Claims adjuster jobs in Vermont - 23 jobs

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.

If you're passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide's Property and Casualty team could be the place for you! At Nationwide , “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we're looking for associates who are passionate about delivering extraordinary care. This is a field-based role on the National Catastrophe Response Team. This position is responsible for managing property claims in response to catastrophic events across the country. As a field-based adjuster, you will be deployed to areas impacted by large-scale disasters-such as hurricanes, tornadoes, floods, or other major events-to assess damages, support policyholders, and help communities begin the recovery process. The role requires extensive travel (up to 80%), often on short notice, and the ability to work in high-pressure, fast-paced environments for extended periods. You will regularly engage in direct, and at times, emotionally charged conversations with customers-clearly explaining coverage decisions, setting expectations, and delivering difficult news with empathy and professionalism. The ability to remain composed and compassionate in the face of loss, frustration, or uncertainty is essential. Strong communication skills and emotional resilience are critical, as you'll be guiding customers through some of the most challenging moments of their lives. In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments. You'll also be responsible for full file ownership, maintaining appropriate reserves, managing claim activity (including supplements and requests for depreciation), ensuring compliance with internal standards and regulatory requirements, and providing proactive communication with external customers throughout each stage of the claim. Collaboration with internal teams such as Special Investigations and Subrogation may be required to identify fraud or recovery opportunities. Staying current on industry repair practices, regional pricing trends, and legal developments is key to success. This is a demanding, customer-facing role that requires a unique blend of technical expertise, critical thinking, and emotional intelligence. Candidates should be comfortable working independently in disaster zones, managing a high volume of claims, working 12 hours a day, up to 21 days in a row, and adapting quickly to evolving priorities. If you're driven by purpose, thrive under pressure, and want to make a meaningful impact during times of crisis, this role offers a challenging and deeply rewarding opportunity. Ideal candidates will have: Prior insurance field/property claims handling or adjusting experience Proficiency with Xactimate Prior estimate writing experience Ability to handle claims of varying complexity from start to finish Prior experience working in on site in a catastrophe environment Ability to carry a ladder and climb a roof Strong customer service competency Strong written and verbal communication skills. A $5000 SIGN-ON BONUS will be given to all external candidates hired into this role. Half of the bonus will be paid after 3 months of employment and the remainder will be paid after 9 months of employment. Summary No two property claims are ever the same and each customer has unique needs. Our team thrives on providing the very best service and building lasting, successful relationships with our customers. If you are confident, curious, driven to learn and grow, and have a desire to help people when they most need it, we want to know more about you! As a National Catastrophe (NATCAT) Field Claims Specialist primarily supporting our Personal Lines (PL) business, you'll investigate and resolve moderate to severe property damage claims by phone. Job Description Key Responsibilities: Handles all assigned claims promptly and effectively, with little to no direction and oversight. Makes decisions within delegated authority as outlined in company policies and procedures. Determines proper policy coverages and applies appropriate claims practices to resolve cases in alignment with company guidelines. Opens, closes, and adjusts reserves according to company practices to ensure reserve adequacy. Adheres to file conferencing notification and authority procedures. Maintains current knowledge of insurance and applicable product/services; court decisions which may impact the claims function; current guidelines; and policy changes and modifications. This may require attending various seminars and training sessions. Maintains current knowledge of local industry repair procedures and local market pricing. Submits severe incident reports, reinsurance reports and other information to claims management as needed. Partners with Special Investigations Unit and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for lawsuit, trial, or subrogation. Initiates and conducts follow-ups through proficient use of claims and other related business systems. Delivers outstanding customer service to all internal, external, current, and prospective Nationwide customers. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service. May perform other responsibilities as assigned. Reporting Relationships: Reports to Claims Manager. Individual contributor role. Typical Skills and Experiences: Education: Undergraduate degree or equivalent experience. License/Certification/Designation: State licensing where required. Successful completion of required/applicable claims certification training/classes. Experience: Three to five years of related property claims experience or comparable job-related experience, or education preferred. Experience in a customer service environment, including flexible work schedules and extended work hours preferred. Commercial claims property experience preferred. Knowledge, Abilities and Skills: General knowledge of insurance theory and practices, and contracts and their application. Property estimating and automated claims systems. Demonstrated knowledge of the investigation, consultation and settlement activities used to resolve extensive property damage claims. Proven ability to meet customer needs and provide exemplary meaningful service by guiding customers through the claims process and ensuring a positive customer experience. Analytical and problem-solving skills necessary to make decisions and resolve issues related to application of coverages to submitted claims, application of laws of jurisdiction to investigation facts, and application of policy exclusions and exceptions. Ability to establish repair requirements and cost estimates for property losses. Ability to evaluate and successfully advise on property claims. Organizational skills to prioritize work. Command of written and verbal communication skills to effectively communicate with policyholders, claimants, repairpersons, attorneys, agents and the general public. Ability to efficiently operate a personal computer and related claims and business software. Able to provide leadership to less experienced claims associates. Must be able to safely access and inspect rooftops using a ladder. Must be prepared and capable of conducting physical inspections on rooftops, including first and second story roofs with pitches up to 8/12. Other criteria, including leadership skills, competencies and experiences may take precedence. Staffing exceptions to the above must be approved by the business unit executive and HR Business Partner. Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors. Job Conditions: Overtime Eligibility: Not Eligible (Exempt) Working Conditions: Normal office or field claims environment. May require ability to sit and operate phone and personal computer for extended periods of time. Able to make physical inspections of property loss sites; including climb ladders, balance at various heights and rooftops up to 8/12 pitch stoop, bend and/or crawl to inspect vehicles and structures; work outside in all types of weather. Must be willing to work irregular hours and to travel with possible overnight requirements. May be on-call. Must be available to work catastrophes (CAT). Extended and/or non-standard hours as required. Must have a valid driver's license with satisfactory driving record in accordance with Nationwide standards. ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties. Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process. We currently anticipate accepting applications until 01/29/2026. However, we encourage early submissions, as the posting may close sooner if a strong candidate slate is identified before the deadline. Benefits We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage, paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here. Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law. #claims Smoke-Free Iowa Statement: Nationwide Mutual Insurance Company, its affiliates and subsidiaries comply with the Iowa Smokefree Air Act. Smoking is prohibited in all enclosed areas on or around company premises as well as company issued vehicles. The company offers designated smoking areas in which smoking is permitted at each individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air Act, individuals may contact the Smokefree Air Act Helpline at ************. For NY residents please review the following state law information: Notice of Employee Rights, Protections, and Obligations LS740 (ny.gov) ************************************************************* NOTE TO EMPLOYMENT AGENCIES: We value the partnerships we have built with our preferred vendors. Nationwide does not accept unsolicited resumes from employment agencies. All resumes submitted by employment agencies directly to any Nationwide employee or hiring manager in any form without a signed Nationwide Client Services Agreement on file and search engagement for that position will be deemed unsolicited in nature. No fee will be paid in the event the candidate is subsequently hired as a result of the referral or through other means. Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. If a Sales job, Sales Incentives, based on performance goals are possible in addition to this range. Note on Compensation for Part-Time Roles: Please be aware that the salary ranges listed below reflect full-time compensation. Actual compensation may be prorated based on the number of hours worked relative to a full-time schedule.The national salary range for Field Claims Specialist II, National Catastrophe Property - Personal Lines : $62,500.00-$115,500.00The expected starting salary range for Field Claims Specialist II, National Catastrophe Property - Personal Lines : $62,500.00 - $93,500.00

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. The Crop Division of Great American has been helping generations of farmers take control of their risks since 1915. The D ivision is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI policies. With six regional offices throughout the U.S., the teams provide tremendous expertise in the specific needs of farmers and crops. ********************************** Great American is currently seeking Seasonal Crop Adjusters. These positions are seasonal and may not be eligible for full-time or part-time benefits. Qualified candidates will cover territory in one of the following states: Alabama Arkansas California Colorado Florida Georgia Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Michigan Minnesota Mississippi Missouri Montana Nebraska New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania South Carolina South Dakota Tennessee Texas Washington Wisconsin Wyoming Schedule: Seasonal part-time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, you will: Understand and can work claims for all major crops, policy/plan types, in all stages of growth. Complete field inspections, reviews, and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company Crop insurance policies. Review and evaluates coverage and/or liability. Secure and analyze necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims. Ensure compliant and cost effective application of Crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory requirements. Accurately document, process and transmit loss information to determine potential. Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions, or trials as necessary. May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority. Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. Ensures that claims handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed. Follow regulatory and company rules, policies, and procedures. Performs other duties as assigned. Physical Requirements for employees in the Crop Business Unit/Crop Claims General Adjuster Requires continuous and prolonged walking and standing. Requires frequent lifting, carrying, pushing and pulling of objects up to 50 lbs. Requires frequent climbing grain bins, bending, twisting, stooping, kneeling and crawling. Requires overhead reaching and grabbing. Requires regular and predictable attendance. Requires ability to conduct visual inspections. Requires work outdoors, in inclement weather conditions. Requires frequent travel. May require ability to operate a motor vehicle. Business Unit: Crop Salary Range: $0.00 -$0.00 Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.

We welcome both local and remote applicants to apply: While there is a preference for candidates who can work in a hybrid capacity from our Montpelier, VT office, remote candidates located throughout the Northeast will also be fully considered. Not just another job, but an opportunity to work for one of the best insurance companies in the country and reap the rewards that go along with that level of success. We're a 197 year old company that works hard not to act our age; as a result, we have been recognized as one of the "Best Places to Work in Vermont". An open and collaborative environment, coupled with exceptional compensation and benefits help to make us one of the most attractive employment opportunities in the country. We are seeking a senior casualty representative who has experience in handling significant bodily injury claims of moderate to high complexity presenting significant financial exposure and often involving substantive coverage issues and/or litigation. The senior casualty representative should also be skilled in all coverage's written and be capable of seeing more difficult adjustments through final resolution within the provisions of the policy contract and in accordance with known damages and legal requirements. All files handled must comply with claim handling guidelines and all other job expectations, regulations and requirements. If you have qualifications that you feel would allow you to contribute to the continued success of Vermont Mutual, we'd love to hear from you. How to Apply: Submit cover letter, salary requirements and resume, in strict confidence. Apply Online

The Claims Management Specialist serves as the central liaison for General Liability (GL), Auto Liability, and Workers' Compensation (WC) claims. This role ensures timely, accurate, and compliant handling of claims while partnering with Legal, Safety, Finance, HR, and external stakeholders to minimize risk and cost.Salary range is $58,000 -$77,000 annually based on experience. Key Responsibilities * Claims Coordination: Act as the primary point of contact between internal departments (Legal, Safety, Finance, HR), insurance broker and carriers, and third-party claims management company (TPA). Facilitate claim reporting, documentation, and communication across all parties. * General Liability: Oversee third-party claims (e.g., slip-and-fall, property damage). Support Legal in litigation strategy and settlement negotiations. Ensure proper evidence collection and incident investigation with Safety/EHS. * Auto Liability: Coordinate claims for fleet accidents, including driver statements and police reports. Partner with Safety for root-cause analysis and corrective actions. Track claim trends to inform driver training and compliance programs. * Workers' Compensation: Manage employee injury claims in collaboration with HR, Operating Facility Management, and Safety. Ensure timely medical care, claim filing, and return-to-work programs. Monitor OSHA reporting compliance and maintain accurate records. * Financial & Compliance: Monitor reserves, accruals, and claim costs in alignment with SOX and SEC requirements. Prepare periodic loss-run reports and trend analysis for senior management. Ensure adherence to state and federal regulations for insurance claims. * Risk Mitigation & Governance: Implement best practices for claims handling and prevention programs. Participate in quarterly claim reviews with broker and TPA. Support internal audits and insurer reviews. * Participates in training and other learning opportunities to expand knowledge of the company, products, sales, and services, and performs any other duties needed to help drive our vision, fulfill our mission, and/or abide by our core values. Education, Experience & Qualifications The successful candidate will hold a bachelor's degree in Risk Management, Business, or a related field and have 5+ years of experience in claims management, including general liability, auto, and workers' compensation. Strong knowledge of insurance regulations and litigation processes, along with excellent communication and negotiation skills are required. Proficiency in claims management systems and Microsoft Office is essential, as is the ability to work collaboratively across functions and manage multiple priorities effectively. Attributes Enthusiastic, team-oriented individual who possesses the critical combination of in-depth knowledge, analytical and research skills with an ability to see the larger picture. Exceptional reasoning, negotiation and problem-solving combined with the ability to demonstrate sound judgement in the face of challenging and sometimes competing demands is essential.

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.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Specialty Loss Adjuster **Embark on an Exciting Career Journey with Sedgwick Specialty** **Job Location** **: USA, Mexico, Brazil and strategic locations globally** **Job Type** **: Permanent** **Remuneration** **: Salaries can range from** **_$40,000.00USD to $250,000.00USD_** **taking into account skills, experience and qualifications.** **We have a number of fantastic opportunities for Specialty Loss Adjusters across the US, Mexico and Brazil and a number of key locations** We are looking for a variety of skill sets at all levels. Whether you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your skills and grow with a company that values innovation, excellence, and employee satisfaction. Are you ready to be a part of providing a differentiated and best of class proposition to clients whilst working with like-minded colleagues? Sedgwick Specialty is thrilled to announce that we are investing in growth across Natural Resources, Property, Casualty, Technical and Special Risks and Marine. As we expand our operations, we are seeking individuals who are passionate about making a difference to the Adjusting industry. **As a member of the Specialty platform, you will have the opportunity to:** + Work with a wide range of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team of professionals who are dedicated to delivering exceptional results + Utilise state-of-the-art technology and resources to streamline processes and enhance efficiency + Receive ongoing training and development opportunities to further enhance your skills and knowledge in the marine industry + Enjoy a flexible work arrangement that allows you to maintain a healthy work-life balance while contributing to our global success **The skills you will have when you apply:** + **Qualified** : it is important to us that you are either accredited, on your way to be accredited or qualified by experience + **Insurance claims experience:** it is imperative that you have experience working on insurance claims within you respective field. Full claims life cycle experience is a must + **Great communicator:** you will be constantly working with policy holders, brokers, carriers and various third parties, so being able to communicate accurately important. Providing an excellent customer service with our clients in mind. Able to approach issues empathetically + **Commercially minded:** An understanding of how the industry operates and where the role of a Loss Adjuster fits in. Being able to negotiate. Understanding how to market your services is a big advantage **What we'll give you for this role:** As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the annual salaries can range from _$40,000.00 to $250,000.00USD._ Bonus eligible role. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always Accepting Applications. **This isn't just a position, it's a pivotal role in shaping our industry** At Sedgwick, you won't just build your career; you'll cultivate a team of experts. Our Sedgwick University offering empowers you to excel as well as your team members, with the most comprehensive training program in the industry which includes more than 15,000 courses on demand, training specific to roles, and opportunities to continue formal education. Together, we're not only reshaping the insurance landscape, we're building a legacy of talent. Come and be a catalyst for change within our industry. **Next steps for you:** **Think we'd be a great match? Apply now -** ** we want to hear from you.** As part of our commitment to you, we are proud to have a zero tolerance policy towards discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex or sexual orientation. After the closing date we will review all applications and may select some applicants for an interview (which may be virtual, or in-person). \#LI-HYBRID Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for building positive client relationships, providing education, and analyzing client claim losses as well as current issues regarding client activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. **ESSENTIAL RESPONSIBILITIES** + Processes daily incoming Stop Loss claims including initial entry claims or subsequent claims as needed; provides counseling to clients and assists with client service programs. + Evaluates various claims submitted by Third Party Administrators (TPAs) and Pharmacy Benefit Managers (PBMs) on behalf of self-funded clients for compliance with the following: underlying policy provisions, federal and state regulatory guidelines, and industry standards. + Monitors, reviews and analyzes various complex potential claims with emphasis on controlling losses through effective managed care. This includes following a departmental claim checklist to ensure eligibility is met, the payment reimbursement request is accurate by auditing the claim for duplicate line-item charges and determining if all information is available to finalize the payment request. Refers the claim to the cost containment and RxOps departments for review of high dollar charges if applicable. + Determines whether to pend or adjudicate claims following organizational policies and procedures; finalizes and adjudicates claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim information to TPAs, brokers, or customers utilizing the appropriate application and/or template. + Identifies potential discrepancies in claim submissions and involves the Special Investigation Unit as necessary. Identifies issues which can be used to educate/train internal staff, streamline, and improve processes and update documentation. + Assists leadership with performing client performance evaluations to assess the accuracy of client reports submitted to the organization, efficiency of claim operations, and adequacy of systems and procedures. + Approves claim payments on behalf of multiple clients and provides client counseling and support services. Assists in the client service programs including revising and establishing procedures, protocols and ensuring client satisfaction with the organization. + Maintains accurate claim records. + Other duties as assigned or requested. **EDUCATION** **Required** + High School Diploma/GED **Substitutions** + None **Preferred** + Bachelor's degree **EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience processing 1st dollar health insurance claims + 3 years of experience with medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information effectively. + Organizational skills + Ability to manage time effectively. + Ability to work independently. + Problem Solving and analytical skills. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $22.71 **Pay Range Maximum:** $35.18 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273755

The Claims Management Specialist serves as the central liaison for General Liability (GL), Auto Liability, and Workers' Compensation (WC) claims. This role ensures timely, accurate, and compliant handling of claims while partnering with Legal, Safety, Finance, HR, and external stakeholders to minimize risk and cost.Salary range is $58,000 -$77,000 annually based on experience. Key Responsibilities * Claims Coordination: Act as the primary point of contact between internal departments (Legal, Safety, Finance, HR), insurance broker and carriers, and third-party claims management company (TPA). Facilitate claim reporting, documentation, and communication across all parties. * General Liability: Oversee third-party claims (e.g., slip-and-fall, property damage). Support Legal in litigation strategy and settlement negotiations. Ensure proper evidence collection and incident investigation with Safety/EHS. * Auto Liability: Coordinate claims for fleet accidents, including driver statements and police reports. Partner with Safety for root-cause analysis and corrective actions. Track claim trends to inform driver training and compliance programs. * Workers' Compensation: Manage employee injury claims in collaboration with HR, Operating Facility Management, and Safety. Ensure timely medical care, claim filing, and return-to-work programs. Monitor OSHA reporting compliance and maintain accurate records. * Financial & Compliance: Monitor reserves, accruals, and claim costs in alignment with SOX and SEC requirements. Prepare periodic loss-run reports and trend analysis for senior management. Ensure adherence to state and federal regulations for insurance claims. * Risk Mitigation & Governance: Implement best practices for claims handling and prevention programs. Participate in quarterly claim reviews with broker and TPA. Support internal audits and insurer reviews. * Participates in training and other learning opportunities to expand knowledge of the company, products, sales, and services, and performs any other duties needed to help drive our vision, fulfill our mission, and/or abide by our core values. Education, Experience & Qualifications The successful candidate will hold a bachelor's degree in Risk Management, Business, or a related field and have 5+ years of experience in claims management, including general liability, auto, and workers' compensation. Strong knowledge of insurance regulations and litigation processes, along with excellent communication and negotiation skills are required. Proficiency in claims management systems and Microsoft Office is essential, as is the ability to work collaboratively across functions and manage multiple priorities effectively. Attributes Enthusiastic, team-oriented individual who possesses the critical combination of in-depth knowledge, analytical and research skills with an ability to see the larger picture. Exceptional reasoning, negotiation and problem-solving combined with the ability to demonstrate sound judgement in the face of challenging and sometimes competing demands is essential. Benefits Medical, Dental, Vision, Life & Disability Insurance, Maternity & Parental Leave, Flexible Spending Accounts, Discounted Stock Program, 401K, Boot & Clothing Allowance, Safety Awards, Employee Assistance Plan, Wellness Incentive, Tuition Assistance, Career Pathways, and More.

The Claims Management Specialist serves as the central liaison for General Liability (GL), Auto Liability, and Workers' Compensation (WC) claims. This role ensures timely, accurate, and compliant handling of claims while partnering with Legal, Safety, Finance, HR, and external stakeholders to minimize risk and cost. Salary range is $58,000 -$77,000 annually based on experience. Key Responsibilities Claims Coordination: Act as the primary point of contact between internal departments (Legal, Safety, Finance, HR), insurance broker and carriers, and third-party claims management company (TPA). Facilitate claim reporting, documentation, and communication across all parties. General Liability: Oversee third-party claims (e.g., slip-and-fall, property damage). Support Legal in litigation strategy and settlement negotiations. Ensure proper evidence collection and incident investigation with Safety/EHS. Auto Liability: Coordinate claims for fleet accidents, including driver statements and police reports. Partner with Safety for root-cause analysis and corrective actions. Track claim trends to inform driver training and compliance programs. Workers' Compensation: Manage employee injury claims in collaboration with HR, Operating Facility Management, and Safety. Ensure timely medical care, claim filing, and return-to-work programs. Monitor OSHA reporting compliance and maintain accurate records. Financial & Compliance: Monitor reserves, accruals, and claim costs in alignment with SOX and SEC requirements. Prepare periodic loss-run reports and trend analysis for senior management. Ensure adherence to state and federal regulations for insurance claims. Risk Mitigation & Governance: Implement best practices for claims handling and prevention programs. Participate in quarterly claim reviews with broker and TPA. Support internal audits and insurer reviews. Participates in training and other learning opportunities to expand knowledge of the company, products, sales, and services, and performs any other duties needed to help drive our vision, fulfill our mission, and/or abide by our core values. Education, Experience & Qualifications The successful candidate will hold a bachelor's degree in Risk Management, Business, or a related field and have 5+ years of experience in claims management, including general liability, auto, and workers' compensation. Strong knowledge of insurance regulations and litigation processes, along with excellent communication and negotiation skills are required. Proficiency in claims management systems and Microsoft Office is essential, as is the ability to work collaboratively across functions and manage multiple priorities effectively. Attributes Enthusiastic, team-oriented individual who possesses the critical combination of in-depth knowledge, analytical and research skills with an ability to see the larger picture. Exceptional reasoning, negotiation and problem-solving combined with the ability to demonstrate sound judgement in the face of challenging and sometimes competing demands is essential. Benefits Medical, Dental, Vision, Life & Disability Insurance, Maternity & Parental Leave, Flexible Spending Accounts, Discounted Stock Program, 401K, Boot & Clothing Allowance, Safety Awards, Employee Assistance Plan, Wellness Incentive, Tuition Assistance, Career Pathways, and More.

We welcome both local and remote applicants to apply: While there is a preference for candidates who can work in a hybrid capacity from our Montpelier, VT office, remote candidates located throughout the Northeast will also be fully considered. JOB SUMMARY Directly handle a technical claims caseload of a general liability claims. Caseload typically comprised of files arising from a broad range of coverage or perils and possessing a wide range of financial exposure and complexity. Such claims occasionally involve coverage issues or litigation. Employee should possess demonstrated expertise in handling bodily injury claims which involve both comparative negligence theories and defenses and be able to conclude claims promptly and equitably within the provisions of the policy contract and in accordance with known damages and legal requirements. Litigated files should constitute a minority of pending. All files handled must comply with claim file handling guidelines and all other job expectations, regulations and requirements. DUTIES & RESPONSIBILITIES Conduct and coordinate loss investigations on all assigned claims. Negotiate the settlement of claims within authorized amounts or specific file authority. Maintain accountability for all assigned claims until disposition is reached. Recommend further action to supervisor on claims exceeding authority limits. Document all substantive activity on assigned claims and assist in the control of independent vendors. Review new losses and open files on diary to ensure reserve adequacy while keeping management informed of adverse developments. Monitor loss adjustment expense and take steps to mitigate file expenses. Utilize vendors judiciously to maximize value added. Recognize coverage issues and work with supervisor and claim management for manner of redress/resolution. Refer appropriate coverage matters to the Claim Supervisor or Claim Manager. Ensure appropriate file handling, documentation, reporting and expense control of all files handled inclusive of legal bill review/vendor performance/bill review/MSP compliance Provide accurate, courteous and timely information to all eligible external and internal customers concerning claim status and other claim inquiries. Attend meetings with policyholders and agencies as needed. Draft coverage correspondence in collaboration with Supervisor, including reservation of rights and coverage disclaimer along with composing detailed correspondence to insureds, claimants, attorneys, etc. Attend trials, depositions, EUO's, appraisals and mediations where deemed beneficial or required. Participate in various forms of Litigation training and as a mentee with an assigned Examiner Mentor for litigation and coverage advancement Improve processes within the department to increase the level and quality of service provided to internal and external customers, i.e. workflow changes, systems implementation, etc. Participate in setting file direction and recommend appropriate reserves on claim files within specific authority and on files requiring mandatory reporting to management. This position handles an assigned claim pending. Performs other duties or special projects as required or as assigned. SUPERVISION RECEIVED The Claim Supervisor provides direct minimal supervision. SUPERVISION EXERCISED Primarily no supervisory duties; however limited supervision of independent adjusters and vendors may occur. QUALIFICATIONS Bachelor's degree in business, insurance or a related field, or its equivalent Three or more years of relevant claim technical experience; or a combination of education and experience from which comparable knowledge and skills are acquired. Appropriate state adjuster's license(s) where required by law. Demonstrated commitment to professional development through continuing education related to the job such as AIC, AEI, INS, SCLA CPCU, etc. Established and improving skills in specialized technical disciplines; including working knowledge of relevant insurance, contract and tort law. Participation in training courses and mentorship program Knowledgeable about the insurance industry and company operations. Sound analytical, and negotiations skills. Very good verbal and written communication skills. Ability to exercise sound judgment in dealing with professional and personnel situations. Ability to work effectively with a wide range of outside firms, etc. Ability to collaborate effectively with company management, peers and support staff. Demonstrated customer service orientation. Proficiency with PC applications including Microsoft Office (Word, Excel & Outlook); Experience with imaging and claims handling programs preferred. Ability to perform job duties under stressful situations. PHYSICAL DEMANDS/WORKING CONDITIONS Employees in this job classification may be based in a typical office or a remote location or residence as determined by management. Predominately sedentary office position with high frequency of keyboarding/computer work required. Occasional overnight travel required. Potentially subject to stressful situations with respect to claim dispute. May be exposed to adverse external conditions and inclement Weather. The salary range reflected is a good faith estimate of base pay for the position. In addition to base salary, this role is incentive compensation and benefits eligible, and individual salary will ultimately be determined based on individual experience, skills, qualifications and geographic location.

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 Senior Professional Liability Claims Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. **ARE YOU AN IDEAL CANDIDATE?** We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to designated authority level. + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent negotiation skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **TAKING CARE OF YOU BY** + We offer a diverse and comprehensive benefits package including: + Three Medical, and two dental plans to choose from. + Tuition reimbursement eligible. + 401K plan that matches 50% on every $ you put in up to the first 6% you save. + 4 weeks PTO your first full year. **NEXT STEPS** If your application is selected to advance to the next round, a recruiter will be in touch. _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 $100,000 - $110,000. 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._ 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. 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**

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.

We welcome both local and remote applicants to apply: While there is a preference for candidates who can work in a hybrid capacity from our Montpelier, VT office, remote candidates located throughout the Northeast will also be fully considered. Not just another job, but an opportunity to work for one of the best insurance companies in the country and reap the rewards that go along with that level of success. We are a 197 year old company that works hard not to act our age; as a result, we have been recognized as one of the; Best Places to Work in Vermont;. An open and collaborative environment, coupled with exceptional compensation and benefits help to make us one of the most attractive employment opportunities in the country. We are seeking a casualty/general liability claims professional to join our team of adjusters to resolve third party liability claims. The ideal candidate has excellent customer service skills, verbal and written communication, is organized, detail oriented, and is well versed in negotiations and legal discussions. An adjuster's license is preferred, but we are willing to train the right candidate. If you have qualifications that you feel would allow you to contribute to the continued success of Vermont Mutual, we'd love to hear from you. How to Apply: Submit cover letter, salary requirements and resume, in strict confidence. Apply Online

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 National General Adjuster - Northeast Region **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any complex adjustment issue and any medium sized and relatively complex National Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims, and other records to determine insurance coverage. + Administers and reconciles complex catastrophic claims for property. + Interviews, telephones, or corresponds with claimant(s) and witnesses regarding claim. + Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance. + Estimates cost of repair, replacement, or compensation. + Prepares report of findings and negotiates settlement with claimant. + Recommends litigation by legal department when settlement cannot be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probably costs. + Prepares loss experience reports to help determine profitability and calculates adequate future rates. + Interacts with excess carrier to determine coverages, excess insurance levels, and potential reimbursements. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Must have earned the IIA-AIC designation and be actively pursuing another professional insurance designation. **Experience** Five (5) years of related experience or equivalent combination of education and experience required. **Skills & Knowledge** + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong customer service skills + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently or in a team environment + Ability to meet or exceed Performance Competencies **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: + Ability to stand and/or walk for long periods of time. + Ability to kneel, squat or bend. + Ability to work outdoors in hot and/or cold weather conditions. + Ability to climb, crawl, stoop, kneel, reaching/working overhead. + Ability to lift/carry up to 50 pounds. + Ability to push/pull up to 100 pounds. + Ability to drive up to 4 hours per day. + Must have continual use of manual dexterity. 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 88,920.00 - 124,488.00. (Bonus or commission eligibility, if applicable). 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. 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**

Job Description We welcome both local and remote applicants to apply: While there is a preference for candidates who can work in a hybrid capacity from our Montpelier, VT office, remote candidates located throughout the Northeast will also be fully considered. JOB SUMMARY Directly handle a technical claims caseload of a general liability claims. Caseload typically comprised of files arising from a broad range of coverage or perils and possessing a wide range of financial exposure and complexity. Such claims occasionally involve coverage issues or litigation. Employee should possess demonstrated expertise in handling bodily injury claims which involve both comparative negligence theories and defenses and be able to conclude claims promptly and equitably within the provisions of the policy contract and in accordance with known damages and legal requirements. Litigated files should constitute a minority of pending. All files handled must comply with claim file handling guidelines and all other job expectations, regulations and requirements. DUTIES & RESPONSIBILITIES Conduct and coordinate loss investigations on all assigned claims. Negotiate the settlement of claims within authorized amounts or specific file authority. Maintain accountability for all assigned claims until disposition is reached. Recommend further action to supervisor on claims exceeding authority limits. Document all substantive activity on assigned claims and assist in the control of independent vendors. Review new losses and open files on diary to ensure reserve adequacy while keeping management informed of adverse developments. Monitor loss adjustment expense and take steps to mitigate file expenses. Utilize vendors judiciously to maximize value added. Recognize coverage issues and work with supervisor and claim management for manner of redress/resolution. Refer appropriate coverage matters to the Claim Supervisor or Claim Manager. Ensure appropriate file handling, documentation, reporting and expense control of all files handled inclusive of legal bill review/vendor performance/bill review/MSP compliance Provide accurate, courteous and timely information to all eligible external and internal customers concerning claim status and other claim inquiries. Attend meetings with policyholders and agencies as needed. Draft coverage correspondence in collaboration with Supervisor, including reservation of rights and coverage disclaimer along with composing detailed correspondence to insureds, claimants, attorneys, etc. Attend trials, depositions, EUO's, appraisals and mediations where deemed beneficial or required. Participate in various forms of Litigation training and as a mentee with an assigned Examiner Mentor for litigation and coverage advancement Improve processes within the department to increase the level and quality of service provided to internal and external customers, i.e. workflow changes, systems implementation, etc. Participate in setting file direction and recommend appropriate reserves on claim files within specific authority and on files requiring mandatory reporting to management. This position handles an assigned claim pending. Performs other duties or special projects as required or as assigned. SUPERVISION RECEIVED The Claim Supervisor provides direct minimal supervision. SUPERVISION EXERCISED Primarily no supervisory duties; however limited supervision of independent adjusters and vendors may occur. QUALIFICATIONS Bachelor's degree in business, insurance or a related field, or its equivalent Three or more years of relevant claim technical experience; or a combination of education and experience from which comparable knowledge and skills are acquired. Appropriate state adjuster's license(s) where required by law. Demonstrated commitment to professional development through continuing education related to the job such as AIC, AEI, INS, SCLA CPCU, etc. Established and improving skills in specialized technical disciplines; including working knowledge of relevant insurance, contract and tort law. Participation in training courses and mentorship program Knowledgeable about the insurance industry and company operations. Sound analytical, and negotiations skills. Very good verbal and written communication skills. Ability to exercise sound judgment in dealing with professional and personnel situations. Ability to work effectively with a wide range of outside firms, etc. Ability to collaborate effectively with company management, peers and support staff. Demonstrated customer service orientation. Proficiency with PC applications including Microsoft Office (Word, Excel & Outlook); Experience with imaging and claims handling programs preferred. Ability to perform job duties under stressful situations. PHYSICAL DEMANDS/WORKING CONDITIONS Employees in this job classification may be based in a typical office or a remote location or residence as determined by management. Predominately sedentary office position with high frequency of keyboarding/computer work required. Occasional overnight travel required. Potentially subject to stressful situations with respect to claim dispute. May be exposed to adverse external conditions and inclement Weather. The salary range reflected is a good faith estimate of base pay for the position. In addition to base salary, this role is incentive compensation and benefits eligible, and individual salary will ultimately be determined based on individual experience, skills, qualifications and geographic location.

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 Regional General Adjuster - Northeast Region **PRIMARY PURPOSE** **:** To handle losses or claims regionally unassisted up to $10M, including having the ability to address most complex adjustment issues pertaining to damages and coverage; to assist on even larger losses and manage smaller and non-complex National Accounts. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines claim forms and other records to determine insurance coverage. + Administers and reconciles complex catastrophic claims for property. + Interviews, telephones, or corresponds with claimant and witnesses regarding claim. + Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance. + Estimates cost of repair, replacement, or compensation. + Prepares report of findings and negotiates settlement with claimant. + Recommends litigation by legal department when settlement cannot be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Prepares loss experience reports to help determine profitability and calculates adequate future rates. + Interacts with excess carrier to determine coverages, excess insurance levels, and potential reimbursements. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Must have earned the IIA-AIC designation and be actively pursuing another professional insurance designation. Appropriate state adjuster license is required. **Experience** Five (5) years of related experience or equivalent combination of education and experience required. **Skills & Knowledge** + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong customer service skills + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently or in a team environment + Ability to meet or exceed Performance Competencies **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: + Must be able to stand and/or walk for long periods of time. + Must be able to kneel, squat or bend. + Must be able to work outdoors in hot and/or cold weather conditions. + Have the ability to climb, crawl, stoop, kneel, reaching/working overhead + Be able to lift/carry up to 50 pounds + Be able to push/pull up to 100 pounds + Be able to drive up to 4 hours per day. + Must have continual use of manual dexterity 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 71,136.00 - 99,590.00. (Bonus or commission eligibility, if applicable). 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. 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**

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 Executive General Adjuster - Northeast Region **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other companies for personal, casualty, or property loss or damages and attempts to effect out-of-court settlement with claimants. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Handles complex losses locally unassisted up to designated authority; assists on larger losses, including handling accounting-based losses (business interruption and stock). + Examines claim form and other records to determine insurance coverage. + Interviews, telephones, or corresponds with claimant and witnesses regarding claim. + Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance. + Estimates cost of repair, replacement, or compensation. + Prepares report of findings and negotiates settlement with claimant. + Recommends litigation by legal department when settlement cannot be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Prepares loss experience reports to help determine profitability and calculates adequate future rates. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Must have earned the IIA-AIC designation and be actively pursuing another professional insurance designation. Appropriate state adjuster license is required. **Experience** Five (5) years of related experience or equivalent combination of education and experience required. **Skills & Knowledge** + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong customer service skills + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently or in a team environment + Ability to meet or exceed Performance Competencies **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** : + Must be able to stand and/or walk for long periods of time. + Must be able to stand and/or walk for long periods of time. + Must be able to kneel, squat or bend. + Must be able to work outdoors in hot and/or cold weather conditions. + Have the ability to climb, crawl, stoop, kneel, reaching/working overhead + Be able to lift/carry up to 50 pounds + Be able to push/pull up to 100 pounds + Be able to drive up to 4 hours per day. + Must have continual use of manual dexterity. **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 115,596.00 - 161,834.00. (Bonus or commission eligibility, if applicable). 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. 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**

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 Regional General Adjuster - Northeast Region PRIMARY PURPOSE: To handle losses or claims regionally unassisted up to $10M, including having the ability to address most complex adjustment issues pertaining to damages and coverage; to assist on even larger losses and manage smaller and non-complex National Accounts. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Examines claim forms and other records to determine insurance coverage. Administers and reconciles complex catastrophic claims for property. Interviews, telephones, or corresponds with claimant and witnesses regarding claim. Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance. Estimates cost of repair, replacement, or compensation. Prepares report of findings and negotiates settlement with claimant. Recommends litigation by legal department when settlement cannot be negotiated. Attends litigation hearings. Revises case reserves in assigned claims files to cover probable costs. Prepares loss experience reports to help determine profitability and calculates adequate future rates. Interacts with excess carrier to determine coverages, excess insurance levels, and potential reimbursements. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Travels as required. QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Must have earned the IIA-AIC designation and be actively pursuing another professional insurance designation. Appropriate state adjuster license is required. Experience Five (5) years of related experience or equivalent combination of education and experience required. Skills & Knowledge Strong oral and written communication, including presentation skills PC literate, including Microsoft Office products Strong customer service skills Attention to detail and accuracy Good time management and organizational skills Ability to work independently or in a team environment Ability to meet or exceed Performance Competencies 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: Must be able to stand and/or walk for long periods of time. Must be able to kneel, squat or bend. Must be able to work outdoors in hot and/or cold weather conditions. Have the ability to climb, crawl, stoop, kneel, reaching/working overhead Be able to lift/carry up to 50 pounds Be able to push/pull up to 100 pounds Be able to drive up to 4 hours per day. Must have continual use of manual dexterity 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 71,136.00 - 99,590.00. (Bonus or commission eligibility, if applicable). 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. 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.