Claims representative jobs in Maine - 32 jobs

Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into action, we're looking for extraordinary people to join our talented team. Our service-oriented, ethical, knowledgeable, caring associates are the heart of our vision to be the best company serving independent agents. We help protect families and businesses as they work to prevent or recover from a loss. Share your talents to help us reach for continued success as we bring value to the communities we serve and demonstrate that Actions Speak Louder in Person. If you're ready to build productive relationships, collaborate within a diverse team, embrace challenges and develop your skills, then Cincinnati may be the place for you. We offer career opportunities where you can contribute and grow. Build your future with us Our Field Claims department is currently seeking field claims representatives to service the territory surrounding: Bangor, ME. The candidate is required to reside within the territory. This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure accurate settlements. Be ready to: * complete thorough claim investigations * interview insureds, claimants, and witnesses * consult police and hospital records * evaluate claim facts and policy coverage * inspect property and auto damages and write repair estimates * prepare reports of findings and secure settlements with insureds and claimants * use claims-handling software, company car and mobile applications to adjust loss in a paperless environment * provide superior and professional customer service * once eligible, become a certified and active Arbitration Panelist To be an Entry Level Claims Representative: The pay range for this position is $57,000 - $76,000 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance. Be equipped with: * be available and communicative during your regular business hours * a desire to learn about the insurance industry and provide a great customer experience * the ability to work unsupervised * excellent verbal and written communication skills * strong interpersonal skills * excellent problem-solving, negotiation, organizational and prioritization skills * preparedness to follow-up with others in a timely manner * a valid driver's license Bring education or experience from: * a bachelor's degree * AINS, AIC, or CPCU designations preferred Benefits in addition to compensation include: * company car * company stock options, including Restricted Share Units and Incentive based stock options * paid time off (PTO) * 401K with 6% company match To be an Experienced Claims Representative: The pay range for this position is $62,000 - $90,000 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance. Be equipped with: * be available and communicative during your regular business hours * multi-line claims experience preferred * ability to completely assess auto, property, and bodily injury type damages * capacity to work unsupervised * excellent verbal and written communication skills * strong interpersonal skills * excellent problem-solving, negotiation, organizational, and prioritization skills * preparedness to follow-up with others in a timely manner * a valid driver's license Bring education or experience from: * one or more years of claims handling experience * AINS, AIC, or CPCU designations preferred * bachelor's degree or equivalent experience required Benefits in addition to compensation include: * company car * company stock options, including Restricted Share Units and Incentive based stock options * paid time off (PTO) * 401K with 6% company match Enhance your talents Providing outstanding service and developing strong relationships with our independent agents are hallmarks of our company. Whether you have experience from another carrier or you're new to the insurance industry, we promote a lifelong learning approach. Cincinnati provides you with the tools and training to be successful and to become a trusted, respected insurance professional - all while enjoying a meaningful career. Enjoy benefits and amenities Your commitment to providing strong service, sharing best practices and creating solutions that impact lives is appreciated. To increase the well-being and satisfaction of our associates, we offer a variety of benefits and amenities. Embrace a diverse team As a relationship-based organization, we welcome and value a diverse workforce. We grant equal employment opportunity to all qualified persons without regard to race; creed; color; sex, including sexual orientation, gender identity and transgender status; religion; national origin; age; disability; military service; veteran status; pregnancy; AIDS/HIV or genetic information; or any other basis prohibited by law. All job applicants have rights under Federal Employment Laws. Please review this information to learn more about those rights.

Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more. Position Summary Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days. Applicants must be currently authorized to work in the United States on a full-time basis. Principle Duties and Responsibilities: Claims Management * Manage caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations. * Monitor and ensure timely execution of all statutory deadlines or legal filings as needed. * Analyze facts of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines. * Identify fraud indicators and actively pursue subrogation opportunities. * Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks. * Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers. Financial Impact Administration * Manage book of claims business (up to $ 2million) with authority to settle/negotiate a single claim within their authority of up to $25,000. * Communicate ongoing causes of incidents to Safety and Brands. * Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications. Basic Qualifications: * Licensed adjuster (as appropriate by jurisdiction) * Bachelor's degree or experience handling General Liability claims or equivalent expertise. * Thorough knowledge of rules, regulations, statutes, and procedures pertaining to general liability claims. * Knowledge of medical terminology involved in complex claims * Negotiates resolution of claims of various exposure and complexity Skills and Abilities: * Demonstrates relationship building and communication skills, both written and verbal. * Highly self-motivated, goal oriented, and works well under pressure. * Customer focused solid understanding of legal procedures, processes, practices and standards in the handling of general liability claims * Ability to identify problems and effectuate solutions * Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail * Able to apply critical thinking when solving problems and making decisions. ME/NC/PA/SC Salary Range: $63,440-$95,160 IL/MA/MD/NY Salary Range: $72,880 - $109,320 Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws. #LI-SM1 #LI-Hybrid At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent. Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies. Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work. We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: * Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim * The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions * Maintain claim block and meet departmental production and quality metrics * An awareness of industry claim practices * Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records * Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. * Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process * Establish cooperative and productive relationships with professional resources What you will bring with you: * Bachelor's degree preferred * A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing * Demonstrated ability to work as part of a cohesive team * Strong written and verbal communication skills * Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in negotiation, persuasion, and solutions-based underwriting * Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism * Overall knowledge of health care industry * Proficiency using the Microsoft Office suite of products * Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. 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. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026

If you're passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide's Property and Casualty team could be the place for you! At Nationwide , “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we're looking for associates who are passionate about delivering extraordinary care. This is a field-based role on the National Catastrophe Response Team. This position is responsible for managing property claims in response to catastrophic events across the country. As a field-based adjuster, you will be deployed to areas impacted by large-scale disasters-such as hurricanes, tornadoes, floods, or other major events-to assess damages, support policyholders, and help communities begin the recovery process. The role requires extensive travel (up to 80%), often on short notice, and the ability to work in high-pressure, fast-paced environments for extended periods. You will regularly engage in direct, and at times, emotionally charged conversations with customers-clearly explaining coverage decisions, setting expectations, and delivering difficult news with empathy and professionalism. The ability to remain composed and compassionate in the face of loss, frustration, or uncertainty is essential. Strong communication skills and emotional resilience are critical, as you'll be guiding customers through some of the most challenging moments of their lives. In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments. You'll also be responsible for full file ownership, maintaining appropriate reserves, managing claim activity (including supplements and requests for depreciation), ensuring compliance with internal standards and regulatory requirements, and providing proactive communication with external customers throughout each stage of the claim. Collaboration with internal teams such as Special Investigations and Subrogation may be required to identify fraud or recovery opportunities. Staying current on industry repair practices, regional pricing trends, and legal developments is key to success. This is a demanding, customer-facing role that requires a unique blend of technical expertise, critical thinking, and emotional intelligence. Candidates should be comfortable working independently in disaster zones, managing a high volume of claims, working 12 hours a day, up to 21 days in a row, and adapting quickly to evolving priorities. If you're driven by purpose, thrive under pressure, and want to make a meaningful impact during times of crisis, this role offers a challenging and deeply rewarding opportunity. Ideal candidates will have: Prior insurance field/property claims handling or adjusting experience Proficiency with Xactimate Prior estimate writing experience Ability to handle claims of varying complexity from start to finish Prior experience working in on site in a catastrophe environment Ability to carry a ladder and climb a roof Strong customer service competency Strong written and verbal communication skills. A $5000 SIGN-ON BONUS will be given to all external candidates hired into this role. Half of the bonus will be paid after 3 months of employment and the remainder will be paid after 9 months of employment. Summary No two property claims are ever the same and each customer has unique needs. Our team thrives on providing the very best service and building lasting, successful relationships with our customers. If you are confident, curious, driven to learn and grow, and have a desire to help people when they most need it, we want to know more about you! As a National Catastrophe (NATCAT) Field Claims Specialist primarily supporting our Personal Lines (PL) business, you'll investigate and resolve moderate to severe property damage claims by phone. Job Description Key Responsibilities: Handles all assigned claims promptly and effectively, with little to no direction and oversight. Makes decisions within delegated authority as outlined in company policies and procedures. Determines proper policy coverages and applies appropriate claims practices to resolve cases in alignment with company guidelines. Opens, closes, and adjusts reserves according to company practices to ensure reserve adequacy. Adheres to file conferencing notification and authority procedures. Maintains current knowledge of insurance and applicable product/services; court decisions which may impact the claims function; current guidelines; and policy changes and modifications. This may require attending various seminars and training sessions. Maintains current knowledge of local industry repair procedures and local market pricing. Submits severe incident reports, reinsurance reports and other information to claims management as needed. Partners with Special Investigations Unit and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for lawsuit, trial, or subrogation. Initiates and conducts follow-ups through proficient use of claims and other related business systems. Delivers outstanding customer service to all internal, external, current, and prospective Nationwide customers. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service. May perform other responsibilities as assigned. Reporting Relationships: Reports to Claims Manager. Individual contributor role. Typical Skills and Experiences: Education: Undergraduate degree or equivalent experience. License/Certification/Designation: State licensing where required. Successful completion of required/applicable claims certification training/classes. Experience: Three to five years of related property claims experience or comparable job-related experience, or education preferred. Experience in a customer service environment, including flexible work schedules and extended work hours preferred. Commercial claims property experience preferred. Knowledge, Abilities and Skills: General knowledge of insurance theory and practices, and contracts and their application. Property estimating and automated claims systems. Demonstrated knowledge of the investigation, consultation and settlement activities used to resolve extensive property damage claims. Proven ability to meet customer needs and provide exemplary meaningful service by guiding customers through the claims process and ensuring a positive customer experience. Analytical and problem-solving skills necessary to make decisions and resolve issues related to application of coverages to submitted claims, application of laws of jurisdiction to investigation facts, and application of policy exclusions and exceptions. Ability to establish repair requirements and cost estimates for property losses. Ability to evaluate and successfully advise on property claims. Organizational skills to prioritize work. Command of written and verbal communication skills to effectively communicate with policyholders, claimants, repairpersons, attorneys, agents and the general public. Ability to efficiently operate a personal computer and related claims and business software. Able to provide leadership to less experienced claims associates. Must be able to safely access and inspect rooftops using a ladder. Must be prepared and capable of conducting physical inspections on rooftops, including first and second story roofs with pitches up to 8/12. Other criteria, including leadership skills, competencies and experiences may take precedence. Staffing exceptions to the above must be approved by the business unit executive and HR Business Partner. Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors. Job Conditions: Overtime Eligibility: Not Eligible (Exempt) Working Conditions: Normal office or field claims environment. May require ability to sit and operate phone and personal computer for extended periods of time. Able to make physical inspections of property loss sites; including climb ladders, balance at various heights and rooftops up to 8/12 pitch stoop, bend and/or crawl to inspect vehicles and structures; work outside in all types of weather. Must be willing to work irregular hours and to travel with possible overnight requirements. May be on-call. Must be available to work catastrophes (CAT). Extended and/or non-standard hours as required. Must have a valid driver's license with satisfactory driving record in accordance with Nationwide standards. ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties. Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process. We currently anticipate accepting applications until 01/29/2026. However, we encourage early submissions, as the posting may close sooner if a strong candidate slate is identified before the deadline. Benefits We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage, paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here. Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law. #claims Smoke-Free Iowa Statement: Nationwide Mutual Insurance Company, its affiliates and subsidiaries comply with the Iowa Smokefree Air Act. Smoking is prohibited in all enclosed areas on or around company premises as well as company issued vehicles. The company offers designated smoking areas in which smoking is permitted at each individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air Act, individuals may contact the Smokefree Air Act Helpline at ************. For NY residents please review the following state law information: Notice of Employee Rights, Protections, and Obligations LS740 (ny.gov) ************************************************************* NOTE TO EMPLOYMENT AGENCIES: We value the partnerships we have built with our preferred vendors. Nationwide does not accept unsolicited resumes from employment agencies. All resumes submitted by employment agencies directly to any Nationwide employee or hiring manager in any form without a signed Nationwide Client Services Agreement on file and search engagement for that position will be deemed unsolicited in nature. No fee will be paid in the event the candidate is subsequently hired as a result of the referral or through other means. Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. If a Sales job, Sales Incentives, based on performance goals are possible in addition to this range. Note on Compensation for Part-Time Roles: Please be aware that the salary ranges listed below reflect full-time compensation. Actual compensation may be prorated based on the number of hours worked relative to a full-time schedule.The national salary range for Field Claims Specialist II, National Catastrophe Property - Personal Lines : $62,500.00-$115,500.00The expected starting salary range for Field Claims Specialist II, National Catastrophe Property - Personal Lines : $62,500.00 - $93,500.00

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

The Claim Specialist III investigates, evaluates, negotiates, and resolves lost time claims within settlement and reserving authority up to stated maximum. (Supervisor will determine actual individual authority up to the stated maximum). Conducts training classes (including research and position papers) for less experienced Claim Department Representatives. Based on experience and proven ability, an expanded and more difficult caseload will be expected, requiring a lesser degree of supervision. Principal Duties and Responsibilities: Communicates with insureds, injured workers, agents, brokers, witnesses, attorneys, loss prevention, and underwriters to obtain and relate necessary information to determine coverage/compensability, facts of loss, and degree of liability/exposure. Maintains contact throughout the life of the file as needed. Administers the delivery of timely, appropriate and accurate indemnity and medical benefits. Evaluates claim exposure, negotiate and resolve claims. Works closely with defense counsel on litigated cases and attend mediation, arbitration, and hearings, as necessary. Develops litigation plan with defense counsel and tracks adherence to plan in order to control legal expenses and assure effective resolution. Works closely with insureds and employees making visitations and presentations as needed to facilitate partnership approach to claims handling. Maintains quality claim files in accordance with appropriate best practices, and other company procedures. Implements Managed Care strategies, coordinate rehabilitation or medical management, process bills, review all mail through Image Right, and monitor progress as appropriate. Interacts with State and Federal Boards and Commissions, while establishing and maintaining proper reserves, as appropriate. Serves as a mentor and helps prepare/train the less experienced Claim Department representatives. Keeps up-to-date on State laws and Company procedures relating to various claims; educates injured worker and/or insured on same. Prepares and presents files for Agent/Broker Reviews and Insured File Review. Understands medical terminology and standard medical procedures as they pertain to worker's compensation, U.S. Longshoreman's and Jones Act claims. Participates in in-house and outside training programs to keep up-to-date on relevant issues/topics. Maintains a working knowledge of all computer systems currently in use. Continues education in claims through Associate in Claims or Claims Law (AEI) courses. Requirements: Three years of workers' compensation lost time claim handling experience required. Bachelor's degree preferred. Computer skills, Word, Excel and Image Right preferred. Must have valid driver's license. Strong attention to detail and strong communication skills both verbal and written. Adaptable/flexible and self-directed with the ability to manage time and other resources wisely. Must have the ability to work effectively with other organizational team members. Our comprehensive benefits package includes all traditional offerings such as: Health Insurance options, Dental Insurance options and Vision Insurance Employee Life Insurance/AD&D and Dependent Life Insurance options Short-term & Long-term Disability Health Savings Account with potential employer match Flexible Medical and Dependent Care Account Accident Insurance Critical Illness Insurance Employee Assistance Program Legal/Identify Theft Insurance options Long Term Care Insurance Pet Insurance 401 (k) Retirement Plan with match up to 5%, plus profit sharing & discretionary contributions (subject to vesting) 5 weeks of Paid Time Off (PTO) 11 paid holidays We also offer other benefits to help foster a healthy, balance lifestyle such as: Flextime schedules Paid Parental Leave Student loan paydown and refinancing assistance Educational assistance for job related courses, seminars, certifications or degrees One paid day every year to volunteer for your non-profit of choice On-site fitness center (Maine only) or fitness reimbursement Subsidized parking Sit-Stand desks & daily stretch breaks MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law. #IND2022

At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: + Award-winning culture + Inclusion and diversity as a priority + Performance Based Incentive Plans + Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% 401(k) employer contribution + Mental health support + Career advancement opportunities + Student loan repayment options + Tuition reimbursement + Flexible work environments **_*All the benefits listed above are subject to the terms of their individual Plans_** **.** And that's just the beginning... With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! **General Summary:** Minimum starting hourly rate is $22.60 This is an entry level position within the Voluntary Benefits Claims Organization. This position is responsible for the thorough, fair, objective, and timely adjudication of voluntary benefits claims in conjunction with providing technical expertise regarding applicable regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, health care providers and other specialized internal resources. Incumbents in this role are considered trainees and are assigned a formal mentor for 6-12 months until they are assessed as capable of independent work. Incumbents are primarily responsible for learning and developing the skills, knowledge, and behaviors necessary to successfully adjudicate assigned claims, in accordance with our claims philosophy and policies and procedures. Incumbent must demonstrate the ability to effectively manage an assigned caseload, exercise discretion and independent judgment, and appropriately render timely claim decisions while demonstrating strong customer service prior to movement to the exempt level claims specialist role. **Principal Duties and Responsibilities:** + Maintain organizational service standards on all assigned claims demonstrating success in developing and implementing effective strategies to manage a caseload of varying size and complexity. + Develop an understanding and working knowledge of Voluntary Benefits for Unum and Colonial Life, including products, policies, procedures, and contracts. + Develop an understanding of the applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders, and waivers, as well as regulatory and statutory requirements for claim products administered. + Develop skill set to determine appropriate risk management strategies through analyzing and applying technical and complex contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions, and benefits payee. + Develop problem solving skills by demonstrating analytical and logical thinking resulting in the timely and accurate adjudication of a variety of simple to complex voluntary benefits claims. + Develop a working knowledge of systems needed for claims adjudication. + Provide excellent customer service and independently respond to all inquiries within service guidelines. + Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and referrals/notifications to other areas (i.e., medical assessments, billing, etc.) as appropriate. + Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively communicate determinations while ensuring compliance with Voluntary Benefits procedures and all legal requirements including state regulations. + Partner and coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation, when appropriate. + Ensure a timely and well communicated transfer process when transitioning integrated claims across lines of business, ensuring a coordinated and continuous claims experience for customers. + Be familiar with specialized workflow requirements and performance standards for any assigned customers. + May perform other duties as assigned. **Job Specifications:** + 4-year degree preferred or equivalent work experience + Ability to develop Voluntary Benefits product knowledge and apply a best-in-class service experience + Medical background, voluntary benefits claims and/or disability management experience preferred + Possess strong analytical, critical thinking, and problem-solving skills + Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions, including initial decision and ongoing medical management. + Able to effectively utilize a broad spectrum of resources, materials, and tools needed to assist with the decision-making process + Strong service and quality orientation. + Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc. + Demonstrated ability to operate with a sense of urgency and make balanced decisions with the highest degree of integrity and fairness. + Excellent communication skills, written and verbal + Meets the standards for this position, as defined in the Talent Management framework ~IN3 \#LI-LM2022 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $40,000.00-$75,600.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

Combined Insurance, A Chubb company, is seeking a Claim Adjuster to join our fast-paced, high energy, growing company. We are proud of our tradition of success in the insurance industry of nearly 100 years. Come join our team of hard-working, talented professionals! The Claims Adjuster is responsible for contacting claimant and /or service providers to request information needed in order to process claim - includes written correspondence and phone calls. They will evaluate claims based on documentation received including responses from claimant and providers. Will need to handle multiple priorities simultaneously, be self-directed and meet service level expectations. The adjuster must demonstrate customer centricity in all aspects of their job by performing actions with empathy and expertise. RESPONSIBILITIES: Efficiently and accurately adjudicate claims in accordance with the policy terms, established guidelines and regulations. Conduct eligibility claim review by evaluating claim submission and comparing to policy benefits. Request additional information from policyholders, providers and others as necessary to finalize claim. Actively manage inventory and ongoing claim adjudication. Effectively communicate with customers using empathy and professionalism via phone and written correspondence. Interface with Policyholders and Agents answering a variety of questions through different service channels. Develop a broad understanding of our products and systems. Meet Department standards for time, service and quality. Ability to maneuver between system applications confidently to find information and respond to customer needs in a timely manner. Collaborate with other team members and leadership to ensure effective customer service. Actively engage in Continuous Improvement initiatives and identify process and efficiency enhancements. Participate in required training Performs other duties as assigned Competencies: Problem Solving: Takes an organized and logical approach to thinking through problems and complex issues. Simplifies complexity by breaking down issues into manageable parts. Looks beyond the obvious to get at root causes. Develops insight into problems, issues and situation. Continuous Learning: Demonstrates a desire and capacity to expand expertise, develop new skills and grow professionally. Seeks and takes ownership of opportunities to learn, acquire new knowledge and deepen technical expertise. Takes advantage of formal and informal developmental opportunities. Takes on challenging work assignments that lead to professional growth Initiative: Willingly does more than is required or expected in the job. Meets objectives on time with minimal supervision. Eager and willing to go the extra mile in terms of time and effort. Is self-motivated and seizes opportunities to make a difference. Adaptability: Ability to re-direct personal efforts in response to changing circumstances. Is receptive to new ideas and new ways of doing things. Effectively prioritizes according to competing demands and shifting objectives. Can navigate through uncertainty and knows when to change course Results Orientation: Effectively executes on plans, drives for results and takes accountability for outcomes. Perseveres and does not give up easily in challenging situations. Recognizes and capitalizes on opportunities. Takes full accountability for achieving (or failing to achieve) desired results Values Orientation: Upholds and models Chubb values and always does the right thing for the company, colleagues and customers. Is direct truthful and trusted by others. Acts as a team player. Acts ethically and maintains a high level of professional integrity. Fosters high collaboration within own team and across the company; constantly acts and thinks "One Chubb" SKILLS: Exceptional written and verbal communication skills Quality and Customer Centric Orientation Excellent organizational skills Ability to multi-task in fast-paced environment with attention to detail and prioritize tasks Analytical skills and good decision-making skills Proficient in MS Office - Outlook, Word and Excel Navigation between systems and use of technology is important Insurance/Claims Experience Windows based PC Knowledge Bilingual in Spanish and English a plus EDUCATION AND EXPERIENCE: 3 or more years related claims experience required (disability management and critical care desired) Experience in a customer interfacing position with progressive responsibility in role Knowledge of medical terminology ABOUT US Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.

IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.

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

Job DescriptionDescriptionQUICK FACTS: Must have Public Adjuster License Must have experience with Xactimate Must have network of Condo, Apartment, Property Management partners Must be able to physically examine all buildings top to bottom (roofs as well W2, Base Salary 70K+, and industry leading commission package We are looking for a results-oriented Outside Sales Representative with a strong background in direct-to-consumer (D2C) or business-to-business (B2B) sales. This role requires a motivated self-starter who thrives in building and maintaining client relationships while working in a fast-paced, competitive environment. Key ResponsibilitiesKey Responsibilities: Identify and pursue new business opportunities with homeowners, contractors, and referral partners. Educate prospective clients on our services and guide them through the insurance claims process. Develop and maintain a pipeline of leads through prospecting and networking efforts. Conduct presentations and training sessions to build brand awareness and establish partnerships. Provide exceptional customer service to existing clients, ensuring their satisfaction and retention. Work closely with internal teams to optimize the sales process and improve closing rates. Maintain accurate records of sales activities and client interactions. Skills, Knowledge and ExpertiseQualifications & Experience: 3+ years of proven sales experience as a licensed Public Adjuster Strong ability to generate leads, manage relationships, and close deals. Bachelor's degree in Business, Marketing, Communications, or equivalent experience. Familiarity with CRM tools, Microsoft Office Suite, and digital communication platforms. Highly organized with strong follow-through skills in a fast-paced environment. Public Adjuster license BenefitsWhat We Offer: Extensive training and support to help you succeed. Flexible work environment with opportunities for growth and career advancement. A team-oriented culture with strong leadership and professional development opportunities. If you're a highly motivated sales professional looking for a rewarding career with a company that makes a difference, apply today!

At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together. Come be a part of this journey with us as we champion lives! Job Summary The Manager Claims Admin is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our customers and the Claims department. This individual will focus on meeting all key financial business objectives and enhance customer service levels for assigned team; effectively managing the performance of all individuals to achieve optimal productivity; maintaining clear and ongoing communications with other business partners, inside and outside of the Claims department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc. Primary duties may include, but are not limited to: KEY RESPONSIBILITIES: * Consistently adhere to the documented workflow guidelines and established procedures. * Assure consistent, quality claims handling by review of pending claim, diary and Change of Definition reports. * Respond to and track all Insurance Department complaints. * Actively participate in review of claims for approvals/denials. * Conduct one-on-one meetings with all claims staff on a monthly basis to assess performance. * Document and address all performance management issues and communicate those to the Director of Claims. * Monitor caseloads to maintain consistency within team. * Analyze claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc. * Ensure the team provides excellent customer service by appropriately adjudicating claims within established service protocols. * Respond to and document customer complaints from claimants/their representatives, clients, and policyholders. * Ensure quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings. * Participate in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims. * Reach or exceed approved quality rating requirements. * Display a high level of leadership through employee development, coaching and performance management. * Strive to timely utilize appropriate resources across the benefits organization. * Participate in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims Job Requirements Required Education and/or Certifications * B.S. degree or a combination of equivalent related work experience and education. * Or any combination of education and experience which would provide an equivalent background Recommended Education and/or Certifications * Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc. Required Work Experience * Leadership experience strongly preferred * A minimum of 5 years' experience managing disability claims. * Or any combination of education and experience which would provide an equivalent background Salary Band: 06A #LI-SC1 This selected candidate will be expected to work hybrid in Indianapolis, In or Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together. Come be a part of this journey with us as we champion lives! Job Summary The Manager Claims Admin is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our customers and the Claims department. This individual will focus on meeting all key financial business objectives and enhance customer service levels for assigned team; effectively managing the performance of all individuals to achieve optimal productivity; maintaining clear and ongoing communications with other business partners, inside and outside of the Claims department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc. Primary duties may include, but are not limited to: KEY RESPONSIBILITIES: Consistently adhere to the documented workflow guidelines and established procedures. Assure consistent, quality claims handling by review of pending claim, diary and Change of Definition reports. Respond to and track all Insurance Department complaints. Actively participate in review of claims for approvals/denials. Conduct one-on-one meetings with all claims staff on a monthly basis to assess performance. Document and address all performance management issues and communicate those to the Director of Claims. Monitor caseloads to maintain consistency within team. Analyze claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc. Ensure the team provides excellent customer service by appropriately adjudicating claims within established service protocols. Respond to and document customer complaints from claimants/their representatives, clients, and policyholders. Ensure quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings. Participate in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims. Reach or exceed approved quality rating requirements. Display a high level of leadership through employee development, coaching and performance management. Strive to timely utilize appropriate resources across the benefits organization. Participate in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims Job Requirements Required Education and/or Certifications B.S. degree or a combination of equivalent related work experience and education. Or any combination of education and experience which would provide an equivalent background Recommended Education and/or Certifications Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc. Required Work Experience Leadership experience strongly preferred A minimum of 5 years' experience managing disability claims. Or any combination of education and experience which would provide an equivalent background Salary Band: 06A #LI-SC1 This selected candidate will be expected to work hybrid in Indianapolis, In or Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

Job Description At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together. Come be a part of this journey with us as we champion lives! Job Summary The Manager Claims Admin is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our customers and the Claims department. This individual will focus on meeting all key financial business objectives and enhance customer service levels for assigned team; effectively managing the performance of all individuals to achieve optimal productivity; maintaining clear and ongoing communications with other business partners, inside and outside of the Claims department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc. Primary duties may include, but are not limited to: KEY RESPONSIBILITIES: Consistently adhere to the documented workflow guidelines and established procedures. Assure consistent, quality claims handling by review of pending claim, diary and Change of Definition reports. Respond to and track all Insurance Department complaints. Actively participate in review of claims for approvals/denials. Conduct one-on-one meetings with all claims staff on a monthly basis to assess performance. Document and address all performance management issues and communicate those to the Director of Claims. Monitor caseloads to maintain consistency within team. Analyze claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc. Ensure the team provides excellent customer service by appropriately adjudicating claims within established service protocols. Respond to and document customer complaints from claimants/their representatives, clients, and policyholders. Ensure quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings. Participate in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims. Reach or exceed approved quality rating requirements. Display a high level of leadership through employee development, coaching and performance management. Strive to timely utilize appropriate resources across the benefits organization. Participate in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims Job Requirements Required Education and/or Certifications B.S. degree or a combination of equivalent related work experience and education. Or any combination of education and experience which would provide an equivalent background Recommended Education and/or Certifications Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc. Required Work Experience Leadership experience strongly preferred A minimum of 5 years' experience managing disability claims. Or any combination of education and experience which would provide an equivalent background Salary Band: 06A #LI-SC1 This selected candidate will be expected to work hybrid in Indianapolis, In or Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

Vanguard is defined in the Oxford Dictionary as 'a group of people leading the way in new developments or ideas'. Vanguard Adjusters Group is no different. Whether you are a client, an employee or a key vendor, you will find your exposure to the VANGUARD team to be a refreshing change from the ordinary! If you are looking for a change for the better and believe that you have the skills necessary to excel with an energetic, fast growing entity, we would like to talk to you. We are currently in search of an enthusiastic 1099 Field Adjuster responsible for conducting an inspection of the property, writing an estimate and compiling claim reports. Our current need is for a Field Adjuster to handle claims in the state of Maine. In this role you will contact insureds to arrange a time to travel to the loss site to conduct a thorough analysis of the property damage, evaluate damages and compile an estimate using Xactimate in addition to producing IA reports for claims. It is imperative the Field Adjusters we assign claims to deliver compassionate service that is fast, fair and easy to ensure customer retention. You will work independently, prioritizing responsibilities, and managing your own workload while ensuring that you are meeting the customer service standards for our carriers. Specific responsibilities include: Communicate and negotiate effectively with our customers and vendors Treat customers respectfully and compassionately Solve problems, make decisions, and take action Conduct research, investigate details, and estimate damage Create an organized work routine in a virtual environment Work independently and responsibly to handle claims in a professional and caring manner Support Vanguard's commitment to the highest ethical standards Manage communication, verbally or in writing, regarding claim processes/procedures with other customers, employees, leaders and Catastrophe Team.

Job Description Our role as a Field Claims Representative will be responsible for the investigation, evaluation and settlement of assigned claims involving 1st Party Homeowner and Commercial Property claims. This role is a field-based position and will require travel to loss sites to evaluate the damages. This also includes special investigation activities with an emphasis on investigating possible fraudulent activity. This is a field based position, travel will be required within Southern Maine, with occasional travel to other areas as required. Responsibilities Field appraise losses of all types for both personal lines and commercial lines claims Take loss reports directly from insureds and/or claimants and/or their representatives. Appropriately handle incoming correspondence on assigned claim files. Investigate assigned claims - confirm coverage - verify damages. Effectively handle portions of claim investigations principally through on-site investigations, as warranted. Evaluate and settle assigned claims based upon the results of the investigation. A strong ability to work independently. Other related duties as assigned by supervisor including but not limited to aiding during CATs or other unusual spikes in claim volume. Requirements Bachelor's degree preferred or several years of direct experience 5-7 years of experience handling Property Claims; Commercial Lines experience a plus. Strong understanding of personal and commercial lines policy forms and coverage analysis. Multi-line adjuster's license as required in our operating territories. Demonstrated proficiency in writing detailed structural cost of repair/replacement estimates in Xactimate estimating system and proficient in PC Windows environment. Demonstrated proficiency in investigating, evaluating and settling contents claims. Excellent understanding and skill level of claim handling and customer service. Possess or has ability to timely secure and maintain required multiline adjuster licenses. Knowledge of policy contracts, insurance laws, regulations, and the legal environment in which we operate. Outside/Field Adjusters - ability to view damages and prepare estimates based on their inspection of the damaged property. Benefits At The Concord Group, we're proud to offer a comprehensive benefits package designed to support the wellbeing of our associates. This includes medical, vision, dental, life insurance, disability insurance, and a generous paid time off program for vacation, personal, sick time, and holiday pay. Additional benefits include parental leave, adoption assistance, fertility treatment assistance, a competitive 401(k) plan with company match, gym member/fitness class reimbursement, and additional resources and programs that encourage professional growth and overall wellness. Why Concord Group Insurance Since 1928, The Concord Group has been protecting families and small businesses across New England with trusted, personal insurance solutions. The Concord Group is a member of The Auto Owners Group of Companies and is recognized as a leading insurance provider through the independent agency system. Rated A+ (Superior) by AM Best, the company is represented by more than 550 of the best local independent agents throughout Maine, Massachusetts, New Hampshire, and Vermont. At Concord Group, we believe in more than just insurance, we believe in our people. Our associates thrive in a supportive, collaborative workplace where community involvement, professional growth, and shared values drives everything we do. Starting your career with The Concord Group means joining a team that values people first and gives you the opportunity to grow, give back, and make a lasting difference in the lives of those we serve. Compensation We are dedicated to fair and competitive total compensation package that supports the wellbeing and success of our associates. In addition to this, we offer other components like bonus opportunities. Equal Employment Opportunity The Concord Group is an equal opportunity employer and hires, transfers, and promotes based on ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state, or local law. The Concord Group participates in E-Verify

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: * Award-winning culture * Inclusion and diversity as a priority * Performance Based Incentive Plans * Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability * Generous PTO (including paid time to volunteer!) * Up to 9.5% 401(k) employer contribution * Mental health support * Career advancement opportunities * Student loan repayment options * Tuition reimbursement * Flexible work environments * All the benefits listed above are subject to the terms of their individual Plans. And that's just the beginning… With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! General Summary: Minimum starting hourly rate is $22.60 This is an entry level position within the Voluntary Benefits Claims Organization. This position is responsible for the thorough, fair, objective, and timely adjudication of voluntary benefits claims in conjunction with providing technical expertise regarding applicable regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, health care providers and other specialized internal resources. Incumbents in this role are considered trainees and are assigned a formal mentor for 6-12 months until they are assessed as capable of independent work. Incumbents are primarily responsible for learning and developing the skills, knowledge, and behaviors necessary to successfully adjudicate assigned claims, in accordance with our claims philosophy and policies and procedures. Incumbent must demonstrate the ability to effectively manage an assigned caseload, exercise discretion and independent judgment, and appropriately render timely claim decisions while demonstrating strong customer service prior to movement to the exempt level claims specialist role. Principal Duties and Responsibilities: * Maintain organizational service standards on all assigned claims demonstrating success in developing and implementing effective strategies to manage a caseload of varying size and complexity. * Develop an understanding and working knowledge of Voluntary Benefits for Unum and Colonial Life, including products, policies, procedures, and contracts. * Develop an understanding of the applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders, and waivers, as well as regulatory and statutory requirements for claim products administered. * Develop skill set to determine appropriate risk management strategies through analyzing and applying technical and complex contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions, and benefits payee. * Develop problem solving skills by demonstrating analytical and logical thinking resulting in the timely and accurate adjudication of a variety of simple to complex voluntary benefits claims. * Develop a working knowledge of systems needed for claims adjudication. * Provide excellent customer service and independently respond to all inquiries within service guidelines. * Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and referrals/notifications to other areas (i.e., medical assessments, billing, etc.) as appropriate. * Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively communicate determinations while ensuring compliance with Voluntary Benefits procedures and all legal requirements including state regulations. * Partner and coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation, when appropriate. * Ensure a timely and well communicated transfer process when transitioning integrated claims across lines of business, ensuring a coordinated and continuous claims experience for customers. * Be familiar with specialized workflow requirements and performance standards for any assigned customers. * May perform other duties as assigned. Job Specifications: * 4-year degree preferred or equivalent work experience * Ability to develop Voluntary Benefits product knowledge and apply a best-in-class service experience * Medical background, voluntary benefits claims and/or disability management experience preferred * Possess strong analytical, critical thinking, and problem-solving skills * Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions, including initial decision and ongoing medical management. * Able to effectively utilize a broad spectrum of resources, materials, and tools needed to assist with the decision-making process * Strong service and quality orientation. * Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc. * Demonstrated ability to operate with a sense of urgency and make balanced decisions with the highest degree of integrity and fairness. * Excellent communication skills, written and verbal * Meets the standards for this position, as defined in the Talent Management framework ~IN3 #LI-LM2022 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $40,000.00-$75,600.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

Department Insurance & Financial Services Employment Type Full Time Location Maine Workplace type Hybrid Compensation $90,000 - $170,000 / year Key Responsibilities Skills, Knowledge and Expertise Benefits About The Misch Group Stone Hendricks Group is a direct-hire search firm that brings together years of experience and a diverse range of talent to connect businesses with exceptional job candidates. With a focus on timely and effective recruitment, we understand the power of a well-formed employee base in helping businesses achieve their goals. We offer our services to businesses of all sizes, providing qualified candidates for blue- and grey-collar roles, as well as white-collar and executive positions. The success of our direct-hire search process is driven by our advanced training, proprietary technology, and extensive network across industries. At Stone Hendricks Group, we value integrity and prioritize connectedness, commitment, and candor in our interactions with both employers and job seekers. Our clients consider us trusted advisors, relying on the highly personalized service we provide and our ability to find candidates that are an ideal fit for their unique needs. Choose Stone Hendricks Group for unsurpassed direct-hire search services that match successful organizations with talented job candidates.