Claims representative jobs in Hooksett, NH - 29 jobs

Ask Yourself This... Are you someone who thrives working in a fast-paced environment? Do you enjoy providing support to others? Then join us as a Claim Representative in Burlington, MA! What You'll Do This fast-paced, highly rewarding entry-level position is all about helping people with a focus on customer service, and is the first point of contact when a worker is injured at work. The Claim Representative handles the claim process from beginning to end; working closely with injured workers, employers, doctors, insurance companies, as well as co-workers in other departments within the company. The Claim Representative manages the claim process and treatment plans, with the goal of getting an injured worker back on the job as soon as possible. This position offers a hybrid working schedule after an initial training period. We're looking for someone that: has a college degree, has experience in a call center or customer service environment, can organize and prioritize workflows and meet company/industry deadlines, is self-motivated and once trained, able to work with little direction, and has or is willing to pursue a professional insurance designation. At A.I.M. Mutual Insurance Companies, we are committed to building a diverse and inclusive workplace, and we believe that all people are capable of great things. So, if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway! Who We Are At A.I.M. Mutual Insurance Companies, we are committed to setting the standard in service excellence. We are guided by our founding principles to help employers effectively manage their workers' compensation program, providing quality services to injured workers and creating safe workplaces. We are one of the largest regional workers' compensation specialists, and we credit our staff for putting their service-oriented work ethic and workers' compensation insurance knowledge into practice, every day, in all they do. What we do ... We provide a workers' compensation experience that ensures peace of mind for all. Why we do it ... To protect and support the well-being of all New England workers and their families. How we do it ... Listening with empathy Acting with compassion Doing the right thing Succeeding through collaboration We proudly offer robust compensation and benefits packages, including: 35-hour work week Summer hours June through September Competitive pay, with opportunities to advance Medical, dental, vision plans and pet insurance Employer-sponsored retirement plan with matching employer contribution Tuition reimbursement Company-paid life and disability insurance Paid time off and generous holiday time A.I.M. Mutual has also earned the 2024 Best Place for Working Parents business designation. At. A.I.M. Mutual, we recognize the importance of having a highly experienced staff to meet day-to-day customer needs. Come be a part of a great team of people that strives to surpass customer expectations every day. Working for A.I.M. Mutual is not just a job, it's a career. Thank you for your interest in joining the A.I.M. Mutual Insurance team!

This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements. **ESSENTIAL RESPONSIBILITIES** + Coordinate, analyze, and interpret the benefits and claims processes for the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties. + Investigate benefit/claim information and provide technical guidance to clinical and claims staff regarding the final adjudication of complex claims. Research and investigate conflicting benefit structures in multi-payor situations. + Provide prompt, thorough and courteous replies to written, electronic and telephonic inquiries from internal/external customers (e.g., clinical, sales/marketing, providers, vendors, etc.) Follow-up on all inquiries in accordance with corporate and regulatory standards and timeframes. + Must have the ability to apply knowledge about the business operations of the area within the defined scope of the job. Assess benefit limitations in accordance with Medical Policy Guidelines. + Monitor and identify claim processing inaccuracies. Bring trends to the attention of management. + Assist with handling inbound calls and strive to resolve customer concerns received via telephone or written communication. + Work independently of support, frequently utilizing resources to resolve customer inquiries. + Collaborate with Clinical Strategy, Sales/Client Management and other areas across the enterprise to respond to client questions and concerns about care/case management and high-cost claimants. + Gather information and develop presentation/training materials for support and education. + Other duties as assigned or requested. **EDUCATION** **Required** + High School or GED **Substitutions** + None **Preferred** + Associate's degree in or equivalent training in Business or a related field **EXPERIENCE** **Required** + 3 years of customer service, health insurance benefits and claims experience. + Working knowledge of Highmark products, systems (e.g., customer service and clinical platforms, knowledge resources, etc.), operations and medical policies + PC Proficiency including Microsoft Office Products + Ability to communicate effectively in both verbal and written form with all levels of employees **Preferred** + Working knowledge of medical procedures and terminology. + Complex claim workflow analysis and adjudication. + ICD9, CPT, HPCPS coding knowledge/experience. + Knowledge of Medicare and Medicaid policies **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services + Knowledge of administrative and clerical procedures and systems such as managing files and records, designing forms and other office procedures + The ability to take direction, to navigate through multiple systems simultaneously + The ability to interact well with peers, supervisors and customers + Understanding the implications of new information for both current and future problem-solving and decision-making + Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate and not interrupting at inappropriate times + Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems + Ability to solve complex issues on multiple levels. + Ability to solve problems independently and creatively. + Ability to handle many tasks simultaneously and respond to customers and their issues promptly. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $21.53 **Pay Range Maximum:** $32.30 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273827

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory requirements. You will recognize and empathize with members' life events, as appropriate. Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses within your locally assigned territory. Field Adjusters may travel outside of their local territory to respond to claims in other regions when needed. This is an hourly, non-exempt position with paid overtime available. This is a field-based role in the Manchester, NH area. Candidates who are willing and able to work in this area are encouraged to apply. What you'll do: * Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability. * Partners with vendors and internal business partners to facilitate complex claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance. * Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics. * Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies. * Determines and negotiates complex claims settlement within authority limits. Develops recommendations and collaborates with management for determining settlement amounts outside of authority limits and accurately manages claims outcomes. * Maintains accurate, thorough, and current claim file documentation throughout the claims process. * Advance knowledge of estimating technology platforms and virtual inspection tools. Utilizes platforms and tools to prepare claims estimates to manage complex property insurance claims. * Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours. * May be assigned CAT deployment travel with minimal notice during designated CATs. * Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed. * Works independently solving complex problems with minimal guidance; acts as a resource for colleagues with less experience. * Adjusts complex claims with attorney involvement. * Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations. * May require travel to resolve claims, attend training, and conduct in-person inspections. * Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. What you have: * High School Diploma or General Equivalency Diploma. * 2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages. * Advanced knowledge of estimating losses using Xactimate or similar tools and platforms. * Proficient knowledge of residential construction. * Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations. * Proficient negotiation, investigation, communication, and conflict resolution skills. * Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills. * Ability to travel 50-75% of the year (local & non-local) and/or work catastrophe duty when needed. * Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts. * Successful completion of a job-related assessment may be required. What sets you apart: * Hands-on experience in the field handling high-severity and complex property claims such as fire, water damage, vandalism, malicious mischief, foreclosures, earth movement, collapse, and liability. * Residential property field adjusting experience with dwelling, structure and additional living expenses. * Experience working directly for a standard insurance carrier handling claims from start to finish (first notice of loss, reviewing policy, making coverage decisions) * Proficient in using estimating platforms and virtual inspection tools like Xactimate, ClaimXperience and XactAnalysis * Insurance industry designations such as AINS (Associate in General Insurance), CPCU (Chartered Property Casualty Underwriter), AIC (Associate in Claims), or SCLA (Senior Claims Law Associate) or actively pursuing * Active Property & Casualty adjuster license * Currently reside in the Manchester or surrounding areas enabling quicker response times for local claims and a better understanding of regional risks * US military experience through military service or a military spouse/domestic partner Physical Demand Requirements: * May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces. * May need to meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver's license. * May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car. * May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics. Compensation range: The salary range for this position is: $74,240 - $133,620. USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.). Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** As a Product Liability Litigation Adjuster, Risk Management, you will be responsible for managing lawsuits and overseeing outside counsel defending CVS in high exposure, product liability mass tort litigations and general liability cases filed throughout the United States. Responsibilities include: + Developing relationships with internal colleagues for fact-finding and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all aspects of product liability mass tort litigations and complex general liability cases. + Working with outside national counsel and sr. management to develop consistent litigation strategies applicable to mass tort cases filed across the country. + Providing reporting to key internal stake holders on case developments and litigation trends for product liability mass torts and other cases. + Managing large scale discovery investigations by working with internal custodians, outside counsel and vendors to develop comprehensive procedures for identifying, locating, preserving and producing corporate records. + Analyzing case and internal materials and utilizing resources across CVS to discern key issues and identify the litigation strategy in every case assigned. + Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working with and overseeing outside counsel. + Participating in meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. **Required Qualifications** + 2+ years of legal experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. + Juris Doctor degree from an ABA accredited university. + Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. **Preferred Qualifications** + Experience overseeing or defending product liability claims and litigation. + Familiarity or experience with insurance and coverage issues related to litigated claims. + Strong attention to detail and project management skills. + Experience overseeing and answering written discovery. + Ability to work independently and in an environment requiring teamwork and collaboration. + Strong written and verbal communication skills. + Demonstrated negotiation skills and ability. + Ability to articulate and summarize cases with management in a concise, cogent manner. + Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. + 3-5 years of legal or claims experience. + Familiarity with the rules and procedures applicable to mass tort litigations, class actions, and/or multidistrict litigations. + Knowledge and experience navigating attorney-client privilege issues, corporate litigation holds, corporate witness depositions, and e-discovery. + Ability to influence and work collaboratively with senior leaders, CVS' in-house legal counsel and outside counsel. + Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new software programs and systems. + Ability to positively and aggressively represent the company at mediation, arbitration and trial. + Ability to navigate difficult situations and communicate effectively with both internal and external groups. + Excellent organizational and time management skills and ability to handle a high volume of litigated claims. + Experience with and understanding of legal documents (pleadings, discovery, motions and briefs). **Education** + Verifiable Juris Doctor degree **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 01/03/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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.

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.

This position is responsible for assisting the Claims Department with servicing and processing of policyholder claims. The purpose of this position is to provide clerical support to help ensure claims resolve accurately and timely. Responsibilities Demonstrate customer service skills and managing FNOL intake Managing a high volume of incoming calls Scanning and indexing claim file documentation Ability to multitask in a fast-paced environment Ability to learn basic insurance fundamentals Other related duties as assigned by supervisor Requirements High school diploma or GED required General clerical skills Professional telephone manner Excellent interpersonal and organizational skills Proficient in a PC Windows environment Demonstrate experience in Microsoft Excel Accuracy in spelling and grammar Ability to work together in a team setting on shared tasks Experience working in a paperless environment preferred Benefits At The Concord Group, we're proud to offer a comprehensive benefits package designed to support the wellbeing of our associates. This includes medical, vision, dental, life insurance, disability insurance, and a generous paid time off program for vacation, personal, sick time, and holiday pay. Additional benefits include parental leave, adoption assistance, fertility treatment assistance, a competitive 401(k) plan with company match, gym member/fitness class reimbursement, and additional resources and programs that encourage professional growth and overall wellness. Why Concord Group Insurance Since 1928, The Concord Group has been protecting families and small businesses across New England with trusted, personal insurance solutions. The Concord Group is a member of The Auto Owners Group of Companies and is recognized as a leading insurance provider through the independent agency system. Rated A+ (Superior) by AM Best, the company is represented by more than 550 of the best local independent agents throughout Maine, Massachusetts, New Hampshire, and Vermont. At Concord Group, we believe in more than just insurance, we believe in our people. Our associates thrive in a supportive, collaborative workplace where community involvement, professional growth, and shared values drives everything we do. Starting your career with The Concord Group means joining a team that values people first and gives you the opportunity to grow, give back, and make a lasting difference in the lives of those we serve. Compensation We are dedicated to fair and competitive total compensation package that supports the wellbeing and success of our associates. In addition to this, we offer other components like bonus opportunities. Equal Employment Opportunity The Concord Group is an equal opportunity employer and hires, transfers, and promotes based on ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state, or local law. The Concord Group participates in E-Verify.

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**

At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Experienced Auto Damage Adjuster- Concord/Manchester, NH Salary: $34.60-$44.01 per hour/$69,700-$88,663 We are looking for talented Auto Damage Adjusters to join our team in Concord/Manchester, NH. As an experienced Adjuster, you should have a minimum of 12 months of Auto Damage experience and demonstrated a track record of success delivering excellent customer service while promptly and accurately settling claims. The ideal candidate will have the ability to handle complex claims using their technical and industry knowledge. Qualifications & Skills: Motor Vehicle Damage Adjuster/Appraiser's License *required* Valid driver's license (must meet company underwriting guidelines for at least the past 3 consecutive years) and the ability to maintain applicable state and federal certifications and permits Willingness to be flexible with primary work location - position may require either remote/field/in-office work Solid computer, mechanical aptitude, and multi-tasking skills Effective attention to detail and decision-making skills Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities Minimum of high school diploma or equivalent At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.

Our Property Claims department is seeking Senior Outside Property Adjusters in the Nashua territory. This is a remote Full-time/Exempt role with field investigations. Senior outside property adjusters handle property claims requiring field investigations and/or inspections. They must establish rapport with our insureds and maintain relationships with our agents, underwriters, contractors, restoration vendors, and experts. They are expected to know their territory, including the geography; regulations and the law as pertains to property claims; state and local public safety and regulatory agencies and officials; the insurance and legal climate; and public adjusters. Outside property adjusters may use a company claims office location as their base of operations, or they may work out of their homes. IN THIS ROLE, YOU WILL: Handle complex personal and commercial property claims requiring outside field investigations and/or inspections. Use discretion and independent judgment in claim handling. Possess demonstrated technical knowledge and skills, including product and industry, reflective of successful progression through various job family levels. Identify possibly suspicious claims. Claims handled will be of greater complexity, severity, and exposures, including litigation, and will require a higher level of investigation, analysis, evaluation and negotiation including interpretation of commercial coverage. Authority levels are higher in recognition of the higher proficiency associated with this level. May be used as a technical resource by adjusters; may represent the company at mediation, arbitration and trials. May be responsible for all aspects of each claim, including informal hearings, arbitrations, and claims litigation and maintaining a high level of productivity, confidentiality and customer service. May provide training and mentoring to adjusters. Assignments are broad in nature, usually requiring originality and ingenuity. WHAT YOU NEED TO APPLY: 5+ years of adjusting experience. Xactimate certification. Must have or secure and maintain appropriate states adjuster license(s) and continuing education credits. Must have valid driver's license. Required to have and maintain sufficient home-based internet connection. Dedicated to meeting the expectations and requirements of internal and external customers. Makes decisions in an informed, confident and timely manner. Maintains constructive working relationships despite differing perspectives. Strong organizational and time management skills. Ability to negotiate skillfully in difficult situations with both internal and external groups. Demonstrates ability to win concessions without damaging relationships. Demonstrates strong written and verbal communication skills. Promotes and facilitates free and open communication. Understanding of applicable statutes, regulations and case law. Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a timely manner. Easily adapts to new or different changing situations, requirements or priorities. Cultivates an environment of teamwork and collaboration. Operates with latitude for un-reviewed action or decision. Proficient using MS Office (Excel, Word, etc). Proficient using Claims systems (i.e. CSS, PMS, etc). Ability to use a personal computer and other standard office equipment. Ability to travel as necessary. Ability to sit and/or stand for extended periods. Ability to operate a motor vehicle 4-5 hours per day and to get in and out of the vehicle numerous times during the day. Ability to load and unload equipment and supplies weighing up to 30 pounds from a motor vehicle as needed to perform field work. Ability to bend, walk, and climb for several consecutive hours while inspecting damaged buildings, often with utilities turned off or inoperable. Ability to use a ladder safely to get onto and off of roofs, and maintain balance while inspecting roofs. Ability to perform field work in adverse weather. This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.

Equal Opportunity Employer/Disability/Veterans Reliable Respiratory is a Durable Medical Equipment (DME) company that provides the highest quality level of service for patients in need of respiratory, diabetes, urology, and maternity support. Equipment provided includes, CPAPs, BiPAPs, AutoPAPs, nebulizers, oxygen equipment, ventilators, CGM devices, insulin pumps, and breast pumps. Each patient is treated with professionalism, understanding, and attentive service. We care about our customers, work closely with the medical community, and have highly skilled staff ready to assist customers in receiving the best care possible. The Billing Claims Specialist focuses on claims and procurement of authorizations and medical documentation to ensure Reliable is reimbursed in accordance with the procedures provided. This position reports to the Billing Manager, but will perform duties that pertain to customer service, documentation retrieval, medical billing and coding, and reimbursement. The primary purpose of this position is to identify reasons for claim denials and take all corrective action to resubmit the claim and obtain full reimbursement for the services rendered. Additional duties include: Review claims for denied procedures, identify issues, and take appropriate action to correct issue, resubmit claim, and procure maximum reimbursement for specific service. Duties include obtaining authorization, collecting medical documentation directly from facilities, and working with payers and provider services. Organize and report back denial trends to Management to implement measures to improve claim health and reduce payer AR times. Create and/or update written material and documentation related to insurance procedures and programs (i.e., insurance guidelines and processes and procedures). Assist in reviewing and analyzing relevant organizational and payer data (i.e., reviews payments and denials of insurance and communicates when changes need to be made for payment and profit margins) Develop and implement a system for working denials, ranging from dollar value to payor specialization, to age of invoice Issue invoices and bills and send them to customers through various channels (mail, e-mail etc.) Receive payments through various methods (cash, online payments etc.) and check for credibility. Answer questions and handle complaints from customers and payors regarding claims Reconcile deposits and invoices posted. Basic Qualifications 18 years of age or older Must be eligible to work in the United States and not require work authorization from us now or in the future Bachelor's Degree required At least 2 years of medical billing, coding, reimbursement or health insurance experience preferred Required Skills Strong health insurance knowledge of New England payers and Massachusetts ACO plans Proficient in obtaining authorizations in the most efficient manner (portal, fax form, phone in submission) Ability to learn Billing functions and be adaptable to the needs of the position. Strong interdepartmental communication Effective and professional verbal and written communication abilities Professional computer experience (especially Microsoft Office Suite) Ability to investigate problems and make decisions independently. Strong analytical skills Competencies Computer skills Interpersonal skills Product expertise Communication skills Results driven Conflict management Customer service Organizational skills Work Environment & Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate and convey information with the appropriate parties. The job requires assuming a stationary position for long periods of time This role routinely uses standard office equipment such as computers, phones, and printers/scanners The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. This job operates in a professional office environment The noise level in the work environment is usually moderate to loud Direct Reports - None Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Reliable Respiratory, INC participates in E-Verify. E-Verify is a web-based system that allows an employer to determine an employee's eligibility to work in the US using information reported on an employee's Form I-9. The E-Verify system confirms eligibility with both the Social Security Administration (SSA) and Department of Homeland Security (DHS). For more information, please go to the USCIS E-Verify website.

Alacrity Solutions Independent Contractor Daily Property Field Adjuster Alacrity Solutions is a full end-to-end provider delivering streamlined insurance claims, repair, and recovery solutions. As one of the largest independent providers of insurance claims services in North America, we provide property, auto, heavy equipment, and casualty claims management services. Our staffing capabilities, temporary housing services, managed repair network, and subrogation services support a fully integrated solution for all your needs from first notice of loss through completion of repairs. By assembling the best service providers through strategic acquisitions and relying on the right talent, Alacrity Solutions provides consistent, professional, and scalable services throughout the entire claim handling and resolution process. To learn more, visit ************************** The objective of a Daily Property Field Adjuster is to provide excellent claim handling services for our clients regarding daily claim work within your area which can include multiple perils. Contract Requirements Include: A contract will be issued within 24 hours of accepting your first claim assignment with Alacrity. This IA contract will include pay details and other pertinent information regarding your work as an independent contract with Alacrity. A completed contract is required to issue pay. Skills & Requirements/Licensure: MUST live within 50-100 miles of posted location and willing to travel to location. Minimum 2-3 years property field adjusting experience. Independent adjusting license in your home state (area of work), or a designated home state license if residing in a non-licensing state. Experienced in wind, hail, theft, fire, water losses and other perils preferred. Have reliable transportation, computer, digital camera, ladder, and other miscellaneous items necessary to perform adjuster responsibilities. Willing and able to climb roofs. Computer and Phone System Requirements: Smart Cell Phone able to access to internet. Xactimate and/or Symbility proficient with current subscription Working Laptop computer with reliable high-speed internet Digital camera and other miscellaneous items necessary to perform adjuster responsibilities. Working Conditions / Physical & Mental Demands: The physical demands described here are representative and must be met by the independent contractor to successfully perform this job. 100% travel is required within designated working territory based on the location of assignments received. Normal office or field claims environment. Ability to operate a motor vehicle for up to 8 hours daily, repeatedly entering and exiting the vehicle. Must be able to make physical inspections of auto loss sites. Must be able to work outdoors in all types of weather. Available to work catastrophic loss events. A willingness to work irregular hours and to travel with possible overnight requirements a plus. Why Choose Alacrity? Flexibility: Self-determined Scheduling Diversity Statement Alacrity is an equal opportunity employer and is committed to providing employees with a work environment free of discrimination and harassment. All decisions pertaining to an employee's employment are made without regard to race, color, religion, sex (including sexual orientation, pregnancy, childbirth), gender, gender identity or expression, age, national origin, ancestry, physical or mental disability, medical condition, reproductive health decisions, veteran's status, genetic information, creed, marital status, disability, citizenship status, or any other characteristic protected by applicable law. How Long We Retain Personal Information: We will keep your personal information for as long as necessary to fulfill legitimate business purposes and in accordance with applicable laws.

Job Description The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to learn rapidly to develop knowledge and understanding of claims practice Ability to identify, analyze and solve problems Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to meet or exceed performance competencies Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Minimum of 1 year of industry experience and claims management preferred State Certification as an Experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 - $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Job Title Senior Claims Analyst Reporting the Unit Manager, this role will be responsible for direct handling of multi-line commercial claims with a focus on New York Labor Law. Duties include investigation and evaluation of coverage, liability and damages issues. The role will be responsible for claim evaluation, establishment/recommendation of adequate reserves, litigation management, case resolution and transaction processing in alignment with the Company's and Client's Strategic Vision. Essential Functions In addition to the essential functions of a Complex Claim Analyst, the Senior Claim Analyst handles more complex cases and/or industry specific cases that include higher exposure with an increase in severity and complexity. Mastery of the Complex Claim Analyst functions and Company's and Client's systems. Anticipates and identifies risks and opportunities on coverage and liability. Mentors and guides less experienced claim analysts. Assists the Unit Manager with departmental problem solving. Manage external relationships including third party administrative oversight. Serves on Companywide committees and projects assigned. Directly handles and/or assists in monitoring, reviewing, and coordinating the activities involving commercial and personal lines insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims. Reviews loss notices; confirms and interprets policy coverage; establishes adequate reserves; and investigates and handles claims involving primary, umbrella and excess policies. Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures. Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language. Assigns and manages work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations. Ensures proper file setup, reserving, general handling and application of company procedure. Participates in developing claims handling strategies, including defense coordination, litigation strategy and budgets, and expense control. Records specific claims information and reports as appropriate to a manager relative to pertinent financial and general statistical records. Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company's exposure and reports to our Reinsurance Department to assist in providing notice to reinsurers and the Reinsurance Department's recovery of specific amounts when payment exceeds the company's retention. Handles large volume of diverse and dynamic claims effectively. Empowered to make decisions within job description and authority. Seeking guidance where appropriate. Develop creative ideas and solutions to real-time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible. Empowers self and teammates to continuously improve Company's business processes/systems and develops and escalates ideas and solutions. Seeks continuous development by identifying areas for growth and improvement. Works with team to implement process and technical improvements. Consistently delivers superior customer service to both internal and external business partners. Understands Key Performance Indicators and manages towards those priorities. Perform special projects and assignments related to area of authority as necessary. Maintains confidentiality. Establishes and maintains professional relationships. Assists in Due Diligence inquiries as assigned. Obtains and maintains claims adjuster licenses in those states requiring them. Experience Minimum of 5 years of claims handling experience or a related field. Required Education Four-year college degree required or equivalent work experience. Preferred Education or Certification JD, CPCU, SCLA, CCLA Supervisory Role Schedule, assign, and review the work of others in compliance with specific instructions. Travel As required, based upon business needs. Work Environment / Physical Demands This position operates in a professional based collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions. The position uses standard equipment such as phones, computers, copiers/printers and filing cabinets. Noise level is moderate. Diversity, Equity, Inclusion & Belonging RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law. Privacy Notice for California Residents https://www.trg.com/california-consumer-privacy-notice/

Ametros is changing the way individuals navigate healthcare by providing them with the tools and support necessary to make educated decisions on how to spend their medical funds. Ametros's team works closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to create a seamless experience for our clients. Our flagship product is revolutionizing the way funds from insurance claim settlements are administered after settlement. Ametros continues to innovate, bringing new solutions to the market with the goal of simplifying healthcare for our clients. We make managing medical funds safe, effortless, and cost effective for everyone. The Claims Specialist plays a critical role in the end-to-end management of member claims, ensuring accuracy, timeliness, and compliance across all claim-related activities. This position requires strong analytical skills, attention to detail, and the ability to collaborate across departments and with external partners to resolve complex issues and improve operational efficiency. The Claims Specialist plays a critical role in the end-to-end management of member claims, ensuring accuracy, timeliness, and compliance across all claim-related activities. This position requires strong analytical skills, attention to detail, and the ability to collaborate across departments and with external partners to resolve complex issues and improve operational efficiency. What you will do Assess claims to determine whether services are related to covered injuries and compliant with the guidelines of the member's settlements, ensuring appropriate benefit coordination. Maintain comprehensive documentation of all claim-related communications, ensuring timely follow-up and resolution. Proactively detect claim discrepancies, errors, or delays and collaborate with internal teams and providers to drive swift resolution. Manage transitions for claims outside of CareGuard coverage, ensuring seamless member experience and accurate benefit coordination. Handle inbound and outbound calls, emails, and chats related to claims, coverage guidelines, and provider inquiries providing expert-level support and guidance to a wide variety of audiences. Oversee the bill payment process, including detailed review and validation of claims to ensure proper fund allocation and compliance. Audit electronic claims feeds and bill review workflows to ensure data accuracy and operational integrity. Partner with IT and Management to identify and resolve system-related issues impacting claims processing. Coordinate with external vendors to resolve billing discrepancies and ensure alignment with contractual terms. Act as a resource for Member Care and Pharmacy representatives, offering guidance and support on billing and claims procedures. Identify opportunities for improvement within existing claims workflows and contribute to process enhancement initiatives. Generate ad hoc reports in Excel to support management decision-making. Lead or contribute to special projects and initiatives as assigned by Management, driving innovation and continuous improvement. Conduct research and analysis to support the resolution of claims. Skills and Abilities Well versed with healthcare and medical terminology. Excellent written and verbal communication skills with ability to adapt communication style depending on audience. Understanding of Worker's Compensation and Medicare coverage guidelines. Meticulous attention to detail. Highly organized and focused with the ability to prioritize and multitask. Aptitude for problem-solving. Sound business judgment and computer skills. A desire to continue to learn and improve both self and the organization. Ability to work both independently and collaboratively within a team environment. Education Qualifications H.S. Diploma or General Education Degree (GED) required Bachelor's Degree in Arts/Sciences (BA/BS) preferred Experience Qualifications 3-4 years experience with ICD-10, CPT, NDC and HCPCS coding and procedures required 3-4 years Healthcare industry medical billing experience strongly preferred This is a Hybrid role with a 3 day a week in office requirement The estimated salary range for this position is $25.00-$29.00/ per hour. Actual salary may vary up or down depending on job-related factors which may include knowledge, skills, experience, and location. In addition, this position is eligible for incentive compensation. #LI-BB1 Webster Financial Corporation and its subsidiaries (“Webster”) are equal opportunity employers that are committed to sustaining an inclusive environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, marital status, national origin, ancestry, citizenship, sex, sexual orientation, gender identity and/or expression, physical or mental disability, protected veteran status, or any other characteristic protected by law.

Ask Yourself This... Are you someone who thrives working in a fast-paced environment? Do you enjoy providing support to others? If so, this may be the role for you. We are looking for an experienced Claim Adjuster to join our Claim department! Who We Are At A.I.M. Mutual Insurance Companies, we are committed to setting the standard in service excellence. We are guided by our founding principles to help employers effectively manage their workers' compensation program, providing quality services to injured workers and creating safe workplaces. We are one of the largest regional workers' compensation specialists, and we credit our staff for putting their service-oriented work ethic and workers' compensation insurance knowledge into practice, every day, in all they do. What we do ... We provide a workers' compensation experience that ensures peace of mind for all. Why we do it ... To protect and support the well-being of all New England workers and their families. How we do it ... Listening with empathy Acting with compassion Doing the right thing Succeeding through collaboration What You'll Do The Claim Adjuster is responsible for the equitable and justified investigation, evaluation, and settlement/closure of workers compensation claims in accordance with A.I.M Mutual Insurance Company's specified standards, industry requirements, and audit procedures. This is a hybrid position after completion of initial training period. We're looking for someone that has: A minimum of an associate's degree or relevant work experience is required. At least two years of claim experience, preferably in workers compensation. The ability to work independently, meet company/industry deadlines, is self-motivated, organized and prioritizes work. Exceptional communication skills and a strong attention to detail. Has or is willing to pursue a professional insurance designation. At A.I.M. Mutual Insurance Companies, we are committed to building a diverse and inclusive workplace, and we believe that all people are capable of great things. So, if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway! Why work for us? At. A.I.M. Mutual, we recognize the importance of having a highly experienced staff to meet day-to-day customer needs. Come be a part of a great team of people that strives to surpass customer expectations every day. Working for A.I.M. Mutual is not just a job, it's a career. We proudly offer robust compensation and benefits packages, including: 35-hour work week Summer hours June through September Competitive pay, with opportunities to advance Medical, dental, vision plans and pet insurance Employer-sponsored retirement plan with matching employer contribution Tuition reimbursement Company-paid life and disability insurance Paid time off and generous holiday time A.I.M. Mutual has also earned the 2024 Best Place for Working Parents business designation. Pay Philosophy The typical starting salary range for this role is determined by a number of factors, including, but not limited to - qualifications, relevant education, certifications, experience, skills, performance, travel requirements, and business or organizational needs. We may ultimately pay more or less than the posted range, and the range may be modified in the future, but we in good faith believe this is what we would pay for this role as of the time of posting. The full salary range for this role reflects the competitive labor market for all employees in this position across our industry and provides an opportunity to progress and develop within the role. Thank you for your interest in joining the A.I.M. Mutual Insurance team!

**Why USAA?** At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory requirements. You will recognize and empathize with members' life events, as appropriate. Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses within your locally assigned territory. Field Adjusters may travel outside of their local territory to respond to claims in other regions when needed. This is an hourly, non-exempt position with paid overtime available. This is a **field-based role in the Manchester, NH** area. Candidates who are willing and able to work in this area are encouraged to apply. **What you'll do:** + Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability. + Partners with vendors and internal business partners to facilitate complex claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance. + Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics. + Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies. + Determines and negotiates complex claims settlement within authority limits. Develops recommendations and collaborates with management for determining settlement amounts outside of authority limits and accurately manages claims outcomes. + Maintains accurate, thorough, and current claim file documentation throughout the claims process. + Advance knowledge of estimating technology platforms and virtual inspection tools. Utilizes platforms and tools to prepare claims estimates to manage complex property insurance claims. + Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours. + May be assigned CAT deployment travel with minimal notice during designated CATs. + Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed. + Works independently solving complex problems with minimal guidance; acts as a resource for colleagues with less experience. + Adjusts complex claims with attorney involvement. + Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations. + May require travel to resolve claims, attend training, and conduct in-person inspections. + Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. **What you have:** + High School Diploma or General Equivalency Diploma. + 2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages. + Advanced knowledge of estimating losses using Xactimate or similar tools and platforms. + Proficient knowledge of residential construction. + Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations. + Proficient negotiation, investigation, communication, and conflict resolution skills. + Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills. + Ability to travel 50-75% of the year (local & non-local) and/or work catastrophe duty when needed. + Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts. + Successful completion of a job-related assessment may be required. **What sets you apart:** + Hands-on experience in the field handling high-severity and complex property claims such as fire, water damage, vandalism, malicious mischief, foreclosures, earth movement, collapse, and liability. + Residential property field adjusting experience with dwelling, structure and additional living expenses. + Experience working directly for a standard insurance carrier handling claims from start to finish (first notice of loss, reviewing policy, making coverage decisions) + Proficient in using estimating platforms and virtual inspection tools like Xactimate, ClaimXperience and XactAnalysis + Insurance industry designations such as AINS (Associate in General Insurance), CPCU (Chartered Property Casualty Underwriter), AIC (Associate in Claims), or SCLA (Senior Claims Law Associate) or actively pursuing + Active Property & Casualty adjuster license + Currently reside in the Manchester or surrounding areas enabling quicker response times for local claims and a better understanding of regional risks + US military experience through military service or a military spouse/domestic partner **Physical Demand Requirements:** + May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces. + May need to meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver's license. + May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car. + May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics. **Compensation range:** The salary range for this position is: $74,240 - $133,620. **USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).** **Compensation:** USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. **Benefits:** At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com _Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting._ _USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran._ **If you are an existing USAA employee, please use the internal career site in OneSource to apply.** **Please do not type your first and last name in all caps.** **_Find your purpose. Join our mission._** USAA is unlike any other financial services organization. The mission of the association is to facilitate the financial security of its members, associates and their families through provision of a full range of highly competitive financial products and services; in so doing, USAA seeks to be the provider of choice for the military community. We do this by upholding the highest standards and ensuring that our corporate business activities and individual employee conduct reflect good judgment and common sense, and are consistent with our core values of service, loyalty, honesty and integrity. USAA attributes its long-standing success to its most valuable resource: our 35,000 employees. They are the heart and soul of our member-service culture. When you join us, you'll become part of a thriving community committed to going above for those who have gone beyond: the men and women of the U.S. military, their associates and their families. In order to play a role on our team, you don't have to be connected to the military yourself - you just need to share our passion for serving our more than 13 million members. USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law. California applicants, please review our HR CCPA - Notice at Collection (********************************************************************************************************** here. USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.

Liability LevelUP Training Program Schedule: Monday to Friday, 8:00 AM to 4:30 PM Compensation: $23.07/hr About the Program: The Claim Associate I LU position marks the initial phases of our comprehensive training program. This role is designed for those who are new to claims but are enthusiastic about learning and advancing quickly in the field. Participants in the LevelUP Pathway will undergo rigorous training to be promoted to a Claim Associate II and eventually to a Multi-Line Claim Representative I. Training Details: Structured Development: Includes personal study, e-learnings, work shadowing, planned experiences, and regular evaluations. Role Responsibilities: Investigate and evaluate 1st and/or 3rd party claims of minimal complexity under close supervision. Ensure high-quality claim service in alignment with CCMSI's Corporate Claim Standards. Career Advancement: All Claim Associate I LU participants are expected to advance to Claim Associate II LU and subsequently to Multi-Line Claim Representative I upon meeting program requirements. At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. Reasons you should consider a career with CCMSI: Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. Summary: The Claim Associate I LU position is designated for the first and second phases within the CCMSI-U LevelUP Career Pathways Program. Individuals classified in this program are designated as participants in the LevelUP Pathway which is an internal training program for participants/employees to be considered for promotion to a Claim Associate II (Phase 3 & 4) followed by Multi-Line Claim Representative I (Phase 5). The Claim Associate I LU investigates and evaluates 1 st and/or 3 rd party claims of minimal complexity under close supervision. Accountable for the quality of claim service as perceived by CCMSI clients and within Corporate Claim Standards. All Claim Associate II LU's will be expected to be promoted into a Multi-Line Claim Representative I position once they have achieved the necessary skills and competencies (per the LevelUP requirements). Refusal to accept the advancement to Claim Associate II LU or a Multi-Line Claim Representative I position may result in being re-classified to another position if available or withdrawal of the employment offer. Responsibilities Essential Duties & Responsibilities: Investigate, evaluate and adjust 1 st and/or 3 rd party claims of minimal complexity under direct supervision. (Not to exceed 50 claims) Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision. Set up designated claim files and complete all set up instructions, as requested. As appropriate, make referrals to outside vendors on designated cases under direct supervision. (i.e., property damage appraisals, rental vehicles, etc.) Review and approve damage estimates and miscellaneous invoices on designated claims. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process. Authorize and make payments on claims utilizing a claim payment program in accordance with industry standards and within established authority levels under direct supervision. Summarize all correspondence, damage estimates and claims related documents in claim log notes. Review and maintain personal diary on claim system. Provide technical and clerical claims support to designated clients, as requested. Compliance with corporate claim standards and special client handling instructions as established. Will act as a back-up to designated adjusters when needed. Performs other duties as assigned. Qualifications Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position is designated for the LevelUP Career Pathway Program which is an internal career pathway position designed to provide training for consideration as a Multi-Line Claims Representative I. In order to be successful in this position, the candidate must possess the following skills and attributes: Possess a long-term career goal to work in insurance as an adjuster. Excellent oral and written communication skills. Individual must be a self-starter with strong organizational abilities. Proven ability to demonstrate independent critical thinking skills. Ability to coordinate and prioritize required with exceptional time management. Ability to operate general office equipment and perform clerical duties. Flexibility, initiative, and the ability to work with a minimum of direct supervision a must. Discretion and confidentiality required. Ability to work as a team member in a rapidly changing environment. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience Associate's degree or two year's related business experience. Commitment and willingness to learn roles with increasing decision making authority and responsibilities. Bilingual (English/Spanish) preferred. Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Must pass Adjuster license exam as required for respective jurisdiction(s). Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. #CCMSICareers #LiabilityLevelUP #CCMSICareers #InsuranceJobs #ClaimsAdjuster #EntryLevelJobs #CareerDevelopment #TrainingProgram #JoinOurTeam #FastTrackYourCareer #GreatPlaceToWork #InsuranceIndustry #JobOpportunity #CareerGrowth #EmployeeOwned #IND456 We can recommend jobs specifically for you! Click here to get started.

Job Title Senior Claims Analyst, GL/Excess Summary Reporting to the Unit Manager, this role will be responsible for direct handling of commercial claims specific to General Liability and/or Excess General Liability. Familiarity with SME (small to midsize enterprises) involving premises liability, including but not limited to lessor's risks, franchisees, hotels, and restaurants/entertainment, and some contractors and serving risks. Duties include investigation and evaluation of coverage, liability, risk transfer (i.e. indemnification and/or tender application), and damages issues. The role will be responsible for claim and coverage evaluation, establishment/recommendation of adequate reserves, litigation management, liability and damage analysis in detail, case resolution and best claims outcome, and transaction processing in alignment with the Company's and Client's Strategic Vision. Essential Functions Direct handle commercial and business general liability claims. Mentors and guides less experienced claim analysts. Assists the Unit Manager with departmental problem solving. Manages external relationships including third party administrative oversight. Serves on Companywide committees and projects as assigned. Anticipates and identifies risks and opportunities on coverage and liability. Anticipates and identifies transfer of risk, tender and/or indemnification. Manage timely reporting of large losses and potential large loss exposures, coverage issues, time limit and policy limit demands, mediations, and pre-trial reports to Manager for distribution to internal and external clients Directly handles and/or assists in monitoring, reviewing, and coordinating the activities involving commercial and/or personal lines insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims. Reviews loss notices; confirms and interprets policy coverages; establishes adequate reserves; and investigates and handles claims involving primary, umbrella, and/or excess policies. Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures. Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language. Assigns and manages of work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations. Ensures proper file setup, reserving, general handling, and application of company procedure. Participates in developing claims handling strategy, including defense coordination, litigation strategy and budgets, and expense control. Records specific claims information and reports as appropriate to a manager relative to pertinent financial and general statistical records. Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company's exposure and reports to our Reinsurance Department to assist in providing notice to reinsurers and the Reinsurance Department's recovery of specific amounts when payment exceeds the company's retention. Obtains and maintains claims adjuster licenses in those states requiring them. Required Experience Minimum of seven (7) years of commercial, business, and high value premises liability claims handling experience. Required Education Four-year college degree required or equivalent work experience. Preferred Education or Certification JD, CPCU, SCLA, CCLA, state(s) adjuster license, including New York. Supervisory Role Schedule, assign, and review the work of others in compliance with specific instructions. Travel As required, based upon business needs. Work Environment / Physical Demands This position operates in a professional based collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions. The position uses standard equipment such as phones, computers, copiers/printers and filing cabinets. Noise level is moderate. Company retains the right to change or assign other duties to this position as needed. Diversity, Equity, Inclusion & Belonging RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law. Privacy Notice for California Residents https://www.trg.com/california-consumer-privacy-notice/