Claims representative jobs in Mount Pleasant, SC - 136 jobs
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Mechanical Claims Adjuster
Hudson Automotive Group 4.1
Claims representative job in North Charleston, SC
Excela Protect is looking for an accomplished Mechanical Claims Adjuster to join our team. Excela Protect is a fast-growing, technology-driven, dealer-centric administrator dedicated to revolutionizing the F&I industry. We're on a mission to deliver unmatched value to dealers and customers, challenging the status quo with transparency, efficiency, and unparalleled service. If you are an accomplished mechanic or repair professional who loves partnering with customers and helping them navigate the claims process, it's time to shift your career into gear with Excela Protect!
What do we offer?
Compensation: $45-55k (depending on Mechanical experience and certifications)
Schedule: Onsite Mon-Friday (8am-5pm)
Medical, Dental, Vision, and Life Insurance
401k
Paid Vacation/Holidays
Paid Training and Employee development
Who are we looking for?
Customer Centric professional who loves making people smile.
Energetic personality who loves collaborating with a team.
Self-Motivated individual who is competitive and coachable.
Qualifications:
Strong mechanical background and experience as a mechanic or automotive service professional is required.
Previous experience with claims administration.
Bilingual (preferred)
Thorough knowledge of automotive repair, technical vehicle operations, components, and breakdowns.
Ability to handle customers in difficult situations.
Act as technical advisor to claims processors.
Are you ready to work in a rewarding, and high-energy environment? Come take the next step of your career with Excela Protect!
We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
Qualifications
Strong mechanical background and experience as a mechanic or automotive service professional is required.
Previous experience with claims administration.
Thorough knowledge of automotive repair, technical vehicle operations, components, and breakdowns.
Ability to handle customers in difficult situations and act as technical advisor to claims processors.
$45k-55k yearly 12d ago
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Claims Adjuster - Attorney Represented Injury
Progressive 4.4
Claims representative job in North Charleston, SC
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 specialist, you'll play a critical role managing attorney represented bodily injury (BI) claims. An ideal candidate will have experience managing an inventory independently, experience assessing and evaluating liability, coverage, and damages, as well as working independently and directly with attorneys to negotiate and settle claims. By joining our organization, you'll have the support of a collaborative team that will help you grow your claims career. Read on to learn more about some of the day-to-day responsibilities.
This is a hybrid role. You'll be expected to report to an office about four days per month for important meetings, training, and collaboration and will have the benefit of continued coaching from a supportive team. If you prefer an in-office environment, you're welcome to work in the office more than four days per month.
Duties & responsibilities
* Determines coverage and liability
* Negotiate with claimants or their attorneys
* Settle claims and set reserves
* Estimates cost of treatment or compensation for those injured in accidents
* Analyze and interpret medical reports, follow-up with no-fault parties, and manage claims process to ensure efficient resolution
* Interview, collect and document information from various people such as claimants, agents/brokers, attorneys, and police
Must-have qualifications
* Four years of relevant work experience with one year in claims handling
* {OR} Associate's degree and three years relevant work experience with one year in claims handling
* {OR} Bachelor's degree and one year in claims handling
* This position requires a valid driver's license and auto insurance.
Preferred skills
* Auto and/or commercial insurance experience
License: This role requires adjusters to take and pass a licensing exam in order to secure licensing to adjust claims on behalf of Progressive.
Location: Open to our claims offices located in Charlotte, NC, Asheville, NC, Greenville, SC, Myrtle Beach, SC, North Charleston, SC
Compensation
* $63,100-$81,600
* 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
* Onsite gym & healthcare at large locations [delete if not applicable to location]
Energage recognizes Progressive as a 2025 Top Workplace for: Innovation, Purposes & Values, Work-Life Flexibility, Compensation & Benefits, and Leadership.
Equal Opportunity Employer
Applicants must be authorized to work for any employer in the U.S. without the need or potential need, of current or future sponsorship for employment. Progressive does not hire candidates with (e.g., F-1 CPT, OPT, or STEM OPT, H-1B, O-1, E-3, TN) statuses for this role.
For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at ****************************************************************
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$63.1k-81.6k yearly 7d ago
Property Adjuster Specialist - Field
USAA 4.7
Claims representative job in Charleston, SC
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory requirements. You will recognize and empathize with members' life events, as appropriate.
Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses within your locally assigned territory. Field Adjusters may travel outside of their local territory to respond to claims in other regions when needed. This is an hourly, non-exempt position with paid overtime available.
This is a field-based role in the Charleston, SC area. Candidates who are willing and able to work in this area are encouraged to apply.
What you'll do:
Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability.
Partners with vendors and internal business partners to facilitate complex claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance.
Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics.
Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies.
Determines and negotiates complex claims settlement within authority limits. Develops recommendations and collaborates with management for determining settlement amounts outside of authority limits and accurately manages claims outcomes.
Maintains accurate, thorough, and current claim file documentation throughout the claims process.
Advance knowledge of estimating technology platforms and virtual inspection tools. Utilizes platforms and tools to prepare claims estimates to manage complex property insurance claims.
Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
May be assigned CAT deployment travel with minimal notice during designated CATs.
Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
Works independently solving complex problems with minimal guidance; acts as a resource for colleagues with less experience.
Adjusts complex claims with attorney involvement.
Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations.
May require travel to resolve claims, attend training, and conduct in-person inspections.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
What you have:
High School Diploma or General Equivalency Diploma.
2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
Advanced knowledge of estimating losses using Xactimate or similar tools and platforms.
Proficient knowledge of residential construction.
Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations.
Proficient negotiation, investigation, communication, and conflict resolution skills.
Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills.
Ability to travel 50-75% of the year (local & non-local) and/or work catastrophe duty when needed.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
Successful completion of a job-related assessment may be required.
What sets you apart:
Hands-on experience in the field handling high-severity and complex property claims such as fire, water damage, vandalism, malicious mischief, foreclosures, earth movement, collapse, and liability.
Residential property field adjusting experience with dwelling, structure and additional living expenses.
Experience working directly for a standard insurance carrier handling claims from start to finish (first notice of loss, reviewing policy, making coverage decisions)
Proficient in using estimating platforms and virtual inspection tools like Xactimate, ClaimXperience and XactAnalysis
Insurance industry designations such as AINS (Associate in General Insurance), CPCU (Chartered Property Casualty Underwriter), AIC (Associate in Claims), or SCLA (Senior Claims Law Associate) or actively pursuing
Active Property & Casualty adjuster license
Currently reside in the Charleston area, enabling quicker response times for local claims and a better understanding of regional risks
US military experience through military service or a military spouse/domestic partner
Physical Demand Requirements:
May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces.
May need to meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver's license.
May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car.
May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics.
Compensation range: The salary range for this position is: $67,750 - $121,950.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
$67.8k-122k yearly Auto-Apply 60d+ ago
Customer Claims Representative
Service Pros Auto Glass
Claims representative job in Anderson, SC
Job Description
Customer ClaimsRepresentative - Anderson
Join the Service Pros Auto Glass team inside our partnered dealerships! You'll engage customers, spot glass-replacement opportunities, and coordinate quick, professional service - all while building strong relationships and developing a personal team. This role is perfect for a teachable person who loves being part of a supportive, winning team.
What You'll Do:
Engage customers in the service drive and identify windshield replacement needs.
Educate and guide customers through their options and next steps.
Build strong relationships with service advisors, managers, and technicians.
Encourage dealership referrals and hit daily/weekly sales goals.
Schedule and coordinate on-site glass services.
Keep accurate records of leads, interactions, and completed jobs.
Represent the company with a professional, positive attitude.
What Makes You a Great Fit:
Experience in customer service or sales is a plus, but not required.
Strong communication and people skills.
A self-motivated, proactive approach - you enjoy taking the lead.
Team-oriented mindset with a friendly, professional appearance.
Valid driver's license and reliable transportation.
What We Offer:
A fun, energetic, team-first culture
Ability to earn $1000 - $2500 per week
You are
paid on a weekly basis
Promotion from within and clear growth paths
Ongoing training and development
Team events, company outings, and a culture that celebrates wins
$28k-40k yearly est. 19d ago
Daily Claims Adjuster - Charleston Region
Cenco Claims 3.8
Claims representative job in Charleston, SC
CENCO Claims is a trusted provider of property claims solutions, delivering high-quality adjusting services to insurance carriers nationwide. We are currently seeking Daily Claims Adjusters to handle residential property claims throughout the Charleston, South Carolina area.
What You'll Do:
Conduct on-site inspections to assess residential property damage
Capture detailed photo documentation and prepare clear, accurate reports
Review policy coverage and determine loss scope in accordance with carrier guidelines
Write and submit estimates using Xactimate or Symbility
Communicate professionally with policyholders, contractors, and carriers
Manage claim files efficiently while providing strong customer service
What We're Looking For:
Licensing: Active adjuster license required
Tools & Equipment: Reliable transportation, ladder, laptop, and standard field equipment
Work Style: Independent, organized, and detail-oriented
Responsiveness: Ability to accept assignments promptly and meet required deadlines
Preferred Experience:
Experience handling residential property claims
Familiarity working with insurance carriers
Strong communication and time-management skills
Ability to manage a steady claim volume
Why Work with CENCO?
Competitive fee schedules with consistent claim volume
Streamlined processes and a supportive internal team
Opportunities for continued work within a growing organization
If you're a residential adjuster looking for steady assignments and competitive pay in the Charleston area, we'd love to hear from you.
$40k-49k yearly est. Auto-Apply 60d+ ago
Insurance Claims Specialist (Construction Defects and Property Damage)
DPR Construction 4.8
Claims representative job in Greenville, SC
The Insurance Claims Specialist will be responsible for assisting with the management of all aspects of complex Construction Defect and Property Damage incidents and claims for DPR (and DPR-related entities), as assigned. Reporting: Role reports to Insured Claims Manager and Insured Claims Leader
Specific Duties Include:
Claims & Incident Management (General):
* Initial triage and processing of incidents received from project teams for DPR (and DPR-related entities).
* Input and/or review all incidents reported in DPR's RMIS system.
* Working with the incident triage group to ensure timely and appropriate review of all incidents
* Ensure all necessary information is compiled to properly manage claims. This includes working with the DPR teams to collect relevant documents such as the Prime contract, Subcontracts, Certificates of Insurance, Owner Policy Documents, Project Documents and Project Specific Coverage information, etc.
* Assess all potential risks, as well as identify all contractual risk transfer mechanisms.
* Analyzing potential insurance coverage for all applicable lines of coverage and report, with all appropriate documents and information, potential claims for DPR (and DPR-related entities) to the broker for any applicable program (Traditional, CCIP, OCIP).
* Assist with the development and training of other DPR Workgroups (and DPR-related entities) around CD/PD Best Practices.
Construction Defect & Property Damage (CD/PD) Specific Claims Management:
* Manage all assigned claims in DPR's RMIS system relating to Construction Defect and Property Damage matters for DPR (and DPR-related entities). This would include using all appropriate lines of coverage such as Commercial General Liability, Builder's Risk, Property, Contractor's Pollution Liability and Professional Liability, whether the policies are placed by DPR or our Clients.
* Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements.
* Management of and coordination with DPR's consultants and outside attorneys throughout the claim process.
* Continuously analyze claim-specific details as the claim progresses to devise key strategies in conjunction with all internal stakeholders and outside consultants.
* Proactive management and coordination of all phases of the DPR CD/PD Claims Workflow.
Key Skills:
* Basic working knowledge and familiarity of:
* Commercial General Liability
* Property Insurance (Including Inland Marine and Builder's Risk
* Pollution Liability
* Professional Liability
* Controlled Insurance Programs (CCIP/OCIP)
* RMIS Systems
* Construction Industry Expertise
* Strategic thinking
* Strong written and oral communication skills
* High level of EQ (Soft skills)
* Self-Starter
* Highly organized and responsive; ability to meet deadlines
* Detail Oriented
* Contractual risk assessment
* Dispute management
* Integrity
* Ability to mentor and inspire others
* Team player
* Willingness to understand and advance the DPR Culture
* Proactive Learner
Qualifications:
* 5-7 years relevant construction industry and/or insurance industry experience preferred.
* Previous experience in construction company Risk Management highly desired.
* Position location - TBD based on location of most qualified candidate.
DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world.
Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek.
Explore our open opportunities at ********************
$53k-66k yearly est. Auto-Apply 6d ago
Independent Insurance Claims Adjuster in Charleston, South Carolina
Milehigh Adjusters Houston
Claims representative job in Charleston, SC
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.
$40k-50k yearly est. Auto-Apply 60d+ ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claims representative job in Charleston, SC
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.
$41k-50k yearly est. Auto-Apply 5d ago
Liability Field Adjuster - Charleston, SC
CCMS & Associates 3.8
Claims representative job in Charleston, SC
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)
$49k-66k yearly est. Auto-Apply 60d+ ago
Associate VB Claims Specialist
UNUM Group 4.4
Claims representative job in Columbia, SC
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
$40k-75.6k yearly Auto-Apply 13d ago
Rec Marine Adjuster
Sedgwick 4.4
Claims representative job in Charleston, SC
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
Rec Marine Adjuster
**PRIMARY PURPOSE** **:** To investigate and process marine claims adjustments for clients; to handle complex losses locally unassisted up to $50,000 and assist the department on larger losses.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Investigates the cause and extent of the damages, obtains appropriate documentation, and issues settlement.
+ Receives and reviews new claims and maintains data integrity in the claims system.
+ Reviews survey reports and insurance policies to determine insurance coverage.
+ Prepares settlement documents and requests payment for the claim and expenses.
+ Assists in preparing loss experience report to help determine profitability and calculates adequate future rates.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Appropriate state adjuster license is required.
**Experience**
3 years or more of Marine Adjusting preferred.
**Skills & Knowledge**
+ Strong oral and written communication skills
+ PC literate, including Microsoft Office products
+ Good customer service skills
+ Good organizational skills
+ Demonstrated commitment to timely reporting
+ Ability to work independently and in a team environment
+ Ability to meet or exceed Performance Competencies
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical** **:**
+ Must be able to stand and/or walk for long periods of time.
+ Must be able to kneel, squat or bend.
+ Must be able to work outdoors in hot and/or cold weather conditions.
+ Have the ability to climb, crawl, stoop, kneel, reaching/working overhead
+ Be able to lift/carry up to 50 pounds
+ Be able to push/pull up to 100 pounds
+ Be able to drive up to 4 hours per day.
+ Must have continual use of manual dexterity
**Auditory/Visual** **:** Hearing, vision and talking
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**
$50k yearly 49d ago
Liability Claims Adjuster
Canal Insurance Company
Claims representative job in Greenville, SC
About Canal Insurance
Canal Insurance Company specializes in insurance for commercial trucking and specialty transportation operations. Canal was founded in 1939 and is located in Greenville, South Carolina. At Canal, we recognize that our success would not be possible without the hard work and dedication of our employees. We know that happiness and productivity go hand in hand, and to that end, we consciously cultivate a culture that enables us to recruit and retain the very best talent in the business.
Liability Claims Adjuster
Job Summary: The Liability Claims Adjuster position is responsible for the analysis and adjustment of minor to moderate commercial claims.
Major Accountabilities:
Verify coverage as new losses are received.
Adjust claims on an inside basis including investigating, evaluating, negotiating, documenting, and validating to conclusion within authority level.
Work with attorneys assigned in the defense of insured and attend mediations and trials as a representative of the company as needed.
Communicate with interested parties (i.e. insured, claimants, agents, attorneys, repair shops, lien holders) as appropriate.
Monitor, with management consent, approved independent adjusters and attorneys in the field.
Establish and maintain reserves and communicate with management, when appropriate.
Perform other duties as assigned by management.
Qualifications:
Education/Training Requirements: Bachelor's degree and three years' experience required or five years of claims handling experience required. Adjuster's license required. All internal candidates must have manager approval before submitting an application.
Experience/Specialized Skills: Minimum of three years adjuster experience and Bachelor's degree required, or five years claims handling experience required. Familiarity with basic insurance and tort law, understanding of basic legal principles and terminology as it relates to insurance operations and knowledge of basic medical terminology and procedures required. Intermediate computer skills (word processing, spreadsheets, databases, Internet, e-mail) required.
Special Considerations:
Physical Requirements: Constant use of vision, hearing, and communication (oral and written in person and via telephone). Frequent concentration, standing, walking, handling, reaching, and grasping. Occasional bending, kneeling and lifting (up to 25 lbs.). Heavy use of computer and office equipment.
Travel/Hours of Service: Occasional travel may be required. Periodic work outside of standard business hours or on weekends may be required.
$40k-50k yearly est. 20d ago
Liability Adjuster
HDVI
Claims representative job in Anderson, SC
What we do High Definition Vehicle Insurance (HDVI): Technology meets Insurance. HDVI brings telematics, software and data together with commercial trucking insurance, taking transportation insurance and fleet risk management to the next level. Our platform arms fleets with an end-to-end solution that empowers them to save money, mitigate risk, and increase operational efficiencies. Our customers are small to midsize truck fleet operators who benefit from dynamic and transparent pricing - automatically reducing their premiums for safer driving. Leveraging a best-in-class partner ecosystem, HDVI combines magnitude and stability with innovation to revolutionize the commercial trucking insurance space. Why work here HDVI is building the industry defining commercial auto insurance company for the next 100 years. The $50 billion commercial auto industry hasn't seen real innovation for decades and is broken in a number of ways, creating a significant opportunity for HDVI. HDVI is co-founded by a former Esurance co-founder, and has a senior management team with experience building innovative insurance and logistics companies from zero to $1B+ enterprises, and deep expertise in trucking insurance. HDVI is well-funded by leading logistics and mobility-focused venture capital firms and strategic investors including Munich Re, Daimler Trucks and Qualcomm. The HDVI Team is values-driven, data-driven, ambitious, and collaboratively minded with a diverse background of experiences and skills in the insurance and logistics industries. We like challenges and building solutions that improve the quality of life for our customers. We offer generous benefits, including employee stock options, health, dental, vision, 401k, flexible work environment, and unlimited PTO.
About the RoleAs a Liability Adjuster, you will work closely with HDVI's Claims and Fleet Services Teams. The ideal candidate will have extensive knowledge of handling all aspects of Commercial Trucking claims inclusive of but not limited to Third Party Bodily Injury, Third Party Auto Property Damage, First Party Auto Property Damage, Cargo, Truckers General Liability and First Party Medical. You will be responsible for influencing and providing claim resolution and tactical guidance to both internal and external customers in order to achieve world class claims outcomes. The Liability Adjuster role is an associate level position with senior level growth potential as the company expands. What You'll Do
Responsible for the handling First and Third Party Property Damage, and Cargo and Third Party Bodily Injury claims stemming from accidents involving tractor-trailers
Engage with various internal and external partners to drive resolution on high-severity matters that are identified
Be adaptable to various business demands and willing to assist with special claims projects and other duties as assigned
Participate in regular claims reviews with both internal and external customers
Maintain current knowledge of insurance contracts and industry trends by proactively maintaining required adjuster license(s)
Provide technical expertise in response to inquiries from internal and external customers
3+ years experience with handling complex Commercial Trucking claims
Extensive experience across all technical areas of Commercial Auto inclusive of but not limited to Physical Damage, Auto Liability, First Party Medical / Personal Injury Protection and Motor Truck Cargo
Extensive experience with analyzing, determining and applying Coverage for Commercial Auto claims
Advanced experience and capabilities in litigation claims management, including ADR and mediation processes involving Commercial Auto exposures
Experience attending and controlling cases at mediations/settlement conferences, pre-suit, post suit, pretrial and post-trial
Ability to work in a rapidly evolving, high-growth environment with the ability to collaborate across and within different levels of the organization
Experience with large Fleets (250+) with self-insured retentions and/or large deductibles
Excellent communication skills (verbal/written) and strong negotiation skills
Strong time management, organizational and problem-solving skills
Ability to adapt, embrace the unknown and shift priorities
Willingness to look outside your day to day to ensure you keep learning and growing in a startup environment
Preferred Skills
College Education
Active Adjusters License - strongly preferred
Strong analytical, critical thinking, and problem-solving skills
Proficiency in Google Suite, Microsoft Office and Adobe Acrobat
Experience with self-insured retention (SIR), large deductibles and claims involving Independent Owner Operators (IOO)
Benefits
Competitive salary & stock options - we want our success to be yours too
Unlimited PTO with 11 paid holidays each year
Medical, Dental, Vision, Short/Long Term Disability, Basic Life, and AD&D to support you and your well-being
FSA / HSA programs
401(k) retirement plan with company match contribution
Inclusive Parental Leave policy that supports all parents
Wednesdays are standing meeting-free, allowing you to focus on deep work without distractions
Birthday meal reimbursement, because celebrating our employees is part of our company culture
A remote-friendly environment with the opportunity to participate in periodic in-person team offsites
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
$37k-50k yearly est. Auto-Apply 60d+ ago
Claims Mitigation & Management Specialist
The Nuclear Company
Claims representative job in Columbia, SC
Job Description
The Nuclear Company is the fastest growing startup in the nuclear and energy space creating a never before seen fleet-scale approach to building nuclear reactors. Through its design-once, build-many approach and coalition building across communities, regulators, and financial stakeholders, The Nuclear Company is committed to delivering safe and reliable electricity at the lowest cost, while catalyzing the nuclear industry toward rapid development in America and globally.
About the role
The Nuclear Company is looking for an experienced Claims Mitigation & Management Specialist to support the deployment of major nuclear reactor projects. This role will focus on contract formation, administration, and proactive claims prevention. You will work closely with project teams, contract managers, and leadership to identify and address potential risks, respond to claims, and ensure contractual compliance across complex, utility-scale nuclear energy projects.
Responsibilities
Proactively identify potential claims and disputes on projects.
Develop and implement strategies for early claims identification and mitigation.
Provide guidance to project teams on contract administration and documentation.
Conduct detailed forensic analysis of project documentation for claims assessment.
Quantify cost and schedule impacts of potential claims, including delay and disruption.
Prepare comprehensive claims position papers and reports.
Support the negotiation process for claims and disputes.
Assist in preparing for and participating in dispute resolution forums (e.g., mediation, arbitration).
Develop and maintain a robust claims log, tracking all active and potential claims.
Ensure all claims-related documentation is meticulously organized.
Prepare regular reports on claims status, liabilities, and resolution progress.
Work closely with Project Controls, Contracts, and Legal teams on claims management.
Participate in project reviews to provide insights on claims trends.
Experience
Bachelor's degree in Engineering, Construction Management, Quantity Surveying, Law, or a related field.
8+ years of progressive experience in claims management, dispute resolution, or contract administration.
3+ years of focused claims management experience.
Experience on energy mega-projects (utility-scale, high capital, high complexity).
Experience on nuclear energy projects is highly valued.
Demonstrated expertise in contract formation, negotiation, and administration.
Exceptional analytical, critical thinking, and problem-solving skills.
Excellent written and verbal communication and negotiation skills.
Proficiency in project management software, scheduling tools, and advanced Excel.
Ability to work effectively under pressure and manage multiple priorities.
Knowledge of construction law and dispute resolution processes.
Benefits
Competitive compensation packages
401k with company match
Medical, dental, vision plans
Generous vacation policy, plus holidays
Estimated Starting Salary Range
The estimated starting salary range for this role is $121,000 - $143,000 annually less applicable withholdings and deductions, paid on a bi-weekly basis. The actual salary offered may vary based on relevant factors as determined in the Company's discretion, which may include experience, qualifications, tenure, skill set, availability of qualified candidates, geographic location, certifications held, and other criteria deemed pertinent to the particular role.
EEO Statement
The Nuclear Company is an equal opportunity employer committed to fostering an environment of inclusion in the workplace. We provide equal employment opportunities to all qualified applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic. We prohibit discrimination in all aspects of employment, including hiring, promotion, demotion, transfer, compensation, and termination.
Export Control
Certain positions at The Nuclear Company may involve access to information and technology subject to export controls under U.S. law. Compliance with these export controls may result in The Nuclear Company limiting its consideration of certain applicants.
$25k-45k yearly est. 4d ago
Plant/Manufacturing - Adjuster
Schwarz Partners 3.9
Claims representative job in Rock Hill, SC
STS Packaging, a Schwarz Partners, L.P. Joint Venture company, is currently seeking an Adjuster in Charlotte, NC. The primary responsibility of the Adjuster is to serve as the technical and operational leader for a designated group of bag machines. Duties focus on safety, operational efficiencies, machine uptime, instruction and guidance to the group operators, reporting and the overall performance of the machine group/shift. This position is located at 1201 Westinghouse Blvd in Charlotte, NC. 28273
ESSENTIAL JOB FUNCTIONS FOR THIS POSITION
Proven experience in operating a bag machine per production standards and output
Actively check bag quality (both for defects and predictive changes to bag attributes)
Maintain machine - Make comprehensive machine adjustments and lead major machine adjustments effort as needed to ensure quality and efficiency - See position tier levels for specific tasks
Keep machine running at optimal speeds
Interact, train and mentor all employees within the machine group
Maintain cleanliness of machine group and work area
Convey to the Production Superintendent any pending or current conditions that may impede the output of the machine group.
Oversee the accurate, complete documentation of daily shift paperwork
Perform any and all job assignments/functions as necessary to daily business demands as instructed by Management.
Lead PM activities (via dedicated or rotating schedule)
Maintain a positive, instructive attitude every day to foster employee job satisfaction
Technical Duties Include:
Effectively manage the machine group's performance (all operators)
Maximize uptime through optimal adjustments and time-efficient repair of machine during breakdowns
Mentor group Operators and Adjuster Trainees
Act as the area leader for meeting/exceeding production standards
OTHER SIGNIFICANTJOB FUNCTIONS INCLUDE
Maintains a clean and safe work area and reports unsafe conditions to management for resolution
Adheres to all safety policies, including always wearing required PPE, and sets an example to others for model safety behavior
Detailed understanding of quality defects, including how to detect as well as what to do if observed
Conform to Good Manufacturing Practices (GMP's), and Safe Quality Food (SQF) procedures and policies to assure products are suitable for food contact
Responsible for reporting any product quality or food safety issues to the Quality Manager (SQF Practitioner) or Management Team member
Additional duties as assigned by Production Superintendent
REQUIRED EDUCATION / EXPERIENCE
High School Diploma minimum required
Leadership skills and ability to work as an independent thinker
Proven team-oriented mindset
REQUIRED SKILLS (TECHNICAL, CLERICAL, LANGUAGE, ETC.)
Must follow Safety/GMP/PPE guidelines
Ability to work beyond 8-hour shifts as needed and participate in weekend PM and maintenance efforts as needed; Days of work may be shifted to accommodate a 5 day work week
Production-focused
Take direction from Production Superintendent/General Manager
High level of machine and mechanical knowledge
Read and understand instructions and job information
Excellent math and writing abilities
Desire to accept additional responsibility and learn new tasks
LANGUAGE SKILLS
Fluent in English required
Fluency in Spanish a plus
PHYSICAL DEMANDS
Continuous standing and walking with minimal sitting.
Able to bend, twist, kneel, crawl, and lay down on floor during cleanup/startup of machine - involves frequent, constant, continuous, and repetitious motions
Frequent lifting overhead & carrying of cases that can weigh in excess of 35-lbs
Frequent, regular pushing and pulling of paper rolls in excess of 1,500-lbs
Frequent ladder and stair climbing
WORK ENVIRONMENT
Standard production/manufacturing environment; Plants can be hot noisy, exhibit vibrations have, uneven surfaces mechanical hazards, dust/dirt, odor/fumes; work performed inside.
OTHER INFORMATION
Personal Protective Equipment required for the job: Steel toe shoes, hearing protection, safety glasses, hair nets
Steel toe shoes are provided by employee, all other tools provided by employer
If you would like to be part of a forward-thinking team with a family feel, culture of excellence, and customer-focused reliability, we want you to be a part of our team!
Our organization is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
$29k-37k yearly est. 16d ago
Claims Processor I
MUSC (Med. Univ of South Carolina
Claims representative job in Charleston, SC
Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper claims for submittal. Resolves denied/unpaid insurance claims in a timely manner. Entity University Medical Associates (UMA) Only Employees and Financials
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC002058 UMA CORP RC PPA Physician Patient Accounting CC
Pay Rate Type
Hourly
Pay Grade
Health-20
Scheduled Weekly Hours
40
Work Shift
* Account maintenance: Updating registration, authorization issues, identifying charge correction, , processing adjustments as needed and denial follow up according to payer rules and departmental policies.
* Use electronic billing system appropriately to follow up on outstanding denied claims and all no response claims. Corrects claims in electronic billing system for missing or invalid insurance or patient information according to procedures, and places account on hold if you can't resolve
* Follow up on denied or no response claims by calling third party payers or using payer websites. Gathering information from patients or other areas to resolve outstanding denied or no response claims. Researching accounts to take appropriate action necessary to resolve.
* Keep management aware of issues and trends to enhance operations and escalates slow-pay issues to managerial level when necessary.
* Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
* Maintains 95% quality standards on account follow and activity.
* Maintains productivity standard as set forth by management team.
* Other duties as assigned.
Additional Job Description
Education: High School Degree or Equivalent Work Experience: 0-6months
If you like working with energetic enthusiastic individuals, you will enjoy your career with us!
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.
Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: ***************************************
$24k-38k yearly est. 60d+ ago
Associate VB Claims Specialist
Unum Group 4.4
Claims representative job in Columbia, SC
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
$40k-75.6k yearly 13d ago
Associate Liability Claims Adjuster
Canal Insurance Company
Claims representative job in Greenville, SC
About Canal Insurance
Canal Insurance Company specializes in insurance for commercial trucking and specialty transportation operations. Canal was founded in 1939 and is located in Greenville, South Carolina. At Canal, we recognize that our success would not be possible without the hard work and dedication of our employees. We know that happiness and productivity go hand in hand, and to that end, we consciously cultivate a culture that enables us to recruit and retain the very best talent in the business.
Associate Liability Claims Adjuster:
The Associate Liability Claims Adjuster position is responsible for the analysis and adjustment of minor commercial claims as assigned.
Major Accountabilities:
Verify coverage as new losses are received.
Adjust claims on an inside basis including investigating, evaluating, negotiating, documenting, and validating through settlement of the claim.
Communicate with interested parties (i.e. insured, claimants, agents, attorneys, repair shops, lien holders) as appropriate.
Monitor, with management consent, approved independent adjusters and attorneys in the field.
Establish and maintain reserves and communicate with management, when appropriate.
Perform other duties as assigned by management.
Qualifications
Education/Training Requirements: Bachelor's degree or 3 years of claims handling experience required. Adjuster's license required or the ability to obtain an adjuster's license within 30 days of hire.
Experience/Specialized Skills: Minimum of two years insurance industry experience required. Familiarity with basic insurance and tort law, understanding of basic legal principles and terminology as it relates to insurance operations and knowledge of basic medical terminology and procedures preferred. Intermediate computer skills (word processing, spreadsheets, databases, Internet, e-mail) required.
Special Considerations
Physical Requirements: Constant use of vision, hearing, and communication (oral and written in person and via telephone). Frequent concentration, standing, walking, handling, reaching, and grasping. Occasional bending, kneeling and lifting (up to 25 lbs.). Heavy use of computer and office equipment.
Additional Requirements: Occasional travel may be required. Periodic work outside of standard business hours or on weekends may be required.
$40k-50k yearly est. 1d ago
Independent Insurance Claims Adjuster in Greenville, South Carolina
Milehigh Adjusters Houston
Claims representative job in Greenville, SC
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.
$40k-50k yearly est. Auto-Apply 60d+ ago
Claims Mitigation & Management Specialist
The Nuclear Company
Claims representative job in Columbia, SC
The Nuclear Company is the fastest growing startup in the nuclear and energy space creating a never before seen fleet-scale approach to building nuclear reactors. Through its design-once, build-many approach and coalition building across communities, regulators, and financial stakeholders, The Nuclear Company is committed to delivering safe and reliable electricity at the lowest cost, while catalyzing the nuclear industry toward rapid development in America and globally.
About the role
The Nuclear Company is looking for an experienced Claims Mitigation & Management Specialist to support the deployment of major nuclear reactor projects. This role will focus on contract formation, administration, and proactive claims prevention. You will work closely with project teams, contract managers, and leadership to identify and address potential risks, respond to claims, and ensure contractual compliance across complex, utility-scale nuclear energy projects.
Responsibilities
Proactively identify potential claims and disputes on projects.
Develop and implement strategies for early claims identification and mitigation.
Provide guidance to project teams on contract administration and documentation.
Conduct detailed forensic analysis of project documentation for claims assessment.
Quantify cost and schedule impacts of potential claims, including delay and disruption.
Prepare comprehensive claims position papers and reports.
Support the negotiation process for claims and disputes.
Assist in preparing for and participating in dispute resolution forums (e.g., mediation, arbitration).
Develop and maintain a robust claims log, tracking all active and potential claims.
Ensure all claims-related documentation is meticulously organized.
Prepare regular reports on claims status, liabilities, and resolution progress.
Work closely with Project Controls, Contracts, and Legal teams on claims management.
Participate in project reviews to provide insights on claims trends.
Experience
Bachelor's degree in Engineering, Construction Management, Quantity Surveying, Law, or a related field.
8+ years of progressive experience in claims management, dispute resolution, or contract administration.
3+ years of focused claims management experience.
Experience on energy mega-projects (utility-scale, high capital, high complexity).
Experience on nuclear energy projects is highly valued.
Demonstrated expertise in contract formation, negotiation, and administration.
Exceptional analytical, critical thinking, and problem-solving skills.
Excellent written and verbal communication and negotiation skills.
Proficiency in project management software, scheduling tools, and advanced Excel.
Ability to work effectively under pressure and manage multiple priorities.
Knowledge of construction law and dispute resolution processes.
Benefits
Competitive compensation packages
401k with company match
Medical, dental, vision plans
Generous vacation policy, plus holidays
Estimated Starting Salary Range
The estimated starting salary range for this role is $121,000 - $143,000 annually less applicable withholdings and deductions, paid on a bi-weekly basis. The actual salary offered may vary based on relevant factors as determined in the Company's discretion, which may include experience, qualifications, tenure, skill set, availability of qualified candidates, geographic location, certifications held, and other criteria deemed pertinent to the particular role.
EEO Statement
The Nuclear Company is an equal opportunity employer committed to fostering an environment of inclusion in the workplace. We provide equal employment opportunities to all qualified applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic. We prohibit discrimination in all aspects of employment, including hiring, promotion, demotion, transfer, compensation, and termination.
Export Control
Certain positions at The Nuclear Company may involve access to information and technology subject to export controls under U.S. law. Compliance with these export controls may result in The Nuclear Company limiting its consideration of certain applicants.
How much does a claims representative earn in Mount Pleasant, SC?
The average claims representative in Mount Pleasant, SC earns between $24,000 and $46,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.
Average claims representative salary in Mount Pleasant, SC