Key Responsibilities:
Assist in processing insurance claims, ensuring accuracy and timely resolution
Review claims documentation, including reports, medical records, and other evidence
Communicate with claimants, insurance adjusters, and third parties to gather information
Help resolve disputes or issues with claims and escalate when necessary
Maintain detailed records of claims progress and updates
Ensure compliance with industry regulations and internal policies
Provide excellent customer service and answer inquiries related to claims
Qualifications:
Experience in insurance, claims handling, or a related field
Strong attention to detail and organizational skills
Excellent communication and customer service abilities
Ability to handle multiple claims and prioritize effectively in a remote environment
Familiarity with insurance policies and claims procedures is a plus
Must have reliable internet and a quiet, dedicated workspace
Perks & Benefits:
100% remote work flexibility
Competitive hourly pay: $22 - $27
Paid training and professional development opportunities
Flexible work hours, including evening and weekend options
Opportunities for career growth in the insurance industry
A supportive and team-oriented work environment
Executive Claims Examiner- Executive Liability
Claims adjuster job in Summit, NJ
What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.
Join us and play your part in something special!
This position will be an acknowledged technical expert and be responsible for the resolution of high complexity and high exposure Public Company D&O and Financial Institutions D&O and E&O claims. The position will have significant responsibility for decision making and work autonomously within their authority.
Job Duties:
* Confirms coverage of claims by reviewing policies and documents submitted in support of claims
* Analyzes coverage and communicates coverage positions
* Conducts, coordinates, and directs investigation into loss facts and extent of damages
* Directs and monitors assignments to experts and outside counsel
* Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
* Sets timely reserves within authority or makes claim recommendations concerning reserve changes to supervisor
* Negotiates and settles claims either directly or indirectly
* Prepares reports by collecting and summarizing information
* Adheres to Fair Claims Practices regulations and internal Claims Quality Performance Objectives
* Assists in training and mentoring of examiners
* Serves as technical resource to subordinates and others in the organization.
* Reviews and approves correspondence,s reports and authority requests as directed by supervisor
* Participates in special projects or assists other team members as requested
* Travel to meditations, trials, and conferences as required
Education
* Bachelor's degree or equivalent work experience
* JD , advanced degree, or focused technical degree a plus
Certification
* Must have or be eligible to receive claims adjuster license.
* Successful achievement of industry designations (INS, IEA, AIC, ARM, SCLA, CPCU, RPLU) or
* I-Lead or other Management Training
Work Experience
* Public Company D&O, Financial Institutions D&O and E&O, Financial Advisors, and/or Management Liability Claims handling experience preferred.
* Minimum of 10 years of claims handling experience or equivalent combination of education and experience
Skill Sets
* Excellent written and oral communication skills
* Strong analytical and problem solving skills
* Strong organization and time management skills
* Ability to deliver outstanding customer service
* Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word)
* Ability to work in a team environment
* Strong desire for continuous improvement
US Work Authorization
US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future.
Pay information:
The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The national average salary for the Executive Claims Specialist - Executive Liability is $97,520 - $134,090 with 25% bonus potential.
Who we are:
Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world.
We're all about people | We win together | We strive for better
We enjoy the everyday | We think further
What's in it for you:
In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work.
* We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life.
* All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance.
* We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave.
Are you ready to play your part?
Choose 'Apply Now' to fill out our short application, so that we can find out more about you.
Caution: Employment scams
Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that:
* All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings.
* All legitimate communications with Markel recruiters will come from Markel.com email addresses.
We would also ask that you please report any job employment scams related to Markel to ***********************.
Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law.
Should you require any accommodation through the application process, please send an e-mail to the ***********************.
No agencies please.
Auto-Apply