Claims representative jobs in Amherst, NY

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere! Key Objective: Under the direction of the Claims Team Leader investigates and settles claims promptly, equitably and within established best practices guidelines. Duties may include but are not limited to: Receive new assignments. Reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business. Contacts, interviews and obtains statements (recorded or in person) from insured's, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information. Arrange for surveys and experts where appropriate. Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company's obligation to the insured under the policy contract. Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc. Sets reserves within authority limits and recommends reserve changes to Team Leader. Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions. Timely and appropriate management of litigation files. Assists Team Leader in developing methods and improvements for handling claims. Settles claims promptly and equitably. Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims and expenses. Informs claimants, insured's/customers/ agents or attorney of denial of claim when applicable. May assist Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements. Continues efforts to settle claims before trial. Refers claims to subrogation as appropriate. May participate in claim file reviews and audits with customer/insured and broker. Administers benefits timely and appropriately. Maintains control of claim's resolution process to minimize current exposure and future risks Establishes and maintains strong customer relations i.e. agents, underwriters, insureds, experts Depending on line of business, other duties may include: Maintaining system logs Investigating compensability and benefit entitlement Reviewing and approving medical bill payments or forwarding for outside review as necessary. Managing vocational rehabilitation Scope: The position reports directly to a Claims Team Leader or other member of claims management. 3-5 years experience handling higher level Workers' Compensation claims. Basic knowledge of claims handling and familiarity with claims terminologies. Effective negotiation skills. Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc in a positive manner concerning losses. Ability to self motivate and work independently. Knowledge of Chubb products, services, coverages and policy limits, along with awareness of claims best practices Knowledge of applicable state and local laws State adjusters licensing a plus or will require future licensing. Familiar in computer systems 40 words per minute typing skills An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam. The pay range for the role is $62,200 to $105,800. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled. ESIS, a multi-line Third-Party Administrator (TPA), provides claims, risk control & loss information systems to Fortune 1000 clients across its North American platform. ESIS provides a full range of sophisticated risk management services, including workers compensation claims handling; a broad spectrum of casualty insurance products, such as general liability, automobile liability, products liability, professional liability, and medical malpractice claims handling; and disability management.

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.

We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Centivo is seeking a Claims Supervisor to lead a team of Claims Processors, ensuring accurate and efficient claims processing for employer-sponsored health plans. This role sets productivity benchmarks, enforces quality standards, and drives continuous improvement. The Claims Supervisor will collaborate with support teams to manage backlog and turnaround times while working with Quality/Training and System Configuration teams to standardize processes and resolve issues. They may also oversee appeals, subrogation, and overpayment/refunds, ensuring compliance and efficiency. Responsibilities Include: * Demonstrates knowledge and understanding of benefit administration for self-funded healthcare plans * Ensures that claims are processed and paid in accordance with benefit plans, pricing agreements, and required authorizations. * Manages the inventory of claims against standard service level agreements (SLA's) * Educates and mentors claims staff to ensure proper application of client benefit plans to claims processed, at the required quality and production metrics, including establishing performance plans for those falling below expectations with appropriate coaching and mentoring to achieve improvement. * Provides reports to department leaders on claim inventory, production, turn-around lag, and quality metrics * Develops policy and procedures to ensure that benefit plans and claim standards are properly administered; assists in developing policies and procedures for operations, and monitors claim staff for compliance * Accountable for positively influencing the morale of the department employees, including setting achievable goals, fostering teamwork by involving team in the design/implementation of solutions to problems * Responsible to establish annual goals for staff that align with organization strategies and personal growth and can provide timely and constructive feedback on performance * Is a liaison for the claims on various projects and/or initiatives including testing needs to support system implementations and/or upgrades * Performs other duties as deemed essential and necessary Qualifications: Required Skills and Abilities: * Knowledge: Thorough understanding of insurance policies, claims handling processes, and legal requirements associated with claims. * Leadership: Strong leadership and team management skills, with the ability to effectively manage and motivate a team. * Analytical Skills: Ability to analyze claims data and make informed decisions based on findings. * Experience: Previous experience in claims processing or a related field, including supervisory experience. * Understands health insurance benefit administration in a Self-Funded environment * Ability to read and understand various forms, documentation, files, and information with the department. Education and Experience: * Candidate must have at least 3 years of experience with self-funded health care plans, and processing in a TPA environment * Candidate must have at least 3 years of experience supervising a claims team * Candidates must have prior experience with a highly automated and integrated claim adjudication system * Experience working with HealthRules Payer * Understanding of health insurance benefits administration in a self-funded environment Preferred Qualifications: * Past Training Experience * Experience working at TPA * Experience with self-funded plans Work Location: * An ideal candidate would be assigned to the Buffalo Office with ability to work from home. * If not in the Buffalo area, the opportunity can be remote. Leadership Skills & Behaviors: ● Strategic Thinking - Knack for sorting through clutter to find the best route, often by pulling up from the current complexity to identify patterns that guide future direction and allow one to narrow the options and articulate the options from which others can work backward. ● Business Acumen - A keenness and quickness in understanding and dealing with a business situation (risks and opportunities) in a manner that is likely to lead to a good outcome. Critical to this is an ability to think beyond their own function. ● Systems/Analytical Thinking - Demonstrates the ability to think fluidly and integrate information. Able to anticipate non-linear and non-obvious relationships. Often includes an ability to think holistically/conceptually - very powerful when accompanied by ability to communicate & clarify tactically. ● Flexibility/Working through Ambiguity - Tendency to be energized by new experiences/perspectives that test assumptions and thinking. Considers different points of view, sometimes with fragmented information, to arrive at practical, effective, actionable next steps. ● Communicate - Managers discuss the company's vision and strategies, the department's direction and goals, and in times of crisis, what we know and don't know to make sure team members know what they need to know. ● Clarify - As managers, it's up to us to clarify what good looks like. What do we expect? What do our clients, customers or colleagues need? If our teams are not performing as expected, managers must clarify expectations and ensure understanding. ● Coach - Managers provide recognition and feedback; help team members find solutions to challenges; amplify good and filter weaker aspects of organizational culture and the work as they coach employees in their day-to-day performance and their growth and career development. ● Connect - Managers help our teams see their collective purpose and how their work connects to the greater whole. We connect people within our company and network. ● Customize - As managers, we need to understand what makes each team member unique, and then customize, tailor and adapt how we support them. Who we are: Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com. Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.

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.

Job Type: Permanent Build a brilliant future with Hiscox Individual contributor role responsible for the handling of Miscellaneous Professional Liability claims for the organization from inception to resolution. This involves the negotiation and settlement of Miscellaneous Professional Liability insurance claims. May be responsible for single or multi-country claims and will be responsible for all aspects of the claims, including liaise with external and internal business partners (e.g., outside experts and/or or legal counsel; underwriting) as required. Bring your Passion and Enthusiasm to our Team! We are a fun, innovative and growing Claims team where you'll get the opportunity to learn multiple insurance products and interact with business leaders across the organization. Please note that this position is hybrid and requires two (2) days in office weekly. Position can be based in the following locations: Manhattan, NY West Hartford, CT Atlanta, GA Chicago, IL Boston, MA The Role: The Complex Claims Specialist is a high-level adjuster role that adjudicates assigned claims within given authority and provides operational support to the claims team. This person also: Adjusts and resolves complex to severe claims that includes all phases of litigation With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters Reviews and analyses claim documentation and legal filings Drives litigation best practices to lead defense strategy on litigated files Mentors Claim Examiners Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions Identifies emerging exposures and claims trends Identifies suspected fraudulent claims and tracks with special investigations unit Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities Develops content and conducts training for claims team and underwriters as requested The Team: The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox's strong brand built on a long history of outstanding claims handling. Requirements: 8+ years of claims handling experience or 7-8 years litigation experience. (A JD from an ABA accredited law school may be considered as a supplement to claims handling experience.) Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Experience in mentoring and training other claims examiners Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University preferred Additional Factors Considered Ability to act a subject matter expert within team Demonstrated ability to work with minimal oversight Experience attending and leading mediations, arbitrations and trials Demonstrated ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects Demonstrates courage in addressing and solving difficult or complex matters with insureds, attorneys and brokers Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation Commitment to professional development and learning demonstrated by at least 5 hours of continuing education related to insurance topics through Success Factory, Hiscox in-person or video conference training sessions, or other in-person seminars or webinars. What Hiscox USA offers 401(k) with competitive company matching Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care) Company paid group term life, short- term disability and long-term disability coverage 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days Paid parental leave 4-week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing 2023 Gold level recipient of Cigna's Healthy Workforce Designation for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. Diversity and flexible working at Hiscox At Hiscox we care about our people. We hire the best people for the job and we're committed to diversity and creating a truly inclusive culture, which we believe drives success. We also understand that working life doesn't always have to be ‘nine to five' and we support flexible working wherever we can. No promises, but please chat to our resourcing team about the flexibility we could offer for this role. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary range $125,000 - $155,000 (Boston, Manhattan, West Hartford) Salary range $120,000-$130,000 (Chicago, Atlanta) 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. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-AJ1 Work with amazing people and be part of a unique culture

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 Contents Adjuster **PRIMARY PURPOSE** : To handle losses and claims for property and casualty insurers. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies and other records to determine insurance coverage. + Interviews, telephones, and/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. + Assists in preparing loss experience report 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. Obtain IIA-AIC designation within 12 to 18 months. Appropriate state adjuster license is required. **Experience** None. **Skills & Knowledge** + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Demonstrated commitment to timely reporting + Strong customer service skills + Strong interpersonal 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 ($50,000 - $70,000). 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. 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**

FLSA Status: Non-Exempt Starting Rate: $19.50 per hour The Claims Specialist is responsible for maintaining, entering, and following up on all client medical insurance and financial information. The position prepares claim data for transmission to Medicaid, Medicare, and Managed Care plans. A Claims Specialist will organize billing and rebilling materials as well as create and analyze reports from the billing system to provide feedback to program sites. The Claims Specialist is responsible for maintaining positive and professional client and external insurance agency relations. POSITION RESPONSIBILITIES * Enters, updates, and verifies client data from service documents. * Using Medicaid EMEVS or E-PACES verifies client Medicaid information. * Tracks client referrals and authorizations in system. * Prepares claim batches for transmission to Medicaid, Medicare, and 3rd party payers. * Maintains claims batch reports. * Posts client payments to the service level. * Posting and mailing of client statements. * Produces and analyzes routine reports in a timely manner. * Reviews and processes payer denials. * Performs all other duties as assigned. QUALIFICATIONS * High school diploma or equivalency plus a minimum of two years paid experience in medical insurance billing. -OR- Associates degree in Business Administration plus a minimum of 1 year paid experience in medical insurance billing. * Completion of medical billing certification preferred. * Experience working with clients to assist with their medical insurance co-payments/deductibles and other related medical billing inquiries required. * Experience following up with medical insurance companies regarding clients claims and submitting medical insurance claims. * Experience balancing a cash drawer/cash reconciliation. * Knowledge of OMH, DOH, Medicaid, Medicare, and TPA regulations. * Strong ability to utilize common office technology/software including the use of the Microsoft Office Suite (Excel and Outlook mainly) * Ability to organize and maintain billing materials. * High attention to detail. * Ability to take initiative, make appropriate decisions, and solve problems with autonomy * Ability to perform routine arithmetic computations. * Excellent communication skills with all levels of staff Some things you can look forward to: * Welcoming, team environment, that inspires you to thrive and be your BestSelf! * Rewarding work experience! * Generous paid time off * Flexible schedule * Multiple and diverse health insurance options * Many other unique lifestyle & personal insurance options * Tuition reimbursement * CASAC certification tuition support * Career growth and advancement opportunities * We look forward to telling you more!

Full-time Description We're looking for a Claims Specialist who is ready to take ownership of complex claim adjudication tasks within our Flex administration programs, including Section 125, 129, 132, 105(h), and more. In this role, you'll play a key part in ensuring accuracy, efficiency, and an exceptional experience for our customers and clients. If you enjoy detailed work, problem-solving, and making a meaningful impact behind the scenes, this is a great opportunity to grow your expertise. Key Responsibilities Accurately process claims within established timelines Review and complete claim adjustment requests Research claim reversal requests to determine approval or denial Manage debit card dispute workflows, including fraudulent or disputed transactions Provide clear and professional responses to routine phone and written inquiries related to claim processing Issue manual adverse determination letters, notifying participants of required information or appeal rights in accordance with plan rules Adjudicate transactions that fail auto-review and determine whether additional documentation is needed Requirements High School Diploma or equivalent Knowledge of ERISA guidelines preferred Strong written and verbal communication skills with excellent attention to detail Ability to manage multiple priorities using strong organizational and time-management skills Comfortable interacting with customers, colleagues, and management and responding to questions clearly and professionally Self-starter who can work independently in a fast-paced environment with critical deadlines An Equal Opportunity Employer. Salary Description 16.00 - 18.00

Job Description 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. Powered by JazzHR rXzZkqANop

Property Adjusters investigate commercial property claims, evaluate damages, determine coverage, set accurate loss cost estimates, control the insured's exposures and losses, manage consultants, and achieve a prompt, fair and equitable settlement according to fair claims handling requirements. Negotiate settlement of claims with varying complexity and perils. Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. This role is open to both Grades 12 to 13. Responsibilities: Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin, and extent of loss. Reviews and utilizes financial statements to adjust moderately sized business interruption losses. Conduct on-site appraisal or direct independent adjuster to determine facts relevant causation, damages and exposure. Engages and manages consultants and independent adjusters as required. Monitors the costs to ensure they are reasonable and necessary. Establishes and maintains accurate loss cost estimates and reserves for each claim for reporting, financial records, and other purposes. Keeps the Insured and others informed about the claim's status with clear, timely and accurate written/oral communications. Effectively communicates in writing on moderately complex coverage issues with minimal review and coaching. Determines depreciation of claim. Affirms or denies coverage of the claim based on the facts and the policy terms and conditions. Develops information necessary to make advance, partial and final payments when appropriate. Meet time requirements of the policy and fair claims handling practices. Effectively negotiate settlement of claims of varying complexity and perils. Achieves a prompt, fair and equitable settlement of a claim, where there is policy liability. Keeps the electronic claim file properly documented with accurate, clear and timely information and reports that reflect the adjustment activities and substantiate any payments made. May participate in quality assurance file review sessions and serve as a technical resource for less experienced claims personnel. Will be called upon for catastrophe duty. Qualifications Knowledge of property insurance; commercial property claims; coverage evaluation; claims investigation, loss assessment, evaluation and reserves; financial analyses; insurance regulations. Negotiation and settlement of moderate to high complexity claims. Other skills required include a focus on customers; decision making; results oriented; spoken communication; and adaptability. An ability to build relationships, listen (i.e., comprehend nuances and acknowledge others' viewpoints), mentoring and training less experienced team members, write business correspondence, produce accurate work, manage projects and vendors. Use core applications/spreadsheets. As normally acquired through a bachelor's degree or equivalent; successful completion of required internal training programs and AIC (Associate in Claims) modules 33 and 35. Prefer designations such as AIC, SCLA, CPCU, etc, and at least 2-3 year of progressively responsible experience. Ability and willingness to travel to the site of catastrophe for assignments that may last several weeks. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Buffalo, NY. This will be a Full-Time position. This position must be located within driving distance to our pharmacy, with a hybrid work style. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $21.00 an hour and up Sign-On Bonus: $5,000 for employees starting before February 1, 2026. We offer a variety of benefits including: Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Company paid benefits - life; and short and long-term disability Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360... Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information.. Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information. Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim. Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible) Manages all funding related adjudications and works as a liaison to Onco360 Advocate team. Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment. Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable. Document and submit requests for Patient Refunds when appropriate. Pharmacy Adjudication Specialist Qualifications and Responsibilities... Education/Learning Experience Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience Work Experience Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills Desired: Knowledge of Foundation Funding, Specialty pharmacy experience Licenses/Certifications Required: Registration with Board of Pharmacy as required by state law Desired: Certified Pharmacy Technician (PTCB) Behavior Competencies Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills #Company Values: Teamwork, Respect, Integrity, Passion

Summary: Works to resolve claims/issues that impact the customer as it relates to errors in Order Processing, Accounts Receivable, Shipping, and defective products. There is a strong troubleshooting/problem solving component to this position Essential Responsibilities: Customer Care - Help resolve customer complaints/issues when an order was not entered, shipped, or received correctly. Investigation of customer complaints and ensuring resolution to these issues. Create CFB, document and report policy and procedure errors, and see CFBs through to resolution. Carrier Claims - Investigate and gather documentation with evidence. Prepare paperwork and submit claims for pursuance of payment/reimbursement. Act as the liaison with carriers involved with shipping errors. UPS - Coordinate the filing of UPS clams DOT - Ensure Liberty Pumps is in compliance with all DOT requirements/regulations; stay abreast of new DOT requirements; provide training/education to drivers; maintain driver completed log books Risk Management - Assist & work closely with Senior Claims Analyst and Chief Financial Officer in the administration of product liability claims Accounts Receivable - work with A/R in the resolution of disputes such as billing errors & shipping errors to ensure timely payments. Safety - Members are held responsible and accountable to follow safety guidelines, maintain a clean and organized work area, and use good safety judgment. Able to work well in a team environment and diverse group settings You will be expected to operate according to ISO 9001 requirements. Held responsible and accountable to follow safety guidelines, maintain a clean and organized work area, and use good safety judgment. Expected to report all unsafe activities and conditions to the Supervisor and/or Safety Representative. This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the member for this job. Duties, responsibilities, and activities may change at any time with or without notice. Minimum Qualifications: Organizational skills and being able to remain flexible at all times is necessary. Computer literate in common word processing, spreadsheet, and other Windows-based PC programs. Education/Training: High school diploma or GED Experience/Skills/Abilities: Ability to read, write, edit, analyze, and comprehend instructions, short correspondence, and general business documents. Ability to speak effectively before groups of customers or employees of organization. Ability to define problems, collect data, establish facts, and draw valid conclusions. Proficient personal computer skills including electronic mail, record keeping, routine database activity, word processing, spreadsheet, graphics, etc. Handle multiple projects simultaneously. Willing to work in a team environment. Self-motivated, capable of taking direction as well as working with minimal supervision. Ability to remain calm under pressure such as working through an employment situation. Work Schedule/Hours: Monday - Friday with typical business hours. Occasional overtime may be necessary when working on special projects. Minimal overnight travel (up to 10%) by land and/or air. Working Conditions: Well-lighted, heated, and/or air-conditioned indoor office/shop environment with adequate ventilation. Light physical activity performing non-strenuous daily activities of an administrative nature. Moderate noise (examples: business office with computers and printers, light traffic).

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.

Job Description We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Centivo is seeking a Claims Supervisor in Management Ancillary Services (CMAS). The Supervisor will be responsible for the oversight and management of the claim processing functions related to claims adjudication, appeals, escalations, quality, and recovery. The CMAS Supervisor will have direct management of a team that supports, researches, and resolves the accurate processing of healthcare claims for employer-sponsored health plans. This role sets productivity benchmarks, enforces quality standards, and drives continuous improvement. They will collaborate with internal and external partners to resolve issues and standardize processes, ensuring standard processes are established, policies are enforced, and issues are mitigated through collaborative decision-making. Responsibilities Include: Demonstrates knowledge and understanding of benefit administration for self-funded healthcare plans Ensures that claims, appeals, and adjustments are processed and paid in accordance with benefit plans, pricing agreements, and required authorizations Manages the inventory of claims against standard service level agreements (SLA's) Educates and mentors claims staff to ensure proper application of client benefit plans to claims processed, at the required quality and production metrics, including establishing performance plans for those falling below expectations with appropriate coaching and mentoring to achieve improvement. Provides reports to department leaders on claim inventory, production, turn-around lag, and quality metrics Develops policy and procedures to ensure that benefit plans and claim standards are properly administered; assists in developing policies and procedures for operations, and monitors claim staff for compliance Accountable for positively influencing the morale of the department employees, including setting achievable goals, fostering teamwork by involving team in the design/implementation of solutions to problems Responsible to establish annual goals for staff that align with organization strategies and personal growth and can provide timely and constructive feedback on performance Liaison for the CMAS Team on various projects and/or initiatives including claims and testing needs to support system implementations and/or upgrades Performs other duties as deemed essential and necessary Qualifications: Required Skills and Abilities: Knowledge: Thorough understanding of insurance policies, claims handling processes, and legal requirements associated with claims. Leadership: Strong leadership and team management skills, with the ability to effectively manage and motivate a team. Analytical Skills: Ability to analyze claims data and make informed decisions based on findings. Experience: Previous experience in claims processing or a related field, including supervisory experience. Understands health insurance benefit administration in a Self-Funded environment Ability to read and understand various forms, documentation, files, and information with the department. Education and Experience: High School diploma or GED required. Bachelor's degree or equivalent work experience. 5 years or more experience with healthcare claims administration, self-funded preferred. Experience leading and delegating tasks to multiple direct reports. Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others. Must possess proven organizational, rational reasoning, ability to examine information, and problem-solving skills, with attention to detail necessary to act within complex environment. Proficient experience in MS Word, Excel, Outlook, and PowerPoint required. Candidates must have prior experience with a highly automated and integrated claim adjudication system; El Dorado-Javelina and/or Health Rules Payer experience preferred but not required. Preferred Qualifications: Experience with member appeals, recovery processes, including NSA, subrogation and overpayment process, member, and/or client escalations. Ability to understand how, and to do thorough research, comfortable interviewing internal expertise and applying the 5 W's and/or other tools to complete root cause analysis. Ability to assimilate quickly to the organization or department's culture and speak in the voice of the brand; able to see the perspective of others and how to translate towards effective solutions. Ability to take complex issues and break them down so that it can be understood by others; ability to communicate with non-expert audiences. Strong knowledge of benefit plans, policies, and procedures, understanding of medical terminology. Strong technical and analytical skills. Work Location: An ideal candidate would be assigned to the Buffalo Office with ability to work from home. If not in the Buffalo area, the opportunity can be remote. Leadership Skills & Behaviors: Strategic Thinking - Knack for sorting through clutter to find the best route, often by pulling up from the current complexity to identify patterns that guide future direction and allow one to narrow the options and articulate the options from which others can work backward. Business Acumen - A keenness and quickness in understanding and dealing with a business situation (risks and opportunities) in a manner that is likely to lead to a good outcome. Critical to this is an ability to think beyond their own function. Systems/Analytical Thinking - Demonstrates the ability to think fluidly and integrate information. Able to anticipate non-linear and non-obvious relationships. Often includes an ability to think holistically/conceptually - very powerful when accompanied by ability to communicate & clarify tactically. Flexibility/Working through Ambiguity - Tendency to be energized by new experiences/perspectives that test assumptions and thinking. Considers different points of view, sometimes with fragmented information, to arrive at practical, effective, actionable next steps. Communicate - Managers discuss the company's vision and strategies, the department's direction and goals, and in times of crisis, what we know and don't know to make sure team members know what they need to know. Clarify - As managers, it's up to us to clarify what good looks like. What do we expect? What do our clients, customers or colleagues need? If our teams are not performing as expected, managers must clarify expectations and ensure understanding. Coach - Managers provide recognition and feedback; help team members find solutions to challenges; amplify good and filter weaker aspects of organizational culture and the work as they coach employees in their day-to-day performance and their growth and career development. Connect - Managers help our teams see their collective purpose and how their work connects to the greater whole. We connect people within our company and network. Customize - As managers, we need to understand what makes each team member unique, and then customize, tailor and adapt how we support them. Centivo Values: Resilient - This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don't give up. Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon. Positive - We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous, humble, and positive. Who we are: Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com. Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co. Compensation Range: $70K - $80K

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere! The ESIS Senior Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines. Duties may include but are not limited to: Claims Management: Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies. As a Senior Claim Representative, candidate will be responsible for more complex and intricate, requiring an advanced skillset. Communication: Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process. Investigation: Conduct thorough investigations of claims, including gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability. Decision-Making: Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on the facts of the case and applicable laws. Documentation: Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system. Cost Control: Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while ensuring appropriate reserves are established and maintained. Compliance: Ensure adherence to state-specific workers' compensation laws, regulations, and reporting requirements. Customer Service: Provide exceptional service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status. Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal claim outcomes. Experience: Minimum of 5+ years of experience handling workers' compensation claims; prior experience with ESIS or similar third-party administrators is a plus. Knowledge & Licensing: Knowledge of Texas Workers Compensation and active adjuster license or ability to obtain licensure within a specified timeframe. Skills: Strong analytical and problem-solving abilities. Excellent verbal and written communication skills. Proficiency in claims management systems and Microsoft Office Suite. Ability to manage multiple priorities and meet deadlines in a fast-paced environment. Knowledge: Familiarity with workers' compensation laws, medical terminology, and claim handling best practices. As a Senior Claim Representative, candidate will be responsible for more complex and intricate, requiring an advanced skillset. An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam. The pay range for the role is $65,900 to $111,900. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled. ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS' innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients' unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.

Full-time Description Are you a motivated leader with a knack for guiding teams to success? Join our Reimbursement Account Services Department as a Claims Supervisor and take charge of a dynamic claims team! In this role, you'll ensure smooth workflow, provide expert guidance on claims adjudication, and uphold the IRS regulations that govern our services, all while helping your team thrive. Requirements What You'll Do: Lead, motivate, and organize the claims team to meet productivity and quality goals. Oversee workflow, ensuring adherence to procedures and IRS regulations. Streamline processes to boost efficiency without compromising customer service. Coach, develop, and hold your team accountable; praise achievements and provide guidance when needed. Support staffing, onboarding, training, and employee development. Stay up to date on federal, state, and local regulations for accurate claim processing. Assist with claims processing and resolving participant inquiries as needed. What We're Looking For: Associate's degree required 3-5 years of reimbursement account experience Claims processing experience preferred Proven supervisor experience is a must Salary Description $55,000-$65,000

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.

Property Adjusters investigate commercial property claims, evaluate damages, determine coverage, set accurate loss cost estimates, control the insured's exposures and losses, manage consultants, and achieve a prompt, fair and equitable settlement according to fair claims handling requirements. Negotiate settlement of claims with varying complexity and perils. Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. This role is open to both Grades 12 to 13. Responsibilities: * Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin, and extent of loss. Reviews and utilizes financial statements to adjust moderately sized business interruption losses. * Conduct on-site appraisal or direct independent adjuster to determine facts relevant causation, damages and exposure. * Engages and manages consultants and independent adjusters as required. Monitors the costs to ensure they are reasonable and necessary. * Establishes and maintains accurate loss cost estimates and reserves for each claim for reporting, financial records, and other purposes. * Keeps the Insured and others informed about the claim's status with clear, timely and accurate written/oral communications. Effectively communicates in writing on moderately complex coverage issues with minimal review and coaching. Determines depreciation of claim. * Affirms or denies coverage of the claim based on the facts and the policy terms and conditions. Develops information necessary to make advance, partial and final payments when appropriate. * Meet time requirements of the policy and fair claims handling practices. * Effectively negotiate settlement of claims of varying complexity and perils. Achieves a prompt, fair and equitable settlement of a claim, where there is policy liability. * Keeps the electronic claim file properly documented with accurate, clear and timely information and reports that reflect the adjustment activities and substantiate any payments made. * May participate in quality assurance file review sessions and serve as a technical resource for less experienced claims personnel. * Will be called upon for catastrophe duty. Qualifications * Knowledge of property insurance; commercial property claims; coverage evaluation; claims investigation, loss assessment, evaluation and reserves; financial analyses; insurance regulations. * Negotiation and settlement of moderate to high complexity claims. * Other skills required include a focus on customers; decision making; results oriented; spoken communication; and adaptability. * An ability to build relationships, listen (i.e., comprehend nuances and acknowledge others' viewpoints), mentoring and training less experienced team members, write business correspondence, produce accurate work, manage projects and vendors. * Use core applications/spreadsheets. * As normally acquired through a bachelor's degree or equivalent; successful completion of required internal training programs and AIC (Associate in Claims) modules 33 and 35. * Prefer designations such as AIC, SCLA, CPCU, etc, and at least 2-3 year of progressively responsible experience. * Ability and willingness to travel to the site of catastrophe for assignments that may last several weeks. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

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.