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Michigan Homeowners Claim Representative II
The Auto Club Group 4.2
Claims representative job in Milwaukee, WI
Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager IWhat you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss. Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Employees assigned to the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update. Supervisory Responsibilities: None How you will benefit: A competitive annual salary between $64,000 - $72,000 ACG offers excellent and comprehensive benefits packages, including: Medical, dental and vision benefits 401k Match Paid parental leave and adoption assistance Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays Paid volunteer day annually Tuition assistance program, professional certification reimbursement program and other professional development opportunities AAA Membership Discounts, perks, and rewards and much more We're looking for candidates who:Required Qualifications (these are the minimum requirements to qualify) Education: Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members. Experience: One year of experience or equivalent training in the following: Negotiating claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advance knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Knowledge of building construction and repair techniques Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG Claim policies, procedures and guidelines Work within assigned ACG Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Research, analyze, and interpret subrogation laws in various states Strong negotiating skills Ability to work outside normal business hours as needed Preferred Qualifications: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Xactimate software experience/training or experience in an equivalent software Claims adjuster experience specifically in home/property claims preferred Experience working within a customer service setting Call center experience or experience handling high volume calls preferred, but not required Excellent communication skills both oral and written Experience working within an insurance or claims-based role for one year or more Full claims cycle experience preferred Work Environment This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
$64k-72k yearly 1d ago

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Island Passport Club Representative
Treasure Island Resort & Casino 4.1
Claims representative job in Prescott, WI
Pay Rate: $16.00 an hour with $2.00 an hour additional shift differential on swing and grave shift ESSENTIAL DUTIES AND RESPONSIBILITIES Welcome guests, answer questions and provide information and support to guests Input, update and maintain accurate player information in the casino management system Issue Island Passport club cards for club members Be knowledgeable about and provide guests with information regarding Island Passport club membership, property-wide events and other property amenities Redeem cash, prizes and comps for guests following department guidelines Meet goals as established by management Maintain a working knowledge of promotional systems Performance point and promotion adjustments following department guidelines KNOWLEDGE AND CERTIFICATION, SKILLS AND ABILITIES Required Knowledge and Certification: High School Diploma/GED or equivalent experience Preferred Knowledge and Certification: 1-year hospitality or guest service experience, preferably in casinos Required Skills: Accurate and detail oriented Highly organized and ability to adapt quickly to changing priorities Excellent verbal and interpersonal communication and problem solving skills Proven high guest service skills Proficient computer skills Microsoft Office (Word, Excel and Outlook) and Windows Required Abilities: Ability to work in a fast paced environment Ability to interact with guests, coworkers and management in a professional and courteous manner Ability to follow established dress code policies and practice good personal hygiene Ability to speak in a clear, concise and pleasant voice Ability to retain large amounts of information regarding the property and its amenities Ability to read and write English PHYSICAL DEMANDS Must be able to walk, stand and/or sit for long periods throughout the day Must have a good sense of balance, and be able to bend, kneel, stoop and twist Must be able to push, pull and grasp objects occasionally Must have the ability to independently lift up to 25 pounds occasionally Must be able to perform repetitive hand and wrist motions WORKING ENVIRONMENT Office, restaurant, gaming floor and convention center environment including flashing lights, frequent loud noises and cigarette smoke and outdoors for guest events Must be willing to work a flexible schedule including all shifts, weekends and holidays Extensive computer use Occasionally must deal with angry or hostile individuals High volume direct public contact
$16 hourly 6d ago
Claims Representative - Workers Compensation
West Bend Mutual Insurance 4.8
Claims representative job in Appleton, WI
Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities. Job Summary When employees are injured on the job, they need someone who can guide them through the process with care and expertise. As a Workers' Compensation Claims Representative at West Bend, you'll guide injured employees through the recovery process, ensure fair and timely claim resolution, and help businesses stay compliant. If you thrive on problem-solving, negotiation, and making a real impact, this is your opportunity to lead with confidence. Work Location This position offers a hybrid schedule with three in-office collaboration days for team meetings and other events. In certain cases, highly qualified candidates with strong jurisdictional experience may be considered for a remote arrangement. External applications will be accepted on a rolling basis while the position remains open. Responsibilities & Qualifications As a Claims Representative, you will manage claims of varying complexity using current claim technology and best practices. You will conduct thorough investigations to determine coverage, evaluate damages/benefits, and assess liability/compensability. You will negotiate settlements with insureds, claimants, and attorneys while maintaining proactive file management, accurate reserving, and adherence to audit and regulatory standards. This role collaborates closely with internal partners and external stakeholders, with the scope of responsibility (including field work and regional liaison duties) increasing with experience level. Key Responsibilities * Investigate and resolve claims within assigned authority * Determine coverage, damages, and liability * Negotiate settlements with insureds, claimants, and attorneys * Maintain accurate documentation and reserving * Communicate promptly and professionally with all stakeholders * Collaborate with internal teams and external partners * Adhere to audit and compliance standards * Participate in training and team initiatives Preferred Experience and Skills * Prior experience managing claims at the appropriate level of complexity (from low/moderate to high-exposure/complex) * Proficiency with computers and current claim technology * Interpersonal, oral, and written communication skills with customer-focused professionalism * Negotiation, problem-solving, and conflict resolution skills * Time management and organizational discipline with proactive file handling * Independent decision-making ability (higher levels) and results orientation * Technical expertise in coverage analysis, compensability, and damages evaluation (higher levels) * Prior experience managing claims across multiple jurisdictions (higher levels) with preferred jurisdictions of Illinois, Wisconsin, and North Carolina Preferred Education and Training * Bachelor's degree in Business, Insurance or related field * Associate in General Insurance (AINS) designation * Associate in Claims (AIC) designation * CPCU coursework or other continuing education * Licensure in jurisdictions where required #LI-LW1 Salary Statement The salary range for this position is $67,000 - $100,000. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate. Benefits West Bend offers a comprehensive benefit plan including but not limited to: * Medical & Prescription Insurance * Health Savings Account * Dental Insurance * Vision Insurance * Short and Long Term Disability * Flexible Spending Accounts * Life and Accidental Death & Disability * Accident and Critical Illness Insurance * Employee Assistance Program * 401(k) Plan with Company Match * Pet Insurance * Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates * Bonus eligible based on performance * West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies. EEO West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.
$33k-42k yearly est. Auto-Apply 30d ago
Claims Representative - Workers Compensation
Thesilverlining
Claims representative job in Appleton, WI
Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities. Job Summary When employees are injured on the job, they need someone who can guide them through the process with care and expertise. As a Workers' Compensation Claims Representative at West Bend, you'll guide injured employees through the recovery process, ensure fair and timely claim resolution, and help businesses stay compliant. If you thrive on problem-solving, negotiation, and making a real impact, this is your opportunity to lead with confidence. Work Location This position offers a hybrid schedule with three in-office collaboration days for team meetings and other events. In certain cases, highly qualified candidates with strong jurisdictional experience may be considered for a remote arrangement. External applications will be accepted on a rolling basis while the position remains open. Responsibilities & Qualifications As a Claims Representative, you will manage claims of varying complexity using current claim technology and best practices. You will conduct thorough investigations to determine coverage, evaluate damages/benefits, and assess liability/compensability. You will negotiate settlements with insureds, claimants, and attorneys while maintaining proactive file management, accurate reserving, and adherence to audit and regulatory standards. This role collaborates closely with internal partners and external stakeholders, with the scope of responsibility (including field work and regional liaison duties) increasing with experience level. Key Responsibilities Investigate and resolve claims within assigned authority Determine coverage, damages, and liability Negotiate settlements with insureds, claimants, and attorneys Maintain accurate documentation and reserving Communicate promptly and professionally with all stakeholders Collaborate with internal teams and external partners Adhere to audit and compliance standards Participate in training and team initiatives Preferred Experience and Skills Prior experience managing claims at the appropriate level of complexity (from low/moderate to high-exposure/complex) Proficiency with computers and current claim technology Interpersonal, oral, and written communication skills with customer-focused professionalism Negotiation, problem-solving, and conflict resolution skills Time management and organizational discipline with proactive file handling Independent decision-making ability (higher levels) and results orientation Technical expertise in coverage analysis, compensability, and damages evaluation (higher levels) Prior experience managing claims across multiple jurisdictions (higher levels) with preferred jurisdictions of Illinois, Wisconsin, and North Carolina Preferred Education and Training Bachelor's degree in Business, Insurance or related field Associate in General Insurance (AINS) designation Associate in Claims (AIC) designation CPCU coursework or other continuing education Licensure in jurisdictions where required #LI-LW1 Salary Statement The salary range for this position is $67,000 - $100,000. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate. Benefits West Bend offers a comprehensive benefit plan including but not limited to: Medical & Prescription Insurance Health Savings Account Dental Insurance Vision Insurance Short and Long Term Disability Flexible Spending Accounts Life and Accidental Death & Disability Accident and Critical Illness Insurance Employee Assistance Program 401(k) Plan with Company Match Pet Insurance Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates Bonus eligible based on performance West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies. EEO West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.
$29k-42k yearly est. Auto-Apply 1d ago
Claims Specialist
Jewelers Mutual 3.8
Claims representative job in Neenah, WI
Responsible for adjudicating PL, CL, Shipping, and CarePlan claims as assigned. The claims specialist also assists with administrative duties for the department, helping the team effectively negotiate and resolve claims in a timely manner and in accordance with established good faith handling procedures. A secondary responsibility within this role is to provide support to the Jewelry Recovery Specialist with salvage-related documentation including salvage-related invoices, payments, and recoveries. Why Jewelers Mutual: Since 1913 we've been committed to supporting the Jewelry industry and putting customers at the center of everything we do. With over a century of trusted expertise, we're financially strong, forward-thinking, and driven by curiosity. Guided by our core values of Agility, Accountability, and Relevancy, we lead through innovation. As a technology focused organization, we embrace cutting-edge tools and data-driven insights to continuously improve our products, services, and customer experience. Our mission is to be the industry's most trusted advisor by investing in our people, adopting new technologies, and striving for excellence. We're dedicated to fostering growth through collaboration, powered by bold thinking, teamwork, and the passion of our people. Here, you'll: Move fast and embrace change Always look for better ways Grow, thrive, and help shape what's next Join us and be part of a culture where you can make an impact while building your future. What You'll Do: Investigates, evaluates, and resolves multi-line claims in accordance with established procedures, good faith practices, and in accordance with the policy. Examines claim adjustors' reports or similar claims/precedents to determine extent of coverage and liability. Pays claimant/insured amount due according to our contractual obligation and in alignment with our company procedures. Identifies and refers questionable claims to the special investigation unit in accordance with established fraud reporting procedures. Maintains excellent written and verbal correspondence with all parties involved on the claim. Evaluates and obtains damage documentation to accurately set reserves and effectively resolve claims. Maintains current status on claims and reviews claims on diary system. May be required to provide testimony under oath on claims in litigation. Provides quality customer service along with accurate and timely claim investigations and payments. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. What You'll Bring: Property/casualty insurance adjusting experience is desired. Jewelry expertise, including experience working in the jewelry trade, is desired. Proficient in Microsoft suite applications including Word, Excel, Outlook, and PowerPoint. Proficiency in Guidewire software desired. CERTIFICATES, LICENSES, REGISTRATIONS None PHYSICAL REQUIREMENTS Prolonged periods sitting at a desk and working on a computer. Occasionally required to stand; walk; use hands to finger, handle, or touch objects or controls; and talk or hear. What We Offer You: Competitive Compensation & Benefits: Includes performance bonuses, generous paid time off, and a top-tier retirement program with 401(k) matching and additional company contributions. Collaborative Culture: Work alongside talented, passionate peers who value ownership and continuous learning. Community & Giving: Benefit from 50% charitable gift matching and paid volunteer time to support nonprofit causes Great Place to Work Certified: Join a team recognized for an environment of innovation and growth. Accessibility and Accommodations We are committed to providing an inclusive and accessible recruitment process. If you require accommodation at any stage of the application or interview process, please let us know by contacting *************************.
$52k-69k yearly est. 28d ago
Claims Adjuster Trainee
Progressive 4.4
Claims representative job in Green Bay, WI
Progressive is dedicated to helping employees move forward and live fully in their careers. Your journey has already begun. Apply today and take the first step to Destination: Progress. As a claims adjuster trainee, you'll learn how to help customers get back on the road after an accident. This is not a field position, which means you'll be building relationships with customers over the phone. In a fast-paced environment, you'll learn how to resolve a full case load of claims efficiently while managing the claims process from start to finish. You'll have the support of a collaborative team and ongoing coaching from leaders. We'll also teach you the insurance stuff - providing in-depth training on property damage and insurance contracts so you can confidently and independently adjust claims. This is a hybrid role, which means you'll work in-office two days that are selected by local leadership and choose where you want to work the other three days, whether that's at home or in the office, for a period of 12 months. After that period, the days you'll be expected to report to an office for important meetings, training, and collaboration will vary based on business need. In this hybrid work environment, you'll be supported by your leaders and tenured colleagues to develop relationships, establish connections, and share practices that are important to your development. If you prefer an in-office environment, you're welcome to work in the office as often as you would like. Duties & responsibilities (upon completion of training) * Determine coverage * Determine liability (who's at fault for the damages) * Interview customers, claimants, and witnesses * Partner with appraisers/estimators to manage vehicle repairs * Negotiate with customers and other insurance carriers and resolve claims Must-have qualifications * Three years of work experience OR * Bachelor's degree OR * Two years work experience and an associate degree Schedule: Monday - Friday, 8:30 am - 5:30 pm for the first four weeks during training, then 9:00 am - 6:00 pm. Location: 2505 E Evergreen Dr, Ste B, Appleton, WI or 8333 Greenway Blvd, Ste 200, Middleton, WI Compensation * Once you complete training and pass any necessary testing requirements, your salary will be $54,000-$57,500/year, however, during training, you'll be paid hourly based on your annual salary. * Gainshare annual cash incentive payment up to 16% of your eligible earnings based on company performance Benefits * 401(k) with dollar-for-dollar company match up to 6% * Medical, dental & vision, including free preventative care * Wellness & mental health programs * Health care flexible spending accounts, health savings accounts, & life insurance * Paid time off, including volunteer time off * Paid & unpaid sick leave where applicable, as well as short & long-term disability * Parental & family leave; military leave & pay * Diverse, inclusive & welcoming culture with Employee Resource Groups * Career development & tuition assistance Energage recognizes Progressive as a 2025 Top Workplace for: Innovation, Purposes & Values, Work-Life Flexibility, Compensation & Benefits, and Leadership. Applicants must be authorized to work for any employer in the U.S. without the need or potential need, of current or future sponsorship for employment. Progressive does not hire candidates with (e.g., F-1 CPT, OPT, or STEM OPT, H-1B, O-1, E-3, TN) statuses for this role. Equal Opportunity Employer For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at ************************************************************** Share: Email X Facebook LinkedIn Apply Now
$54k-57.5k yearly 5d ago
Analyst, Claims Research
Molina Healthcare Inc. 4.4
Claims representative job in Green Bay, WI
Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. Essential Job Duties * Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. * Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. * Assists with reducing rework by identifying and remediating claims processing issues. * Locates and interprets claims-related regulatory and contractual requirements. * Tailors existing reports and/or available data to meet the needs of claims projects. * Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. * Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. * Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. * Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. * Works collaboratively with internal/external stakeholders to define claims requirements. * Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. * Fields claims questions from the operations team. * Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. * Appropriately conveys claims-related information and tailors communication based on targeted audiences. * Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. * Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. * Supports claims department initiatives to improve overall claims function efficiency. Required Qualifications * At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. * Medical claims processing experience across multiple states, markets, and claim types. * Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. * Data research and analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Ability to work cross-collaboratively in a highly matrixed organization. * Customer service skills. * Effective verbal and written communication skills. * Microsoft Office suite (including Excel), and applicable software programs proficiency. Preferred Qualifications * Health care claims analysis experience. * Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $22.81 - $46.42 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$22.8-46.4 hourly 8d ago
Claims Specialist
Evans Transportation Services, Inc. 4.2
Claims representative job in Delafield, WI
Job DescriptionDescription: Claims Manager has no supervisory responsibilities Department: Client Solutions | Claims FLSA/Pay Status: Non-Exempt - Salary Full Time Updated: January 2026 JOB SUMMARY Under the direction of the Claims Manager, the Claims Specialist is responsible for the day-to-day execution of freight claims on behalf of Evans' customers. This role will manage the full lifecycle of a freight claim, including information collection, documentation validation, carrier filing, follow-up, negotiation, and payment resolution. The Claims Specialist plays a critical role in protecting customer interests, ensuring timely resolution, maximizing claim recoveries, and delivering a positive customer experience through detailed execution, persistence, and proactive communication. This role works closely with internal teams, carriers, and customers to ensure claims are handled accurately, efficiently, and in accordance with contractual and regulatory requirements. ESSENTIAL FUNCTIONS Collects and organizes all required documentation to initiate freight claims, including but not limited to bills of lading, delivery receipts, invoices, photos, inspection reports, and customer statements. Reviews and validates claim documentation for accuracy, completeness, and compliance prior to carrier submission. Files freight claims with carriers in accordance with carrier contracts, tariffs, and applicable regulations. Manages ongoing communication with carriers to track claim status, request updates, and resolve outstanding issues. Negotiates claim settlements with carriers to maximize recovery while maintaining professional carrier relationships. Ensures timely collection of approved claim payments and coordinates payment processing to customers. Maintains accurate and up-to-date claim records within internal systems and reporting tools. Provides proactive updates to internal stakeholders and customers regarding claim status, timelines, and outcomes. Identifies trends or recurring claim issues (damage, shortages, service failures, packaging concerns, etc.) and escalates insights to the Claims Manager. Partners with internal teams (Client Success, Operations, Finance, Sales) to support claim resolution and improve overall claims outcomes. Adheres to company policies, procedures, and best practices related to claims handling and customer communication. Supports continuous improvement initiatives related to claims processes, documentation standards, and carrier performance. Adheres to Evans' Five Guiding Principles and all departmental and company procedures, policies, and handbooks. All other duties as assigned. Requirements: QUALIFICATIONS AND REQUIREMENTS Associate's or Bachelor's Degree preferred. 1-3 years of experience in transportation, logistics, freight claims, customer service, or a related operational role. Prior experience handling freight claims or working with carriers is preferred but not required. Strong attention to detail and ability to manage multiple claims simultaneously. Excellent written and verbal communication skills, with the ability to professionally interact with customers and carriers. Strong critical thinking, problem-solving, and negotiation skills. Working knowledge of truckload and less-than-truckload transportation is preferred. Proficiency in Microsoft Office Suite (Excel, Outlook, Word); experience with Transportation Management Systems is a plus. High level of organizational skills with the ability to meet deadlines in a fast-paced environment. Ability to read, write, type, and speak English fluently is a requirement of this position. PHYSICAL DEMANDS / WORK ENVIRONMENT While performing the duties of this job, the employee must be able to use a keyboard, calculator, and telephone. Frequent sitting, talking, hearing, and close-vision work are required, with occasional standing and lifting (up to 10 lbs.). Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
$72k-102k yearly est. 4d ago
Associate Claims Specialist - Workers Compensation - Central Region
Liberty Mutual 4.5
Claims representative job in Wisconsin Dells, WI
Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers exciting openings for Workers Compensation Claims Specialists within the Central Region! As a Workers Compensation Claims Specialist, the successful candidate will join a dedicated Claims Team, utilizing the latest technology to manage a caseload of routine to moderately complex claims. Responsibilities include investigating claims, assessing liability and compensability, evaluating losses, and negotiating settlements. The role involves interactions with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claims management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers. Training is a critical component of your success, and that success starts with reliable attendance. Attendance and active engagement during training are mandatory. Training will require 1 week in our Plano, TX office onsite in February 2026. This position may be filled as a Workers Compensation Associate Claims Specialist, Workers Compensation Claims Specialist I, or a Workers Compensation Claims Specialist II. The salary range posted reflects the range for the varying pay scale across various locations. To be considered for this position, candidates must reside within 50 miles of Hoffman Estates, IL, or Indianapolis, IN, and will be required to work in the office twice a month. Candidates located in Ohio, Montana, and Virginia are eligible for 100% remote work, as we do not have claims offices in these states. Please note that this policy is subject to change. Responsibilities * Manages an inventory of claims to evaluate compensability/liability. * Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources. * Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages. * Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. * Evaluates actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. * Performs other duties as assigned. Qualifications * Effective interpersonal, analytical and negotiation abilities required * Ability to provide information in a clear, concise manner with an appropriate level of detail * Demonstrated ability to build and maintain effective relationships * Demonstrated success in a professional environment; success in a customer service/retail environment preferred * Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent * Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory * Licensing may be required in some states 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
$60k-82k yearly est. Auto-Apply 5d ago
Daily Claims Adjuster - Milwaukee, WI Region
Cenco Claims 3.8
Claims representative job in Milwaukee, WI
CENCO is a trusted provider of property claims solutions, partnering with leading insurance carriers to deliver dependable and efficient adjusting services. We're currently seeking experienced Daily Property Claims Adjusters to support residential and commercial claims throughout Milwaukee and southeastern Wisconsin. This is an excellent opportunity for adjusters seeking steady work with the flexibility of independent assignments. Key Responsibilities: Conduct on-site inspections for wind, hail, water, and fire-related property damage. Capture detailed documentation, including photos and written reports. Prepare accurate estimates using Xactimate or Symbility. Communicate clearly and professionally with policyholders, contractors, and carriers. Handle claims promptly and meet all carrier reporting requirements. Requirements: Licensing: Must have an active adjuster license in Wisconsin. Software: Experience with Xactimate or Symbility is preferred. Equipment: Reliable transportation, ladder, laptop, and standard field tools. Work Style: Self-motivated, organized, and able to manage tasks independently. Responsiveness: Ability to accept assignments quickly and complete them on time. Why Work with CENCO? Steady claim volume in Milwaukee and surrounding areas Competitive, timely pay Strong support from our internal team and streamlined systems If you're ready for consistent daily claims work and the opportunity to grow with a respected name in the industry, we want to hear from you!
$45k-54k yearly est. Auto-Apply 60d+ ago
Independent Insurance Claims Adjuster in Manitowoc, Wisconsin
Milehigh Adjusters Houston
Claims representative job in Manitowoc, WI
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.
$45k-55k yearly est. Auto-Apply 60d+ ago
Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)
Holmes Murphy 4.1
Claims representative job in Wisconsin
We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
$70k-97k yearly est. Auto-Apply 23d ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claims representative job in Milwaukee, WI
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.
$45k-55k yearly est. Auto-Apply 43d ago
Workers' Compensation Claims Specialist (Remote - MN, SD, WI, PA, IA)
HMA Group Holdings 3.7
Claims representative job in Wisconsin
Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers' Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred. Essential Responsibilities: Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves Workers' Compensation claims. Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching coverage issues. Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. Generates checks for indemnity and medical payments daily. Develops and monitors consistency in procedural matters of the claims handling process with CRS. Compiles and interprets Workers' compensation reports on designated accounts, as requested. Ability to adjudicate lost time claims. Participates in claim reviews and attends Risk Control Workshops when requested by agency partners or insureds. These could be in person or by phone. Performs special projects and other duties as requested. Qualifications: Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Willingness and ability to obtain additional state specific licenses during duration of employment as needed. Experience: 2-4 years claims experience with strong background in Workers' Compensation coverage. Technical Competencies: Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Here's a little bit about us: At Creative Risk Solutions, you'll be part of a collaborative, innovative team that values trust, communication, and client focus. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth within the Holmes Murphy family. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! The salary range for this role is $45,800- $78,800. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development. Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
$45.8k-78.8k yearly Auto-Apply 22d ago
Property Adjuster Insurance Claims
Elevate Claims Solutions
Claims representative job in Green Bay, WI
Elevate Claims Solutions is founded on the belief that human experience and claim quality are the essence of profitable growth and retention for our adjuster partners, our clients, and ourselves. Are you ready, willing, and able to Elevate? Elevate Claims Solutions is seeking an Independent Adjuster adjusters with commercial and residential property claims in Wisconsin: Greenbay Appleton and Fox Cities area. How will we Elevate you? We want to know and understand your unique skillset and goals. We are committed to receiving your feedback on how we can best support your progression and advancement towards those goals. Expand your career opportunities in a role where you can see that you are making a difference in people's lives. Meaningful work in a culture of continuous improvement. A diverse market of carriers Clear communication of service and quality expectations; internal and external. Guidelines that provide upfront understanding of each carrier's requirements. Continuous feedback, including real -time Quality Assurance and formalized quarterly coaching sessions to identify areas of strength and opportunity. Training and development opportunities tailored to individual growth objectives. A tenured foundation of industry experts with a wide knowledge base for you to consult. How will you Elevate? Prioritize policyholders during their time loss through demonstrated empathy and understanding. Valuing our partnerships with our carrier clients; recognizing and maximizing the ways in which our Elevated Claims Handling can support them and their policyholders. Outstanding work ethic. This is not a 9 -5 position, and you will be called upon to maintain a flexible schedule to help meet the needs of insureds and carriers. Clear, consistent, and timely communication. We, and our carriers, want and need strong lines of communication. You must be open to receiving and providing feedback. The ability to manage workload while exercising good judgment effectively and independently. Strong written and verbal communication skills. Strong technological skills with the ability to work within various claims management systems. Minimum of three years of residential and commercial property adjusting experience. Carrier experience is desired. Liability experience is a plus. Current, active Xactimate license and experience writing both residential and commercial damage estimates in Xactimate. Ability to pass a background screen. Current, active license where required. Equipment and ability to access roofs. If you are ready to Elevate claims with a firm that truly values and supports you, let us know - we may be a fit.
$47k-64k yearly est. 60d+ ago
Field Adjuster (Residential or Commercial) - Green Bay, WI
CCMS & Associates 3.8
Claims representative job in Green Bay, WI
Job Description CCMS & Associates is looking for a 1099 Field Adjuster in Wisconsin, specifically the Green Bay area. We are answering a call to action to add to our existing roster. The time is now to get on with our innovative team! We are seeking a residential or commercial field adjuster with at least 1 year of field experience. Requirements: Minimum 1 year first-party commercial and/or residential property adjusting experience Maintain own current estimating software - Xactimate preferred (Symbility experience a plus) Working computer - internet access and Microsoft Word required Must demonstrate strong time management and customer service skills Experience in preparing Statement of Loss, Proof of Loss, and denial letters Must have a valid drivers license Responsibilities: Complete residential and commercial field property inspections utilizing Xactimate software Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses and by interviewing fire, police, or other governmental officials as well as inspecting claimed damages Recommend claim reserves based on investigation, through well-supported reserve report Obtain and interpret official reports Review applicable coverage forms and endorsements, provide a thorough analysis of coverage and any coverage issues in a well-documented initial captioned report to the client Maintain acceptable product quality through compliance with established best practices Knowledge and Skills: In-depth knowledge of property and liability insurance coverage and industry standards Ability to prepare full-captioned reports by collecting and summarizing required information Strong verbal and written communications skills Prompt, reliable, and friendly Preferred but Not Required: College degree AIC, IICRC, HAAG or other professional designations All candidates must pass a full background check (void in states where prohibited) CCMS & Associates offers multi-line claim adjusting and third-party administration services dedicated to solving the challenges of the complex claim in the property and casualty insurance industry. We create programs that drive a successful claim life cycle while strategically managing all aspects of the complicated issues carriers and policyholders are facing. Servicing excess and surplus/domestic carriers in the United States. Powered by JazzHR AIcQNNs4d3
$44k-58k yearly est. 19d ago
Claims Rep II-General Liability (Bodily Injury focused)
Society Insurance Company
Claims representative job in Fond du Lac, WI
Job InformationJob TitleClaims Representative II-General Liability (Bodily Injury focused) Home Department:ClaimsEmployment Status:Exempt; Full-time Schedule:40 hours/week with Flexible Scheduling Opportunities Position Location:Home Office, Telecommuting, and Remote Opportunities in CO, GA, IL, IN, IA, MN, TN, TX, & WIOverviewProtecting our policyholders dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society.Society Insurance is seeking a Claims Representative II to join our Claims team. This position has a general liability focus. This position will resolve mildly complex general liability claims by investigating losses and negotiating out-of-court settlements. About the Role Settles mildly complex claims by determining insurance carriers liability and reaches agreement with claimant according to policy provisions and authority level.Handles mediations, arbitrations, subrogation, and recorded settlement agreements.Determines coverage through investigations by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; consulting police and hospital records; inspecting damages; and consulting with experts when appropriate.Mentors and trains claims representatives in claims expertise by assisting in identifying training needs and opportunities.May be involved with litigation by analyzing negotiated settlement options; evaluating evidence, and overseeing attorney in the handling of discovery and settlement.Resolves questionable claims by investigating the claim and comparing claims information with evidence.Ensures proper file documentation of assigned files by complying with company and state requirements.Prepares reports by collecting, analyzing, and summarizing claim information.Contributes to team effort by participating on catastrophe teams; participating in determining department investigation guidelines; providing feedback to underwriting as needed. About YouYou enjoy communicating and building relationships with others.You are composed, cool under pressure, and can negotiate without damaging relationships. You hold yourself accountable and act in accordance with rules and regulations. You enjoy analyzing, investigating, and using the facts to make decisions. You are naturally curious and have a desire to know more. What it Will TakeBachelors Degree and 3+ years of claims handling experience OR 5+ years of claims handling experience.Proficiency in general liability claims demonstrated through knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology. Ability to obtain and maintain proper licensing prior to handling a state that requires it. Professional insurance designations highly desirable.Experience using Guidewire Claims System preferrable. What Society Can Offer Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing PlanWork-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options Education: Career Coaching; company-paid courses; student loan and tuition reimbursement Community: Charitable Match; paid volunteer time; team sponsorships Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws. Society Insurance is a drug-free workplace. PIb3123d83a457-31181-38667021
$41k-52k yearly est. 8d ago
Claims Rep II-General Liability (Bodily Injury focused)
Society Insurance
Claims representative job in Fond du Lac, WI
Job Information Job Title Claims Representative II-General Liability (Bodily Injury focused) Home Department: Claims Employment Status: Exempt; Full-time Schedule: 40 hours/week with Flexible Scheduling Opportunities Position Location: Home Office, Telecommuting, and Remote Opportunities in CO, GA, IL, IN, IA, MN, TN, TX, & WI Overview Protecting our policyholders' dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society. Society Insurance is seeking a Claims Representative II to join our Claims team. This position has a general liability focus. This position will resolve mildly complex general liability claims by investigating losses and negotiating out-of-court settlements. About the Role Settles mildly complex claims by determining insurance carrier's liability and reaches agreement with claimant according to policy provisions and authority level. Handles mediations, arbitrations, subrogation, and recorded settlement agreements. Determines coverage through investigations by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; consulting police and hospital records; inspecting damages; and consulting with experts when appropriate. Mentors and trains claims representatives in claims expertise by assisting in identifying training needs and opportunities. May be involved with litigation by analyzing negotiated settlement options; evaluating evidence, and overseeing attorney in the handling of discovery and settlement. Resolves questionable claims by investigating the claim and comparing claims information with evidence. Ensures proper file documentation of assigned files by complying with company and state requirements. Prepares reports by collecting, analyzing, and summarizing claim information. Contributes to team effort by participating on catastrophe teams; participating in determining department investigation guidelines; providing feedback to underwriting as needed. About Yo u You enjoy communicating and building relationships with others. You are composed, cool under pressure, and can negotiate without damaging relationships. You hold yourself accountable and act in accordance with rules and regulations. You enjoy analyzing, investigating, and using the facts to make decisions. You are naturally curious and have a desire to know more. What it Will Take Bachelor's Degree and 3+ years of claims handling experience OR 5+ years of claims handling experience. Proficiency in general liability claims demonstrated through knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology. Ability to obtain and maintain proper licensing prior to handling a state that requires it. Professional insurance designations highly desirable. Experience using Guidewire Claims System preferrable. What Society Can Offer Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options Education: Career Coaching; company-paid courses; student loan and tuition reimbursement Community: Charitable Match; paid volunteer time; team sponsorships Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws. Society Insurance is a drug-free workplace.
$41k-52k yearly est. Auto-Apply 60d+ ago
Claims Representative - Workers Compensation
West Bend Insurance Company 4.8
Claims representative job in West Bend, WI
Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities. Job Summary When employees are injured on the job, they need someone who can guide them through the process with care and expertise. As a Workers' Compensation Claims Representative at West Bend, you'll guide injured employees through the recovery process, ensure fair and timely claim resolution, and help businesses stay compliant. If you thrive on problem-solving, negotiation, and making a real impact, this is your opportunity to lead with confidence. Work Location This position offers a hybrid schedule with three in-office collaboration days for team meetings and other events. In certain cases, highly qualified candidates with strong jurisdictional experience may be considered for a remote arrangement. External applications will be accepted on a rolling basis while the position remains open. Responsibilities & Qualifications As a Claims Representative, you will manage claims of varying complexity using current claim technology and best practices. You will conduct thorough investigations to determine coverage, evaluate damages/benefits, and assess liability/compensability. You will negotiate settlements with insureds, claimants, and attorneys while maintaining proactive file management, accurate reserving, and adherence to audit and regulatory standards. This role collaborates closely with internal partners and external stakeholders, with the scope of responsibility (including field work and regional liaison duties) increasing with experience level. Key Responsibilities Investigate and resolve claims within assigned authority Determine coverage, damages, and liability Negotiate settlements with insureds, claimants, and attorneys Maintain accurate documentation and reserving Communicate promptly and professionally with all stakeholders Collaborate with internal teams and external partners Adhere to audit and compliance standards Participate in training and team initiatives Preferred Experience and Skills Prior experience managing claims at the appropriate level of complexity (from low/moderate to high-exposure/complex) Proficiency with computers and current claim technology Interpersonal, oral, and written communication skills with customer-focused professionalism Negotiation, problem-solving, and conflict resolution skills Time management and organizational discipline with proactive file handling Independent decision-making ability (higher levels) and results orientation Technical expertise in coverage analysis, compensability, and damages evaluation (higher levels) Prior experience managing claims across multiple jurisdictions (higher levels) with preferred jurisdictions of Illinois, Wisconsin, and North Carolina Preferred Education and Training Bachelor's degree in Business, Insurance or related field Associate in General Insurance (AINS) designation Associate in Claims (AIC) designation CPCU coursework or other continuing education Licensure in jurisdictions where required #LI-LW1 Salary Statement The salary range for this position is $67,000 - $100,000. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate. Benefits West Bend offers a comprehensive benefit plan including but not limited to: Medical & Prescription Insurance Health Savings Account Dental Insurance Vision Insurance Short and Long Term Disability Flexible Spending Accounts Life and Accidental Death & Disability Accident and Critical Illness Insurance Employee Assistance Program 401(k) Plan with Company Match Pet Insurance Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates Bonus eligible based on performance West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies. EEO West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.
$33k-41k yearly est. Auto-Apply 30d ago
Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)
HMA Group Holdings 3.7
Claims representative job in Wisconsin
We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
$43k-74k yearly est. Auto-Apply 23d ago

Learn more about claims representative jobs

How much does a claims representative earn in Appleton, WI?

The average claims representative in Appleton, WI earns between $25,000 and $48,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.

Average claims representative salary in Appleton, WI

$35,000

$25,00010%

$35,000Median

$48,00090%

What are the biggest employers of Claims Representatives in Appleton, WI?

The biggest employers of Claims Representatives in Appleton, WI are:

West Bend Mutual Insurance
Thesilverlining

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Claims representative jobs in Appleton, WI - 162 jobs

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Learn more about claims representative jobs

How much does a claims representative earn in Appleton, WI?

What are the biggest employers of Claims Representatives in Appleton, WI?