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  • Remote Property Claims Adjuster (COLORADO SPRINGS)

    Usaa 4.7company rating

    Remote claims representative job

    Why USAA? The full job description covers all associated skills, previous experience, and any qualifications that applicants are expected to have. 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, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle low to moderate complexity 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. This hybrid role requires an individual to be in the office 3 days per week,available to work standard business hours Monday-Friday with availability for occasional evenings and weekends as business need dictates. This position can be based in in our office in Colorado Springs, CO. Relocation assistance is not available for this position. What you'll do: Proactively manages assigned claims caseload comprised of claims with low to moderate complexity damages that require commensurate knowledge and understanding of claims coverage. Partners with vendors and internal business partners to facilitate low to moderate complexity 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 investigation information involving low to moderate complexity policy terms and contingencies. Determines and negotiates low to moderate complexity claims settlement. Coordinates with management for guidance on assessing settlement amounts outside of authority limits to support managing claims outcomes. Maintains accurate, thorough, and current claim file documentation throughout the claims process. Applies knowledge of estimating technology platforms and virtual inspection tools to prepare and manage low to moderate complexity property insurance claims estimates Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations. 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. 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. 1 year of customer service, military leadership, construction related industry/insurance experience and/or experience handling low complexity property claims Knowledge of estimating losses using Xactimate or similar tools and platforms. Demonstrated negotiation, investigation, communication, and conflict resolution skills. Working knowledge and understanding of claims contracts as well as application of case law and state laws and regulations. Ability to prioritize and multi-task, including navigating through multiple business applications. May need to travel up to 25% 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. What sets you apart: 2+ years relevant property claims adjusting Desk adjusting residential property claims to include water, roof, and personal property Handling claims from start (FNOL, reviewing policy, making coverage decisions) to finish including settlement Proficient with virtual tools (such as Claim X, Hover, and Hosta) Call center experience Xactimate proficiency Bachelor's Degree US military experience through military service or a military spouse/domestic partner Compensation range: The salary range for this position is: $59,760 - $100,850. 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 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. xevrcyc Remote working/work at home options are available for this role.
    $59.8k-100.9k yearly 1d ago
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  • Commercial Property Claims Examiner

    CWA Recruiting

    Remote claims representative job

    Commercial Property Claims Examiner - Property & Casualty Insurance Remote but must be in NYC About the Role Handle commercial property claims by investigating losses; managing and controlling independent adjusters and experts; interpreting the policy to make proper coverage determinations; addressing reserves; writing coverage letter and reports; and providing good customer service. Assure timely reserving and handling of a claim from assignment to completion by investigating that claim and interpreting coverage. Manage independent adjusters and experts. Inside desk adjusting role - 100% Remote for now - NYC based. Responsibilities Investigate losses Manage and control independent adjusters and experts Interpret the policy to make proper coverage determinations Address reserves Write coverage letters and reports Provide good customer service Assure timely reserving and handling of a claim from assignment to completion Manage independent adjusters and experts Qualifications Bachelor's degree is required Required Skills 3-5 years of first party property claims handling is required Experience with Microsoft Office 365 is required Preferred Skills Experience with ImageRight is a plus Availability to work extended hours in a CAT situation
    $35k-65k yearly est. 5d ago
  • Automotive Claims Representative

    Alpha Automotive 4.3company rating

    Claims representative job in Columbus, OH

    Alpha Automotive is looking for an Automotive Claims Representative to join our rapidly growing team! Here at Alpha Automotive, we pride ourselves on providing the best service possible for our customers by being an alternative to large, impersonal dealerships and providing them with an elevated level of personalized service each and every time. We are now hiring for ALL of our locations: Stealth Auto Recovery, Excite Towing, Wayne's Auto Powell, Wayne's Auto Schrock, Wayne's Auto Westerville, Mann's Expedite Service, H.I.N.T., Excite Collision Repair, and Ernie's Auto Repair! As an Automotive Claims Representative, a typical day may include the following: Acting as a liaison between insurance companies and customers, to assure claims are being paid in a timely manner so repairs can begin Working in harmony with the service writers in getting repair estimates sent to insurance companies, and following up to confirm they have been received and submitted correctly Keeping customers in the loop with any updates from the insurance company, and communicate when there are changes or any additional information is needed from them This career may be for you if: You enjoy helping people and problem solving You love the automotive industry and are ready to make the transition to an office environment You thrive in a fast paced environment Benefits include: Training & competitive pay Dental, vision, life & disability insurance Paid time off after a year of service View all jobs at this company
    $29k-36k yearly est. 13d ago
  • Medical Claims Representative - Office/Hybrid positions

    Edwards Health Care Services 4.3company rating

    Remote claims representative job

    GEMCORE's continued success has earned us national recognition with Inc. Magazine's list of America's Fastest-Growing Companies and with the Cleveland Plain Dealer as a Top Workplace six years running! GEMCORE is a rapidly growing multi-state family of companies headquartered in Hudson, OH. Are you looking to begin or further your career in the medical supply industry where you are able to contribute to the success of the business, and build lasting relationships? All while allowing for personal time every evening, weekend, and holiday? Edwards Health Care Services (EHCS), a division of GEMCORE , is a well-established and growing national direct-to home medical supply provider. We are seeking a highly motivated Medical Claims Representative to join our high energy team. The Medical Claims Representative's primary role is to determine the root cause of denials and payment delays. We are a fast-growing company with advancement opportunities! This position offers the ability to work unique problems and to apply complex problem solving skills. This is a full-time, non-exempt, position. Once training is complete, this position will potentially be part of a hybrid remote work schedule. This position is located in Hudson, OH. Schedule is 8:00 am - 4:45 pm, Monday through Friday. Employer paid vacation. Benefits available include medical/dental/vision, life, short and long-term disability insurances, and 401K Retirement Savings Plan. Key Responsibilities Analyze reports on insurance payment differences, appeals and rebills. Work claim denials. Identify denial trends and suggest process improvements. Collaborate with claims team and communicate effectively with all other department managers in solving issues and implementing new procedures. Proficient in the knowledge of healthcare products, deductibles, co-payments and third-party reimbursement for customer education and employee training purposes. Job requirements Key requirements: Self-starter with the ability to work independently to achieve desired results. Clinical background or medical terminology knowledge helpful but not necessary. Demonstrated proficiency in Microsoft Outlook and Excel with 30 WPM typing skills. Strong organizational skills and multitasking ability. Excellent telephone skills required. Good cognitive reasoning ability. Detailed and thorough work orientation. Minimum 1-2 years of experience in a consumer service organization or healthcare environment. Education/Experience High School Diploma or GED Equivalent About Edwards Health Care Services, Inc. Edwards Health Care Services, Inc. (EHCS) is a national direct-to home medical supply provider of high quality medical and diabetes products that support the needs of individuals with diabetes and other conditions. For over 25 years, EHCS have been lighting the way to better health by providing customers an easier way to have products delivered directly to their door. By partnering with healthcare professionals, product manufacturers, and a large network of government and private insurers, EHCS prides itself on personalized customer service and a simplified, seamless order process for every customer…every time! For more information, visit *************** About GEMCORE GEMCORE, a family of companies headquartered in Hudson, Ohio - Edwards Health Care Services, GEMCO Medical, GemCare Wellness, and GEM Edwards Pharmacy - offers a core set of healthcare solutions by partnering with manufacturers, providers, employer groups, insurance groups, and patients to deliver high quality healthcare products and innovative services to proactively better lives. For more information, visit ********************** All done! Your application has been successfully submitted! Other jobs
    $36k-41k yearly est. 21d ago
  • Level 1 - REMOTE BCBS Facility Claim Follow-Up Representative

    Insight Global

    Remote claims representative job

    Insight Global is looking for an Outpatient Facility Claim Follow Up Representative to support a large hospital system in the Maryland/DC area. This person is responsible for managing post-billing, specifically for Blue Cross Blue Shield, claim activity, for three acute hospital centers in Washington, DC. This role focuses on resolving underpayments, denials, and contract interpretation issues-not clinical denials or patient balances. The representative ensures accurate reimbursement by analyzing Explanation of Benefits (EOBs), identifying discrepancies, and initiating corrective actions with payers. This team focuses on facility claims only, and this role is focused only on outpatient claims follow up, specifically to BCBS. The role focuses on resolving technical denials (underpayment or partial payment issues, authorization issues, COB issues, coding issues, misinterpretation of contract issues, etc.). Primary Responsibilities: Claims Management: - Take ownership of outpatient hospital claims after billing, especially those that are denied or underpaid. - Determine what was paid, what was denied, and why. - Identify and resolve technical denials related to coding, coordination of benefits (COBs), charge discrepancies, contract interpretation, etc. Payer Interaction: - Handle all outpatient claims for Blue Cross Blue Sheild CareFirst and/or BlueCard. - Understand and navigate multiple contracts. - Utilize BCBS portal to follow up and resolve outstanding claim issues. Analytical Review: - Differentiate between pricing errors vs. payment errors. - Accurately price claims based on contract terms and identify variances. Scope of Work: - Outpatient facility claims ONLY - Technical denials ONLY We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements - High school diploma or equivalent - Outpatient hospital billing experience - Experience with facility claims follow-up & appeals handling o Experience with UB04 forms o This team handles all technical denials (underpayment or partial payment issues, authorization issues, COB issues, coding issues, misinterpretation of contract issues, etc.) - Strong experience working with BlueCross BlueShield CareFirst and/or BlueCard o Familiarity using payer portal, their escalation process, how to read and interpret contracts - Experience meeting a productivity standard of following up on ~55 claims per day. - Knowledgeable of ICD + CPT Codes - Attention to Detail: o Must be able to spot errors and inconsistencies in claims and contracts. - Analytical Thinking: o Capable of identifying discrepancies in claim pricing vs. payment. Must be able to determine whether a claim was underpaid, denied, or priced incorrectly. - Independent & Fast Learner - Tech Savvy (Excel, Teams, etc.) and experience working fully remotely - Experience with systems: Med-Connect for medical records, RCI (repository where denials go), Envision (SMS), Epic
    $37k-57k yearly est. 36d ago
  • Claims CL Casualty Large Loss Auto Injury Representative (remote)

    Grange Insurance Careers 4.4company rating

    Remote claims representative job

    Summary: This position is responsible for investigating, evaluating and negotiating settlement of assigned large loss Commercial Auto Body Injury Claims in accordance with best practices and to promote retention or purchase of insurance from Grange Enterprise. If you're excited about this role but don't meet every qualification, we still encourage you to apply! At Grange, we value growth and are committed to supporting continuous learning and skill development as you advance in your career with us. What You'll Be Doing: Pursuant to line of business strategies and good faith claim settlement practices, investigates, evaluates, negotiates, and resolves (within authorized limits) assigned claims. Demonstrates technical proficiency, routinely handling the most complex claims with minimal manager oversight. Establishes and maintains positive relationships with both internal and external customers, providing excellent customer service. Assists in building business relationships with agents, insureds and Commercial Lines partners through regular, effective and insightful communications. May include face-to-face as needed. Will be the “point person” (when required) for certain identified large customer accounts where specialized communication and handling are required. Regularly develops and mentors other associates. Assists leadership in advancing the technical acumen of the department through the development of formal and informal training and resources. Establishes and maintains proper reserving through proactive investigation and ongoing review. Assists other departments (when required) with investigations. May be assigned general liability claims during high volume workload periods. Demonstrates effectiveness and efficiencies in managing diary system and handling workload with limited supervision or direction. What You'll Bring To The Company: High school diploma or equivalent education plus five (5) years claims experience with at least three (3) years of Commercial Casualty experience. Experience in General Liability preferred. Bachelor's degree preferred. Must possess strong communication and organization skills, critical thinking competencies and be proficient with personal computer. Requires excellent decision-making ability, a broad depth of experience and technical competence and capacity to manage work to meet time sensitive deadlines. Demonstrated ability to interact with internal and external customers in a professional manner. State specific adjusters' license may be required. About Us: Grange Insurance Company, with $3.2 billion in assets and more than $1.5 billion in annual revenue, is an insurance provider founded in 1935 and based in Columbus, Ohio. Through its network of independent agents, Grange offers auto, home and business insurance protection. Grange Insurance Company and its affiliates serve policyholders in Georgia, Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and Wisconsin and holds an A.M. Best rating of "A" (Excellent). Grange understands that life requires flexibility. We promote geographical diversity, allowing hybrid and remote options and flexibility in work hours (role dependent). In addition to competitive traditional benefits, Grange has also created unique benefits based on employee feedback, including a cultural appreciation holiday, family formation benefits, compassionate care leave, and expanded categories of bereavement leave. Who We Are: We are committed to an inclusive work environment that welcomes and values diversity, equity and inclusion. We hire great talent from various backgrounds, and our associates are our biggest strength. We seek individuals that represent the diversity of our communities, including those of all abilities. A diverse workforce's collective ideas, opinions and creativity are necessary to deliver the innovative solutions and service our agency partners and customers need. Our core values: Be One Team, Deliver Excellence, Communicate Openly, Do the Right Thing, and Solve Creatively for Tomorrow. Our Associate Resource Groups help us create a more diverse and inclusive mindset and workplace. They also offer professional and personal growth opportunities. These voluntary groups are open to all associates and have formed to celebrate similarities of ethnicity/race, nationality, generation, gender identity, and sexual orientation and include Multicultural Professional Network, Pride Partnership & Allies, Women's Group, and Young Professionals. Our Inclusive Culture Council, created in 2016, is focused on professional development, networking, business value and community outreach, all of which encourage and facilitate an environment that fosters learning, innovation, and growth. Together, we use our individual experiences to learn from one another and grow as professionals and as people.  We are committed to maintaining a discrimination-free workplace in all aspects, terms and conditions of employment and welcome the unique contributions that you bring from education, opinions, culture, beliefs, race, color, religion, age, sex, national origin, handicap, disability, sexual orientation, gender identity or expression, ancestry, pregnancy, veteran status, and citizenship.
    $34k-45k yearly est. 13d ago
  • Workers' Compensation Claims Representative (Remote)

    MEM Insurance

    Remote claims representative job

    Are you an experienced claims professional ready to take on complex cases and make a meaningful impact? MEM Insurance is seeking a seasoned Claims Representative to join our dynamic Claims team. In this role, you will manage a caseload of high-exposure workers' compensation claims, oversee advanced medical case management, and develop tailored Return-to-Work plans. You'll collaborate with vocational consultants, legal counsel, and internal teams to ensure compliance, negotiate settlements, and deliver exceptional service to our policyholders. This position offers the opportunity to work independently while providing leadership on complex claims and contributing to workflow improvements. Essential Duties and Responsibilities Manage complex workers' compensation claims involving high financial exposure, sensitive issues, or extended life cycles. Investigate coverage and compensability, ensuring thorough documentation and compliance with state statutes. Oversee advanced medical case management, including coordination with Nurse Case Managers and external vendors. Develop and implement Return-to-Work plans for high-risk claims, collaborating with vocational consultants and legal counsel. Identify and investigate potential fraud and subrogation opportunities, partnering with the Special Investigation Unit. Establish and maintain accurate claim reserves within authority levels, ensuring timely responsiveness to changing circumstances. Evaluate and negotiate settlements within approved authority levels, including structured settlements and Medicare compliance. Collaborate with legal counsel to manage litigation and ensure adherence to MEM guidelines. Maintain accurate system data and prepare reports for management on high-profile claims. Foster cross-departmental collaboration with Underwriting, Premium Consultation, and Loss Prevention. Provide mentorship and training to junior adjusters, supporting professional growth and team development. Qualifications High school diploma or equivalent required; bachelor's degree preferred. Associate in Claims (AIC) designation preferred. Valid driver's license required; Texas-All Lines license preferred. 3-5 years of claims handling experience, primarily in Workers' Compensation. Company Culture and Values At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other's growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered. Diversity Statement MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities. Total Rewards Overview Health Plans: Medical, Dental, and VisionIncludes fertility benefits, fully paid preventative care, and adult orthodontia. Employer-Paid Life and Disability Benefits:Life Insurance (3x base salary), AD&D, Short and Long-term Disability. Wellness and Recognition Program: Employer-paid incentives for employees and spouses. Flexible Spending Account and Dependent Care options Health Savings Account: Generous employer contribution. Time Away from Work:Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave. Employee Assistance Programs 401k Retirement Plan: Employer match and profit sharing. Adoption Assistance and Tuition Assistance Notice Regarding Use of Artificial IntelligenceMEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.
    $31k-43k yearly est. 7d ago
  • Complex Adjuster Trainee

    Root Insurance 4.8company rating

    Claims representative job in Columbus, OH

    The Opportunity At Root, we offer clear career paths, structured training, and company funded licensing so adjusters can grow into their claims role with confidence. Our teams gain hands-on experience early, receive ongoing coaching, and advance through clearly defined career paths based on performance, readiness, and business needs. If you are looking to pursue a career in insurance, this opportunity might be for you! Claims Adjuster Trainee, Liability Our Claims Adjuster Trainee role offers hands-on experience, structured development, and defined advancement into complex liability work. In this role, you will complete a 6-month training program that combines formal instruction with live claim handling. You will learn how to investigate claims, evaluate coverage and liability, communicate with customers and partners, and make informed claim decisions with the support of experienced leaders. The trainee position offers a starting base salary of approximately $45,840 to $50,000, with a defined increase to $55,000 upon successful completion of training and meeting performance expectations, at which point you will transition into the Complex Adjuster role. After training, you will handle a balanced mix of claim complexity that supports continued skill development and long term success. This role is a strong fit for candidates who are motivated, customer focused, and interested in building a long term career in claims, where strong performance in the Complex Adjuster role can open opportunities in other areas such as auto physical damage, total loss, and injury claims. This position may be required to have an onsite presence in our Columbus office based on operational needs. Salary Range: $45,000 - $50,000 How You Will Make an Impact Deliver a high-quality claims experience for all policyholders and claimants by managing claims with professionalism and empathy Verify coverage and assist in determining liability for a range of accident scenarios, under guidance from senior adjusters or claims leadership Obtain detailed accident statements from drivers, passengers, and witnesses to develop clear liability perspectives Maintain consistent, prompt, and courteous contact with all involved parties throughout the claim lifecycle Use time management and organizational skills to proactively manage pending claims, tasks, and correspondence Coordinate vehicle repairs and assist customers with rental reimbursement processes Participate in team reviews of claims handling practices to strengthen understanding of policy language and claim best practices Engage in continuous learning to develop a strong understanding of: Policy interpretation Liability assessment and shared negligence scenarios Court decisions and legislation affecting claims functions Emerging claims guidelines and industry best practices Recommend process and product improvements based on observed opportunities Interact and communicate effectively with customers, peers, vendors, and managers Support the development of claims documentation and training materials as knowledge grows What You Will Need to Succeed Bachelor's degree or equivalent work experience Successful history of time management, multi-tasking, and customer-facing communication Ability to secure an adjuster insurance license within 90 days of the start date Strong written and verbal communication skills Proficient in Microsoft Office Suite and/or Google Suite High sense of professionalism while remaining empathetic Curious in nature Willingness and ability to keep learning Great attention to detail with high organizational skills Ability to approach problems with an open mind Strong decision-making capabilities Ability to complete other duties as assigned As part of Root's interview process, we kindly ask that all candidates be on camera for virtual interviews. This helps us create a more personal and engaging experience for both you and our interviewers. Being on camera is a standard requirement for our process and part of how we assess fit and communication style, so we do require it to move forward with any applicant's candidacy. If you have any concerns, feel free to let us know once you are contacted. We're happy to talk it through. Please see our Privacy Notice available HERE for more information on how we process your personal data.
    $45.8k-50k yearly 11d ago
  • Liability Claims Adjuster

    Porch Group 4.6company rating

    Remote claims representative job

    Porch Group is a leading vertical software and insurance platform and is positioned to be the best partner to help homebuyers move, maintain, and fully protect their homes. We offer differentiated products and services, with homeowners insurance at the center of this relationship. We differentiate and look to win in the massive and growing homeowners insurance opportunity by 1) providing the best services for homebuyers, 2) led by advantaged underwriting in insurance, 3) to protect the whole home. As a leader in the home services software-as-a-service (“SaaS”) space, we've built deep relationships with approximately 30 thousand companies that are key to the home-buying transaction, such as home inspectors, mortgage companies, and title companies. In 2020, Porch Group rang the Nasdaq bell and began trading under the ticker symbol PRCH. We are looking to build a truly great company and are JUST GETTING STARTED. Job Title: Liability Claims Examiner Location: United States Workplace Type: Remote Homeowners of America is a provider of Personal Lines Insurance products. We're always looking to add talented and passionate people to our team. We value the knowledge that comes from experienced individuals with diverse backgrounds and strengths that can contribute to the various departments within our company. Our shared values are no jerks, no egos, be ambitious, solve each problem, care deeply and together we win. Summary The Liability Claims Examiner is responsible for managing complex and litigated 3rd party claims arising under homeowners' insurance policies. This role involves investigating losses, evaluating coverage, assessing liability exposures, and directing litigation strategies to achieve fair and timely resolution of claims. The examiner will work closely with insureds, claimants, field adjusters, defense counsel, experts, and internal stakeholders ensuring compliance with company guidelines and regulatory requirements while mitigating risk and controlling costs. Liability Claims Examiners are responsible for requesting payments, documenting files, and preparing and issuing claim payment letters or denial letters when appropriate. What you Will Do As A Liability Claims Examiner Responsibilities: May include any or all the following. Other duties may be assigned. Investigate and Evaluate Claims: Review policy language, coverage issues, and liability exposures. Analyze incident reports, statements, expert opinions, and other evidence to determine liability and damages. Handles claims from all types of policies, including homeowners, dwelling fire, tenant, condo, and renters. Confers with legal counsel on claims involving coverage, legal, or complex matters Effectively manage difficult or emotional customer situations Litigation Management: Direct and oversee defense counsel in litigated matters, including strategy development, budgeting, and case progression. Attend mediations, settlement conferences, and trials as needed. Evaluate litigation reports and provide recommendations for resolution. Negotiation and Settlement: Negotiate settlements within authority limits to achieve equitable outcomes. Collaborate with legal counsel to resolve complex coverage and liability disputes. Financial Oversight: Establish and adjust reserves based on claim developments and litigation exposure. Monitor litigation costs and ensure adherence to budget guidelines. Seeking out and utilizing top vendors that build quality, increase efficiency, and reduce cost Communication and Documentation: Maintain accurate and detailed claim files, including litigation plans and correspondence. Communicate effectively with insureds, claimants, attorneys, and internal teams. Enters claims payments when applicable and maintains clean, concise, and accurate file documentation Manages correspondence and communication with various parties involved in the claim Draft and prepare letters and other correspondence related to the claim Compliance and Best Practices: Ensure adherence to claims handling guidelines, regulatory requirements, and ethical standards. Identify opportunities for process improvement and cost containment. Take on assignments and duties as requested by the management team What you Will Bring As A Liability Claims Examiner Bachelor's degree or equivalent experience Minimum 5+ years of liability claims experience, with a strong focus on litigated 3rd party claims Appropriate state adjuster license and continuing education credits In-depth knowledge of homeowners liability and med pay coverage, policy language, and litigation processes Strong negotiation, analytical, and decision-making skills Excellent written and verbal communication skills Ability to manage multiple complex cases and meet deadlines in a fast-paced environment Proficiency in claims management systems and Microsoft Office suite (Outlook, Word, Excel, PowerPoint) Works with integrity and ethics Exceptional customer service skills Effectively manages difficult or emotional customer situations Ability to read, write, and interpret routine correspondence, policies, and reports Makes decisions and completes activities in a confident and timely manner Follows Claims Handling Guidelines, policies and procedures Maintains confidentiality Works independently, with the ability to assess workload and plan accordingly to meet competing deadlines Cultivates environment of teamwork and collaboration Comprehensive and up-to-date knowledge of General Liability and P&C insurance, contractual policy language requirements and the implications of that language as it pertains to denial of claims Demonstrated commitment to continuing education in the industry through licensing or designations applicable to property and liability insurance field is preferred. Certificates, Licenses, Registrations Appropriate state adjuster license and continuing education credits. The application window for this position is anticipated to close in 2 weeks (10 business days) from December 17th, 2025. Please know this may change based on business and interviewing needs. At this time, Porch Group does not consider applicants from the following states for remote positions: Alaska, Arkansas, Delaware, Hawaii, Iowa, Maine, Mississippi, Montana, New Hampshire, and West Virginia. What You Will Get As A Porch Group Team Member Pay Range*: Annually$67,500.00 - $94,500.00 *Please know your actual pay at Porch will reflect a number of factors among which are your work experience and skillsets, job-related knowledge, alignment with market and our Porch employees, as well as your geographic location. Our benefits package will provide you with comprehensive coverage for your health, life, and financial wellbeing. Our traditional healthcare benefits include three (3) Medical plan options, two (2) Dental plan options, and a Vision plan from which to choose. Critical Illness, Hospital Indemnity and Accident plans are offered on a voluntary basis. We offer pre-tax savings options including a partially employer funded Health Savings Account and employee Flexible Savings Accounts including healthcare, dependent care, and transportation savings options. We provide company paid Basic Life and AD&D, Short and Long-Term Disability benefits. We also offer Voluntary Life and AD&D plans. Both traditional and Roth 401(k) plans are available with a discretionary employer match. Headspace is part of our employer paid wellbeing program and provides employees and their families access to on demand guided meditation and mindfulness exercises, mental health coaching, clinical care and online access to confidential resources including will preparation. Brio Health is another employer paid wellbeing tool that offers quarterly wellness challenges and prizes. LifeBalance is a free resource to employees and their families for year-round discounts on things like gym memberships, travel, appliances, movies, pet insurance and more. Our wellness programs include flexible paid vacation, company-paid holidays of typically nine per year, paid sick time, paid parental leave, identity theft program, travel assistance, and fitness and other discounts programs. #LI-JS1 #LI-Remote What's next? Submit your application and our Porch Group Talent Acquisition team will be reviewing your application shortly! If your resume gets us intrigued, we will look to connect with you for a chat to learn more about your background, and then possibly invite you to have virtual interviews. What's important to call out is that we want to make sure not only that you're the right person for us, but also that we're the right next step for you, so come prepared with all the questions you have! Porch is committed to building an inclusive culture of belonging that not only embraces the diversity of our people but also reflects the diversity of the communities in which we work and the customers we serve. We know that the happiest and highest performing teams include people with diverse perspectives that encourage new ways of solving problems, so we strive to attract and develop talent from all backgrounds and create workplaces where everyone feels seen, heard and empowered to bring their full, authentic selves to work. Porch is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected veteran status, or any other characteristic protected by applicable laws, regulations, and ordinances. Porch Group is an E-Verify employer. 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.
    $67.5k-94.5k yearly Auto-Apply 35d ago
  • Experienced CA WC Adjuster - Remote - Multi-Industry (Trucking, Staffing, Valet)

    Ccmsi 4.0company rating

    Remote claims representative job

    Overview Workers' Compensation Claim Consultant (CA Jurisdiction Only) - Remote Salary: $77,000-$87,000 annually Schedule: Monday-Friday, 8:00 AM-4:30 PM PST Experience Required: 5+ Years (Litigated & Some Complex Claims) 🚨 Please Note This is not an HR, risk management, or consulting position. This is an experienced California Workers' Compensation adjusting role requiring hands-on claim investigation, evaluation, negotiation, and settlement. Candidates must have direct experience investigating, evaluating, reserving, negotiating, and resolving claims as an adjuster or adjuster supervisor within a carrier, TPA, or similar claims environment. Applicants without hands-on adjusting experience will not be considered. Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We're seeking an experienced Workers' Compensation Claim Consultant to handle California jurisdiction claims for a multi-account desk supporting clients in the trucking & warehouse, valet/shuttle services, and staffing agency industries. This fully remote position requires strong litigated claim handling experience, the ability to independently manage complex files, and a commitment to CCMSI's best practice standards. You'll join a collaborative team of four other consultants, working together to deliver high-quality, timely, and accurate claim service to our clients. Responsibilities When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems. Conduct timely 3-point contact per CCMSI best practices. Investigate, evaluate, and adjust California workers' compensation claims with independence and sound judgment. Establish, maintain, and justify detailed reserve levels. Administer indemnity and award payments in accordance with CA jurisdictional requirements. Negotiate settlements consistent with corporate standards, client instructions, and state law. Maintain a current and thorough diary, ensuring all deadlines and statutory requirements are met. Pursue subrogation recovery as applicable. Prepare claim status reports, reserve analyses, and updates for client meetings. Conduct claim reviews with clients and participate in discussions as needed. Communicate effectively with injured workers, employers, providers, and attorneys throughout the claim lifecycle. Ensure all documentation meets CCMSI best practice requirements. Qualifications Qualifications - Required 5+ years of California WC adjusting experience, including litigated files and some complex exposure. Adjuster designation required. Strong working knowledge of California WC laws, timelines, benefits, and litigation processes. Proficiency with Microsoft Office (Word, Excel, Outlook). Excellent written and verbal communication skills, critical thinking, and decision-making ability. Nice to Have SIP certification preferred. Strong documentation habits per CCMSI best practices. Experience presenting or conducting client reviews. Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Work Environment & Travel Remote role reporting to the Irvine, CA branch. Occasional travel to the office may be required for rare mandatory in-office meetings. Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions • Compliance & audit performance - adherence to jurisdictional and client standards • Timeliness & accuracy - purposeful file movement and dependable execution • Client partnership - proactive communication and strong follow-through • Professional judgment - owning outcomes and solving problems with integrity • Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. 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. 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. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompJobs #CaliforniaAdjuster #RemoteJobs #ClaimsConsultant #InsuranceCareers #AdjusterLife #NowHiring #LI-Remote
    $77k-87k yearly Auto-Apply 54d ago
  • Professional Liability Adjuster (Fully Remote)

    Bridge Specialty Group

    Remote claims representative job

    Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. This is a remote work from home opportunity. Summit Risk Services is seeking a Professional Liability Adjuster, Attorney and /or JD required, to join our growing team! The Professional Liability Adjuster is responsible for evaluating coverage, managing claims, and overseeing defense strategies to ensure fair and cost-effective resolutions. This role involves interpreting policy language, assigning and supervising defense counsel, attending mediations, and providing high-quality claims handling in collaboration with an experienced legal and claims professional. How You Will Contribute: Reviewing various insurance policies; determine whether the carrier has a duty to provide a defense and/or indemnification to the insured; prepare coverage correspondence, if there is a duty to defend, assign approved defense counsel. Oversee the work of defense counsel who will report generally in 90-day intervals. Attend mediations. Determine the most cost-effective way to effectuate resolution of the claims. You will be working with and reporting to someone with 27 years legal and claims experience. Some travel required. Skills & Experience to Be Successful: Juris Doctorate degree (JD) from an accredited U.S. law school and licensed to practice law. Excellent verbal and written communication skills required. Excellent time management skills needed. Must have strong organizational skills and ability to multi-task. Excellent PC skills with working knowledge of Microsoft Office suite. About Us: Our group is a Claims Management Third Party Administrator Specializing in Professional Liability Claims Management. We are publicly traded on NYSE and our team includes lawyers who serve as Claim Management Specialists for various insurance companies in the United States. Pay Range $100,000 - $105,000 Annual The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.
    $100k-105k yearly Auto-Apply 6d ago
  • Field Property Claims Representative

    Goodville Mutual Casualty Company 3.7company rating

    Remote claims representative job

    This position is responsible for investigation, inspection, and settlement of assigned losses. This position is also responsible for providing outside field property claims inspection service as directed by inside claims representatives, and adjusting and settling claims for all lines of business written by the company with settlement authority up to $30,000. Functions: Handle claims according to company guidelines and in compliance with the Unfair Claims Practices Act. Investigate claims assigned. This may include taking photos, measuring damaged property, diagramming, and writing estimates as well as written and phone communication with insureds, claimants, and their legal representatives. Verify policy coverage on assigned losses. Pursue subrogation, salvage, and third-party liability contribution. Conduct physical inspections of property loss sites. Evaluate claim information to determine if payment of the claim or a denial is in order. Notify Property Claim Manager of all claims that exceed settlement authority of $30,000. Establish and maintain proper and adequate reserves on assigned claims. Report claim complaints, questionable claim submissions and possible fraud to Property Claim Manager or Claims Manager. Attend claims seminars and insurance related meetings; participate in claims associations. Assist Property Claim Manager and Claims Manger in attending arbitrations, hearings, or court proceedings, as needed. Remain available to service claims after normal business hours, weekends, and holidays, if needed. Perform other duties as assigned by the Property Claims Manager and Claims Manager. Requirements Five to ten years' Property and Casualty claims experience, with some prior experience handling claims as a field claims representative preferred. Ability to learn the coverages of all insurance policies written by the company required. Effective communication and negotiation skills required. Ability to work effectively with company computer systems required. Ability to work remotely, independently and without direct supervision required. Proficiency and knowledge of the Xactimate estimating platform preferred. Involvement in insurance-related seminars and continuing education preferred. Ability to effectively converse with the public required. Valid driver's license with a safe driving record required. Ability to set up and climb ladders, balance at various heights, stoop, bend, or crawl to inspect structures while conducting physical inspections of property loss sites required. Ability to carry work materials weighing up to 50 lbs. required. Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required. Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required. Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required. Ability to perform the essential functions of the job with or without reasonable accommodation required.
    $30k yearly 7d ago
  • 1099 Adjuster Apply Here!

    Capstone ISG 3.7company rating

    Remote claims representative job

    Requirements 2+ years handling property insurance claims required Candidate must have an active Xactimate account Can handle partial and full assignments Commercial and personal lines experience preferred A qualified candidate must have their own transportation, equipment and software Good writing and technology skills
    $43k-61k yearly est. 60d+ ago
  • Remote Medical Claims Representative

    NTT Data North America 4.7company rating

    Remote claims representative job

    At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Remote **Medical Claims Representative** to join our team in **for a remote position** . This is a US based, W-2 project. All candidates will be paid through NTT DATA only. **Role Responsibilities** **- Pay rate is $18.00** -Processing of Professional claim forms files by provider -Reviewing the policies and benefits -Comply with company regulations regarding HIPAA, confidentiality, and PHI -Abide with the timelines to complete compliance training of NTT Data/Client -Work independently to research, review and act on the claims -Prioritize work and adjudicate claims as per turnaround time/SLAs -Ensure claims are adjudicated as per clients defined workflows, guidelines -Sustaining and meeting the client productivity/quality targets to avoid penalties -Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. -Timely response and resolution of claims received via emails as priority work -Correctly calculate claims payable amount using applicable methodology/ fee schedule **-Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities** **-Time management with the ability to cope in a complex, changing environment** **-Ability to communicate (oral/written) effectively in a professional office setting** **Required Skills/Experience** + 1+ year(s) hands-on experience in **Healthcare Claims Processing** + **Previously performing - in P&Q work environment; work from queue; remotely** + 2+ year(s) using a computer with Windows applications using a keyboard, **navigating multiple screens and computer systems, and learning new software tools** + Key board skills and computer familiarity - + **Toggling back and forth between screens** /can you navigate multiple systems. + Working knowledge of MS office products - Outlook, MS Word and **MS-Excel** . **Preferences** Amisys &/or Xcelys Preferred About NTT DATA: NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com. NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is **$18.00/hourly** . This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.
    $18 hourly 50d ago
  • Multi-Line Adjuster - Ohio

    Property Claim Professionals

    Remote claims representative job

    A dynamic organization supplying quality claims outsource solutions to insurance carriers, countrywide is seeking multi-line adjusters in your area. There are many competing vendors in our marketplace, but we are not your typical “vendor”. Our company was built by insurance company claims executives to support insurance companies' claim operations to help them meet their organizations goal of providing quality claims solutions at a reasonable cost. We excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Position Summary: A national independent insurance adjusting firm has immediate openings for Multi-Line Claims adjusters that possess the ability to work remotely and have the experience to handle both property and liability claims. The candidate must possess the ability to adjust commercial and residential property losses and must also have a working knowledge of how to determine negligence and assess damages. The candidate should be able to perform all tasks with modest supervision. The candidate must possess the ability to understand coverage, how to investigate a variety of property and negligence claims, how to value and estimate property damage as well as the ability to evaluate Bodily Injury damages for settlement. Requirements: Minimum 5 years first-party commercial and/or residential property and liability adjusting experience Maintain own current estimating software; Xactimate preferred Working computer; internet access and Microsoft Word required Must demonstrate strong time management and customer service skills Ability to take recorded statements in the field or with legal representatives Experience in preparing Statements of Loss, Proofs of Loss, and denial letters State adjuster's license where required Must have valid driver's license Knowledge and Skills: In-depth knowledge of property and liability insurance coverage and industry standards Prepare full captioned reports by collecting and summarizing information required by client Strong verbal and written communications skills Prompt, reliable, and friendly service Must submit to background check; void in states where prohibited Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations Responsibilities: Completes residential and commercial field property inspections utilizing Xactimate software and general liability field investigations to determine negligence and damages Investigate claims by obtaining recorded statements from insureds, claimants or witnesses; by interviewing fire, police or other governmental officials as well as inspecting claimed damages Recommend claim reserves based on investigation, through well supported reserve report Obtain and interpret official reports Review applicable coverage forms and endorsement, providing thorough analysis of coverage and any coverage issues in well documented initial captioned report to client Maintain acceptable product quality through compliance with established Best Practices of client Preferred but Not Required: College Degree AIC, or other professional designations All candidates must pass a full background check
    $44k-62k yearly est. Auto-Apply 60d+ ago
  • PIP Adjuster - Remote Bilingual/Spanish

    Responsive Auto Insurance Company

    Remote claims representative job

    Full-time Description Description Department: Claims Schedule: Monday to Friday; flexibility for additional hours as needed. Salary: $60,000 - $75,000; negotiable About Responsive Founded in 2007 and headquartered in Plantation, Florida, Responsive is a leading provider of personal auto insurance in Florida. We collaborate with thousands of agents from the most respected insurance agencies to deliver world-class service and claims experiences. Responsive stands for making auto insurance simple, affordable, and hassle-free; a promise we deliver through innovation, feedback, and a commitment to excellence. Why Join Responsive? At Responsive, we're committed to supporting our team with comprehensive benefits and a positive work environment, including: Employer-Paid Healthcare: Medical, dental, and vision plans with free preventative care. Retirement Savings: 401(k) with company match. Wellness Programs: Mental health support and wellness initiatives. Career Development: Training and growth opportunities in a collaborative environment. What You Will Do As a Bilingual PIP Adjuster, you'll work closely with customers, attorneys, medical providers, other insurance carriers, and vendors in resolving coverage, and liability from start to finish. You'll plan and schedule work needed to process claims, interview claimants and witnesses, investigate claims, negotiate to reach a fair and equitable settlement of the PIP exposure, and identify situations where claims may require special investigation. You'll maintain strong relationships with customers while resolving auto injury claims efficiently. You'll perform the duties below, along with other work as assigned. Investigate, evaluate, and settle insurance claims (e.g., establish coverage and qualification for injured parties; negotiate claims with providers to reach a fair and equitable settlement of the PIP exposure). Maintain a well-organized and accurate diary to ensure timeliness in handling claims as well as detailed, accurate, and timely records. Write clear and accurate responses in response to demands, requests, or questions. Display courtesy, accuracy, and uniformity when interacting with others (on the phone, in person). Be familiar with tools such as ISO, TLO, & other public sites such as buycrash.com, MDCC, BCC, FDHSMV, and Google Maps. Continuously develop knowledge and expertise (e.g., keep current on job-relevant laws, regulations, trends, and emerging issues). Conduct activities in compliance with applicable Federal & State laws, and company regulations and guidelines. Requirements At least 2 years PIP Adjuster experience with Automobile Property Damage Claims to operate in the state of Florida Licensed Adjuster - All Lines required (FL 620 license) Bi-lingual (English/Spanish) required Bachelor's degree preferred Demonstrated ability to develop and maintain relationships with others Oral communication skills, especially active listening Written communication skills Well organized Strong analytical, problem-solving, and critical thinking skills Demonstrated experiences in a production environment where time management, workload prioritization, case management, recordkeeping and documentation, accountability, and follow-up are key priorities Team player Curious (e.g., ability to identify the right questions to ask customers) Self-motivated Openness to feedback and a strong desire to learn Proficiency with software programs such as Word and Outlook Responsive provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, veteran, marital, or domestic partner status.
    $60k-75k yearly 60d+ ago
  • Commercial Casualty Litigation Adjuster (Remote)

    Aaaie

    Remote claims representative job

    External candidates: In order for your application to be correctly processed please sign-in before you apply Internal candidates: Please go to Workday and click "Find Jobs" link under Career Thank you for considering opportunities with us! Job Title Commercial Casualty Litigation Adjuster (Remote) Requisition Number R7516 Commercial Casualty Litigation Adjuster (Remote) (Open) Location Colorado - Home Teleworkers Additional Locations Alabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers, Nebraska - Home Teleworkers {+ 19 more} Job Information We're Mobilitas, a commercial insurance company created by CSAA Insurance. Our mission is to reinvent commercial insurance in the mobility space by providing technologically advanced solutions for today's way of doing business. At Mobilitas, we believe in what's possible, we use our inventive skills to create new opportunities - we're not chasing the status quo, we're chasing a shared vision. We're looking for motivated, innovative individuals who think big, move fast and are dedicated to creating a company from the ground up, without the constraints of a traditional insurance company. We're excited to push the boundaries of commercial insurance and are looking for enthusiastic team members to help us reimagine insurance. We are actively hiring for a Commercial Casualty Litigation Adjuster! Your Role: As a Commercial Casualty Litigation Adjuster, you will be assigned as owning adjuster when injury exposures are identified. Claims will include catastrophic injuries, fatalities, and litigation. In this role, you will be responsible for management of the claim through conclusion, including trial, of litigated claims. May own claims within other specialized lines of business or during catastrophes. You will provide input and direction to defense counsel and be responsible for ultimate resolution through providing settlement authority and participating in negotiations with limited oversight. You will also be responsible for effective management of defense costs and indemnity. May handle first party non-liability-based injury claim (Medical Payment, PIP, Inland Marine, auto physical damage). Your Work: Assigned as owning adjuster when injury exposure is identified. Handles complex 1st and 3rd party auto liability cases involving injury, including complexity litigated cases with defense attorney involvement. May handle 1st party medical payment and PIP claims. Responsible for managing, investigating, and negotiating claims, including collaborating with defense counsel to identify strategy for negotiations. Provides input as the face of the organization via phone or in attendance on video or in-person at mediations and settlement conferences for litigation claims. Interacts directly with defense counsel providing direction, authority for resolution (i.e., settle or go to trial) and ensures appropriate outcome in balancing defense costs and indemnity on litigation claims. Making coverage determinations and advising customers as to proper course of action related to coverage issues. Conducting investigative work of a complex nature (interviewing witnesses; obtaining and analyzing evidence, including medical records; deciding whether an independent medical examination is warranted; etc.). Direct defense counsel in non-litigated or litigated claims. May require appearing at and representing the insureds at arbitrations and trials. May require testimony in a deposition setting. Evaluate defense counsel fees and cost for reasonableness and resolve. Evaluating potential for subrogation and initiating initial notice of subrogation request. Making final decisions to settle within settlement authority, without supervisory approval, and developing negotiating strategies. Presenting cases in Committee setting when seeking above settlement authority level; thereafter, independently negotiating and settling the claim. Will develop and present executive summaries on individual claims to external clients and internal executives in a virtual setting to gain alignment with client on next steps, and settlements. Handles most commercial product types including but not limited to auto, fleet, last mile delivery, and trucking. Will handle claims in most geographic venues. Handles claims involving any vehicle types that may include, but is not limited to auto, motorcycles, scooters, recreational vehicles, trucks, and remote-controlled delivery vehicles. Understands and handles claims in line with any applicable insurance program agreements, claim service level agreements. Plays a direct role in the development of other adjusters through mentorship, training, and coaching. Required Experience, Education, & Skills: 6+ years of claims experience. 3+ years of experience in a Casualty claims role within P&C insurance industry with a minimum of 1 year in a Sr. Casualty role or equivalent Complex Casualty / Litigation experience. BA/BS in business, insurance or related area, or equivalent combination of education and experience. Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of filling position as a condition of employment. What would make us excited about you? 6+ years of Casualty claims adjusters experience. 3+ years of experience in a Commercial claims role Bilingual a plus. Proficiency or ability to obtain proficiency in the handling of minor, moderate and complex litigated claims. Strong analytical, problem-solving, and organizational skills. Proficient in ability to work independently. Strong decision-making ability. Extensive understanding of statutory and regulatory requirements, and ability to develop proficiency in standards of civil procedure. Ability to travel and to work extended hours and/or weekends. Proficient oral and written communication skills and ability to organize and present complex facts to executive management. Strong math skills, basic computer skills and ability to type at least 30 words per minute. Mobilitas Careers At Mobilitas, we're proudly devoted to protecting our customers, our employees, our communities, and the world at large. We are on a climate journey to continue to do better for our people, our business, and our planet. Taking bold action and leading by example. We are citizens for a changing world, and we continually change to meet it. Join us if you… BELIEVE in a mission focused on building a community of service, rooted in inclusion and belonging. COMMIT to being there for our customers and employees. CREATE a sense of purpose that serves the greater good through innovation. Recognition: We offer a total compensation package, performance bonus, 401(k) with a company match, and so much more! Read more about what we offer and what it is like to be a part of our dynamic team at careers.mobilitasinsurance.com In most cases, you will have the opportunity to choose your preferred working location from the following options when you join us: remote, hybrid, or in-person. Submit your application to be considered. We communicate via email, so check your inbox and/or your spam folder to ensure you don't miss important updates from us. If a reasonable accommodation is needed to participate in the job application or interview process, please contact *************************** As part of our values, we are committed to supporting inclusion and diversity. We actively celebrate colleagues' different abilities, sexual orientation, ethnicity, and gender. Everyone is welcome and supported in their development at all stages in their journey with us. We are always recruiting, retaining, and promoting a diverse mix of colleagues who are representative of the U.S. workforce. The diversity of our team fosters a broad range of ideas and enables us to design and deliver a wide array of products to meet customers' evolving needs. Mobilitas is an equal opportunity employer. If you apply and are selected to continue in the recruiting process, we will schedule a preliminary call with you to discuss the role and will disclose during that call the available salary/hourly rate range based on your location. Factors used to determine the actual salary offered may include location, experience, or education. Must have authorization to work indefinitely in the US Please note we are hiring for this role remote anywhere in the United States with the following exceptions: Hawaii and Alaska. #LI-CH1 .
    $42k-57k yearly est. Auto-Apply 12d ago
  • Liability Adjuster II

    TWAY Trustway Services

    Remote claims representative job

    JOIN THE ASSURANCEAMERICA TEAM Do you want to be part of an organization where you are valued, and your ideas and opinions have an impact? Join the AssuranceAmerica team. For more than 25 years, AssuranceAmerica has provided superior property and casualty insurance products through contracted independent agents and directly to customers. Our team succeeds through diversity of thought, experiences, skills, and backgrounds. Liability Adjuster II The Liability Adjuster II is responsible for managing a caseload of complex liability and coverage claims, including those involving minor bodily injuries. This role requires the execution of thorough investigations to gather all necessary facts, along with a strong understanding of policy language to ensure accurate and timely coverage and liability determinations. While working with a degree of autonomy, the Adjuster will collaborate with their supervisor for guidance on more nuanced or high-exposure cases. About the ROLE Each day at AssuranceAmerica is different, but as a Liability Adjuster II you will: Conduct thorough investigations and evaluations of coverage, liability, and damages across all lines of personal automobile insurance/. Accurately assess exposure and evaluate injury claims in a fair, consistent, and equitable manner based on the facts and extent of damages. Negotiate timely and appropriate settlements, ensuring all required documentation is obtained to support proper claim resolution and closure. Manage low-complexity, attorney-represented injury claims with sound judgement and attention detail, maintaining compliance with internal guidelines and industry standards. Control expenses and adhere to company reserving philosophy by maintaining proper reserves on all pending claims/potential exposures. Meet and maintain general file handling goals and procedures as outlined by the company including maintaining a 1:1 closing ratio and status on diary reviews. Properly utilize underwriting and policy systems and understand its features and functionality, as needed. Attend any available seminars and classes applicable to this position and the skills required to meet the job duties and responsibilities. Continually ask questions and have a desire to develop additional skills to better investigate and evaluate claims. About YOU Excellent communication skills with demonstrative ease with both verbal and written formats. Attention to detail and ability to multi-task. A high degree of motivation and team orientation. Direct, results driven, and dedicated to the success of the business and each other. Required Minimum three years of experience handling auto claims. Minimum of two years of experience handling complex liability and coverage issues and unrepresented bodily injury cases. Preferred Bachelor's degree or equivalent. Non-standard experience. Adjuster's license in relevant state or the ability to obtain one quickly. Bilingual (English-Spanish). Physical Requirements Prolonged periods sitting at a desk and working on a computer. Must be able to lift 15 pounds at times. Must be able to navigate various departments of the organization's physical premises. About US We are direct, results-driven, and dedicated to the success of our business and each other. We are a diverse group of thinkers and doers. We offer many opportunities to grow in your professional skills and career. We fight homelessness by directing 5% of our earnings from each policy we sell to organizations that help those in need. We call it our Generous Policy. WHAT WE OFFER AssuranceAmerica provides these benefits to Associates: Premium healthcare plans: All full-time Associates and part-time Associates working a regular schedule of 30 hours, or more, are eligible for benefits including Medical, Dental, Vision, Voluntary Life, Flexible Spending Accounts, and a Health Savings Account. Employer Paid Benefits: We enroll all eligible Associates in Group Life and AD&D Insurance, Short- and Long-Term Disability Plans, Employee Assistance Program, Travel Assist, and the Benefit Resource Card which includes Teladoc™, Pet Insurance and Health Advocate. Additional Benefits: 401(k) Employer Match: We want to help you prepare for the future, now. All full-time and part-time Associates over age 21 are eligible to participate in the 401(k) Savings Plan. AssuranceAmerica will match 100% of the first 4% of an Associate's contributions. Engagement Events. We make time for fun activities that strengthen Associate relationships in all our locations. Annual Learning Credit: Want to learn something new? We'll reimburse you for approved educational assistance. Time Off: Paid Time Off (PTO), Parental Leave Pay, Volunteer Time Off (VTO), Bereavement Pay, Military Leave Pay, and Jury Duty Pay.
    $41k-58k yearly est. Auto-Apply 60d+ ago
  • Total Loss Settlement Adjuster

    Snapsheet 4.4company rating

    Remote claims representative job

    Job Title: Total Loss Settlement Adjuster Company: Snapsheet Job Type: Full-time About Snapsheet: Snapsheet is claims technology the way it should be: purposeful, precise, and designed to deliver outcomes. Where others bolt things on, we engineer them in to our core systems and processes across cloud-based claims management, virtual vehicle appraisals, and elite loss and recovery services. Trusted by over 170+ P&C Carriers, MGAs, MGUs, TPAs, and logistics companies, our open architecture is built to fit how our companies work, not the other way around. What you'll get: Remote working environment - your new commute is however long it takes to walk to your desk! Flexibility - empathy is ingrained in who we are and we are happy to offer a flexible PTO policy, casual dress code, and more! Development - Mentorship programs, 1-on-1 management, promote when ready culture, quarterly internal promotion opportunities, and goal setting sessions. Fun - Celebrations just because, yearly in-person and remote events, Snapsheet Swag, Employee Resource Groups, and more! Job Overview: As a Total Loss Settlement Adjuster at Snapsheet, you are highly competitive and motivated by constant improvement. You are an effective communicator, whether you are emailing a request to your peer, talking with a body shop, lienholder or a carrier customer. You love working in an ever-evolving environment where openness to feedback and the ability to adapt is highly valued. You are a strong problem solver, identifying and resolving the day-to-day challenges involved in auto claims handling, specifically understanding total loss evaluations, settlements with carrier customers, salvage regulations and state compliance, as well as solving more complex problems. You want to work for a company where you can make a real impact and do it all from the comfort of your home office! Not licensed? We will license you prior to starting. Responsibilities: Settle Total Loss claims with owners and lienholders Secure vehicle releases, negotiate release fees, and relocate salvage Mitigate expenses for storage, rental, etc, within state compliance Process associated paperwork to transfer title and secure salvage returns Issue settlement payments to owners and lienholders Maintain working understanding of estimatics, policy and carrier guidelines, state and regional regulatory compliance and laws. Maintain working understanding of Actual Cash Value. Candidates should be able to confidently speak to options, condition ratings, unrelated prior damage, refurbishments, comparable vehicles and market availability to negotiate settlement agreement Utilize internal training tools and external resources to clearly document every claim with high attention to detail Maintain documentation of all interactions with internal and external customers or sources Work effectively with repair facilities, rental agencies and salvage yards while maintaining a positive and professional demeanor Manage and maintain virtual relationships with teammates, managers, and directors while working remotely from home Qualifications: Must be currently completing total loss settlements with an insurance carrier Must have a working understanding or background in estimating and evaluating total losses Thorough understanding of UPD estimates, parts costs, total loss classification, and fraud detection 2-5 years of Auto Total Loss Settlement experience in the Insurance Industry Extensive knowledge of Automobile Total Loss Conditioning and Optioning processes Thorough understanding of automobile terminology and vehicle construction. Working experience of estimating platforms: Mitchell UltraMate, CCC One and/or Audatex Excellent verbal and written communication skills Detail-oriented and organized, with a commitment to delivering accurate and timely results Excellent negotiation and communication skills to interact with customers, shops and vendors remotely Team player with positive attitude and ability to work well with others Ability to work independently and manage time efficiently in a virtual work environment We're Built to Grow With You - And That Starts With How We Support You At Snapsheet, we know that growth doesn't happen in a vacuum-it's fueled by the right support at the right time. That's why we've built a benefits experience designed to grow with you, wherever life takes you. Choose from 2 robust medical plans through Blue Cross Blue Shield-plus, we contribute to your HSA when you enroll in our high-deductible health plan. Offer two dental plans and one vision plan to keep you and your family healthy. Peace of mind with company-paid Short Term Disability, Long Term Disability, and Life Insurance. Additional protection through voluntary benefits like Accident Insurance, Hospital Indemnity, Critical Illness, and Legal Assistance. 401(k) with a 4% company match-because your future is worth investing in. Employee Assistance Program (EAP) with 6 sessions per life incident to support your mental well-being. Perks That Make Growing Here Even Better: Flexible PTO and 7.5 company-observed holidays to recharge on your terms. In-person connection points throughout the year including our annual Summit and Roadshows. Snapsheet SWAG and surprise mailers to keep the spirit alive. Endless opportunity to shape your path-career growth, learning, and real impact are all within reach. Health and wellness campaigns that evolve with you year over year. Compensation that Grows with You For this position, the base salary range is $50,000-$60,000. While this range serves as a guideline, your actual compensation will reflect your experience and skillset. At Snapsheet, we believe growth should be rewarded-our compensation and benefits are built to evolve with you as your career does. *Please note that we are unable to sponsor applicants for work visas for this position at this time. Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply for jobs unless they meet every single qualification. At Snapsheet, we are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. Snapsheet is committed to providing reasonable accommodations for candidates with disabilities in our recruiting process. If you need assistance or accommodations, please let us know by emailing [email protected]. Snapsheet is proud to be an Equal Opportunity employer. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender, gender identity, gender expression, transgender status, sexual stereotypes, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law. #BI-Remote #LI-Remote Snapsheet is an equal opportunity employer.
    $50k-60k yearly Auto-Apply 14d ago
  • Process Expert II - Claims

    Elevance Health

    Claims representative job in Columbus, OH

    Location: Ohio. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. The Process Expert II supports the claims issue research and resolution for Home & Community Based Services (HCBS) by participating in project and process work. How you will make an impact Primary duties may include, but are not limited to: Researches operations workflow problems and system irregularities. Develops tests, presents process improvement solutions for new systems, new accounts and other operational improvements. Develops and leads project plans and communicates project status. Minimum Qualifications: Requires a BA/BS and minimum of 5 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred. Claims issue research and resolution for Home & Community Based Services (HCBS) highly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $66,880.00 to $100,320.00. Location(s): Columbus, OH. In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: BSP > Process Improvement Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $28k-35k yearly est. Auto-Apply 11d ago

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