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Claims representative jobs in Mississippi - 62 jobs

  • Claims Adjuster Trainee

    Progressive 4.4company rating

    Claims representative job in Oxford, MS

    Progressive is dedicated to helping employees move forward and live fully in their careers. Your journey has already begun. Apply today and take the first step to Destination: Progress. As a claims adjuster trainee, you'll learn how to help customers get back on the road after an accident. This is not a field position, which means you'll be building relationships with customers over the phone. In a fast-paced environment, you'll learn how to resolve a full case load of claims efficiently while managing the claims process from start to finish. You'll have the support of a collaborative team and ongoing coaching from leaders. We'll also teach you the insurance stuff - providing in-depth training on property damage and insurance contracts so you can confidently and independently adjust claims. This is a hybrid role, which means you'll work in-office two days that are selected by local leadership and choose where you want to work the other three days, whether that's at home or in the office, for a period of 12 months. After that period, the days you'll be expected to report to an office for important meetings, training, and collaboration will vary based on business need. In this hybrid work environment, you'll be supported by your leaders and tenured colleagues to develop relationships, establish connections, and share practices that are important to your development. If you prefer an in-office environment, you're welcome to work in the office as often as you would like. Duties & responsibilities (upon completion of training) * Determine coverage * Determine liability (who's at fault for the damages) * Interview customers, claimants, and witnesses * Partner with appraisers/estimators to manage vehicle repairs * Negotiate with customers and other insurance carriers and resolve claims Must-have qualifications * Three years work experience OR * Bachelor's degree OR * Two years work experience and an associate degree Training Schedule: Monday-Friday, 8:30 am to 5:30 pm Onboarding Training Schedule: Monday-Friday, 8:00 am to 5:00 pm Work Schedule: Monday-Friday, 9:00 am to 6:00 pm Location: Oxford, MS Compensation * Once you complete training and pass any necessary testing requirements, your salary will range from $52,500 - $56,000 year, however, during training, you'll be paid hourly based on your annual salary. * Gainshare annual cash incentive program up to 16% of your eligible earnings based on company performance Benefits * 401(k) with dollar-for-dollar company match up to 6% * Medical, dental & vision, including free preventative care * Wellness & mental health programs * Health care flexible spending accounts, health savings accounts, & life insurance * Paid time off, including volunteer time off * Paid & unpaid sick leave where applicable, as well as short & long-term disability * Parental & family leave; military leave & pay * Diverse, inclusive & welcoming culture with Employee Resource Groups * Career development & tuition assistance Energage recognizes Progressive as a 2025 Top Workplace for: Innovation, Purposes & Values, Work-Life Flexibility, Compensation & Benefits, and Leadership. Equal Opportunity Employer For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at ************************************************************** Share: Email X Facebook LinkedIn Apply Now
    $52.5k-56k yearly 4d ago
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  • Claims Adjuster II, Field Property - National Catastrophe ($5000 Sign-on Bonus)

    Nationwide Mutual Insurance Company 4.5company rating

    Claims representative job in Mississippi

    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
    $62.5k-115.5k yearly Auto-Apply 7d ago
  • Field Claims Adjuster

    EAC Claims Solutions 4.6company rating

    Claims representative job in Mississippi

    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.
    $40k-48k yearly est. Auto-Apply 42d ago
  • Benefit and Claims Analyst

    Highmark Health 4.5company rating

    Claims representative job in Jackson, MS

    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
    $21.5-32.3 hourly 33d ago
  • Senior Professional Liability Claims Specialist

    Sedgwick 4.4company rating

    Claims representative job in Jackson, MS

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

    Alfa Insurance Corporate Careers 4.5company rating

    Claims representative job in Aberdeen, MS

    Job DescriptionBenefits: Dental insurance Health insurance Opportunity for advancement Paid time off Alfa Insurance is an A-rated insurance carrier that offers an excellent array of auto, home, life, farm and business insurance products. Alfa is known for its superior customer service and boasts 94% claims satisfaction. Since its humble beginnings in 1946, Alfa and its affiliates now serve more than 1 million customers across 14 states. Working as a Claims Adjuster for Alfa Insurance offers a remarkable opportunity that extends beyond the mere tasks of handling property and casualty clams. It entails joining a revered company built on principles of faith, family, community, and unwavering integrity. By becoming a member of the Alfa family, you can uncover your true purpose and actively contribute to enhancing the lives of our valued policyholders and making a positive impact in your community. Job Summary Are you looking for a rewarding career in the insurance industry? Do you have a keen eye for details, have excellent time management skills and thrive in a fast-paced working environment? Do you enjoy working with a team of professionals who are committed to customer service excellence? If you answered yes, then you might be the perfect fit for the Claims Adjuster position at Alfa Insurance. As a Claims Adjuster, you will be responsible for handling all assigned company property and casualty and/or subrogation claims in an efficient and accurate manner. At Alfa Insurance, we pride ourselves on delivering on our promise to our customers. Our Claims department has a 94% satisfaction rating, and we work hard to help our customers get back on their feet as quickly as possible. Responsibilities Responsible for handling all company property and casualty claims assigned to the position in an efficient and accurate manner. Maintain the company standard of professional claims handling providing fast, fair claims service with a minimum of customer complaints. Contribute to the financial planning of the company by adequate reserving and control of expenses. Assure control of claimants and insured to avoid lawsuits. Qualifications 4-year bachelors degree In lieu of degree, must have 2 years as an Adjuster -OR- 3 years in automobile repair, home and/or commercial construction, law, law enforcement, auto and/or property estimating Valid drivers license and satisfactory driving record. Helpful to this position would be a background in automobiles, home construction, or law. Must be able to perform various physically demanding job functions included but not limited to, carrying a ladder that weighs in excess of fifty pounds, climb ladders, walk on roofs, crawl under houses/cars. Must be able to work in adverse weather and work conditions, with some extended stay away from home. Benefits/Perks Opportunity for annual performance bonus Discounts on your auto insurance (underwriting approval required) Benefits include: Health, dental, supplemental cancer, vision insurance and 401(k) plan Paid Time Off Bank to include 3 days PTO available after first 80 hours worked for New Hires Short-term and long-term disability Flexible Healthcare and Childcare spending accounts for tax savings Opportunities for advancement Continuous training and support throughout your career with Alfa College tuition discounts at various colleges in Alabama
    $34k-39k yearly est. 22d ago
  • Office Claims Rep

    Sfbcic

    Claims representative job in Ridgeland, MS

    Are you looking for a great team environment? Southern Farm Bureau Casualty Insurance Company is currently seeking a Office Claims Representative. Southern Farm Bureau is a great company and an excellent place to work. The Company offers a family-oriented work environment and a rich benefit package including paid time off, company matched 401(k), pension/retirement, medical, dental, vision, group life, accidental death and dismemberment, employee assistance program, a continued education program, and a hybrid home/office work schedule. This position is located in Little Rock , Arkansas. The Office Claims Representative will resolve property damage and injury claims caused by or incurred by insureds. This includes verifying coverage, determining liability, evaluating damages and affecting a settlement with the parties involved. Essential Functions • Analyze policy contracts to determine coverage. • Negotiate fair settlement with insured, third party claimants and/or legal representatives and issue payment. • Collect settlement documents and prepare status reports for file documentation. • Investigate the facts surrounding the claim by using various types of communication such as telephone, mail, email, and other means available to determine liability. • Prepare status reports to the District Claims Manager and/or Office Claims Supervisor in a timeline designated by those individuals. • Assist in catastrophe claims operations as needed. • Attend training sessions to gain the skills and ability to perform the functions of a Claims Representative. Additional Responsibilities • Other duties and responsibilities as assigned. • Regular and predictable attendance is required. Education Education Level Education Details Req Pref H.S. Diploma or equivalent required. X Bachelor's Degree X Or Other Previous insurance or customer service experience (minimum 2 years) may be substituted for degree. X And Other Must be able to obtain required adjuster licenses in applicable states within one year of hire. X Other Must be able to obtain appraiser license for FL & SC within one year of hire. X
    $28k-38k yearly est. 60d+ ago
  • Crop Claims Seasonal Adjuster

    Great American Insurance 4.7company rating

    Claims representative job in Mississippi

    Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. The Crop Division of Great American has been helping generations of farmers take control of their risks since 1915. The D ivision is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI policies. With six regional offices throughout the U.S., the teams provide tremendous expertise in the specific needs of farmers and crops. ********************************** Great American is currently seeking Seasonal Crop Adjusters. These positions are seasonal and may not be eligible for full-time or part-time benefits. Qualified candidates will cover territory in one of the following states: Alabama Arkansas California Colorado Florida Georgia Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Michigan Minnesota Mississippi Missouri Montana Nebraska New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania South Carolina South Dakota Tennessee Texas Washington Wisconsin Wyoming Schedule: Seasonal part-time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, you will: Understand and can work claims for all major crops, policy/plan types, in all stages of growth. Complete field inspections, reviews, and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company Crop insurance policies. Review and evaluates coverage and/or liability. Secure and analyze necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims. Ensure compliant and cost effective application of Crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory requirements. Accurately document, process and transmit loss information to determine potential. Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions, or trials as necessary. May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority. Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. Ensures that claims handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed. Follow regulatory and company rules, policies, and procedures. Performs other duties as assigned. Physical Requirements for employees in the Crop Business Unit/Crop Claims General Adjuster Requires continuous and prolonged walking and standing. Requires frequent lifting, carrying, pushing and pulling of objects up to 50 lbs. Requires frequent climbing grain bins, bending, twisting, stooping, kneeling and crawling. Requires overhead reaching and grabbing. Requires regular and predictable attendance. Requires ability to conduct visual inspections. Requires work outdoors, in inclement weather conditions. Requires frequent travel. May require ability to operate a motor vehicle. Business Unit: Crop Salary Range: $0.00 -$0.00 Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.
    $40k-48k yearly est. Auto-Apply 48d ago
  • Biloxi Mississipi Daily Claims Adjuster

    Cenco Claims 3.8company rating

    Claims representative job in Biloxi, MS

    Cenco Claims is a trusted provider of property claims solutions, partnering with insurance carriers to deliver accurate, timely, and customer-focused adjusting services. We are actively seeking Daily Claims Adjusters to support residential and commercial property claims throughout Biloxi Region. Key Responsibilities: Conduct on-site inspections and assess damages for both residential and commercial property claims Document findings with clear photos and notes, and prepare detailed reports in line with policy guidelines Use Xactimate or Symbility to write and submit accurate estimates Maintain professional and timely communication with policyholders, contractors, and insurance carriers Deliver high-quality service while meeting deadlines and file standards What You'll Need: Licensing: Active adjuster license in Mississippi Tools: Reliable vehicle, ladder, laptop, and basic inspection equipment Skills: Strong organization, communication, and time management Independence: Ability to manage assignments and schedule without direct supervision Responsiveness: Willingness to respond to assignments quickly and meet carrier expectations Why Cenco? Steady claim volume and competitive pay structure Efficient workflows and responsive support from our internal team Clear expectations Ready to take the next step? If you're looking for consistent work and value professionalism, communication, and independence in your claims career, we'd love to hear from you.
    $40k-49k yearly est. Auto-Apply 39d ago
  • Claim Clerk - Administrative Support - In Office

    Cannon Cochran Management 4.0company rating

    Claims representative job in Jackson, MS

    Claim Clerk ) Schedule: Monday-Friday, 7:30 a.m. - 4:00 p.m. (37.5 hours per week) Salary Range:$12.00 - $15.50 per hour Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary The Claim Clerk provides administrative support to both Liability and Workers' Compensation adjusters, ensuring accurate documentation and timely processing of claim-related tasks. This role requires strong attention to detail, organizational skills, and the ability to manage multiple priorities in a fast-paced environment. You'll work closely with a team of four and play a critical role in maintaining compliance and efficiency within the claims process. Responsibilities When we hire claim clerks, we look for detail-oriented professionals who take pride in accuracy, organization, and supporting a team that delivers exceptional service. In this role, you'll help keep claims moving by managing documentation, deadlines, and communication with precision. What You'll Do Match mail for assigned accounts and file claim-related documents Follow up on bills and assist with claim file maintenance Set up designated claim files and complete all setup instructions as requested Summarize correspondence and medical records in claim log notes and file appropriately Provide administrative support to claim staff on client-specific teams Back up the receptionist as needed Retrieve closed files and maintain storage organization Photocopy claim documents and return provider calls as directed Ensure compliance with service commitments established by the team Qualifications Required: High school diploma or equivalent Proficiency in Microsoft Word, data entry, and typing skills Strong attention to detail and organizational abilities Nice to Have: Experience with Microsoft Excel Knowledge of medical terminology Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Why You'll Love Working Here 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great claim clerks stand out through accuracy, efficiency, and teamwork. We measure success by: Quality administrative support - organized filing, accurate documentation, and dependable assistance to adjusters Compliance & audit performance - adherence to client-specific and corporate standards for recordkeeping and data integrity Timeliness & accuracy - prompt handling of mail, bills, and claim file updates with attention to detail Team collaboration - proactive communication and responsiveness to adjuster and client needs Professional judgment - maintaining confidentiality and prioritizing tasks effectively Cultural alignment - understanding that every claim represents a real person and supporting the process with care This is where we shine, and we hire clerks who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #ClaimsCareers #InsuranceJobs #JacksonMSJobs #AdminSupport #CareerGrowth #EmployeeOwned #GreatPlaceToWorkCertified #NowHiring #ClericalJobs #TeamSupport #CCMSICareers #LI-InOffice #IND456 We can recommend jobs specifically for you! Click here to get started.
    $12-15.5 hourly Auto-Apply 7d ago
  • Independent Insurance Claims Adjuster in Holly Springs, Mississippi

    Milehigh Adjusters Houston

    Claims representative job in Holly Springs, MS

    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.
    $39k-48k yearly est. Auto-Apply 60d+ ago
  • Claims Examiner

    Harris 4.4company rating

    Claims representative job in Mississippi

    Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.
    $48k-66k yearly est. Auto-Apply 33d ago
  • Automotive Claims Specialist

    Loss Prevention Services, LLC 3.6company rating

    Claims representative job in Natchez, MS

    The Claims Specialist is responsible for handling damage claims and property loss claims, to help resolve them efficiently and fairly. Successful Candidates MUST have prior experience with automotive insurance claims or experience working with insurance in a body shop or similar vehicle repair facility to be considered for this role. Job Type: Full Time On-Site or Hybrid at our office in Natchez, MS - This is not a fully remote position. Duties and Responsibilities: Investigating and analyzing details of damage claims and property loss claims to determine the level of liability. Reviewing and evaluating damage claims and property loss claims for accuracy and completeness. Interacting with service providers, clients, and claimants to gather more information about damage claims and property loss claims. Documenting all claim related activities and maintaining claim files for review and auditing purposes. Following all company policies and procedures and complying with all legal requirements Maintaining a high level of customer service by answering questions and providing information to all parties involved in the claims process. Requirements: Experience in the Collateral Recovery industry required, preferably in a Claims related role. Excellent written and verbal communications skills. Excellent listening, negotiation and problem-solving skills. Attention to detail and high level of accuracy. Must be proficient in Microsoft Office or Google Suite. Benefits: · Medical, Dental and Vision Insurance · Paid Time Off · Paid Holidays
    $37k-66k yearly est. 35d ago
  • Claims Examiner

    Harriscomputer

    Claims representative job in Mississippi

    Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.
    $35k-55k yearly est. Auto-Apply 33d ago
  • Liability Field Adjuster - Gulfport, MS

    CCMS & Associates 3.8company rating

    Claims representative job in Gulfport, MS

    Job Description CCMS & Associates is looking for 1099 Field Liability Adjusters. We are answering a call to action to add to our existing roster. The time is now to get on with our innovative team! We are seeking auto/homeowners/general liability field adjusters with at least 5 years of field experience. Requirements: Minimum 5 years auto and/or premise liability adjusting experience Working computer/laptop - internet access and Microsoft Word required Must demonstrate strong time management and customer service skills State adjusters license (where applicable) Must have a valid drivers license Responsibilities: Conduct in-depth investigations into liability claims to gather facts regarding the loss Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses, and by interviewing fire, police, or other government officials as well as inspecting claimed damages Inspect damage to property and obtain personal injury information to assist in determining liability Maintain acceptable product quality through compliance with established best practices Knowledge and Skills: In-depth knowledge of property and liability insurance coverage and industry standards Ability to prepare full-captioned reports by collecting and summarizing required information Strong verbal and written communication skills Prompt, reliable, and friendly Detail-oriented individual to accurately gather and analyze information to avoid errors Preferred but Not Required: College degree Professional designations and certifications All candidates must pass a full background check (void in states where prohibited) Powered by JazzHR 6a4Iau4EmO
    $39k-53k yearly est. 7d ago
  • Public Adjuster

    The Misch Group

    Claims representative job in Jackson, MS

    Job DescriptionDescriptionPosition: Production Public Adjuster (Licensed) Compensation: $75,000 - $100,000 compensation + Performance-based bonuses QUICK 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) About the Company:A well-established, industry-leading public adjusting firm is seeking motivated and driven Outside Sales Representatives to join our growing team. We specialize in advocating for policyholders, ensuring they receive fair settlements for property damage claims. Our sales team plays a critical role in developing strong client relationships and driving company growth. Position Overview: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!
    $31k-42k yearly est. 15d ago
  • Workers Comp Claims Coordinator

    Savard Group

    Claims representative job in Hattiesburg, MS

    Join SAVARD Personnel Group - where your skills are valued! Key Requirements: We are hiring anexperienced workers' comp claims adjustor. Strong problem-solving and analytical skills. Excellent communication and interpersonal skills. Ability to work independently and as part of a team. Familiarity with safety protocols and claims management software. Valid driver's license and willingness to travel to job sites as needed. Investigate and document claims, including gathering evidence, interviewing claimants, and assessing damages. Conduct on-site inspections and assessments to evaluate the extent of damage and determine athe ppropriate course of action. Coordinate with safety teams and clients to ensure compliance with relevant regulations and protocols. Shifts: Monday to Friday - 8:00 AM to 5:00 PM Occasional over time and weekends as needed Duration: Temporary to Permanent How to Apply: Apply & Receive offers NOW! Download Savard 24/7 App! Call us at ************ Job ID# 54024573
    $29k-36k yearly est. 7d ago
  • Senior Stop Loss Claims Analyst - HNAS

    Highmark Health 4.5company rating

    Claims representative job in Jackson, MS

    This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for building positive client relationships, providing education, and analyzing client claim losses as well as current issues regarding client activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. **ESSENTIAL RESPONSIBILITIES** + Processes daily incoming Stop Loss claims including initial entry claims or subsequent claims as needed; provides counseling to clients and assists with client service programs. + Evaluates various claims submitted by Third Party Administrators (TPAs) and Pharmacy Benefit Managers (PBMs) on behalf of self-funded clients for compliance with the following: underlying policy provisions, federal and state regulatory guidelines, and industry standards. + Monitors, reviews and analyzes various complex potential claims with emphasis on controlling losses through effective managed care. This includes following a departmental claim checklist to ensure eligibility is met, the payment reimbursement request is accurate by auditing the claim for duplicate line-item charges and determining if all information is available to finalize the payment request. Refers the claim to the cost containment and RxOps departments for review of high dollar charges if applicable. + Determines whether to pend or adjudicate claims following organizational policies and procedures; finalizes and adjudicates claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim information to TPAs, brokers, or customers utilizing the appropriate application and/or template. + Identifies potential discrepancies in claim submissions and involves the Special Investigation Unit as necessary. Identifies issues which can be used to educate/train internal staff, streamline, and improve processes and update documentation. + Assists leadership with performing client performance evaluations to assess the accuracy of client reports submitted to the organization, efficiency of claim operations, and adequacy of systems and procedures. + Approves claim payments on behalf of multiple clients and provides client counseling and support services. Assists in the client service programs including revising and establishing procedures, protocols and ensuring client satisfaction with the organization. + Maintains accurate claim records. + Other duties as assigned or requested. **EDUCATION** **Required** + High School Diploma/GED **Substitutions** + None **Preferred** + Bachelor's degree **EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience processing 1st dollar health insurance claims + 3 years of experience with medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information effectively. + Organizational skills + Ability to manage time effectively. + Ability to work independently. + Problem Solving and analytical skills. **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:** $22.71 **Pay Range Maximum:** $35.18 _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: J273755
    $22.7-35.2 hourly 29d ago
  • Field Claims Adjuster - Auto Damage

    Progressive 4.4company rating

    Claims representative job in Ridgeland, MS

    Progressive is dedicated to helping employees move forward and live fully in their careers. Your journey has already begun. Apply today and take the first step to Destination: Progress. As an auto damage claims adjuster, you'll serve as Progressive's point of contact with customers - directing and making decisions regarding the repair process from beginning to end. Managing your own inventory while working independently, you'll work closely with body shops and others to negotiate repair pricing and assess liability. Ideal candidates will possess leadership and conflict management skills, along with strong attention to detail and a passion for providing excellent customer service. This is a field position with access to a company car and frequent driving within your assigned geographical area. We assess our workload collectively, which means you may cover assignments outside your geographical area. You may also be required to report into an office occasionally. Duties and responsibilities * Complete vehicle inspections, write estimates, determine total loss evaluations, and set clear expectations and timelines * Negotiate repair process with body shops * Document information related to the claim and make decisions consistent with claims standards and local laws * Evaluate and handle claim payments and resolution of claims without payments * Review and determine validity of any supplement requests Must-have qualifications * A minimum of four years of relevant work experience with one year appraisal/estimatics or insurance experience * {OR} Associate's degree and a minimum of three years relevant work experience with one year appraisal/estimatics or insurance experience * {OR} Bachelor's degree and a minimum of one year appraisal/estimatics or insurance experience * Valid driver's license, auto insurance, and compliance with Progressive's driving standards and/or policies Compensation * $66,800 - $81,600/yearly * Gainshare annual cash incentive payment up to 16% of your eligible earnings based on company performance Benefits * 401(k) with dollar-for-dollar company match up to 6% * Medical, dental & vision, including free preventative care * Wellness & mental health programs * Health care flexible spending accounts, health savings accounts, & life insurance * Paid time off, including volunteer time off * Paid & unpaid sick leave where applicable, as well as short & long-term disability * Parental & family leave; military leave & pay * Diverse, inclusive & welcoming culture with Employee Resource Groups * Career development & tuition assistance Energage recognizes Progressive as a 2025 Top Workplace for: Innovation, Purposes & Values, Work-Life Flexibility, Compensation & Benefits, and Leadership. Equal Opportunity Employer For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at **************************************************************** Share: Email X Facebook LinkedIn Apply Now
    $66.8k-81.6k yearly 2d ago
  • Claims Adjuster- Oxford, MS

    Alfa Insurance 4.5company rating

    Claims representative job in Oxford, MS

    Benefits: Dental insurance Health insurance Opportunity for advancement Paid time off Company Overview Alfa Insurance is an A-rated insurance carrier that offers an excellent array of auto, home, life, farm and business insurance products. Alfa is known for its superior customer service and boasts 94% claims satisfaction. Since its humble beginnings in 1946, Alfa and its affiliates now serve more than 1 million customers across 14 states. Working as a Claims Adjuster for Alfa Insurance offers a remarkable opportunity that extends beyond the mere tasks of handling property and casualty clams. It entails joining a revered company built on principles of faith, family, community, and unwavering integrity. By becoming a member of the Alfa family, you can uncover your true purpose and actively contribute to enhancing the lives of our valued policyholders and making a positive impact in your community. Job Summary Are you looking for a rewarding career in the insurance industry? Do you have a keen eye for details, have excellent time management skills and thrive in a fast-paced working environment? Do you enjoy working with a team of professionals who are committed to customer service excellence? If you answered yes, then you might be the perfect fit for the Claims Adjuster position at Alfa Insurance. As a Claims Adjuster, you will be responsible for handling all assigned company property and casualty and/or subrogation claims in an efficient and accurate manner. At Alfa Insurance, we pride ourselves on delivering on our promise to our customers. Our Claims department has a 94% satisfaction rating, and we work hard to help our customers get back on their feet as quickly as possible. Responsibilities Responsible for handling all company property and casualty claims assigned to the position in an efficient and accurate manner. Maintain the company standard of professional claims handling providing fast, fair claims service with a minimum of customer complaints. Contribute to the financial planning of the company by adequate reserving and control of expenses. Assure control of claimants and insured to avoid lawsuits. Qualifications 4-year bachelor's degree In lieu of degree, must have 2 years as an Adjuster -OR- 3 years in automobile repair, home and/or commercial construction, law, law enforcement, auto and/or property estimating Valid driver's license and satisfactory driving record. Helpful to this position would be a background in automobiles, home construction, or law. Must be able to perform various physically demanding job functions included but not limited to, carrying a ladder that weighs in excess of fifty pounds, climb ladders, walk on roofs, crawl under houses/cars. Must be able to work in adverse weather and work conditions, with some extended stay away from home. Benefits/Perks Opportunity for annual performance bonus Discounts on your auto insurance (underwriting approval required) Benefits include: Health, dental, supplemental cancer, vision insurance and 401(k) plan Paid Time Off Bank to include 3 days PTO available after first 80 hours worked for New Hires Short-term and long-term disability Flexible Healthcare and Childcare spending accounts for tax savings Opportunities for advancement Continuous training and support throughout your career with Alfa College tuition discounts at various colleges in Alabama Alfa Insurance is an A-rated insurance carrier that offers an excellent array of auto, home, life, farm and business insurance products. Alfa is known for its superior customer service and boasts 94% claims satisfaction. Since its humble beginnings in 1946, Alfa and its affiliates now serve more than 1 million customers across 14 states. Working for Alfa Insurance is more than just servicing customers and selling insurance. It's becoming part of a well-respected company that is based on our core 4 values of faith, family, community and integrity.
    $34k-39k yearly est. Auto-Apply 4d ago

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