Casualty Claims Adjuster
Claims representative job in Hingham, MA
Responsibilities:
Conduct in-depth investigations into complex bodily injury claims, determining coverage, establishing liability, and evaluating damages by analyzing medical records, police reports, and witness statements.
Develop and execute effective negotiation strategies to achieve fair and timely settlements with claimants, attorneys, and other parties.
Manage litigated files, including developing defense strategies, communicating with legal counsel, and attending mediations, arbitrations, and trials as necessary.
Maintain meticulous and accurate claim file documentation in compliance with company standards and regulatory requirements.
Provide exceptional customer service, guiding insureds and claimants through complex claim processes with professionalism and empathy.
Candidate & SkillsTop 3-5 Skills:
5 + years of direct experience handling casualty claims, with a strong focus on bodily injury (BI) claims across various lines (Auto, Homeowners, Commercial).
Proven ability to investigate, analyze, and evaluate complex BI claims, including understanding medical terminology and injury causation.
Solid understanding of insurance policies, relevant state laws, and the litigation process.
Strong negotiation and conflict resolution skills, with a track record of successful settlements.
Takes ownership of files, even when litigation is involved.
Soft Skills:
Exceptional communication (verbal and written), interpersonal, and customer service skills.
Ability to work independently, manage a challenging caseload, and make sound judgments.
Strong analytical, problem-solving, and decision-making abilities.
Meticulous attention to detail and excellent organizational skills.
An eagerness to learn, adapt, and embrace new technologies
Ability to work effectively both independently and as part of a supportive team.
Certifications/Licenses/Education:
Active Adjuster License in CT, MA, RI - willing to get additional licenses as needed (company to assist)
A bachelor's degree is preferred, or equivalent work experience.
Senior Claims Adjuster
Claims representative job in Boston, MA
Commercial General Liability Sr. Adjuster - (CGL) Litigation Specialist.
This is a full time, exempt role
Remote - 100%
Pay Rate: 80-90K
Overview/Summary:
This position requires daily telephone contacts with the commercial line policyholders, risk managers, and agents. Fully responsible for the analysis, investigation, evaluation, negotiation and resolution of complex commercial claims requiring thorough investigations including telephone contacts with the involved parties; technical expertise and complex analysis. Claim assignments are multi-state and involve commercial customers.
Responsibilities/Essential Functions:
• Must have or secure and maintain appropriate state adjuster license(s) and continuing education
credits.
• Handle complex commercial liability claims.
• Works within significant limits and authority on assignments of higher technical complexity and
coordination.
• Uses discretion and independent judgment in claim handling
• Identifies possibly suspicious claims
• Possesses demonstrated technical knowledge and skills, including product and industry.
• Claims handled will be of greater complexity and will require a higher level of investigation,
analysis, evaluation and negotiation including interpretation of commercial coverages.
• Claims handled will involve moderate complexity, severity and exposures
• Authority levels are higher in recognition of the higher proficiency associated with this level.
• May be responsible for all aspects of each claim, including informal hearings, arbitrations and small
claims litigation and maintaining a high level of productivity, confidentiality and customer service.
• They may be used as a technical resource by adjusters may represent the company at mediation,
arbitration and trials.
• May provide training and mentoring to adjusters.
• Assignments are broad in nature, usually requiring originality and ingenuity.
• Review and analyze contracts, leases, and identify risk transfer opportunities
• Demonstrate ability to write positional coverage letters.
Required Skills, Key Competencies and Experience:
• Typically has 4 to 10 years Commercial General Liability experience
• Bachelor's Degree or equivalent experience, industry designation preferred.
• Dedicated to meeting the expectations and requirements of internal and external customers
• Makes decisions in an informed, confident and timely manner
• Maintains constructive working relationships despite differing perspectives
• Considers the perspectives of others and gives them credibility
• Strong organizational and time management skills
• Ability to negotiate skillfully in difficult situations with both internal and external groups
Demonstrates ability to win concessions without damaging relationships.
• Demonstrates strong written and verbal communication skills. Promotes and facilitates free and
open communication.
• Understanding of applicable statutes, regulations and case law
• Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a
timely manner.
• Easily adapts to new or different changing situations, requirements or priorities.
• Cultivates an environment of teamwork and collaboration
• Operates with latitude for un-reviewed action or decision.
• Computer experience (MS Office, excel, word, etc.)
• Proficient using Claims systems (i.e. CSS, PMS, CMX, etc.)
• Ability to work in a paperless environment
Physical Demands and Work Environment:
• Ability to use a personal computer and other standard office equipment
• Ability to travel as necessary
• Ability to sit and/or stand for extended periods
Benefits include:
Medical, dental, vision, life, and disability insurance
401K with a company match
Tuition reimbursement
PTO
Company paid holidays
Flexible work arrangements
Cultural Awareness Day in support of IDE
On-site medical/wellness center (Worcester only)
Claims Senior Auto Adjuster
Claims representative job in Providence, RI
The Claims Senior Auto Adjuster supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include liability investigation, coverage evaluation, claims resolution and negotiation strategies of moderate complexity claims in compliance with established company technical and customer service best Practices. Under limited supervision, works within specific limits and authority to resolve claims with well-defined procedures.
Job Duties
Communicate and interact with a variety of individuals including insureds and claimants. Verify and explain benefits, coverages, fault, and claims process either verbally or in writing which complies with regulatory and statutory requirements. Recognize and appropriately address moderate-complexity coverage issues.
Identify and obtain statements from insureds, claimants and witnesses. Conduct investigations to determine liability and damages and differentiate between allegations and facts.
Evaluate and negotiate within settlement authority with insureds and claimants to resolve first and third-party claims in multiple markets. Demonstrate proficiency with estimates, property, material damage, liability, total loss evaluations, analysis of claims, claims technology, and tool usage.
Coordinate with internal and external departments as required.
Respond quickly to customer needs and inquiries.
Overtime and holiday hours may be required
Qualifications
Bachelors Equivalent combination of education and experience Preferred
1-3 years Claims handling experience. Required
Working knowledge of claims administration best practices and procedures.
Understanding of vehicle repair processes and procedures
Knowledge of fault assessment, negligence and subrogation principles required.
Knowledge of Microsoft Office suite, general computer software and claims software.
Organization and planning recognition skills required.
Oral and written communication skills required.
Interpersonal skills required.
Property and Casualty Insurance License, valid in selling state - Issued by State Preferred
May be required to obtain an Adjuster license as applicable in accordance with state law. within 60 Days Preferred
Travel Requirements
Occasional travel to off-site business meetings or conferences. (5% proficiency)
The starting pay range for this position is $68,640 - $77,900 annually. Additionally, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.
Remarkable benefits:
• Health coverage for medical, dental, vision
• 401(K) saving plan with company match AND Pension
• Tuition assistance
• PTO for community volunteer programs
• Wellness program
• Employee discounts (membership, insurance, travel, entertainment, services and more!)
Auto Club Enterprises is the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity - we win. All of Us! With our national brand recognition, long-standing reputation since 1902, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value.”
AAA is an Equal Opportunity Employer
Auto Physical Damage Claim Representative
Claims representative job in West Bridgewater, MA
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$55,200.00 - $91,100.00
**Target Openings**
4
**What Is the Opportunity?**
This position is responsible for handling low to moderate Personal and Business Insurance Auto Damage claims from the first notice of loss through resolution/settlement and payment process. This may include applying laws and statutes for multiple state jurisdictions. Claim types include multi-vehicle (2 or more cars) auto damage with unclear liability and no injuries. Will also handle more complex Auto Damage claims such as non-owned vehicles, fire/theft, and potential fraud as well as non-auto, property related damage. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.
**What Will You Do?**
+ Customer Contacts/Experience:
+ Delivers consistent service quality throughout the claim life cycle, including but not limited to prompt contact, explaining the process, setting expectations, on-going communication, follows-through and meeting commitments to achieve optimal outcome on every file. Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC).
+ Coverage Analysis:
+ Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements for Auto Damage only claims in assigned jurisdictions. Addresses proper application of any deductibles and verifies benefits available and coverage limits that will apply. Confirms priority of coverage (i.e. primary, secondary, concurrent) and takes into consideration other issues relevant to the jurisdiction.
+ Investigation/Evaluation:
+ Investigates each claim to obtain relevant facts necessary to determine coverage, causation, extent of liability/establishment of negligence, damages, contribution potential and exposure with respect to the various coverages provided through prompt contact with appropriate parties (e.g.. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, etc.) Takes recorded statements as necessary.
+ Recognizes and requests appropriate inspection type based on the details of the loss and coordinates the appraisal process. Maintains oversight of the repair process and ensures appropriate expense handling.
+ Refers claims beyond authority as appropriate based on exposure and established guidelines. Recognizes and forwards appropriate files to subject matter experts (i.e., Subrogation, SIU, Property, Adverse Subrogation, etc.).
+ Reserving:
+ Establishes timely and maintains appropriate claim and expense reserves. Manages file inventory and expense reserves by utilizing an effective diary system, documenting claim file activities to resolve claim in a timely manner.
+ Negotiation/Resolution:
+ Determines settlement amounts based upon appraisal estimate, negotiates and conveys claim settlements within authority limits to insureds and claimants. As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to insureds and claimants.
+ May provide support to other parts of Auto Line of Business (e.g. Total Loss, Salvage, etc.) when needed.
+ Insurance License:
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor's degree preferred.
+ Demonstrated ownership attitude and customer centric response to all assigned tasks
+ Ability to work in a high volume, fast paced environment managing multiple priorities
+ Attention to detail ensuring accuracy
+ Keyboard skills and Windows proficiency, including Excel and Word - Intermediate
+ Verbal and written communication skills - Intermediate
+ Analytical Thinking- Intermediate
+ Judgment/Decision Making- Intermediate
+ Negotiation- Intermediate
+ Insurance Contract Knowledge-
+ Basic
+ Principles of Investigation- Intermediate
+ Value Determination- Basic
+ Settlement Techniques- Basic
**What is a Must Have?**
+ High School Diploma or GED required.
+ A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Claims Representative - Total Loss Adjuster
Claims representative job in Boston, MA
The Total Loss Unit within our Claims Organization is responsible for identifying, negotiating and settling total losses with both insureds and claimants. The Total Loss Claim Representative processes payments and is responsible for the documentation of assigned claims as well as coordinate disposition of the total loss salvage vehicle. He/she is responsible for controlling total loss expenses and salvage recoveries on all total losses assigned.
Responsibilities:
* Negotiates and communicates all total loss and diminished value settlements per company and state guidelines. Multi jurisdictions, including MA, NH, CT, NY, and others as required
* Understands the total loss evaluation methodology processes with the ability to effectively communicate these to vehicle owners.
* Has a basic understanding of vehicle financing / leasing.
* Reviews damage estimates to confirm vehicles are total losses.
* Documents all settlements and actions in the claim file system.
* Works directly with salvage vendor to move vehicles and obtains salvage bids where necessary
* Negotiates and settles claims within his/her individual authority. Submits claims for approval to supervisor when over his/her authority or for guidance, review and/or referral when appropriate.
* Escalates claims to supervisor that are not moving in a positive direction.
* Maintains an effective diary system on pending files. Prioritize and handle multiple tasks simultaneously.
* Quickly adjusts to fluctuating workload and responsibilities.
* Keeps involved parties and agents updated on the status of the claim and emerging issues.
* Ensures that service, loss and expense control are maintained at all times.
* Adheres to privacy guidelines, law and regulations pertaining to claims handling.
* Prepares payments to vehicle owners, banks and lease companies.
* This role will report in person to our Boston office, located directly across from South Station.
Qualifications:
* Property and casualty claims handling experience desired
* Ability to work independently and in a team environment
* Excellent oral and written communication skills
* Excellent organizational skills
* Solid problem solving skills
* Proficient in Word, Excel, MS Outlook
Salary Range:
The pay range for this position is $50,000 to $73,500 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
Benefits & Perks:
* Paid time off
* Free onsite gym at our Boston location
* Tuition reimbursement
* Low cost and excellent health insurance coverage options that start on Day 1 (medical, dental, vision)
* Robust health and wellness programs
* Auto and home insurance discounts
* Matching donation opportunities
* Annual 401(k) employer contribution
* Various Paid Family leave options including Paid Parental Leave
* Resources to promote professional development
* Convenient locations and pre-tax commuter benefits
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of "A-/Excellent".
#LI-DNI
Auto-ApplyGeneral Liability Claims Adjuster II
Claims representative job in Quincy, MA
Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.
Position Summary
Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners.
Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days.
Applicants must be currently authorized to work in the United States on a full-time basis.
Principle Duties and Responsibilities:
Claims Management
* Manage caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations.
* Monitor and ensure timely execution of all statutory deadlines or legal filings as needed.
* Analyze facts of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines.
* Identify fraud indicators and actively pursue subrogation opportunities.
* Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks.
* Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers.
Financial Impact Administration
* Manage book of claims business (up to $ 2million) with authority to settle/negotiate a single claim within their authority of up to $25,000.
* Communicate ongoing causes of incidents to Safety and Brands.
* Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications.
Basic Qualifications:
* Licensed adjuster (as appropriate by jurisdiction)
* Bachelor's degree or experience handling General Liability claims or equivalent expertise.
* Thorough knowledge of rules, regulations, statutes, and procedures pertaining to general liability claims.
* Knowledge of medical terminology involved in complex claims
* Negotiates resolution of claims of various exposure and complexity
Skills and Abilities:
* Demonstrates relationship building and communication skills, both written and verbal.
* Highly self-motivated, goal oriented, and works well under pressure.
* Customer focused solid understanding of legal procedures, processes, practices and standards in the handling of general liability claims
* Ability to identify problems and effectuate solutions
* Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail
* Able to apply critical thinking when solving problems and making decisions.
ME/NC/PA/SC Salary Range: $63,440-$95,160
IL/MA/MD/NY Salary Range: $72,880 - $109,320
Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws.
#LI-SM1 #LI-Hybrid
At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent.
Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies.
Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work.
We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.
Field Claims Representative - Massachusetts
Claims representative job in Westborough, MA
Our role as a Senior Field Claims Representative will be responsible for the investigation, evaluation and settlement of assigned claims involving 1st Party Homeowner and Commercial Property claims. This role is a field-based position and will require travel to loss sites to evaluate the damages. This also includes special investigation activities with an emphasis on investigating possible fraudulent activity.
This is a field based position, travel will be required within Central/Eastern Massachusetts, with occasional travel to other areas as required.
Responsibilities
Field appraise losses of all types for both personal lines and commercial lines claims
Take loss reports directly from insureds and/or claimants and/or their representatives.
Appropriately handle incoming correspondence on assigned claim files.
Investigate assigned claims - confirm coverage - verify damages.
Effectively handle portions of claim investigations principally through on-site investigations, as warranted.
Evaluate and settle assigned claims based upon the results of the investigation.
A strong ability to work independently.
Other related duties as assigned by supervisor including but not limited to aiding during CATs or other unusual spikes in claim volume.
Requirements
Bachelor's degree preferred or several years of direct experience
5-7 years of experience handling Property Claims; Commercial Lines experience a plus.
Strong understanding of personal and commercial lines policy forms and coverage analysis.
Multi-line adjuster's license as required in our operating territories.
Demonstrated proficiency in writing detailed structural cost of repair/replacement estimates in Xactimate estimating system and proficient in PC Windows environment.
Demonstrated proficiency in investigating, evaluating and settling contents claims.
Excellent understanding and skill level of claim handling and customer service.
Possess or has ability to timely secure and maintain required multiline adjuster licenses. Knowledge of policy contracts, insurance laws, regulations, and the legal environment in which we operate.
Outside/Field Adjusters - ability to view damages and prepare estimates based on their inspection of the damaged property.
Benefits
At The Concord Group, we're proud to offer a comprehensive benefits package designed to support the wellbeing of our associates. This includes medical, vision, dental, life insurance, disability insurance, and a generous paid time off program for vacation, personal, sick time, and holiday pay. Additional benefits include parental leave, adoption assistance, fertility treatment assistance, a competitive 401(k) plan with company match, gym member/fitness class reimbursement, and additional resources and programs that encourage professional growth and overall wellness.
Why Concord Group Insurance
Since 1928, The Concord Group has been protecting families and small businesses across New England with trusted, personal insurance solutions. The Concord Group is a member of The Auto Owners Group of Companies and is recognized as a leading insurance provider through the independent agency system. Rated A+ (Superior) by AM Best, the company is represented by more than 550 of the best local independent agents throughout Maine, Massachusetts, New Hampshire, and Vermont.
At Concord Group, we believe in more than just insurance, we believe in our people. Our associates thrive in a supportive, collaborative workplace where community involvement, professional growth, and shared values drives everything we do.
Starting your career with The Concord Group means joining a team that values people first and gives you the opportunity to grow, give back, and make a lasting difference in the lives of those we serve.
Compensation
We are dedicated to fair and competitive total compensation package that supports the wellbeing and success of our associates. In addition to this, we offer other components like bonus opportunities. For this position, the anticipated annualized starting base pay range is: $60,000 - $80,000.
Equal Employment Opportunity
The Concord Group is an equal opportunity employer and hires, transfers, and promotes based on ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state, or local law.
The Concord Group participates in E-Verify
Auto-ApplySr. Claims Examiner, Excess Casualty
Claims representative job in Boston, MA
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.
Position Summary
Arch Insurance Group Inc., AIGI, has an opening with the Claims Division on the Excess Casualty Team as a Sr. Claims Examiner. In this role, the responsibilities include actively managing commercial claims for primary and supported Excess Casualty high severity, complex general liability, and auto accounts and providing oversight to underlying carrier(s) claims handlers for coverage, liability, and damages in jurisdictions throughout the United States.
Responsibilities
* Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis
* Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
* Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures
* Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary
* Investigate claims and review the insureds' materials, pleadings, and other relevant documents
* Identify and review each jurisdiction's applicable statutes, rules, and case law
* Review litigation materials including depositions and expert's reports
* Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
* Retain counsel when necessary and direct counsel in accordance with resolution strategy
* Analyze coverage, liability and damages for purposes of assessing and recommending reserves
* Process large amounts of complex information, distill it down to key issues and decision points and concisely communicate the information verbally and in writing.
* Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves
* Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter
* Negotiate resolution of claims
* Select and utilize structure brokers
* Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims
Experience & Required Skills
* Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
* Strong time management and organizational skills
* Demonstrated ability to take part in active strategic discussions
* Demonstrated ability to work well independently and in a team environment
* Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
* Willing and able to travel 10%
Education
* Juris Doctorate degree preferred
* Bachelor's degree required
* Seven to ten (7-10) years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims; with Casualty and Construction a plus
* Proper & active adjuster licensing in all applicable states
#LI-SW1
#LI-HYBRID
For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$107,900- $160,000/year
* Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
* Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
For Colorado Applicants - The deadline to submit your application is:
March 08, 2026
14400 Arch Insurance Group Inc.
Auto-ApplyAssociate Claims Specialist
Claims representative job in Boston, MA
Under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Assists in providing service to policyholders/customers on mid-sized and/or large commercial accounts.
This is a hybrid position. You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Westborough, MA; Boston, MA; Suwanee, GA; Hoffman Estates, IL; Plano, TX. Please note this is subject to change.
Responsibilities:
* Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly.
* Establishes action plans based on case facts, best practices, protocols, jurisdictional issues and available resources.
* Manages an inventory of property/casualty and disability claims (e.g. workers` compensation, general liability, commercial automobile, property, group benefits), evaluates compensability/liability and losses, and negotiates settlements within prescribed limits.
* Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols.
* Confirms or denies coverage based on facts obtained during the investigation and advises policyholders as to proper course of action.
* Makes effective use of loss management techniques (e.g. Immediate Contact Plan, L9 check, Disability Management, open end release, first call settlements) and other resources.
* Updates files and provides comprehensive reports as required.
* Work on resolution in early life of a claim to avoid attorney representation.
* High volume of incoming claims.
* Time management skills are in need.
Qualifications
* Effective interpersonal, analytical and negotiation abilities required
* Ability to provide information in a clear, concise manner with an appropriate level of detail
* Demonstrated ability to build and maintain effective relationships
* Demonstrated success in a professional environment; success in a customer service/retail environment preferred
* Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent
* Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory
* Licensing may be required in some states
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in
every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive
benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
Auto-ApplyClaims Representative I
Claims representative job in Woburn, MA
Location: Virtual in Woburn, MA or Manchester, NH. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual/ work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law
Hours: Monday - Friday, 8:30 am - 5:00 pm EST
The Claim Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.
How you will make an impact:
Learning the activities/tasks associated with his/her role.
Works under direct supervision.
Relies on others for instruction, guidance, and direction.
Work is reviewed for technical accuracy and soundness.
Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made.
Researches and analyzes claims issues.
Minimum Requirements:
Requires HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
Good oral and written communication skills, previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly preferred.
Previous experience working in health claims (CAS or ConnectsNX) is strongly preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $16.67 to $25.00
Locations: Massachusetts
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
*The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Job Level:
Non-Management Non-Exempt
Workshift:
1st Shift (United States of America)
Job Family:
CLM > Claims Reps
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyClaims Representative I
Claims representative job in Woburn, MA
**Location:** Virtual in Woburn, MA or Manchester, NH. This role enables associates to work virtually full-time, **with the exception of required in-person training sessions** , providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
_Please note that per our policy on hybrid/virtual/ work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law_
**Hours:** Monday - Friday, 8:30 am - 5:00 pm EST
The **Claim Representative I** is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.
**How you will make an impact:**
+ Learning the activities/tasks associated with his/her role.
+ Works under direct supervision.
+ Relies on others for instruction, guidance, and direction.
+ Work is reviewed for technical accuracy and soundness.
+ Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made.
+ Researches and analyzes claims issues.
**Minimum Requirements:**
+ Requires HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background.
**Preferred Skills, Capabilities, and Experiences:**
+ Good oral and written communication skills, previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly preferred.
+ Previous experience working in health claims (CAS or ConnectsNX) is strongly preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $16.67 to $25.00
**Locations** : Massachusetts
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
*The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Stop Loss & Health Claim Analyst
Claims representative job in Wellesley, MA
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.
Job Description:
The Opportunity:
This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim.
The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources.
How you will contribute:
* Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim
* The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions
* Maintain claim block and meet departmental production and quality metrics
* An awareness of industry claim practices
* Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records
* Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc.
* Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process
* Establish cooperative and productive relationships with professional resources
What you will bring with you:
* Bachelor's degree preferred
* A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing
* Demonstrated ability to work as part of a cohesive team
* Strong written and verbal communication skills
* Knowledge of Stop Loss Claims and Stop Loss industry preferred
* Demonstrated success in negotiation, persuasion, and solutions-based underwriting
* Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism
* Overall knowledge of health care industry
* Proficiency using the Microsoft Office suite of products
* Ability to travel
Salary Range: $54,900 - $82,400
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Job Category:
Claims - Life & Disability
Posting End Date:
30/01/2026
Auto-ApplyExperienced Multi-Line Adjuster
Claims representative job in Boston, MA
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
Multi-Line Property Damage Adjuster -In Massachusetts and surrounding area
Salary: Starting pay rate varies based upon position and location. Ask your Recruiter for details!
We are looking for a highly motivated and service-oriented individual to join our Multi-line Damage team as a Multi-line Property Damage Adjuster! As an ambassador for GEICO's renowned customer service, you will work in a dynamic environment that may include repair shops, salvage yards, a customer's home or in a virtual estimating environment. You will be responsible for inspecting damage, estimating cost of repairs, negotiating settlements, issuing payments, and providing excellent customer service. This position primarily will include servicing boat, motorcycle, RV and other specialty claims.
Qualifications & Skills:
Valid driver's license (must meet company underwriting guidelines for at least the past 3 consecutive years) and the ability to maintain applicable state and federal certifications and permits
Willingness to be flexible with primary work location - position may require either remote or in-office work
Solid computer, mechanical aptitude, and multi-tasking skills
Effective attention to detail and decision-making skills
Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities
Minimum of high school diploma or equivalent, college degree or currently pursuing preferred
Annual Salary
$36.63 - $57.49
The above annual salary range is a general guideline. Multiple factors are taken into consideration to arrive at the final hourly rate/ annual salary to be offered to the selected candidate. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations.
At this time, GEICO will not sponsor a new applicant for employment authorization for this position.
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs.
We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being.
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
Auto-ApplyPublic Adjuster
Claims representative job in Boston, MA
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!
Property Adjuster Specialist - Field
Claims representative job in Providence, RI
**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 Rhode Island and surrounding areas. 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 Rhode Island or surrounding 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: $76,400 - $137,520.
**USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).**
**Compensation:** USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
**Benefits:** At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
_Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting._
_USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran._
**If you are an existing USAA employee, please use the internal career site in OneSource to apply.**
**Please do not type your first and last name in all caps.**
**_Find your purpose. Join our mission._**
USAA is unlike any other financial services organization. The mission of the association is to facilitate the financial security of its members, associates and their families through provision of a full range of highly competitive financial products and services; in so doing, USAA seeks to be the provider of choice for the military community. We do this by upholding the highest standards and ensuring that our corporate business activities and individual employee conduct reflect good judgment and common sense, and are consistent with our core values of service, loyalty, honesty and integrity.
USAA attributes its long-standing success to its most valuable resource: our 35,000 employees. They are the heart and soul of our member-service culture. When you join us, you'll become part of a thriving community committed to going above for those who have gone beyond: the men and women of the U.S. military, their associates and their families. In order to play a role on our team, you don't have to be connected to the military yourself - you just need to share our passion for serving our more than 13 million members.
USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.
California applicants, please review our HR CCPA - Notice at Collection (********************************************************************************************************** here.
USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.
Independent Insurance Claims Adjuster in Boston, Massachusetts
Claims representative job in Boston, MA
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.
Auto-ApplyField Claims Adjuster
Claims representative job in Boston, MA
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.
Workers Compensation Claims Specialist, East
Claims representative job in Boston, MA
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
JOB DESCRIPTION:
Essential Duties & Responsibilities:
Performs a combination of duties in accordance with departmental guidelines:
* Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
* Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
* Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols.
* Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
* Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
* Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
* Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
* Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
* Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
* Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
* May serve as a mentor/coach to less experienced claim professionals
May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
* Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
* Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
* Demonstrated ability to develop collaborative business relationships with internal and external work partners.
* Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
* Demonstrated investigative experience with an analytical mindset and critical thinking skills.
* Strong work ethic, with demonstrated time management and organizational skills.
* Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
* Developing ability to negotiate low to moderately complex settlements.
* Adaptable to a changing environment.
* Knowledge of Microsoft Office Suite and ability to learn business-related software.
* Demonstrated ability to value diverse opinions and ideas
Education & Experience:
* Bachelor's Degree or equivalent experience.
* Typically a minimum four years of relevant experience, preferably in claim handling.
* Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
* Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
* Professional designations are a plus (e.g. CPCU)
#LI-AR1
#Li-Hybrid
In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
Auto-ApplyMedicare/Medicaid Claims Editing Specialist
Claims representative job in Boston, MA
011250 CCA-Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this time._** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration requirements for Optum CES and Zelis edits. This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for timely review and research, as necessary on all new and revised coding logic, related Medicare/Medicaid policies for review/approval through the Payment Integrity governance process.
**Supervision Exercised:**
+ No, this position does not have direct reports.
**Essential Duties & Responsibilities:**
+ Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary coding configuration requirements for Optum CES and Zelis edits.
+ Quarterly and Annual review and research, as necessary on all new CPT and HCPCS codes for coding logic, related Medicare/Medicaid policies to make recommend reimbursement determinations.
+ Analyze, measure, manage, and report outcome results on edits implemented.
+ Utilize data to examine large claims data sets to provide analysis and reports on existing provider billing patterns as compared to industry standard coding regulations, and make recommendations based on new/revised coding edits for presentation to Payment Integrity committee meetings.
+ Analyze, measure, manage, and report outcome results on edits implemented.
+ Use and maintain the rules and policies specific to CES and Zelis.
+ Query and analyze claims to address any negative editing impacts and create new opportunities for savings based on provider billing trends
+ Liaison between business partners and vendors; bringing and interpreting business requests, providing solutioning options and documentation, developing new policies based on State and Federal requirements, host meetings, and managing projects to completion
+ Define business requests received, narrow the scope of the request based on business needs and requirements, provider resolution option based on financial ability and forecasting for small to large Operations Management
+ Collaborate system and data configuration into CES (Claims Editing System) with BPaaS vendor and other PI partners, perform user acceptance testing, and analyze post production reports for issues
+ Support collaboration between PI/Claims and other internal stakeholders related to the identification and implementation of cost-savings initiatives specific to edits.
**Working Conditions:**
+ Standard office conditions. Remote opportunity.
**Other:**
+ Standard office equipment
+ None/stationary
**Required Education (must have):**
+ Bachelor's Degree or Equivalent experience
Ideal Candidate to have the one or all of the required certification OR willing to get certified within 1 year of employment -
+ Certified Professional Coder (CPC)
+ Certified Inpatient Coder (CIC)
+ Certified Professional Medical Auditor (CPMA)
**Desired Education (nice to have):**
+ Masters Degree
**Required Experience (must have):**
+ 7+ years of Healthcare experience, specific to Medicare and Medicaid
+ 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims, settlement, claims auditing and/or utilization review required
+ 7+ years experience with Optum Claims Editing System (CES), Zelis, Lyric or other editing tools
+ Extensive knowledge and experience in Healthcare Revenue Integrity, Payment Integrity, and Analytics
+ 5+ years of Facets Claims Processing System
**Required Knowledge, Skills & Abilities (must have):**
+ Knowledge and experience of claim operations, health care reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare)
+ Medical Coding, Compliance, Payment Integrity and Analytics
+ Direct and relevant experience with HCFA/UB-04 claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies (i.e . Center for Medicare & Medicaid Services (CMS) & MA Medicaid, Correct Coding Initiative (CCI), Medically Unlikely Edits (MUEs) both practitioner and facility, modifier to procedure validation, and other CMS and American Medical Association (AMA) guidelines, etc.)
+ Advanced experience of medical terminology and medical coding (CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims' processing policies, coding principals and payment methodologies
+ Ability to work cross functionally to set priorities, build partnerships, meet internal customer needs, and obtain support for department initiatives
+ Ability to plan, organize, and manage own work; set priorities and measure performance against established benchmarks
+ Ability to communicate and work effectively at multiple levels within the company
+ Customer service orientation; positive outlook, self-motivated and able to motivate others
+ Strong work ethic; able to solve problems and overcome challenges
**Required Language (must have):**
+ English
**Compensation Range/Target: $64,000 - $96,000**
Commonwealth Care Alliance takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Claims Analyst
Claims representative job in Chelmsford, MA
Van Pool Transportation LLCHeadquartered in Massachusetts, Beacon Mobility is a growing family of companies committed to serving the diverse needs of our customers. Experienced, compassionate, and inspired, we take pride in our ability to create customized, mobility-based solutions that empower people to get where they need to go. Our purpose is simple - MOBILITY WITHOUT LIMITS: Transporting people to live, learn, and achieve. We provide those we serve with the opportunities, resources, and support to confidently move ahead.
Description
Headquartered in Massachusetts, Beacon Mobility is a growing family of companies committed to serving the diverse needs of our customers. Experienced, compassionate, and inspired, we take pride in our ability to create customized, mobility-based solutions that empower people to get where they need to go. Our purpose is simple - MOBILITY WITHOUT LIMITS: Transporting people to live, learn, and achieve. We provide those we serve with the opportunities, resources, and support to confidently move ahead.
We support safe, compassionate, and inclusive environments that provide our communities with the mobility solutions they need to flourish and succeed. Providing support to 13,000 employees through more than 500 contracts, we collectively deliver Paratransit and School Bus services with a fleet of 13,000+ vehicles at 200+ locations from New England to New Mexico.
Reporting to the Director of Claims, the Region Claims Analyst provides oversight and controls to reporting and management of crash and injury events across all locations within a region. This position is responsible for utilizing company defined reporting processes, KPI's and predictive analytics tools to ensure appropriate shareholders are aware of the opportunities to improve or sustain results.
The role will require highly effective communication, motivation and project management skills while delivering analytical support to operations, safety and claims leadership. Support to locations will require compliance with applicable company practices, governmental reporting regulations, and contractual requirements.
The candidate for this role requires successful experience in managing complex data systems. Our ideal candidate will be flexible and result-oriented with a track record of continually inspiring shareholders buy in. Achieving that end will also require the ability to proactively analyze current processes/procedures and appropriately challenge colleagues and leadership as needed to build continued process improvement and reliable safety practices.
Primary Responsibilities:
Reporting process oversight -
Support and oversee timely crash and injury event reporting:
Training safety directors on intake process/portal
Communicating outlier reporting to safety directors for correction or process modelling
Propose resource or process modification to drive accuracy and efficiency
Ensure event coding accuracy
- Review and correct event coding and details to achieve:
Timely actionable performance metrics
Efficient claims mitigation
Efficient recovery opportunities
Claims administration support/oversight
- maintain command of claims within prescribed values to:
Drive employee injury and return to work awareness - who, what needed, when
Ensure TPA and operations awareness of critical elements and drive claims closure
Ensure TPA and operations awareness of physical damage/subrogation events and values
Significant Event & Crisis Support
- Provides immediate and ongoing support to regional operations staff with crash/injury crisis response and investigations.
Provide crisis response support with deploying investigators and conducting an initial review of the loss prior to Sedgwick submission/intervention.
Communicate potential indicators which affect values (i.e.: venue, questionable damage, questionable video, questionable liability).
Communicate significant events claims progression (i.e.: safety, operations, external counsel, executive team).
Interdepartmental Communication
- Establishes and maintains effective business relationships with internal teams, TPA's, and underwriters/brokers.
Qualification Requirements:
Bachelor's degree in business administration or risk management; or evidence of equivalent experience specifically around critical thinking, leading investigations and verbal & written communication skill development
Broad understanding of safety policies and transportation best practices
Excellent written and verbal communication skills.
Ability to travel up to 25% of the time within the assigned Region, with periodic outside of the assigned region travel (as needed)
Preferred qualifications:
Demonstrate competency in the areas of research methodologies, project management and contract administration
Advanced knowledge of Microsoft Office software (Word, Excel, Outlook, PowerPoint, etc.) and transportation related software and telematics
Terms of acceptance:
Upon acceptance of an offer of employment, employee will perform services for Beacon Mobility that may require Beacon Mobility to disclose confidential and proprietary information ("Confidential Information") to Employee. (Confidential Information is information and data of any kind concerning any matters affecting or relating to Beacon mobility, the business or operations of Beacon Mobility, and/or the products, drawings, plans, processes, or other data of Beacon Mobility not generally known or available outside of the company.)
Employee will hold the Confidential Information received from Beacon Mobility in strict confidence and will exercise a reasonable degree of care to prevent disclosure to others and will not disclose or divulge either directly or indirectly the Confidential Information to others unless first authorized to do so in writing by Beacon Mobility management.
All provisions of this agreement will be applicable only to the extent that they do not violate any applicable law and are intended to be limited to the extent necessary so that they will not render this agreement invalid, illegal or unenforceable. If any provision of this agreement or any application thereof will be held to be invalid, illegal or unenforceable, the validity, legality and enforceability of other provisions of this agreement or of any other application of such provision will in no way be affected thereby.
Beacon Mobility is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Beacon Mobility makes hiring decisions based solely on qualifications, merit, and business needs at the time.
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