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  • Senior Marine Claims Specialist-Hull

    Zurich Na 4.8company rating

    Claims representative job in San Juan, PR

    130521 We are excited to share that Zurich North America is hiring a Marine Claims Senior Claims Specialist Role (With Hull and Liability experience preferred) to join our team! We are open to remote work for the right candidate located within the U.S.. In this role you will be responsible for: + Ability to handle dedicated accounts. + Frequent interaction with Assureds, Brokers and Underwriters. + Some travel may be required but this is not very frequent. Basic Qualifications: + Bachelor's Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.OR + Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.OR + Zurich Certified Insurance Apprentice, including an associate degree with 6 or more years of experience in the Claims and/ or Litigation Management area.OR + Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.OR + High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.AND + Must obtain and maintain required adjuster license(s) + Microsoft Office experience + Knowledge of insurance regulations, markets, and products as well as maritime and admiralty practices. Preferred Qualifications: + Extensive Marine Hull claims experience preferred. + Emphasis on Marine Liability, Hull, Blue water and brown water claims, Jones Act, General Average and Ocean Cargo Claims experience preferred. + Licensed in all states as needed required. + Effective verbal and written communication skills + Strong analytical, critical thinking and problem-solving skills + Strong multi-tasking and prioritization skills + Experience collaborating in a team environment and building cross functional working relationships + Proactively shares and promotes sharing of insights + Ability to gather unique perspectives from other teams/functions to optimize outcomes. + Understands, analyzes, and applies the component parts of an insurance policy for complex claims + Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims + Ability to determine the scope and exposure for complex claims + Ability to leverage trend and relationships to provide high-quality customer service + Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts. + Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims + Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies Your pay at Zurich is based on your role, location, skills, and experience. We follow local laws to ensure fair compensation. You may also be eligible for bonuses and merit increases. If your expectations are above the listed range, we still encourage you to apply-your unique background matters to us.The pay range shown is a national average and may vary by location. The proposed Salary range for this position is $75,800.00 - $124,100.00, with short-term incentive bonus eligibility set at 15%. We offer competitive pay and comprehensive benefits for employees and their families. [Learn more about Total Rewards here .] **Why Zurich?** At Zurich, we value your ideas and experience. We offer growth, inclusion, and a supportive environment-so you can help shape the future of insurance. Zurich North America is a leader in risk management, with over 150 years of expertise and coverage across 25+ industries, including 90% of the Fortune 500 . Join us for a brighter future-for yourself and our customers. Zurich in North America does not discriminate based on race, ethnicity, color, religion, national origin, sex, gender expression, gender identity, genetic information, age, disability, protected veteran status, marital status, sexual orientation, pregnancy or other characteristics protected by applicable law. Equal Opportunity Employer disability/vets. Zurich complies with 18 U.S. Code § 1033. **Please note:** Zurich does not accept unsolicited CVs from agencies. Preferred vendors should use our Recruiting Agency Portal. Location(s): AM - Texas Virtual Office, AM - Remote Work (US) Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-JJ1 #LI-ASSOCIATE #LI-REMOTE EOE Disability / Veterans
    $75.8k-124.1k yearly 4d ago
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  • PFML Claim Support Specialist 13944

    Metlife, Inc. 4.4company rating

    Claims representative job in San Juan, PR

    Global Operations (Global Ops) focuses on creating positive experiences for MetLife customers and helping the company make the best use of its global resources. We're looking for unique talent with fresh perspectives that can propel innovation. In this role you will provide exemplary customer service by facilitating Multi-State Paid Family Leave (PFL) benefits, Family Medical leave Act (FMLA) and Americans with Disabilities Act (ADA) claim adjudication in a timely and accurate manner. Location: Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT Cary, NC, Aurora, IL, Bridgewater, NJ, Omaha, NE, Warwick, RI, Clark Summit, PA, San Juan, PR, West Des Moines, IA office Once a month in office for meetings How You'll Help Us Build a Confident Future (Key Responsibilities) * Coaches, coordinates, and develops Multi-State PFL, FML and ADA Claims Specialists. * Acts as resources for claim-related and technical issues. * Monitors case managers' work queues to ensure claims team is meeting expectations and applicable performance guarantees. * Conducts exceeds authority reviews daily, weekly quality audits; resolves escalated phone calls. * Analyzes trending opportunities to provide ongoing trainings. * Provides real time coaching to Claims Specialists. * Provides feedback to Unit Leaders on individuals' and overall team performance. * Daily and weekly reporting to ensure compliance measures are met. * Performs other related duties as assigned or required. What You Need to Succeed (Required Qualifications) * Positive mindset and willingness to learn. * 1+ years of Disability Insurance experience. * Must be able to communicate clearly and effectively, both written and verbal. * Ability to work with autonomy, minimal direction. * Strong computer skills (word, excel, manipulating reports, spreadsheets, etc…). * High School Diploma. What Can Give You an Edge (Additional Skills) * 1+ years of Paid Family Leave experience. * 5+ years of Disability Insurance experience. * Excellent analytical, decision making and problem-solving skills. * Highly self-motivated. The expected salary range for this position is $41,600 - $61,500. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms. Benefits We Offer Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more! About MetLife Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East. Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible. Join us! MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics"). If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities. $41,600 - $61,500
    $41.6k-61.5k yearly 12d ago
  • Specialty Loss Adjuster

    Sedgwick 4.4company rating

    Claims representative job in San Juan, PR

    By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Specialty Loss Adjuster **Embark on an Exciting Career Journey with Sedgwick Specialty** **Job Location** **: USA, Mexico, Brazil and strategic locations globally** **Job Type** **: Permanent** **Remuneration** **: Salaries can range from** **_$40,000.00USD to $250,000.00USD_** **taking into account skills, experience and qualifications.** **We have a number of fantastic opportunities for Specialty Loss Adjusters across the US, Mexico and Brazil and a number of key locations** We are looking for a variety of skill sets at all levels. Whether you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your skills and grow with a company that values innovation, excellence, and employee satisfaction. Are you ready to be a part of providing a differentiated and best of class proposition to clients whilst working with like-minded colleagues? Sedgwick Specialty is thrilled to announce that we are investing in growth across Natural Resources, Property, Casualty, Technical and Special Risks and Marine. As we expand our operations, we are seeking individuals who are passionate about making a difference to the Adjusting industry. **As a member of the Specialty platform, you will have the opportunity to:** + Work with a wide range of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team of professionals who are dedicated to delivering exceptional results + Utilise state-of-the-art technology and resources to streamline processes and enhance efficiency + Receive ongoing training and development opportunities to further enhance your skills and knowledge in the marine industry + Enjoy a flexible work arrangement that allows you to maintain a healthy work-life balance while contributing to our global success **The skills you will have when you apply:** + **Qualified** : it is important to us that you are either accredited, on your way to be accredited or qualified by experience + **Insurance claims experience:** it is imperative that you have experience working on insurance claims within you respective field. Full claims life cycle experience is a must + **Great communicator:** you will be constantly working with policy holders, brokers, carriers and various third parties, so being able to communicate accurately important. Providing an excellent customer service with our clients in mind. Able to approach issues empathetically + **Commercially minded:** An understanding of how the industry operates and where the role of a Loss Adjuster fits in. Being able to negotiate. Understanding how to market your services is a big advantage **What we'll give you for this role:** As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the annual salaries can range from _$40,000.00 to $250,000.00USD._ Bonus eligible role. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always Accepting Applications. **This isn't just a position, it's a pivotal role in shaping our industry** At Sedgwick, you won't just build your career; you'll cultivate a team of experts. Our Sedgwick University offering empowers you to excel as well as your team members, with the most comprehensive training program in the industry which includes more than 15,000 courses on demand, training specific to roles, and opportunities to continue formal education. Together, we're not only reshaping the insurance landscape, we're building a legacy of talent. Come and be a catalyst for change within our industry. **Next steps for you:** **Think we'd be a great match? Apply now -** ** we want to hear from you.** As part of our commitment to you, we are proud to have a zero tolerance policy towards discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex or sexual orientation. After the closing date we will review all applications and may select some applicants for an interview (which may be virtual, or in-person). \#LI-HYBRID Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $51k-61k yearly est. 60d+ ago
  • Representative 3

    Western Digital 4.4company rating

    Claims representative job in San Juan, PR

    ** At Western Digital, our vision is to power global innovation and push the boundaries of technology to make what you thought was once impossible, possible. At our core, Western Digital is a company of problem solvers. People achieve extraordinary things given the right technology. For decades, we've been doing just that-our technology helped people put a man on the moon and capture the first-ever picture of a black hole. We offer an expansive portfolio of technologies, HDDs, and platforms for business, creative professionals, and consumers alike under our Western Digital , WD and WD_BLACK Professional brands. We are a key partner to some of the largest and highest-growth organizations in the world. From enabling systems to make cities safer and more connected, to powering the data centers behind many of the world's biggest companies and hyperscale cloud providers, to meeting the massive and ever-growing data storage needs of the AI era, Western Digital is fueling a brighter, smarter future. Today's exceptional challenges require your unique skills. Together, we can build the future of data storage. **Job Description** ESSENTIAL DUTIES AND RESPONSIBILITIES + Work cross-functionally between Technical Support, Supply Chain, Pricing, Legal, and Product Marketing organizations within company to meet customers' needs + Manage the relationship with the account - including contract manufacturers, distributors, and end customer + Drive customer revenue and shipments to the goals of the account and company + Manage the internal and external communication regarding the account, making sure there is alignment and consistency within WD and externally to the customer Is available, responsive, and timely to customer inquiries, requests for information and/or quotations, problem resolution, etc - even if after normal business hours. + Coordinate customer pricing and rebate communication, and ensure correct rebates are paid on time to the customers + Manage the product lifecycle by account: product list, product roadmap, product launch, qualification, End of Life Schedule and host various technology and business meetings on weekly & quarterly basis + Manage meeting preparation, including creating pre-meeting document and scheduling pre-meeting for internal review and alignment prior to facing the customer + Manage meeting logistics including travel for customer engagements Map customer relationships and identify areas for improvement Manage historical and current revenue, PB, and unit shipment data for the account **Qualifications** REQUIRED + Bachelor's degree in a related field + 5+ years of account management experience or equivalent experience. + Understand market conditions and how they affect WD and the customer + Understand the customer legal contracts and terms in place + Understand the supply chain process from WD to the end customer, identify areas of concern as they arise, and escalate when necessary SKILLS + Exceptional customer service and communication skills, with the ability to explain complex technical concepts to all levels of users. + Strong problem-solving and analytical skills. + Proven troubleshooting skills in customer-facing environments. + Strong desire and ability to learn new products and technologies. **Additional Information** Western Digital is committed to providing equal opportunities to all applicants and employees and will not discriminate against any applicant or employee based on their race, color, ancestry, religion (including religious dress and grooming standards), sex (including pregnancy, childbirth or related medical conditions, breastfeeding or related medical conditions), gender (including a person's gender identity, gender expression, and gender-related appearance and behavior, whether or not stereotypically associated with the person's assigned sex at birth), age, national origin, sexual orientation, medical condition, marital status (including domestic partnership status), physical disability, mental disability, medical condition, genetic information, protected medical and family care leave, Civil Air Patrol status, military and veteran status, or other legally protected characteristics. We also prohibit harassment of any individual on any of the characteristics listed above. Our non-discrimination policy applies to all aspects of employment. We comply with the laws and regulations set forth in the "Know Your Rights: Workplace Discrimination is Illegal (************************************************************************************** " poster. Our pay transparency policy is available here (*********************************************************************************************** . Western Digital thrives on the power and potential of diversity. As a global company, we believe the most effective way to embrace the diversity of our customers and communities is to mirror it from within. We believe the fusion of various perspectives results in the best outcomes for our employees, our company, our customers, and the world around us. We are committed to an inclusive environment where every individual can thrive through a sense of belonging, respect and contribution. Western Digital is committed to offering opportunities to applicants with disabilities and ensuring all candidates can successfully navigate our careers website and our hiring process. Please contact us at jobs.accommodations@wdc.com to advise us of your accommodation request. In your email, please include a description of the specific accommodation you are requesting as well as the job title and requisition number of the position for which you are applying. Based on our experience, we anticipate that the application deadline will be 1/16/2025 (3 months from posting), although we reserve the right to close the application process sooner if we hire an applicant for this position before the application deadline. If we are not able to hire someone from this role before the application deadline, we will update this posting with a new anticipated application deadline. \#LI-VV1 **Compensation & Benefits Details** + An employee's pay position within the salary range may be based on several factors including but not limited to (1) relevant education; qualifications; certifications; and experience; (2) skills, ability, knowledge of the job; (3) performance, contribution and results; (4) geographic location; (5) shift; (6) internal and external equity; and (7) business and organizational needs. + The salary range is what we believe to be the range of possible compensation for this role at the time of this posting. We may ultimately pay more or less than the posted range and this range is only applicable for jobs to be performed in California, Colorado, New York or remote jobs that can be performed in California, Colorado and New York. This range may be modified in the future. + If your position is non-exempt, you are eligible for overtime pay pursuant to company policy and applicable laws. You may also be eligible for shift differential pay, depending on the shift to which you are assigned. + You will be eligible to be considered for bonuses under **either** Western Digital's Short Term Incentive Plan ("STI Plan") or the Sales Incentive Plan ("SIP") which provides incentive awards based on Company and individual performance, depending on your role and your performance. You may be eligible to participate in our annual Long-Term Incentive (LTI) program, which consists of restricted stock units (RSUs) or cash equivalents, pursuant to the terms of the LTI plan. Please note that not all roles are eligible to participate in the LTI program, and not all roles are eligible for equity under the LTI plan. RSU awards are also available to eligible new hires, subject to Western Digital's Standard Terms and Conditions for Restricted Stock Unit Awards. + We offer a comprehensive package of benefits including paid vacation time; paid sick leave; medical/dental/vision insurance; life, accident and disability insurance; tax-advantaged flexible spending and health savings accounts; employee assistance program; other voluntary benefit programs such as supplemental life and AD&D, legal plan, pet insurance, critical illness, accident and hospital indemnity; tuition reimbursement; transit; the Applause Program; employee stock purchase plan; and the Western Digital Savings 401(k) Plan. + **Note:** No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. **Notice To Candidates:** Please be aware that Western Digital and its subsidiaries will never request payment as a condition for applying for a position or receiving an offer of employment. Should you encounter any such requests, please report it immediately to Western Digital Ethics Helpline (******************************************************************** or email ****************** .
    $24k-42k yearly est. 5d ago
  • Claims Examiner

    Harris Computer Systems 4.4company rating

    Claims representative job in Florida, PR

    Responsibilities & Duties:Claims Processing and Assessment: * Evaluate incoming claims to determine eligibility, coverage, and validity. * Conduct thorough investigations, including reviewing medical records and other relevant documentation. * Analyze policy provisions and contractual agreements to assess claim validity. * Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: * Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. * Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. * Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: * Ensure compliance with company policies, procedures, and regulatory requirements. * Maintain accurate records and documentation related to claims activities. * Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: * Identify opportunities for process improvement and efficiency within the claims department. * Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. * Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: * Generate reports and provide data analysis on claims trends, processing times, and outcomes. * Contribute to the development of management reports and presentations regarding claims operations.
    $52k-60k yearly est. Auto-Apply 37d ago
  • Parts Representative

    Ricardo Caballero Auto 4.4company rating

    Claims representative job in Coamo, PR

    The person in this position acts as the main contact between the parts department of Ricardo Caballero Grupo Automatize and the different suppliers, and supplies the parts needs to the service department, as well as with retail and wholesale customers in the sale of parts and accessories for cars under the MITSUBISHI brand. He carries out all part transactions such as sale, shipping, receipt, return, among others. Responsibilities: Executes work assigned by the Parts & Service Manager. Inspects daily inventory and ensures that there is always an inventory of all parts to meet customer and service department needs. Keeps a record of the part or accessory orders placed and identifies in the system who owns each one and coordinates the delivery with the client or the appointment with the advisor. Keep the areas assigned to store parts clean, orderly and in good condition. Create new areas as needed and not have pieces on the floor that obstruct the passage. In charge of performing “Scrapping” and complying with the standard. Is responsible for keeping parts in the assigned area properly organized. Dispatch parts to the customer through the counter and to the workshop through the workshop window. Promote the installation of parts sold over the counter and refer it to the Service Advisor. Responsible for ordering parts complying with the standards of each brand. Estimates parts over the counter and for repairs in the workshop, whether warranty or paying customer, and will follow up on them. Ensure that you receive all the parts that are ordered and that they are in perfect condition. Responsible for communicating with the supplier when parts do not meet standards, or the ordered quantity is not received. Maintains contact with suppliers for order status or part returns. Document all delivery of special tools to technicians. Know the MITSUBISHI brand parts policies and procedures manual to comply with the brand's standards, including obsolescence. Make efforts to get new clients, whether regular or wholesale. Work as a team providing support to colleagues. Participate in seminars and training courses, whether online or in person, and do your best to acquire new skills. Follows up with advisors on uninstalled parts in inventory. Carry out other activities if requested by your supervisor. Know Service Advisor processes and guarantees to cover if necessary. Requirements: High School Diploma Valid Driver's License required. Basic knowledge of the use of dangerous objects and the risks. Basic knowledge of vehicle diagnosis. Knowledge of physical inventory, obsolescence, parts movements. Basic knowledge of safety in the work area. Basic reading and writing skills to understand repair orders and document work performed or needed. Knowledge of MITSUBISHI brand vehicles preferably and everything related to the development of the parts department. Ability to lift boxes of merchandise. Knowledge of information systems. Good verbal and written communication Kind of position: Full time, Indefinite contract Benefits: Professional development training. Private medical insurance Uniform provided Christmas Bonus Schedule: From Monday to Saturday One day off during the week and on Sundays Job Location: Face-to-face employment *Equal Employment Opportunities
    $16k-23k yearly est. Auto-Apply 25d ago
  • Multi-Line Adjuster - Inside

    Crawford 4.7company rating

    Claims representative job in Puerto Rico

    College degree or an equivalent combination of education and experience. Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine). Personal computer, typing and keyboarding skills In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business. Familiarity with legal, medical and technical disciplines within specific business lines. Strong verbal and written communication skills. Good analytical ability and mathematical aptitude. Good attention to detail and organizational skills. Ability to gather and analyze information, then determine and implement the appropriate course of action. Good interpersonal skills. Licensing as required by state and local jurisdictions. Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated. Responsibilities Investigate coverage, liability, and damages with all parties involved in a claim as requested by our customers or Crawford and Company or a subsidiary thereof. Investigate claims by interviewing claimants, witnesses, establish claim reserves, handle evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings. Negotiates and settles claims, sets reserves, and manages litigation within client service parameters and authority levels by obtaining demands and making offers to claimants. May present evidence at legal proceedings. Provide filings with regulatory agencies, disposing of salvage and pursuing subrogation when appropriate. Prepare reports by collecting and summarizing information required by the client and obtained through investigation. Self starter capable of working alone or with others. Maintains company reputation and insurance product integrity by complying with Federal and state regulations, client and Crawford and Company service standards. Maintain expected case loads in multiple lines of business while meeting established service delivery, production, quality, sales and educational objectives. May be required to work on-call during off work hours to respond to emergency on-site investigations. Maintain professional and technical knowledge through continuing education in multiple lines of business. Maintain acceptable product quality through compliance with service standards and compliance with internal quality control initiatives. Uphold and project the corporate image by participating in industry organizations and functions. Ability to multi-task in a time sensitive environment and handle job responsibilities with a sense of urgency. Participates in special projects or performs duties in other areas as requested. Upholds the Crawford Code of Conduct. Qualifications College degree or an equivalent combination of education and experience. Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine). Personal computer, typing and keyboarding skills In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business. Familiarity with legal, medical and technical disciplines within specific business lines. Strong verbal and written communication skills. Good analytical ability and mathematical aptitude. Good attention to detail and organizational skills. Ability to gather and analyze information, then determine and implement the appropriate course of action. Good interpersonal skills. Licensing as required by state and local jurisdictions. Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated. #LI-CB3
    $49k-56k yearly est. Auto-Apply 60d+ ago
  • Sr. Claims Specialist, Professional Liability | Medical Malpractice

    Sedgwick 4.4company rating

    Claims representative job in San Juan, PR

    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 Sr. Claims Specialist, Professional Liability | Medical Malpractice **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. **ARE YOU AN IDEAL CANDIDATE?** We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to designated authority level. + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent negotiation skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **TAKING CARE OF YOU BY** + We offer a diverse and comprehensive benefits package including: + Three Medical, and two dental plans to choose from. + Tuition reimbursement eligible. + 401K plan that matches 50% on every $ you put in up to the first 6% you save. + 4 weeks PTO your first full year. **NEXT STEPS** If your application is selected to advance to the next round, a recruiter will be in touch. _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $100,000 - $110,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $100k-110k yearly 13d ago
  • Claim Support Specialist - PFML

    Metlife 4.4company rating

    Claims representative job in San Juan, PR

    Location: Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT Cary, NC, Aurora, IL, Bridgewater, NJ, Omaha, NE, Warwick, RI, Clark Summit, PA, San Juan, PR, West Des Moines, IA office Once a month in office for meetings How You'll Help Us Build a Confident Future (Key Responsibilities) * Coaches, coordinates, and develops Multi-State PFL, FML and ADA Claims Specialists. * Acts as resources for claim-related and technical issues. * Monitors case managers' work queues to ensure claims team is meeting expectations and applicable performance guarantees. * Conducts exceeds authority reviews daily, weekly quality audits; resolves escalated phone calls. * Analyzes trending opportunities to provide ongoing trainings. * Provides real time coaching to Claims Specialists. * Provides feedback to Unit Leaders on individuals' and overall team performance. * Daily and weekly reporting to ensure compliance measures are met. * Performs other related duties as assigned or required. What You Need to Succeed (Required Qualifications) * Positive mindset and willingness to learn. * 1+ years of Disability Insurance experience. * Must be able to communicate clearly and effectively, both written and verbal. * Ability to work with autonomy, minimal direction. * Strong computer skills (word, excel, manipulating reports, spreadsheets, etc...). * High School Diploma. What Can Give You an Edge (Additional Skills) * 1+ years of Paid Family Leave experience. * 5+ years of Disability Insurance experience. * Excellent analytical, decision making and problem-solving skills. * Highly self-motivated. Equal Employment Opportunity/Disability/Veterans If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace.
    $29k-33k yearly est. 48d ago
  • University Representative

    Kevane Grant Thornton LLP

    Claims representative job in San Juan, PR

    You can become a Kevane Grant Thornton University Representative. We are accepting resumes for our talent database. The University Representatives: Represent the firm in the campuses. Deliver the firm's key messages to the universities and identify talented candidates. Maintain a close relationship with the professors and student's organizations to promote the firm. Principal Function: The University Representative is responsible for assisting the Human Resources Department in increasing and improving the exposition of the Firm in their respective universities and throughout accounting students. The incumbent must demonstrate skills such as: leadership, ethical conduct, self-confidence, excellent interpersonal communication, and familiarization with the Firm environment. Educational Background: The incumbent must comply with the following requirements: Enrolled in a bachelor's degree program in accounting of any university and coursing his/her second year, preferably. Having a 3.30 GPA or more on a scale of 4.00. This average should be maintained during the years of studies. Active member of the Accounting Students Association. Fluent in English and Spanish, written and oral. Kevane Grant Thornton is proud to be an Equal Employment Opportunity and Affirmative Action employer. The Company's policy is not to unlawfully discriminate against any applicant or employee on the basis of race, color, sex, religion, sexual orientation, gender identity, gender expression, national origin, age, disability status, genetic information, military or veteran status or any other applicable legally protected considerations made unlawful by federal, state, or local laws.
    $18k-28k yearly est. Auto-Apply 60d+ ago
  • Accident & Health Claims Adjuster

    Chubb 4.3company rating

    Claims representative job in San Juan, PR

    Role Purpose The Accident and Health Claims Adjuster is responsible to handle, investigate, analyze, calculate and approve insurance claims filed by policyholders and determine the extent of insurance company's liability concerning Accident and Health claims. Key Responsabilities Manage, evaluate and adjust Accident & Health claims as per the policy terms and conditions including application of exclusions if applicable. Work and manage as many fast track claims as possible (Medical Expenses) and analyze medical records. Assist in resolving complaints from policyholders relative to claims. Comply with OCS, PMP objectives, Claims Best Practices guidelines & standards of services as required. Do coverage determination position letters to policyholders. Perform specials projects and other related duties as assigned. Make timely decisions on claim approval, partial payment, or denial with clear justifications. Identify potential fraudulent claims and refer cases as necessary for investigation. Bachelor's Degree in Business Administration. Adjusters License from the Office of the Commissioner of Insurance of Puerto Rico (OCS). Demonstrated experience and/or knowledge in claims related to the following coverage's: Accident, Medical Expenses, Cancer, Critical Illnesses, Disability, Hospitalization, and SINOT, among others including policy interpretation. Strong ability to perform mathematical calculations. Demonstrate flexibility and adaptability to work in a fast moving and challenging environment. Proficient in MS Applications (Word, Excel and Power Point). Intermediate knowledge of the structure and content of the English and Spanish Language.
    $48k-56k yearly est. Auto-Apply 60d+ ago
  • Administrative Representative

    Enterprise 4.6company rating

    Claims representative job in San Juan, PR

    Overview Enterprise Mobility operates the Enterprise Rent-A-Car, National Car Rental, and Alamo car rental brands and has frequently been named one of the top places to work. Enterprise Mobility is the largest and fastest growing privately owned automotive rental and leasing company in North America and we are hiring now! We are working towards our shared vision to be the world's best and most trusted mobility company. The Enterprise brand of Enterprise Mobility has an exciting opportunity for an Administrative Representative. The Administrative Representative will provide a high level of customer service by assisting both internal and external customers primarily via the phone, in addition to administrative support. The starting rate of pay is $11.25 based on a 40 hour work week. This positions is located at San Juan Airport location. We offer a robust Benefits Package including, but not limited to: - Paid time off - Employee rental car discounts - Retirement savings plan including 401k with matching profit sharing - Health Insurance - Life Insurance - Dental Insurance - Vision Insurance - Training and development Schedule: Enterprise Mobility is a leading provider of mobility solutions, owning and operating the Enterprise Rent-A-Car, National Car Rental and Alamo Rent A Car brands through its integrated global network of independent regional subsidiaries. Enterprise Mobility and its affiliates offer extensive car rental, carsharing, truck rental, fleet management, retail car sales, as well as travel management and other transportation services, to make travel easier and more convenient for customers. Privately held by the Taylor family of St. Louis, Enterprise Mobility together with its affiliate Enterprise Fleet Management manages a diverse fleet of 2.4 million vehicles and accounted for nearly $38 billion in revenue through a network of more than 9,500 fully-staffed neighborhood and airport rental locations in more than 90 countries and territories. Qualifications - High school diploma or GED required; some college preferred - Must have at least 6 months of prior customer service, retail, or administrative support experience - Must have a valid driver's license with no more than two chargeable moving violations or accidents within the last three years. - No drug or alcohol related convictions on driving record (DWI/DUI) in past 5 years - Must be authorized to work in the United States and not require work authorization sponsorship by our company for this position now or in the future. - Must be at least 18 years old Responsibilities We are hiring now for immediate openings. Responsibilities include: Take incoming calls- reservations, rate quotes, general questions and answers, provide information and resolution for customers, other branches, insurance companies, dealerships, repair shops and other vendors Make outgoing calls- callback management, A/Rs and miscellaneous calls as assigned Provide a high level of customer service by assisting customers and assessing their rental needs primarily over the phone Meet and greet customers in a friendly and timely manner Provide directions and general assistance Assist to assess condition of rental upon return Notify Management of any known customer problems Notify Management of any known vehicle problems and any required vehicle maintenance Clean vehicle interior and exterior by hand or by operating washing equipment when needed Perform various administrative and basic accounting functions such as: research and billing support tasks, accounts receivables, transfer and key logs, run miscellaneous reports, supply maintenance, process customer billing Perform miscellaneous and backup job-related duties as assigned Equal Opportunity Employer/Disability/Veterans
    $11.3 hourly Auto-Apply 8d ago
  • Long Term Disability Claims Specialist I 3 30 26 NY NC CT PR

    Metlife, Inc. 4.4company rating

    Claims representative job in San Juan, PR

    At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The LTD Claims Specialist I evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the LTD Claims Specialist is required to exercise critical thinking skills, exemplary customer service skills as well as effective inventory management skills with oversight and expected progression to a LTD Claims Specialist II role. Job Location: Virtual, but must be commutable to the following offices: * Oriskany, NY * Bloomfield, CT * Cary, NC * San Juan, PR Employees are required to come into the office for 2 weeks after initial training. After training, employees are to report to the office 1x a month. Key Responsibilities: * Virtual roles predominately work from a home office with periodic visits to the assigned office as needed for team events, meetings, training, business continuity, etc. * Effectively manages some level of oversight an assigned caseload which consists of pending, ongoing/active reviews. The LTD CS will be evaluated for increases in their authority levels as they become more experienced in their decision-making and demonstrate consistency in meeting all key performance indicators * Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations. * Develop actions plans and identify return to work potential * Provides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other information that may be pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skills * Interacts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations * Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available * Collaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants as needed to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions. * Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed * Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas. Essential Business Experience and Technical Skills: Required: * New hires should live a commutable distance from the site the role is posted in * High School Diploma * Minimum 2 years of experience in external customer service or related experience * Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning * Creative problem-solving abilities and the ability to think outside the box * Excellent interpersonal and communication skills in both verbal and written form * Excellent customer service skills proven through internal and external customer interactions * Organizational and time management skills Preferred: * Bachelor's degree Business Category Operations - Claims At MetLife, we're leading the global transformation of an industry we've long defined. United in purpose, diverse in perspective, we're dedicated to making a difference in the lives of our customers. The expected salary range for this position is $41,600 - $60,500. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms. Benefits We Offer Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more! About MetLife Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East. Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible. Join us! MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics"). If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities. $41,600 - $60,500
    $41.6k-60.5k yearly 12d ago
  • University Representative

    Kevane Grant Thornton LLP

    Claims representative job in San Juan, PR

    Job Description You can become a Kevane Grant Thornton University Representative. We are accepting resumes for our talent database. The University Representatives: Represent the firm in the campuses. Deliver the firm's key messages to the universities and identify talented candidates. Maintain a close relationship with the professors and student's organizations to promote the firm. Principal Function: The University Representative is responsible for assisting the Human Resources Department in increasing and improving the exposition of the Firm in their respective universities and throughout accounting students. The incumbent must demonstrate skills such as: leadership, ethical conduct, self-confidence, excellent interpersonal communication, and familiarization with the Firm environment. Educational Background: The incumbent must comply with the following requirements: Enrolled in a bachelor's degree program in accounting of any university and coursing his/her second year, preferably. Having a 3.30 GPA or more on a scale of 4.00. This average should be maintained during the years of studies. Active member of the Accounting Students Association. Fluent in English and Spanish, written and oral. Kevane Grant Thornton is proud to be an Equal Employment Opportunity and Affirmative Action employer. The Company's policy is not to unlawfully discriminate against any applicant or employee on the basis of race, color, sex, religion, sexual orientation, gender identity, gender expression, national origin, age, disability status, genetic information, military or veteran status or any other applicable legally protected considerations made unlawful by federal, state, or local laws.
    $18k-28k yearly est. 15d ago
  • Claims Specialist, Professional Liability (Medical Malpractice)

    Sedgwick 4.4company rating

    Claims representative job in San Juan, PR

    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 Claims Specialist, Professional Liability (Medical Malpractice) **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to designated authority level. + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent negotiation skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** **:** Computer keyboarding, travel as required **Auditory/Visual** **:** Hearing, vision and talking _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_ **_$117,000 - $125,000_** _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $42k-48k yearly est. 15d ago
  • Administrative Representative

    Enterprise Mobility 4.6company rating

    Claims representative job in San Juan, PR

    Enterprise Mobility operates the Enterprise Rent-A-Car, National Car Rental, and Alamo car rental brands and has frequently been named one of the top places to work. Enterprise Mobility is the largest and fastest growing privately owned automotive rental and leasing company in North America and we are hiring now! We are working towards our shared vision to be the world's best and most trusted mobility company. The Enterprise brand of Enterprise Mobility has an exciting opportunity for an Administrative Representative. The Administrative Representative will provide a high level of customer service by assisting both internal and external customers primarily via the phone, in addition to administrative support. The starting rate of pay is $11.25 based on a 40 hour work week. This positions is located at **San Juan Airport location.** We offer a robust **Benefits Package** including, but not limited to: + Paid time off + Employee rental car discounts + Retirement savings plan including 401k with matching profit sharing + Health Insurance + Life Insurance + Dental Insurance + Vision Insurance + Training and development Schedule: Enterprise Mobility is a leading provider of mobility solutions, owning and operating the Enterprise Rent-A-Car, National Car Rental and Alamo Rent A Car brands through its integrated global network of independent regional subsidiaries. Enterprise Mobility and its affiliates offer extensive car rental, carsharing, truck rental, fleet management, retail car sales, as well as travel management and other transportation services, to make travel easier and more convenient for customers. Privately held by the Taylor family of St. Louis, Enterprise Mobility together with its affiliate Enterprise Fleet Management manages a diverse fleet of 2.4 million vehicles and accounted for nearly $38 billion in revenue through a network of more than 9,500 fully-staffed neighborhood and airport rental locations in more than 90 countries and territories. **Responsibilities** We are hiring now for immediate openings. Responsibilities include: + Take incoming calls- reservations, rate quotes, general questions and answers, provide information and resolution for customers, other branches, insurance companies, dealerships, repair shops and other vendors + Make outgoing calls- callback management, A/Rs and miscellaneous calls as assigned + Provide a high level of customer service by assisting customers and assessing their rental needs primarily over the phone + Meet and greet customers in a friendly and timely manner + Provide directions and general assistance + Assist to assess condition of rental upon return + Notify Management of any known customer problems + Notify Management of any known vehicle problems and any required vehicle maintenance + Clean vehicle interior and exterior by hand or by operating washing equipment when needed + Perform various administrative and basic accounting functions such as: research and billing support tasks, accounts receivables, transfer and key logs, run miscellaneous reports, supply maintenance, process customer billing + Perform miscellaneous and backup job-related duties as assigned _Equal Opportunity Employer/Disability/Veterans_ **Qualifications** + High school diploma or GED required; some college preferred + Must have at least 6 months of prior customer service, retail, or administrative support experience + Must have a valid driver's license with no more than two chargeable moving violations or accidents within the last three years. + No drug or alcohol related convictions on driving record (DWI/DUI) in past 5 years + Must be authorized to work in the United States and not require work authorization sponsorship by our company for this position now or in the future. + Must be at least 18 years old Enterprise Mobility/Enterprise Rent-A-Car/Alamo Rent A Car and National Car Rental seeks and values people of all backgrounds because every employee, customer and business partner is important. Enterprise Mobility is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, gender identity or protected veteran status and will not be discriminated against on the basis of disability. If you have any difficulty using our online system and you need an accommodation due to a disability, you may use this alternative email address (JobsPrivacy@ehi.com) to contact us about your interest in employment.
    $11.3 hourly 8d ago
  • Long Term Disability Claims Specialist I

    Metlife 4.4company rating

    Claims representative job in San Juan, PR

    * Oriskany, NY * Bloomfield, CT * Cary, NC * San Juan, PR Employees are required to come into the office for 2 weeks after initial training. After training, employees are to report to the office 1x a month. Key Responsibilities: * Virtual roles predominately work from a home office with periodic visits to the assigned office as needed for team events, meetings, training, business continuity, etc. * Effectively manages some level of oversight an assigned caseload which consists of pending, ongoing/active reviews. The LTD CS will be evaluated for increases in their authority levels as they become more experienced in their decision-making and demonstrate consistency in meeting all key performance indicators * Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations. * Develop actions plans and identify return to work potential * Provides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other information that may be pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skills * Interacts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations * Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available * Collaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants as needed to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions. * Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed * Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas. Essential Business Experience and Technical Skills: Required: * New hires should live a commutable distance from the site the role is posted in * High School Diploma * Minimum 2 years of experience in external customer service or related experience * Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning * Creative problem-solving abilities and the ability to think outside the box * Excellent interpersonal and communication skills in both verbal and written form * Excellent customer service skills proven through internal and external customer interactions * Organizational and time management skills Preferred: * Bachelor's degree Business Category Operations - Claims At MetLife, we're leading the global transformation of an industry we've long defined. United in purpose, diverse in perspective, we're dedicated to making a difference in the lives of our customers. Equal Employment Opportunity/Disability/Veterans If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace.
    $43k-48k yearly est. 11d ago

Learn more about claims representative jobs

How much does a claims representative earn in Carolina, PR?

The average claims representative in Carolina, PR earns between $24,000 and $41,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.

Average claims representative salary in Carolina, PR

$32,000

What are the biggest employers of Claims Representatives in Carolina, PR?

The biggest employers of Claims Representatives in Carolina, PR are:
  1. Humana
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