Senior Claims Adjuster
Claims adjuster job in South San Francisco, CA
About Us:
The Greenspan Co./Adjusters International is the leading Public Insurance Adjusting firm with locations in California, Nevada, and Arizona. We advocate for the insured during times of crisis, navigating them through the complex and tedious insurance claims process. We aim to be the gold standard in customer service, and we've helped thousands of residential and commercial clients with their claims for over 70 years.
Job Summary:
We are seeking a Senior Claims Adjuster for our San Jose office. This role is a full time position with base salary plus commission. The Senior Claims Adjuster role will have the following responsibilities but not limited to: will investigate commercial and residential property claims, evaluate damages, determine coverage, set accurate 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. Additionally, negotiate settlement of claims with varying complexity and perils. If you're an independent adjuster or a staff adjuster who wants to do the right thing for the policy holder and work to help homeowners and business owners rebuild after a catastrophe, we are the right team to join!
The Senior Claims Adjuster will have the following duties & responsibilities but not limited to:
Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin, and extent of loss losses. Reviews & utilizes financial statements to adjust complex residential and/or business interruption losses.
Conduct on-site appraisal or direct independent adjuster to determine facts relevant causation, damages and exposures
Engages and manages team members as required to assist in determining facts, causation, damages and exposure; 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 clients 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 depreciate of claim.
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 reflects the adjustment activities and substantiates any payments made.
Provide guidance to inexperienced team members and may act as a mentor to other entry level adjusters.
Qualifications:
10 years plus experience in an insurance company handling residential & commercial property and casualty claims required
2 years' experience handling losses in excess of $ 200,000.00 required
Bachelor's degree required
Must have a valid CA Driver License
Ability and willingness to travel to the site of catastrophe for assignments.
Capability to build and maintain positive relationships
Ability to train and mentor less experienced team members
Ability to write business correspondence, produce accurate work, manage projects and vendors; and use core applications/spreadsheets
Empathetic and Compassionate advocate for policy holder
Someone invested in protecting and defending the best interests of the claimant
The ability to be an avid listener and a conscientious member of our team
Compensation:
Competitive salary (Base plus commission package worth $150k to $175k per year)
Company Offered Benefits:
Health, Dental, Vision Coverage
401K
ESOP
LTD Coverage
Find out how you can become a dynamic part of our growing team and employee owned company.
Workers' Compensation Claim Rep II (CA Expertise Required)
Claims adjuster job in Concord, CA
Workers' Compensation Claim Representative II
Schedule: Monday-Friday, 8:00 AM-4:30 PM PST Salary Range: $70,000-$80,000 annually (dependent on experience)
Build Your Career With Purpose at CCMSI
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified
Great Place to Work
, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.
Job Summary
We are seeking a Workers' Compensation Claim Representative II to manage California workers' compensation claims from intake through resolution for a PEO/Staffing account. This role may be remote or hybrid, reporting to our Irvine, CA branch.
This position is designed for an experienced adjuster who can independently manage claims, apply sound judgment, and deliver consistent results within California's complex regulatory environment. You'll handle more complex claim scenarios, contribute to claim strategy, and partner closely with supervisors, clients, and vendors to drive quality outcomes.
Responsibilities
When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems with purpose and care.
Independently investigate, evaluate, and resolve California workers' compensation claims in compliance with CCMSI standards and client handling instructions
Manage claims cradle-to-grave, including compensability, medical management, litigation coordination, and resolution strategy
Review medical, legal, and miscellaneous invoices for accuracy, reasonableness, and claim-relatedness; negotiate disputed bills
Establish, monitor, and adjust reserves in accordance with authority levels and best practices
Authorize and issue claim payments within assigned settlement authority
Negotiate settlements with injured workers and attorneys in accordance with client authorization
Coordinate with and assist in the selection and oversight of defense counsel
Identify and pursue subrogation opportunities
Prepare and maintain accurate claim documentation, reports, payments, and reserve summaries
Ensure compliance with service commitments, jurisdictional requirements, and excess reporting obligations
Deliver consistent, high-quality claim service aligned with CCMSI's corporate standards
Qualifications
What You'll Bring
Required
5-10 years of workers' compensation claims experience, with demonstrated success handling California claims
Proven ability to manage claims independently from intake through resolution
Strong working knowledge of the California workers' compensation claims process
Excellent communication, organization, and time-management skills
Ability to prioritize work, meet deadlines, and manage a full caseload with minimal supervision
Reliable, predictable attendance within established client service hours
Preferred
SIP designation or ability to obtain within a defined timeframe
Associate degree or higher
Experience supporting PEO and/or staffing accounts
Proficiency with Microsoft Word, Excel, Outlook, and claims systems
Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required.
Why You'll Love Working Here
4 weeks PTO + 10 paid holidays in your first year
Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
Career growth: Internal training and advancement opportunities
Culture: A supportive, team-based work environment
How We Measure Success
At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
• Quality claim handling - thorough investigations, strong documentation, well-supported decisions
• Compliance & audit performance - adherence to jurisdictional and client standards
• Timeliness & accuracy - purposeful file movement and dependable execution
• Client partnership - proactive communication and strong follow-through
• Professional judgment - owning outcomes and solving problems with integrity
• Cultural alignment - believing every claim represents a real person and acting accordingly
This is where we shine, and we hire adjusters who want to shine with us
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.
ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.
Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.
Our Core Values
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
Lead with transparency We build trust by being open and listening intently in every interaction.
Perform with integrity We choose the right path, even when it is hard.
Chase excellence We set the bar high and measure our success. What gets measured gets done.
Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
Win together Our greatest victories come when our clients succeed.
We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
#NowHiring #WorkersCompensation #WCClaims #WCClaimRepII #ClaimsAdjuster #CaliforniaWorkersComp #CAClaims #CAAdjusters #InsuranceCareers #ClaimsCareers #TPACareers #PEOClaims #StaffingClaims #HybridWork #RemoteJobs #CaliforniaJobs #EmployeeOwned #GreatPlaceToWorkCertified #CareerWithPurpose #CCMSICareers #LI-Hybrid #LI-Remote
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Auto-ApplySenior Claims Examiner
Claims adjuster job in Concord, CA
DETAILS
Senior Claims Examiner
Department:
Workers' Compensation California
Reports To:
Claims Supervisor
FLSA Status:
Non-Exempt
Job Grade:
12
Career Ladder:
Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor
ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices. This position requires residing in the Bay Area, in order to attend meetings in Concord and San Mateo as needed. Additionally, employees who live less than 26 miles from the Concord, CA office are required to work once a week in the office on a day determined by their supervisor between Tuesday - Thursday. The remaining days can be worked remotely if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. The Senior Claims Examiner will adjust workers' compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. The Senior Claims Examiner will adjust workers' compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
Establish contact with employer to review issues
Respond to inquiries from the employer, employee, doctors, and attorneys
Establish and maintain appropriate reserves
Review legal correspondence and medical reports
Evaluate and approve medical procedures and treatment
Administer benefits and ensure appropriateness of all payments
Investigate coverage, liability, and monetary value of claim
Review medical and legal bills for appropriateness
Discuss appropriateness of medical treatment with medical case manager
Determine compensability
Monitor and assist litigation
Negotiate settlement of claim, liens, rehabilitation plans, etc.
Prepare and present reports to clients
Appropriately close claims
Help resolve client billing and payment inquiries
Investigate complaints from injured workers
Document and code the claim files and claims system with all relevant information
Maintain and update action plans within specified time frames
Provide direction to Claims Assistants and Claims Technicians and assist with training, coaching, and mentoring as needed for them to support daily claims tasks
Contact with employers, employees, attorneys, doctors, vendors, and other parties
Provide customer service and support to clients and claimants
Work collaboratively with attorneys to draft settlements and assist with litigation strategies
Negotiate settlements
Authorize and negotiate cost of medical treatment and supplies
Internal communication with staff
Prepare professional, well written correspondence and other communications
ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
High School Diploma or equivalent (GED) required for all positions
AA/AS or BA/BS preferred but not required
Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained
Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)
3+ years recent workers compensation claims handling experience required
At least 5 years of workers compensation claims experience preferred
Solid knowledge of workers compensation laws, policies, and procedures'
Completion of IEA or equivalent courses
Proficiency in determining case value and negotiating settlements
Understanding of medical and legal terminology
Mathematical calculating skills
Well-developed verbal and written communication skills with strong attention to detail
Excellent organizational skills and ability to multi-task
Ability to type quickly, accurately and for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor.
Ability to attend occasional in office meetings or file reviews
APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here
Experienced Claims Adjuster
Claims adjuster job in Walnut Creek, CA
WHAT WE'RE LOOKING FORBerkshire Hathaway Homestate Companies has an immediate opportunity for an experienced workers compensation adjuster. We're looking for self-starters who can work under minimum direction, can achieve defined results, and are willing to accept ownership for their work product.
This Claims Professional is responsible for the management of a caseload of workers compensation indemnity claims from inception to resolution, performing initial investigation and compensability determination, reserve analysis and strategic planning, timely benefit administration to injured workers, and coordination of medical care and legal process, while maintaining the highest level of service to our insureds. ESSENTIAL RESPONSIBILITIES
Conducts the investigation of reported claims via three-point contact calls to determine coverage, compensability and severity, and to gather all other relevant information, documenting all relevant information thoroughly and escalating the investigation for further investigation when appropriate.
Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.
Calculates and administers benefits in accordance with statutory requirements, including timely issuance of appropriate notices and filings.
Develops and updates a Plan of Action for the successful resolution of each claim; timely updates Plan as new information is obtained.
Makes prompt, sound decisions on issues that arise in claims based on the best information available, ensuring that work is performed in accordance with Company standards, training, supervisory direction, and applicable laws. Timely escalates issues/red flags to Supervisor and/or appropriate internal team.
Ensures that the actions of all other professionals involved in claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim.
Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently.
Accurately and thoroughly prepares litigation referrals, AOE/COE investigation referrals, and MSA referrals for submission to vendor; obtains proper approval from Management.
Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates settlement of claims.
Fosters a positive and close working relationship with partner company staff, including the Call Center, Medical Management, Special Investigations, Client Services, Underwriting, and Claims Legal.
Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers.
Collaborates with Adjusting staff and relevant interdepartmental personnel on special projects focused on process efficiency.
Ensures continual education requirements are met.
REQUIRED QUALIFICATIONS
EDUCATION: Minimum of a High School diploma required or equivalent certificate required; Bachelor's degree from four-year College or university preferred.
DESIGNATION: Designated as a Claims Adjuster or Experienced Claims Adjuster per the California Code of Regulations and has completed the minimum required continuing education credits to adjust workers compensation claims for the State of California; Self-Insured certification a plus.
EXPERIENCE: Minimum of three years of indemnity adjusting experience managing large and/or complex claims and accounts within a workers' compensation carrier required
Maintains qualifying educational criteria to adjust workers' compensation claims for the State of California; Self-Insured certification preferred.
Inquisitive, critical thinker; agile learner with adaptive, smart time management skills.
To perform this job successfully, an individual should be proficient in the Microsoft Office Suite of applications (highly proficient in Excel preferred), and be proficient on applicable databases, systems and vendor software programs.
WHAT WE OFFER
Work-Life Balance
Work From Home Program (up to 2 days per week)
Reasonable caseload with in-house Medical Management support (UR, Med Bill Review, Resource Nurses); In-house Claims Assistant support
Modern Office Setting
Free On-Site Fitness Facility
Free downtown shuttle route
Two-minute walk from Walnut Creek BART Station
Three-minute car ride from CA-24 and I-680
Free On-Site Garage Parking
Paid Time Off
Paid Holidays
Retirements Savings Match
Group Health Insurance (Medical, Dental, and Vision)
Life and AD&D Insurance
Long Term Disability Insurance
Accident and Critical Illness Insurance
Flexible Savings Accounts
Paid Community Volunteer Day
Employee Assistance Program
Tuition Reimbursement Program
Employee Referral Program
Diversity, Equity and Inclusion Program
ABOUT USWith more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts. At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplace-something we truly value. We've created an approachable and collaborative atmosphere. Here you'll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.
Auto-ApplyGeneral Liability Claims Adjuster II
Claims adjuster job in Pleasant Hill, CA
Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.
Position Summary
Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners.
Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days.
Applicants must be currently authorized to work in the United States on a full-time basis.
Principle Duties and Responsibilities:
Claims Management
Manage caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations.
Monitor and ensure timely execution of all statutory deadlines or legal filings as needed.
Analyze facts of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines.
Identify fraud indicators and actively pursue subrogation opportunities.
Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks.
Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers.
Financial Impact Administration
Manage book of claims business (up to $ 2million) with authority to settle/negotiate a single claim within their authority of up to $25,000.
Communicate ongoing causes of incidents to Safety and Brands.
Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications.
Basic Qualifications:
Licensed adjuster (as appropriate by jurisdiction)
Bachelor's degree or experience handling General Liability claims or equivalent expertise.
Thorough knowledge of rules, regulations, statutes, and procedures pertaining to general liability claims.
Knowledge of medical terminology involved in complex claims
Negotiates resolution of claims of various exposure and complexity
Skills and Abilities:
Demonstrates relationship building and communication skills, both written and verbal.
Highly self-motivated, goal oriented, and works well under pressure.
Customer focused solid understanding of legal procedures, processes, practices and standards in the handling of general liability claims
Ability to identify problems and effectuate solutions
Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail
Able to apply critical thinking when solving problems and making decisions.
ME/NC/PA/SC Salary Range: $63,440-$95,160
IL/MA/MD/NY Salary Range: $72,880 - $109,320
Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws.
#LI-SM1 #LI-Hybrid
At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent.
Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies.
Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work.
We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.
Outside Property Claim Representative Trainee
Claims adjuster job in San Francisco, CA
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
$52,600.00 - $86,800.00
Target Openings
2
What Is the Opportunity?
This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.
As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.
This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
What Will You Do?
* Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel.
* The on the job training includes practice and execution of the following core assignments:
* Handles 1st party property claims of moderate severity and complexity as assigned.
* Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates.
* Broad scale use of innovative technologies.
* Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate.
* Establishes timely and accurate claim and expense reserves.
* Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
* Negotiates and conveys claim settlements within authority limits.
* Writes denial letters, Reservation of Rights and other complex correspondence.
* Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
* Meets all quality standards and expectations in accordance with the Knowledge Guides.
* Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
* Manages file inventory to ensure timely resolution of cases.
* Handles files in compliance with state regulations, where applicable.
* Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
* Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
* Identifies and refers claims with Major Case Unit exposure to the manager.
* Performs administrative functions such as expense accounts, time off reporting, etc. as required.
* Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
* May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
* Must secure and maintain company credit card required.
* 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.
* In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards.
* This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position
* Perform other duties as assigned.
What Will Our Ideal Candidate Have?
* Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience preferred.
* Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic
* Verbal and written communication skills -Intermediate
* Attention to detail ensuring accuracy - Basic
* Ability to work in a high volume, fast paced environment managing multiple priorities - Basic
* Analytical Thinking - Basic
* Judgment/ Decision Making - Basic
* Valid passport preferred.
What is a Must Have?
* High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required.
* Valid driver's license - 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 *********************************************************
Field Claims Adjuster
Claims adjuster job in Hayward, CA
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 Oakland, California
Claims adjuster job in Oakland, CA
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 Healthcare Claims Data Analyst, Enterprise Analytics
Claims adjuster job in San Francisco, CA
At Collective Health, we're transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design.
The Analytics team is a data-driven team focused on unlocking insights that improve member outcomes and drive business performance. Our team sits at the intersection of data, strategy, and execution. The Analytics team reports directly to the Vice President, Data Engineering, Analytics, and AI in Product Development.
In this role, you will help with standardizing and scaling all of the analytics deliverables which include reporting and self-serve dashboards leveraging data from claims, eligibility, population health, customer engagement, and digital platforms. You will collaborate across departments, mentor junior analysts, and work directly with business stakeholders and present meaningful insights to clients. If you're passionate about using data to make a meaningful impact in healthcare, you'll find a home here.
What you'll do:
Design, build, and deliver sophisticated analyses focusing on core metrics from various domains such as claims, eligibility, customer experience, digital engagement, and the complete member journey.
Translate business questions into analytic plans and communicate results in a clear, actionable manner to both technical and non-technical audiences.
Design logical categorizations for dashboards and views, building scalable and automated reports in Looker and other BI tools to provide self-service insights to the business.
Support internal stakeholders (e.g., Product, Customer Success, Marketing, etc.) by generating insights that inform strategy and operational improvements.
Proactively identify and execute opportunities to build automated reports and analytical processes, reducing manual effort and increasing reliability.
Provide technical mentorship and peer review, including refactoring and optimizing complex code for existing reports to improve performance and scalability.
Work closely with the Data Architect and engineering teams to help build and refine the semantic layer, ensuring data models are optimized for analytical use.
To be successful in this role, you'll need:
A minimum of 5+ years in data analytics in healthcare, particularly with claims data
Requires a track record of success in a high-velocity environment and a strong technical aptitude for simplifying and scaling complex data assets to support long-term standardization.
Proven ability to work with complex, large-scale datasets from disparate silos, with a deep focus on healthcare data.
Strong SQL skills with a track record of writing efficient, scalable queries for analysis and reporting.
To be technically savvy with modern data tools. This includes advanced SQL, hands-on experience with cloud data platforms like Databricks, and expert-level proficiency in BI tools, especially Looker (required).
Demonstrated project management skills, with the ability to prioritize tasks, manage timelines, and drive cross-functional collaboration.
Strong communication skills, with the ability to translate technical findings into clear, actionable recommendations for non-technical stakeholders.
To champion data governance and quality by conducting audits and validation. This includes the ability to pull and interpret data from EDI files to support claims audits and analysis.
A strong functional understanding of the claims adjudication process, from submission to payment.
To be self-sufficient, intellectually curious and take ownership for everything you do.
Pay Transparency Statement
This is a hybrid position based out of one of our offices: San Francisco, CA, Plano, TX, or Lehi, UT. Hybrid employees are expected to be in the office two days per week.#LI-hybrid
The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the salary, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at ********************************************
San Francisco, CA Pay Range$120,000-$150,500 USDLehi, UT Pay Range$96,300-$120,500 USDPlano, TX Pay Range$105,575-$132,550 USD Why Join Us?
Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare
Impactful projects that shape the future of our organization
Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests
Flexible work arrangements and a supportive work-life balance
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact recruiting-accommodations@collectivehealth.com.
Privacy Notice
For more information about why we need your data and how we use it, please see our privacy policy: *********************************************
Auto-ApplySr. Claims Examiner
Claims adjuster job in Walnut Creek, CA
Company Details
W. R. Berkley Corporation, founded in 1967, is one of the nation's premier commercial lines property casualty insurance providers. Founded in 2004, Berkley Environmental has underwriting and account executive units in seven regions. Berkley Environmental offers an array of coverages for virtually all classes traditionally known to have environmental liability exposures on both an admitted and non-admitted basis. We provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers' compensation, along with claim services, providing expertise to meet the unique business needs of our customers.
Company URL: *********************************
The company is an equal opportunity employer.
Responsibilities Senior Claims Examiner - Lost Time (California Workers' Compensation)
Location: Remote or Hybrid (3 days in-office, location dependent)
Key functions include but are not limited to the following:
Manage a caseload of lost time claims, ranging from minor to complex.
Ensure compliance with California Workers' Compensation laws and regulations.
Conduct thorough investigations, evaluate claims, and determine appropriate benefits.
Collaborate with internal and external stakeholders to drive timely and fair claim resolutions.
Identify and pursue subrogation opportunities where applicable.
Qualifications
Minimum 10 years of experience handling California Workers' Compensation claims.
Familiarity with other WC jurisdictions is a strong plus.
In-depth knowledge of California Labor Code and Regulations.
Strong analytical, communication, and negotiation skills.
Experience with subrogation is highly desirable.
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include:
• Base Salary Range: $76,000 - $125,000
• Eligible to participate in annual discretionary bonus.
• Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Sponsorship Details Sponsorship not Offered for this Role
Auto-ApplyW2 Adjuster CA (PT)
Claims adjuster job in San Francisco, CA
Job Description
The Field Adjuster will investigate and evaluate daily property claims for clients pursuant to client and company direction. Provide timely, accurate, fair, and professional service to all clients and insured parties while maintaining a high level of production.
Essential Functions:
Handles all assigned claims promptly and effectively, with minimal need for direction and oversight.
Inspect damaged property and determine claim related damage.
Makes decisions within delegated authority as outlined in company policies and procedures.
Understands insurance coverage and applies appropriate claims practices to resolve claims in alignment with company guidelines.
Sets and relays adequate reserves according to carrier guidelines.
Maintains current knowledge of insurance policies and carrier guidelines.
Maintains current knowledge of local industry repair procedures and local market pricing.
Submits severe incident reports, insured to value (ITV) reports and other information to claims management as needed.
Delivers outstanding customer service experience to all internal, external, current, and prospective customers nationwide. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service.
Perform other duties as assigned.
Job Requirements:
Bachelors preferred; High School required.
Must have a valid adjuster license for state residing/covering.
Must have a valid driver's license to travel to insureds locations.
2-3 years of experience with property claims required.
Experience preparing estimates with Symbility required. Xactimate preferred.
Knowledge of insurance policies, theories, and practices.
General understanding of construction concepts and principles strongly preferred.
Must have the ability to climb ladders, get in attics/crawlspaces, get on roofs, kneel, bend, etc.
Must complete continuing education credits where required to maintain licensing.
Strong investigative, analytical, and problem-solving skills
Capability to plan, organize and manage time efficiently.
Ability to work within specific client guidelines concerning both service timelines and preparation of estimates.
Outside Property Claim Representative Trainee
Claims adjuster job in San Francisco, CA
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 CategoryClaimCompensation 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$52,600.00 - $86,800.00Target Openings2What Is the Opportunity?This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.
As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.
This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.What Will You Do?
Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel.
The on the job training includes practice and execution of the following core assignments:
Handles 1st party property claims of moderate severity and complexity as assigned.
Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates.
Broad scale use of innovative technologies.
Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate.
Establishes timely and accurate claim and expense reserves.
Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
Negotiates and conveys claim settlements within authority limits.
Writes denial letters, Reservation of Rights and other complex correspondence.
Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
Meets all quality standards and expectations in accordance with the Knowledge Guides.
Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
Manages file inventory to ensure timely resolution of cases.
Handles files in compliance with state regulations, where applicable.
Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
Identifies and refers claims with Major Case Unit exposure to the manager.
Performs administrative functions such as expense accounts, time off reporting, etc. as required.
Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
Must secure and maintain company credit card required.
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.
In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards.
This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position
Perform other duties as assigned.
What Will Our Ideal Candidate Have?
Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience preferred.
Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic
Verbal and written communication skills -Intermediate
Attention to detail ensuring accuracy - Basic
Ability to work in a high volume, fast paced environment managing multiple priorities - Basic
Analytical Thinking - Basic
Judgment/ Decision Making - Basic
Valid passport preferred.
What is a Must Have?
High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required.
Valid driver's license - 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 *********************************************************
Auto-ApplyField Adjuster (Residential or Commercial) - San Francisco, CA
Claims adjuster job in San Francisco, CA
Job Description
CCMS & Associates is looking for a 1099 Field Adjuster in California, specifically the San Francisco / Bay area. We are looking to add to our existing roster. The time is now to get on board with our team! We are seeking a residential or commercial field adjuster with at least 1 year of field experience.
Requirements:
Minimum 1 year first-party commercial and/or residential property adjusting experience
Maintain own current estimating software - Xactimate preferred (Symbility experience a plus)
Working computer - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
Experience in preparing Statement of Loss, Proof of Loss, and denial letters
California state adjusters license
Must have a valid drivers license
Responsibilities:
Complete residential and commercial field property inspections utilizing Xactimate software
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses and by interviewing fire, police, or other governmental officials as well as inspecting claimed damages
Recommend claim reserves based on investigation, through well-supported reserve report
Obtain and interpret official reports
Review applicable coverage forms and endorsements, provide a thorough analysis of coverage and any coverage issues in a well-documented initial captioned report to the client
Maintain acceptable product quality through compliance with established best practices
Knowledge and Skills:
In-depth knowledge of property and liability insurance coverage and industry standards
Ability to prepare full-captioned reports by collecting and summarizing required information
Strong verbal and written communications skills
Prompt, reliable, and friendly
Preferred but Not Required:
College degree
AIC, IICRC, HAAG or other professional designations
All candidates must pass a full background check (void in states where prohibited)
CCMS & Associates offers multi-line claim adjusting and third-party administration services dedicated to solving the challenges of the complex claim in the property and casualty insurance industry. We create programs that drive a successful claim life cycle while strategically managing all aspects of the complicated issues carriers and policyholders are facing. Servicing excess and surplus/domestic carriers in the United States.
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Contracts and Legal Claims Specialist
Claims adjuster job in Fremont, CA
Salary Range: $50.42 - $68.08
The Contracts and Legal Claims Specialist oversees contracts management the organization's system. and contract lifecycle, from drafting and preparation to execution; ensuring contractual accountability and duties are met by all parties involved. The role ensures effective administration of the full contract lifecycle, from drafting and review. to execution and compliance monitoring. The Contracts and Legal Claims Specialist is also responsible for coordinating claims and legal matter in collaboration with Vice President, outside legal counsel, insurance carriers and internal stakeholders.
The Contracts and Legal Claims Specialist is also responsible for the following duties:
Oversite and daily management Management System of the health system's Contract administrative function. Oversite and management of health system policies and numbered memorandums lifecycle with the collaboration stakeholders. on internal
Subpoena intake and management for the healthcare system, ensuring timely and accurate response to subpoenas and related data requests and coordinating with legal counsel and internal departments and external vendor to manage the subpoena lifecycle Daily management of the health system's Public Record Request website and coordinate with the appropriate stake holders and legal counsel to ensure compliance with regulatory requirements for responding to requests. Supporting the Vice President and Chief Compliance & Risk Officer with management of litigation claims and other legal matter logistics. Facilitates the claims filing and adjudication process with malpractice carriers and collaborates malpractice carriers with legal counsel and to ensure timely coordination of the discovery process for litigation.
Works with legal counsel to coordinate meetings, interviews depositions with and
support. staff and medical staff and provides logistical
In addition to performing the essential functions listed below, may also be assigned other duties as required.
Washington Hospital Health System does not utilize any form of electronic chatting, such as Google chat for the purposes of interviewing candidates for employment. If you are contacted by any entity or individual attempting to engage you in this format, do not disclose any personal information and contact Washington Hospital Healthcare System.
Auto-ApplyContracts and Claims Manager
Claims adjuster job in San Francisco, CA
About the Positions
We're seeking Contracts and Claims Managers to support large, heavy-civil infrastructure programs-including highways, roads, bridges, transit (including rail and bus), and airport projects delivered through both traditional and alternative methods. You'll safeguard the owner's commercial interests, steer change order negotiations, and resolve claims in ways that keep budgets protected and project momentum intact.
This posting is for future roles and not for a specific opportunity that is available right now. We accept applications and conduct interviews in advance of upcoming hiring needs. When a candidate is selected, their profile is activated in our talent pool for this specialty area. We notify our talent pool candidates first whenever we have a project need. This posting targets the greater San Francisco Bay Area, CA.
Responsibilities
may include, but are not limited to, the following:
Develop and implement contract and/or commercial-management strategies across DBB, DB, CM/GC, and P3 delivery models.
Lead and/or support the end-to-end change-management and claims process-from entitlement review through negotiation, settlement, or formal dispute resolution.
Draft, review, and negotiate contract amendments, change orders, and service agreements in alignment with FAR, FIDIC, or state statutory frameworks.
Coordinate with project controls, schedulers, estimators, and legal counsel to quantify cost-and-time impacts and maintain an auditable change and claims log.
Prepare risk exposure analyses and executive briefings that connect commercial issues to contingency, schedule float, and program KPIs.
Represent the owner in mediation, arbitration, or litigation; manage outside counsel and expert consultants as required.
Coach project teams on contract-compliance and claims-avoidance best practices, embedding lessons learned into future procurement documents.
May establish change order and claims management procedures, ensuring consistency across multiple contracts and delivery partners.
Attributes
Excellent written and verbal communication and interpersonal skills. You are a persuasive communicator and skilled negotiator who builds trust across technical, legal, and executive audiences.
Excellent multitasking and organizational skills.
Strong analytical mindset with the ability to translate schedule and cost data into actionable commercial strategies.
Collaborative mindset that fosters teamwork, trust, and positive relationships and thrives in multidiscipline, owner-representative environments.
Natural curiosity, problem-solving abilities, and a passion for continuous improvement.
Minimum Qualifications
Bachelor's degree in engineering, construction management, business, or related field, or an equivalent combination of education and experience.
10+ years of hands-on contracts, change order, or claims management experience on heavy-civil infrastructure programs.
Experience with alternative delivery methods (e.g., DB, CM/GC, P3) and associated risk-allocation mechanisms.
Demonstrated success administering and negotiating complex civil works contracts as an owner's representative or in a role protecting client interests.
Ability to interpret design documents, schedules, cost reports, and commercial terms to build clear entitlement narratives and quantum analyses.
Proficiency with industry standard project management software (e.g., Primavera P6, MS Project, etc.).
Proficiency with Microsoft Office Suite/Office 365 (e.g., Outlook, Teams, Word, PowerPoint, etc.).
Preferred Qualifications
Advanced degree (e.g., JD, LLM, or MBA) with construction law emphasis.
Active professional certifications such as CCM (CMAA), MRICS/FRICS (RICS), PMP (PMI), or CCA (AACE).
Experience with large (>$500M), complex, heavy-civil infrastructure projects that include highways, roads, bridges, transit (including rail and bus), and/or airport projects.
Prior success steering claims through mediation, DRB, or litigation.
Experience with Microsoft Power BI, Oracle Cloud Analytics, or other dashboard KPI reporting software.
Compensation Details
The salary range listed for this role is $150k-$190k/year ($72-$91/hour). The final salary offered will be based on multiple factors and thoughtfully aligned with each candidate's level of experience, breadth of skills, total education achieved, certifications/licenses that have been obtained, geographic location, etc.
Just LOOK at the Benefits We Offer!
Unlimited flexible time off
Paid holidays
Paid parental leave
Health, dental, and vision insurance
Flexible spending accounts (healthcare and dependent or elder care)
Long-term disability insurance
Short-term disability insurance
Life insurance and accidental death and dismemberment
401(k) plan with guaranteed employer contribution
Formal career planning and development program
$2,500 annually toward professional development
Wellness program with monthly wellness stipend
Company cell phone or cell phone plan reimbursement
Free personalized meal planning and nutrition support with a registered dietitian
Free personal financial planning services
Employee assistance program
Employee discounts
Employee referral bonus
Specific plan details and coverage for each benefit noted above will be provided upon offer.
Luster is committed to creating an inclusive work environment with a diverse workforce. All qualified applicants will receive consideration for employment without regard to criminal history, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. This employer participates in E-Verify. The employer will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS) with information from each new employee's I-9 to confirm work authorization.
All positions may be subject to a background check and drug test once a conditional offer of employment is made for any convictions directly related to its duties and responsibilities, in accordance with all applicable local, state, and/or federal regulations.
This job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills for the position.
Luster does not accept unsolicited resumes. In the absence of a signed agreement, Luster will not consider or agree to payment of any kind. Any unsolicited resumes presented to Luster personnel, including those submitted to Luster hiring managers, are deemed to be the property of Luster.
Please email ***************** for accommodations necessary to complete the application process.
Auto-ApplyWorkers Compensation Claims Representative Trainee | West Hills, CA (In-Office)
Claims adjuster job in Hillsborough, CA
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
Workers Compensation Claims Representative Trainee | West Hills, CA (In-Office)
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
+ A stable and consistent work environment in an office setting.
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities.
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due.
**OFFICE LOCATIONS**
Onsite - West Hills, CA
**ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 4-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Attendance and completion of designated classroom claims professional training program.
+ Performs on-the-job training activities including:
+ Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims.
+ Adjusting low and mid-level liability and/or physical damage claims under close supervision.
+ Processing disability claims of minimal disability duration under close supervision.
+ Documenting claims files and properly coding claim activity.
+ Communicating claim action/processing with claimant and client.
+ Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned.
+ Participates in rotational assignments to provide temporary support for office needs.
**QUALIFICATIONS**
Bachelor's or Associate's degree from an accredited college or university preferred.
**EXPERIENCE**
Prior education, experience, or knowledge of:
- Customer Service
- Data Entry
- Medical Terminology (preferred)
- Computer Recordkeeping programs (preferred)
- Prior claims experience (preferred)
Additional helpful experience:
- State license if required (SIP, Property and Liability, Disability, etc.)
- WCCA/WCCP or similar designations
- For internal colleagues, completion of the Sedgwick Claims Progression Program
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum
+ An assigned mentor and manager that will support and guide you on your career journey
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental** **:** Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical** **:** Computer keyboarding, travel as required
**Auditory/Visual** **:** Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
_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 range of starting pay for this role is $27.69/hr. 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._
\#claimsrepresentative #claims #LI-DA1
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Claims Investigator - Experienced
Claims adjuster job in San Francisco, CA
Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must.
Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments.
If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ******************
The Claims Investigator should demonstrate proficiency in the following areas:
AOE/COE, Auto, or Homeowners Investigations.
Writing accurate, detailed reports
Strong initiative, integrity, and work ethic
Securing written/recorded statements
Accident scene investigations
Possession of a valid driver's license
Ability to prioritize and organize multiple tasks
Computer literacy to include Microsoft Word and Microsoft Outlook (email)
Full-Time benefits Include:
Medical, dental and vision insurance
401K
Extensive performance bonus program
Dynamic and fast paced work environment
We are an equal opportunity employer.
Auto-ApplySan Francisco- Field Adjuster - Residential Field Adjuster
Claims adjuster job in San Francisco, CA
SUMMARY DESCRIPTION: The Residential Field Adjuster is responsible for investigating, inspecting, negotiating, and bringing to final resolution property claims of all named-peril losses. For claims where the damage is less severe, the Property Field Adjuster may be assigned tasks, such as verification of damage. The role's primary duties include reviewing coverage, inspecting damaged property, and estimating repair/replacement costs in accordance with the client's and RENFROE's guidelines. The Property Field Adjuster is also responsible for documenting all activity, submitting proper claims paperwork, handling renters and personal property policies, meeting with contractors, effectively communicating with the client and all stakeholders, and ensuring compliance with legal and contractual obligations.
REPORTS TO: Assigned RENFROE Manager
ESSENTIAL JOB FUNCTIONS:
Follows RENFROE and clients' policies and procedures to handle all assigned property claims
Works with the RENFROE Manager and other adjusters to share knowledge and experience and to gain new skills
Completes assigned property adjustments, such as property or contents inspections, verification of loss, and updates claims as new information becomes available using XactAnalysis, Xactimate, or other estimating platforms
Manages the progression of claims/tasks and claim inventories assigned to the them
Travels to the loss location to inspect the property, which could include climbing the roof, inspecting the attic, or other inspection points, to establish the cause and scope of the loss
Works with contractors or another representative to reach an agreement on the scope of loss
Reviews the insurance policy and endorsement details to confirm coverage
Contacts and interacts with the insured to obtain documents such as property deeds, purchase receipts, warranties, photographs, or other documents to establish the existence, ownership, and value of the items claimed lost
Assists the client and claims examiner in determining coverage and amounts for additional living expenses such as rental housing, travel, meals, etc.
Writes closing reports, including recommendations for repair and/or replacement, the pursuit of subrogation, and salvage potential
Maintains required jurisdictional adjusting licenses as required by the client and/or RENFROE
Does not handle claims for which they do not have client authorization or for which they are not licensed
Participates and communicates in client team meetings to discuss claim handling trends, team production, and any claim handling concerns or changes
Makes suggestions on ways to improve process efficiency
Participates in special projects and completes other duties as assigned
Non-Authorized Activities:
Field adjusters should not:
Communicate training requirements to client staff adjusters and non-affiliated firms
Communicate training requirements to any claim handler who is not deployed with RENFROE
Discuss Human Resource issues with any client staff adjusters in any segment or any claim handler that is not deployed with RENFROE
Discuss any of the following topics with a client staff adjuster or any claim handler that is not deployed with RENFROE: job openings, termination, prior work history, attendance, absence requests, daily work schedule, claim volume or workload, meal and rest break schedule, promotions, development, compensation, or mentoring of any kind
EXPERIENCE/QUALIFICATIONS:
Minimum of 1 year of property claims experience is preferred
Participation in technical insurance coursework is preferred, such as CPCU
Experience using various claims processing systems is preferred
Appropriate licenses, depending on state requirements, and successful completion of required/applicable claims certification training classes
Effective problem resolution and decision-making skills to include analyzing insurance policies and information, demonstrating sound judgment, and utilizing one's own experience and the experience of others
Strong analytical skills and consistent attention to detail
Knowledge of ISO forms, and client policy coverage, procedures, and systems
Communicates clearly and effectively, both verbally and in writing
Strong customer service orientation and good rapport with the insured
Well-organized and hard-working, with the ability to thrive in a fast-paced work environment
Strong interpersonal skills and proven ability to establish good relationships with clients, RENFROE management, employees, and others with whom they interact
Computer skills, including but not limited to practical knowledge of Word and Excel
PHYSICAL DEMANDS:
Ability to operate an automobile and have a valid driver's license with a safe driving record
Ability to travel by automobile or airplane
Must be able to lift, carry, unfold/extend, and climb a ladder (which may exceed 50 lbs. in weight) that is approved by the appropriate regulatory agency or complies with legislative or regulatory occupational health and safety requirements
Must be able to complete measurements of roofs and inspect interior as necessary, including attics, basements, and crawl spaces for residential and commercial structures
Must be able to do the following while conducting an inspection: climb, bend, crawl, stoop, walk, reach, kneel, squat, and carry/lift objects (typically weighing less than 50 lbs.)
Must be able to work outdoors in all types of weather
Ability to operate a telephone and a computer for extended periods of time
Must be able to work extended and varying work schedules, including working up to 12 hours a day, 7 days a week, for extended periods of time, including weekends and holidays
Ability to work in a fast-paced, changing, and multi-tasking environment
Daily Property Field Adjuster
Claims adjuster job in San Francisco, CA
Alacrity Solutions
Independent Contractor
Daily Property Field Adjuster
Alacrity Solutions is a full end-to-end provider delivering streamlined insurance claims, repair, and recovery solutions. As one of the largest independent providers of insurance claims services in North America, we provide property, auto, heavy equipment, and casualty claims management services. Our staffing capabilities, temporary housing services, managed repair network, and subrogation services support a fully integrated solution for all your needs from first notice of loss through completion of repairs. By assembling the best service providers through strategic acquisitions and relying on the right talent, Alacrity Solutions provides consistent, professional, and scalable services throughout the entire claim handling and resolution process. To learn more, visit **************************
The objective of a Daily Property Field Adjuster is to provide excellent claim handling services for our clients regarding daily claim work within your area which can include multiple perils.
Contract Requirements Include:
A contract will be issued within 24 hours of accepting your first claim assignment with Alacrity. This IA contract will include pay details and other pertinent information regarding your work as an independent contract with Alacrity. A completed contract is required to issue pay.
Skills & Requirements/Licensure:
MUST live within 50-100 miles of posted location and willing to travel to location.
Minimum 2-3 years property field adjusting experience.
Independent adjusting license in your home state (area of work), or a designated home state license if residing in a non-licensing state.
Experienced in wind, hail, theft, fire, water losses and other perils preferred.
Have reliable transportation, computer, digital camera, ladder, and other miscellaneous items necessary to perform adjuster responsibilities.
Willing and able to climb roofs.
Computer and Phone System Requirements:
Smart Cell Phone able to access to internet.
Xactimate and/or Symbility proficient with current subscription
Working Laptop computer with reliable high-speed internet
Digital camera and other miscellaneous items necessary to perform adjuster responsibilities.
Working Conditions / Physical & Mental Demands:
The physical demands described here are representative and must be met by the independent contractor to successfully perform this job.
100% travel is required within designated working territory based on the location of assignments received.
Normal office or field claims environment. Ability to operate a motor vehicle for up to 8 hours daily, repeatedly entering and exiting the vehicle. Must be able to make physical inspections of auto loss sites. Must be able to work outdoors in all types of weather. Available to work catastrophic loss events. A willingness to work irregular hours and to travel with possible overnight requirements a plus.
Why Choose Alacrity?
Flexibility: Self-determined Scheduling
Diversity Statement
Alacrity is an equal opportunity employer and is committed to providing employees with a work environment free of discrimination and harassment. All decisions pertaining to an employee's employment are made without regard to race, color, religion, sex (including sexual orientation, pregnancy, childbirth), gender, gender identity or expression, age, national origin, ancestry, physical or mental disability, medical condition, reproductive health decisions, veteran's status, genetic information, creed, marital status, disability, citizenship status, or any other characteristic protected by applicable law.
How Long We Retain Personal Information:
We will keep your personal information for as long as necessary to fulfill legitimate business purposes and in accordance with applicable laws.
Auto-ApplyClaim Representative III - Property
Claims adjuster job in San Jose, CA
Why CIG? At Capital Insurance Group we offer our employees more than just a job. We foster career growth, provide opportunities to give back to our communities, and help you take the next step in your career! CIG was founded in 1898 by a group of earnest farmers in need of protection and today, we are the leading West Coast Property & Casualty insurer. CIG is certified as a Great Place to Work and provides a collaborative, inclusive, and fun work culture for all employees.
Why choose CIGs Claims Team?
CIG claims department is here to support our insureds throughout their claims process. We work directly with our agency partners and policyholders to accomplish successful claim resolutions. Join the claims operation and you can be part of a team who provides excellent service, build relationships, and achieves successful outcomes for our clients.
Learn what it means to be a Claim Representative III - Property at CIG