Claims Specialist
Pay: $60,000 - $85,000/year
Experience: At least 9 years handling general liability and/or commercial auto claims; experience with high-value, complex files; strong analytical and coverage evaluation skills.
Education: Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
Type: Full-time; Direct Hire
Schedule: Monday - Friday, 8:00 AM to 5:00 PM
ProRecruiters is seeking a Claims Specialist to join a growing and dynamic team!
Job Description:
Manage a portfolio of complex commercial general liability and auto claims.
Lead investigations and evaluate coverage, liability, and exposure.
Represent the company during mediations, depositions, and trials.
Develop and execute resolution strategies for complex claims.
Collaborate with underwriting and marketing teams to identify trends.
Serve as a technical expert and advisor within the business.
Ensure compliance with all legal and regulatory standards.
Position Requirements:
Strong strategic thinking and analytical ability.
Excellent written and verbal communication skills.
Strong negotiation and problem-solving skills.
Ability to guide and support teammates on complex claim matters.
Strong organizational and time-management abilities.
ProRecruiters is part of Array Corporation, the leading technology-enabled workforce solutions company whose mission is to fix how work is bought, sold and delivered to enable access to the American Dream.
We are proud to be an Equal Employment Opportunity and Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
$26k-43k yearly est. 1d ago
Looking for a job?
Let Zippia find it for you.
Product Liability Litigation Adjuster
CVS Health 4.6
Claims representative job in Oklahoma City, OK
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**Position Summary**
As a Product Liability Litigation Adjuster, Risk Management, you will be responsible for managing lawsuits and overseeing outside counsel defending CVS in high exposure, product liability mass tort litigations and general liability cases filed throughout the United States.
Responsibilities include:
+ Developing relationships with internal colleagues for fact-finding and key litigation activities.
+ Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution.
+ Managing all aspects of product liability mass tort litigations and complex general liability cases.
+ Working with outside national counsel and sr. management to develop consistent litigation strategies applicable to mass tort cases filed across the country.
+ Providing reporting to key internal stake holders on case developments and litigation trends for product liability mass torts and other cases.
+ Managing large scale discovery investigations by working with internal custodians, outside counsel and vendors to develop comprehensive procedures for identifying, locating, preserving and producing corporate records.
+ Analyzing case and internal materials and utilizing resources across CVS to discern key issues and identify the litigation strategy in every case assigned.
+ Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working with and overseeing outside counsel.
+ Participating in meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases.
**Required Qualifications**
+ 2+ years of legal experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier.
+ Juris Doctor degree from an ABA accredited university.
+ Ability to travel and participate in legal proceedings, arbitrations, depositions, etc.
**Preferred Qualifications**
+ Experience overseeing or defending product liability claims and litigation.
+ Familiarity or experience with insurance and coverage issues related to litigated claims.
+ Strong attention to detail and project management skills.
+ Experience overseeing and answering written discovery.
+ Ability to work independently and in an environment requiring teamwork and collaboration.
+ Strong written and verbal communication skills.
+ Demonstrated negotiation skills and ability.
+ Ability to articulate and summarize cases with management in a concise, cogent manner.
+ Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure.
+ 3-5 years of legal or claims experience.
+ Familiarity with the rules and procedures applicable to mass tort litigations, class actions, and/or multidistrict litigations.
+ Knowledge and experience navigating attorney-client privilege issues, corporate litigation holds, corporate witness depositions, and e-discovery.
+ Ability to influence and work collaboratively with senior leaders, CVS' in-house legal counsel and outside counsel.
+ Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new software programs and systems.
+ Ability to positively and aggressively represent the company at mediation, arbitration and trial.
+ Ability to navigate difficult situations and communicate effectively with both internal and external groups.
+ Excellent organizational and time management skills and ability to handle a high volume of litigated claims.
+ Experience with and understanding of legal documents (pleadings, discovery, motions and briefs).
**Education**
+ Verifiable Juris Doctor degree
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$46,988.00 - $122,400.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/03/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
$47k-122.4k yearly 60d+ ago
Claims Adjuster II, Field Property - National Catastrophe ($5000 Sign-on Bonus)
Nationwide Mutual Insurance Company 4.5
Claims representative job in Oklahoma
If you're passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide's Property and Casualty team could be the place for you! At Nationwide , “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we're looking for associates who are passionate about delivering extraordinary care.
This is a field-based role on the National Catastrophe Response Team. This position is responsible for managing property claims in response to catastrophic events across the country. As a field-based adjuster, you will be deployed to areas impacted by large-scale disasters-such as hurricanes, tornadoes, floods, or other major events-to assess damages, support policyholders, and help communities begin the recovery process. The role requires extensive travel (up to 80%), often on short notice, and the ability to work in high-pressure, fast-paced environments for extended periods.
You will regularly engage in direct, and at times, emotionally charged conversations with customers-clearly explaining coverage decisions, setting expectations, and delivering difficult news with empathy and professionalism. The ability to remain composed and compassionate in the face of loss, frustration, or uncertainty is essential. Strong communication skills and emotional resilience are critical, as you'll be guiding customers through some of the most challenging moments of their lives.
In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments. You'll also be responsible for full file ownership, maintaining appropriate reserves, managing claim activity (including supplements and requests for depreciation), ensuring compliance with internal standards and regulatory requirements, and providing proactive communication with external customers throughout each stage of the claim. Collaboration with internal teams such as Special Investigations and Subrogation may be required to identify fraud or recovery opportunities. Staying current on industry repair practices, regional pricing trends, and legal developments is key to success. This is a demanding, customer-facing role that requires a unique blend of technical expertise, critical thinking, and emotional intelligence. Candidates should be comfortable working independently in disaster zones, managing a high volume of claims, working 12 hours a day, up to 21 days in a row, and adapting quickly to evolving priorities. If you're driven by purpose, thrive under pressure, and want to make a meaningful impact during times of crisis, this role offers a challenging and deeply rewarding opportunity.
Ideal candidates will have:
Prior insurance field/property claims handling or adjusting experience
Proficiency with Xactimate
Prior estimate writing experience
Ability to handle claims of varying complexity from start to finish
Prior experience working in on site in a catastrophe environment
Ability to carry a ladder and climb a roof
Strong customer service competency
Strong written and verbal communication skills.
A $5000 SIGN-ON BONUS will be given to all external candidates hired into this role. Half of the bonus will be paid after 3 months of employment and the remainder will be paid after 9 months of employment.
Summary
No two property claims are ever the same and each customer has unique needs. Our team thrives on providing the very best service and building lasting, successful relationships with our customers. If you are confident, curious, driven to learn and grow, and have a desire to help people when they most need it, we want to know more about you!
As a National Catastrophe (NATCAT) Field Claims Specialist primarily supporting our Personal Lines (PL) business, you'll investigate and resolve moderate to severe property damage claims by phone.
Job Description
Key Responsibilities:
Handles all assigned claims promptly and effectively, with little to no direction and oversight. Makes decisions within delegated authority as outlined in company policies and procedures.
Determines proper policy coverages and applies appropriate claims practices to resolve cases in alignment with company guidelines.
Opens, closes, and adjusts reserves according to company practices to ensure reserve adequacy. Adheres to file conferencing notification and authority procedures.
Maintains current knowledge of insurance and applicable product/services; court decisions which may impact the claims function; current guidelines; and policy changes and modifications. This may require attending various seminars and training sessions.
Maintains current knowledge of local industry repair procedures and local market pricing.
Submits severe incident reports, reinsurance reports and other information to claims management as needed.
Partners with Special Investigations Unit and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for lawsuit, trial, or subrogation.
Initiates and conducts follow-ups through proficient use of claims and other related business systems.
Delivers outstanding customer service to all internal, external, current, and prospective Nationwide customers. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service.
May perform other responsibilities as assigned.
Reporting Relationships: Reports to Claims Manager. Individual contributor role.
Typical Skills and Experiences:
Education: Undergraduate degree or equivalent experience.
License/Certification/Designation: State licensing where required. Successful completion of required/applicable claims certification training/classes.
Experience: Three to five years of related property claims experience or comparable job-related experience, or education preferred. Experience in a customer service environment, including flexible work schedules and extended work hours preferred. Commercial claims property experience preferred.
Knowledge, Abilities and Skills: General knowledge of insurance theory and practices, and contracts and their application. Property estimating and automated claims systems. Demonstrated knowledge of the investigation, consultation and settlement activities used to resolve extensive property damage claims. Proven ability to meet customer needs and provide exemplary meaningful service by guiding customers through the claims process and ensuring a positive customer experience. Analytical and problem-solving skills necessary to make decisions and resolve issues related to application of coverages to submitted claims, application of laws of jurisdiction to investigation facts, and application of policy exclusions and exceptions. Ability to establish repair requirements and cost estimates for property losses. Ability to evaluate and successfully advise on property claims. Organizational skills to prioritize work. Command of written and verbal communication skills to effectively communicate with policyholders, claimants, repairpersons, attorneys, agents and the general public. Ability to efficiently operate a personal computer and related claims and business software. Able to provide leadership to less experienced claims associates. Must be able to safely access and inspect rooftops using a ladder. Must be prepared and capable of conducting physical inspections on rooftops, including first and second story roofs with pitches up to 8/12.
Other criteria, including leadership skills, competencies and experiences may take precedence.
Staffing exceptions to the above must be approved by the business unit executive and HR Business Partner.
Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors.
Job Conditions:
Overtime Eligibility: Not Eligible (Exempt)
Working Conditions: Normal office or field claims environment. May require ability to sit and operate phone and personal computer for extended periods of time. Able to make physical inspections of property loss sites; including climb ladders, balance at various heights and rooftops up to 8/12 pitch stoop, bend and/or crawl to inspect vehicles and structures; work outside in all types of weather. Must be willing to work irregular hours and to travel with possible overnight requirements. May be on-call. Must be available to work catastrophes (CAT). Extended and/or non-standard hours as required. Must have a valid driver's license with satisfactory driving record in accordance with Nationwide standards.
ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.
Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process.
We currently anticipate accepting applications until 01/29/2026. However, we encourage early submissions, as the posting may close sooner if a strong candidate slate is identified before the deadline.
Benefits
We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage, paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here.
Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law.
#claims Smoke-Free Iowa Statement: Nationwide Mutual Insurance Company, its affiliates and subsidiaries comply with the Iowa Smokefree Air Act. Smoking is prohibited in all enclosed areas on or around company premises as well as company issued vehicles. The company offers designated smoking areas in which smoking is permitted at each individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air Act, individuals may contact the Smokefree Air Act Helpline at ************.
For NY residents please review the following state law information: Notice of Employee Rights, Protections, and Obligations LS740 (ny.gov) *************************************************************
NOTE TO EMPLOYMENT AGENCIES:
We value the partnerships we have built with our preferred vendors. Nationwide does not accept unsolicited resumes from employment agencies. All resumes submitted by employment agencies directly to any Nationwide employee or hiring manager in any form without a signed Nationwide Client Services Agreement on file and search engagement for that position will be deemed unsolicited in nature. No fee will be paid in the event the candidate is subsequently hired as a result of the referral or through other means.
Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. If a Sales job, Sales Incentives, based on performance goals are possible in addition to this range. Note on Compensation for Part-Time Roles: Please be aware that the salary ranges listed below reflect full-time compensation. Actual compensation may be prorated based on the number of hours worked relative to a full-time schedule.The national salary range for Field Claims Specialist II, National Catastrophe Property - Personal Lines : $62,500.00-$115,500.00The expected starting salary range for Field Claims Specialist II, National Catastrophe Property - Personal Lines : $62,500.00 - $93,500.00
$62.5k-115.5k yearly Auto-Apply 2d ago
Contestable Claims Analyst
Globe Life 4.6
Claims representative job in Oklahoma City, OK
The Contestable Analyst reviews all aspects of a contestable claim and determines how to process. High exposure to a multitude of life claims is a norm for this position; Analyst needs to be able to identify claim benefits in regards to the specific policy and operates on multiple claims systems. The Analyst has a checklist of items to review before the claim can progress for further processing. Some of these items include; performing a name search to see if the insured has additional coverage, reinstating a policy if it has already been removed from the system, requesting various types of letters, reviewing application date versus effective date of policy, reviewing Medical Information Bureau reports, requesting recordings of contact with insured, ordering medical records, and reviewing medical records. The Contestable Analyst also determines if certain policies should be investigated by external third parties (i.e., RSB). Once the Analyst makes a claim determination, they either proceed with paying the claim or rescind the claim. A Contestable Analyst is responsible for keeping a claim moving through the processing procedures. Contestable Analyst is in contact with agents, funeral homes, coroners, medical providers, and police departments to gather and confirm information in regards to the claim.
Investigates all contestable life claims and processes in accordance with policy provisions and Company procedures.
Processes claims on a multiple claims system.
Contacts outside 3rd parties and obtains additional claim information needed. Third parties consist of agents, beneficiaries, funeral homes, coroners, medical providers and police departments.
Updates system notes with claim progress.
Orders and reviews medical information.
Responsible for claim movement and progression.
Maintains production data and must meet the production quota set by the department.
Other duties; as assigned by the supervisor.
Required Skills:
Must be PC/Windows literate and posses a working knowledge of MS Office (Outlook, Excel and Word).
Strong communication skills.
Detail oriented.
Ability to work in a fast paced environment.
Problem solving skills.
Physical Requirements; While performing the duties of the job, the employee is regularly required to sit for extended lengths of time. The employee is frequently required to reach with hands and arms, occasionally required to stand and walk, occasionally lift and or move up to 25 lbs.
Qualifications
Must be PC/Windows literate and posses a working knowledge of MS Office (Outlook, Excel and Word).
Strong communication skills.
Detail oriented.
Ability to work in a fast paced environment.
Problem solving skills.
Additional Information
All your information will be kept confidential according to EEO guidelines.
$62k-104k yearly est. 52m ago
Claims Audit Analyst
Welbehealth
Claims representative job in Oklahoma City, OK
At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option (PACE) to the most vulnerable senior population while serving as a care provider and care plan to those individuals we serve. Our Health Plan Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate pre-payment or denial of claims while meeting federal/state regulations, provider agreements terms, and/or company policies and procedures.
**Essential Job Duties:**
+ Review processed claims for accuracy prior to payment while maintaining acceptable levels of claim's aged inventory by verifying various aspects of the system and claim
+ Complete and maintain detailed documentation of audit findings which include decision methodology, system or processing errors, and monetary discrepancies
+ Move claims free of processing errors through for full adjudication and return claims with errors back to the claims team for corrections
+ Provide feedback to the Oversight & Monitoring Manager on claims processing errors, quality improvement opportunities, and configuration change requests, when applicable
**Job Requirements:**
+ Minimum of three (3) years of experience processing and auditing Medicare and Medicaid professional, institutional, and dental health insurance claims
+ Experience working with CMS and Medicaid healthcare claims highly preferred
+ Demonstrated skills within Microsoft Office Applications, including Excel
**Benefits of Working at WelbeHealth:** Apply your claims expertise in meaningful ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.
+ Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
+ Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, sick time
+ Advancement opportunities - We've got a track record of hiring and promoting from within, meaning you can create your own path!
+ And additional benefits
Salary/Wage base range for this role is $68,640 - $77,519 / year + Bonus. WelbeHealth offers competitive total rewards package that includes, 401k match, healthcare coverage and a broad range of other benefits. Actual pay will be adjusted based on experience and other qualifications.
Compensation
$68,640-$77,519 USD
**COVID-19 Vaccination Policy**
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.
**Our Commitment to Diversity, Equity and Inclusion**
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
**Beware of Scams**
Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to ****************************
$68.6k-77.5k yearly Easy Apply 2d ago
Claims Specialist/Senior Claims Specialist
Great American Insurance Group (DBA 4.7
Claims representative job in Tulsa, OK
Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other industries. Mid-Continent Group provides a broad selection of General Liability, Commercial Auto, Inland Marine and Umbrella products.
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group, a Fortune 500 company, combines "small company" culture with "big company" expertise. Here, your ideas will be heard, and you'll have the support to succeed. With over 35 specialty and property and casualty operations, there are always opportunities to learn and grow.
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.
Mid-Continent Group is currently seeking a Claims Specialist/Senior Claims Specialist to join our Claims Team. The position will work a hybrid schedule from downtown Tulsa, OK, or downtown Cincinnati, OH.
Essential Job Functions and Responsibilities
* Manage a portfolio of complex, high-value commercial general liability and auto claims across the U.S.
* Lead investigations, evaluate coverage and liability, and drive resolution strategies.
* Represent the company in mediations, depositions, and trials.
* Collaborate with underwriting and marketing teams to identify trends and improve outcomes.
* Serve as a technical expert and strategic advisor within your line of business.
* Ensure compliance with all legal and regulatory standards.
* Offer expert advice to other members of your team on complex claim file management and demonstrate leadership across the organization.
Job Requirements
* 9+ years of experience handling general liability and/or commercial auto claims.
* Strong analytical skills and deep understanding of policy coverage.
* Excellent communication, negotiation, and organizational abilities.
* Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
* Professional designations (e.g., CPCU) are a plus.
Ready to Make a Difference?
Join a team where your expertise is valued, your voice is heard, and your career can flourish. Apply today and be part of something great.
Company:
MCC Mid-Continent Casualty Company
Benefits:
We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.
Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at ****************************
* Excludes seasonal employees and interns.
$63k-100k yearly est. Auto-Apply 25d ago
Benefit and Claims Analyst
Highmark Health 4.5
Claims representative job in Oklahoma City, OK
This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements.
**ESSENTIAL RESPONSIBILITIES**
+ Coordinate, analyze, and interpret the benefits and claims processes for the department.
+ Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties.
+ Investigate benefit/claim information and provide technical guidance to clinical and claims staff regarding the final adjudication of complex claims. Research and investigate conflicting benefit structures in multi-payor situations.
+ Provide prompt, thorough and courteous replies to written, electronic and telephonic inquiries from internal/external customers (e.g., clinical, sales/marketing, providers, vendors, etc.) Follow-up on all inquiries in accordance with corporate and regulatory standards and timeframes.
+ Must have the ability to apply knowledge about the business operations of the area within the defined scope of the job. Assess benefit limitations in accordance with Medical Policy Guidelines.
+ Monitor and identify claim processing inaccuracies. Bring trends to the attention of management.
+ Assist with handling inbound calls and strive to resolve customer concerns received via telephone or written communication.
+ Work independently of support, frequently utilizing resources to resolve customer inquiries.
+ Collaborate with Clinical Strategy, Sales/Client Management and other areas across the enterprise to respond to client questions and concerns about care/case management and high-cost claimants.
+ Gather information and develop presentation/training materials for support and education.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ High School or GED
**Substitutions**
+ None
**Preferred**
+ Associate's degree in or equivalent training in Business or a related field
**EXPERIENCE**
**Required**
+ 3 years of customer service, health insurance benefits and claims experience.
+ Working knowledge of Highmark products, systems (e.g., customer service and clinical platforms, knowledge resources, etc.), operations and medical policies
+ PC Proficiency including Microsoft Office Products
+ Ability to communicate effectively in both verbal and written form with all levels of employees
**Preferred**
+ Working knowledge of medical procedures and terminology.
+ Complex claim workflow analysis and adjudication.
+ ICD9, CPT, HPCPS coding knowledge/experience.
+ Knowledge of Medicare and Medicaid policies
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ None
**SKILLS**
+ Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services
+ Knowledge of administrative and clerical procedures and systems such as managing files and records, designing forms and other office procedures
+ The ability to take direction, to navigate through multiple systems simultaneously
+ The ability to interact well with peers, supervisors and customers
+ Understanding the implications of new information for both current and future problem-solving and decision-making
+ Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate and not interrupting at inappropriate times
+ Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
+ Ability to solve complex issues on multiple levels.
+ Ability to solve problems independently and creatively.
+ Ability to handle many tasks simultaneously and respond to customers and their issues promptly.
**Language (Other than English):**
None
**Travel Requirement:**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$21.53
**Pay Range Maximum:**
$32.30
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J273827
$21.5-32.3 hourly 28d ago
Specialty Loss Adjuster
Sedgwick 4.4
Claims representative job in Oklahoma City, OK
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Specialty Loss Adjuster
**Embark on an Exciting Career Journey with Sedgwick Specialty**
**Job Location** **: USA, Mexico, Brazil and strategic locations globally**
**Job Type** **: Permanent**
**Remuneration** **: Salaries can range from** **_$40,000.00USD to $250,000.00USD_** **taking into account skills, experience and qualifications.**
**We have a number of fantastic opportunities for Specialty Loss Adjusters across the US, Mexico and Brazil and a number of key locations**
We are looking for a variety of skill sets at all levels. Whether you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your skills and grow with a company that values innovation, excellence, and employee satisfaction.
Are you ready to be a part of providing a differentiated and best of class proposition to clients whilst working with like-minded colleagues? Sedgwick Specialty is thrilled to announce that we are investing in growth across Natural Resources, Property, Casualty, Technical and Special Risks and Marine. As we expand our operations, we are seeking individuals who are passionate about making a difference to the Adjusting industry.
**As a member of the Specialty platform, you will have the opportunity to:**
+ Work with a wide range of clients across the globe, handling complex cases and claims
+ Collaborate with a talented and supportive team of professionals who are dedicated to delivering exceptional results
+ Utilise state-of-the-art technology and resources to streamline processes and enhance efficiency
+ Receive ongoing training and development opportunities to further enhance your skills and knowledge in the marine industry
+ Enjoy a flexible work arrangement that allows you to maintain a healthy work-life balance while contributing to our global success
**The skills you will have when you apply:**
+ **Qualified** : it is important to us that you are either accredited, on your way to be accredited or qualified by experience
+ **Insurance claims experience:** it is imperative that you have experience working on insurance claims within you respective field. Full claims life cycle experience is a must
+ **Great communicator:** you will be constantly working with policy holders, brokers, carriers and various third parties, so being able to communicate accurately important. Providing an excellent customer service with our clients in mind. Able to approach issues empathetically
+ **Commercially minded:** An understanding of how the industry operates and where the role of a Loss Adjuster fits in. Being able to negotiate. Understanding how to market your services is a big advantage
**What we'll give you for this role:**
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the annual salaries can range from _$40,000.00 to $250,000.00USD._ Bonus eligible role. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always Accepting Applications.
**This isn't just a position, it's a pivotal role in shaping our industry**
At Sedgwick, you won't just build your career; you'll cultivate a team of experts. Our Sedgwick University offering empowers you to excel as well as your team members, with the most comprehensive training program in the industry which includes more than 15,000 courses on demand, training specific to roles, and opportunities to continue formal education.
Together, we're not only reshaping the insurance landscape, we're building a legacy of talent. Come and be a catalyst for change within our industry.
**Next steps for you:**
**Think we'd be a great match? Apply now -** ** we want to hear from you.**
As part of our commitment to you, we are proud to have a zero tolerance policy towards discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex or sexual orientation.
After the closing date we will review all applications and may select some applicants for an interview (which may be virtual, or in-person).
\#LI-HYBRID
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
$47k-61k yearly est. 60d+ ago
Claims Follow-Up Rep
Trinity Employment Specialists
Claims representative job in Tulsa, OK
Job Description
Accounts Receivable Specialist
Pay: Starting at $16/hour
Responsible for managing all aspects of accounts receivable, including insurance claim follow-up, patient account review, and payment posting. Ensures accuracy in patient demographics, insurance information, and billing processes while maximizing revenue and patient satisfaction. Provides support to front office staff and maintains compliance with HIPAA, OSHA, and Medicare regulations.
Key Responsibilities:
Follow up on outstanding insurance claims and rebills to ensure timely reimbursement.
Post patient payments, credits, and adjustments accurately.
Submit electronic and paper insurance claims (HCFA, UB-04) daily.
Provide excellent customer service to patients regarding account inquiries.
Maintain organized records of coding, insurance, and billing information.
Monitor reimbursements from insurance carriers and managed care networks.
Stay current on accounts receivable best practices and compliance regulations.
Support front office staff with registration, charge entry, insurance processing, and reporting.
Perform other duties as assigned.
Qualifications:
High school diploma or GED required; 2+ years accounts receivable experience preferred.
Knowledge of managed care networks, insurance carriers, CPT, HCPCS, ICD-10, and revenue codes.
Strong customer service, organizational, and communication skills.
Proficient with PCs, MS Windows, multi-line phone systems, and office equipment.
Ability to multitask, prioritize, and work in a fast-paced environment.
#MED
TRINITY EMPLOYMENT SPECIALISTS IS AN EQUAL OPPORTUNITY EMPLOYER
See the great things people are saying by checking out our Google reviews, along with our Facebook, LinkedIn, Instagram, X/Twitter.Please visit the Career Centeron our website for some helpful resources to help in your job search, to build a resume, for interview tips and many job opportunities!
At least one year of claims follow-up experience
* Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
* Examine claims forms and other records to determine insurance coverage.
* Analyze information gathered by investigation and report findings and recommendations.
* Pay and process claims within designated authority level.
* Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
* Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
* Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
* Investigate and assess damage to property and create or review property damage estimates.
* Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
* Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
* Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
* Resolve complex, severe exposure claims, using high service oriented file handling.
* Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
* Confer with legal counsel on claims requiring litigation.
* Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
* Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
* Refer questionable claims to investigator or claims adjuster for investigation or settlement.
* Collect evidence to support contested claims in court.
* Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
$16 hourly 8d ago
Bristol West Liability Claims Representative
Farmers 4.2
Claims representative job in Oklahoma
We are Farmers!
We are… more than just your favorite commercials. At Farmers, we strive to deliver peace of mind to our customers by providing protection and comprehensive advice and delivering in the moments of truth. That means having people who can help us meet changing customer and business needs. Farmers high-performance culture is focused on results and the people who achieve them. We hold ourselves and others accountable for sustainably growing the business and each other. We seek solutions, own our actions, and grow through discomfort. We see setbacks as opportunities while continuously asking ourselves how we impact our customers.
Farmers is an award winning, equal opportunity employer, committed to the strength of an inclusive workforce. We are dedicated to supporting the well-being of our people through our extensive suite of benefits, as well as the well-being of the communities we serve through employee volunteer programs and nonprofit partnerships. Helping others in their time of need isn't just our business - it's our culture! To learn more about our high-performance culture and open opportunities, check out ********************************* and be sure to follow us on Instagram, LinkedIn, and TikTok.
Workplace: Hybrid ( #LI-Hybrid )
Farmers believes in a culture of collaboration, creativity, and innovation, which thrives when we have the ability to work flexibly in a virtual setting as well as the opportunity to be together in person. Our hybrid work environment combines the best of both worlds with at least three (3) days in office and up to two (2) days virtual for employees who live within fifty (50) miles of a Farmers corporate office. Applicants beyond fifty (50) miles may still be considered.
Job Summary Participates in training program to learn basic policies, practices, procedures, and strategies needed to become a ClaimsRepresentative. Trains to handle low to moderately complex claims promptly, proactively, and with a sense of urgency. Performs work under the guidance and supervision of a trainer. Trainee is required to pass an exam at certain phases of the training program. Trainees who successfully complete this training program may be placed into a ClaimsRepresentative role of equivalent salary grade.Essential Job Functions
In a supervised learning environment, trains to adjust low to moderately complex claims.
Learns skills such as conducting thorough i nvestigations, establishing damages, determining liability, negotiating settlements, making claim payments, confirming policy coverage, and explaining claim determination to parties incident to the claim. Works in electronic claim files to handle assigned claims within designated authority.
Learns to manage diaries, update claim files and move them to closure according to established procedures and job aids provided for training purposes. Trains to inspect vehicles and property to assess claim related damage.
Learns to estimate repair or replacement costs. Learns to determine and report on subrogation potential. Reports theft, fraud, and arson losses as required by state and industry regulations.
Trains to interact professionally and courteously with stakeholders including policyholders, claimants, agents, witnesses, repair fa cilities, contractors, police and fire departments, state and country fraud and arson specialists, special investigators, attorneys, medical professionals and other persons incident to the investigation and processing of claims. Acts as a representative of the company. Seeks to grow job knowledge and incorporates new information into daily tasks. Performs other duties as assigned.
Physical Actions This role, whether performed virtually or in an office setting, will include normal and customary distractions, noise, and interruptions. Sits or stands for extended periods of time, up to a full work shift. Occasionally reaches overhead and below the knees, including bending, twisting, pulling, and stooping. Occasionally moves, lifts, carries, and places objects and supplies weighing 0-10 pounds without assistance. Listens to, interprets, and differentiates auditory information (example others speaking) at normal speaking levels with or without correction. Visually verifies and reads information. Visually locates material, resources and other objects. Ability to continuously operate a computer for extended periods of time, up to a full work shift. Physical dexterity sufficient to use hands, arms, and shoulders repetitively to operate keyboard and other office equipment up to a full work shift.Physical Environment Education Requirements High School Diploma or equivalent required. Bachelors degree preferred. Other: Must obtain adjusters license in states where required.Experience Requirements Some experience in insurance or a related field preferred. Claims experience preferred.
Benefits
Farmers offers a competitive salary commensurate with experience, qualifications and location.
o CA Only: $24.70 - $41.88
Medical
Dental
Vision
Health Savings and Flexible Spending Accounts
Life Insurance
Paid Time Off
For more information, review “What we offer” on https://*********************************/#offer
Job Location(s): US - AZ - Phoenix, US - OK - Oklahoma City, US - TX - Dallas
Anticipated application deadline: At Farmers, the recruitment process is designed to ensure that we find the best talent to join our team. As part of this process, we typically close open positions within 8 to 21 days after posting. If you are interested in any of our open positions, we encourage you to submit your application promptly.
Farmers will consider for employment all qualified applicants, including those with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring Ordinance or other applicable law. Pursuant to 18 U.S.C. Section 1033, Farmers is prohibited from employing any individual who has been convicted of any criminal felony involving dishonesty or a breach of trust without prior written consent from the state Department of Insurance.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Farmers is an Equal Opportunity Employer and does not discriminate in any employer/employee relations based on race, color, religion, gender, sexual orientation, gender expression, genetic information, national origin, age, disability, marital status, military and veteran's status, or any other basis protected by applicable discrimination laws.
Want to learn more about our culture & opportunities? Check out ********************************* and be sure to follow us on Instagram, LinkedIn, and TikTok.
Spokane, WA only: Residents who prefer not to provide their address click here to submit your resume via email: *******************
$34k-42k yearly est. Easy Apply 39d ago
Daily Claims Adjuster - Tulsa Region
Cenco Claims 3.8
Claims representative job in Tulsa, OK
CENCO partners with leading insurance carriers to provide fast, accurate, and professional property claims services across the Midwest and Southern Plains. We are currently hiring Daily Property Claims Adjusters to inspect and assess residential and commercial storm damage in the Tulsa region.
Responsibilities:
Conduct on-site inspections of properties damaged by hail, windstorms, tornadoes, and other severe weather events
Document all findings with detailed reports, high-quality photos, and policy coverage analysis
Prepare and submit estimates using Xactimate or Symbility
Maintain professional communication with policyholders, contractors, and insurance carriers
Manage multiple claims efficiently and ensure timely file submission
Qualifications:
Active adjuster license
Experience preparing property estimates using Xactimate or Symbility
Strong organizational and time management skills
Ability to work independently and meet deadlines
Flexible and responsive to incoming assignments
Why Join CENCO?
Consistent daily claims volume in a high-demand market
Competitive pay
Supportive team environment with streamlined workflows
If you're an experienced adjuster looking for steady claims work in the Tulsa region, apply today to join CENCO's trusted network.
$44k-53k yearly est. Auto-Apply 60d+ ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claims representative job in Lawton, OK
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.
$45k-54k yearly est. Auto-Apply 33d ago
Independent Insurance Claims Adjuster in Lawton, Oklahoma
Milehigh Adjusters Houston
Claims representative job in Lawton, OK
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.
$44k-53k yearly est. Auto-Apply 60d+ ago
Public Adjuster
The Misch Group
Claims representative job in Saint Louis, OK
Job DescriptionDescriptionPosition: Production Public Adjuster (Licensed) Location: Primary Locations: KS City, Des Moines IA, State of CO, State of CA, St. Louis, State of IL with emphasis on ChicagoCompensation: $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!
$75k-100k yearly 10d ago
Claims Specialist/Senior Claims Specialist
Mid-Continent Casualty Company 3.8
Claims representative job in Tulsa, OK
Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other industries. Mid-Continent Group provides a broad selection of General Liability, Commercial Auto, Inland Marine and Umbrella products.
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group, a Fortune 500 company, combines “small company” culture with “big company” expertise. Here, your ideas will be heard, and you'll have the support to succeed. With over 35 specialty and property and casualty operations, there are always opportunities to learn and grow.
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.
Mid-Continent Group is currently seeking a Claims Specialist/Senior Claims Specialist to join our Claims Team. The position will work a hybrid schedule from downtown Tulsa, OK, or downtown Cincinnati, OH.
Essential Job Functions and Responsibilities
Manage a portfolio of complex, high-value commercial general liability and auto claims across the U.S.
Lead investigations, evaluate coverage and liability, and drive resolution strategies.
Represent the company in mediations, depositions, and trials.
Collaborate with underwriting and marketing teams to identify trends and improve outcomes.
Serve as a technical expert and strategic advisor within your line of business.
Ensure compliance with all legal and regulatory standards.
Offer expert advice to other members of your team on complex claim file management and demonstrate leadership across the organization.
Job Requirements
9+ years of experience handling general liability and/or commercial auto claims.
Strong analytical skills and deep understanding of policy coverage.
Excellent communication, negotiation, and organizational abilities.
Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
Professional designations (e.g., CPCU) are a plus.
Ready to Make a Difference?
Join a team where your expertise is valued, your voice is heard, and your career can flourish. Apply today and be part of something great.
Company:
MCC Mid-Continent Casualty Company
Benefits:
We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.
Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at ****************************
*Excludes seasonal employees and interns.
$46k-70k yearly est. Auto-Apply 60d+ ago
Property Adjuster Specialist - Field
USAA 4.7
Claims representative job in Oklahoma City, OK
**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 established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements in compliance with all state regulatory requirements.
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 for the area of **Oklahoma City, OK.** Candidates currently living in this location or willing to self-relocate 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 required.
+ 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.
**What sets you apart:**
+ US military experience through military service or a military spouse/domestic partner
+ 5 years of prior carrier field experience handling higher severity/complex losses (i.e. vandalism, malicious mischief, foreclosures, earth movement, collapse, liability, etc.)
+ Prior experience adjusting property claims using virtual technologies
+ Prior property field adjuster experience handling DWG, APS and ALE adjustments
+ Industry designations such as AINS, CPCU, AIC, SCLA (or actively pursuing)
+ Xactimate Level 1 and/or Level 2 certification
+ Prior deployments in support of catastrophes
+ Currently hold an active Adjuster License
+ Currently reside within or have the ability to self-relocate to **Oklahoma City, OK**
**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: $69,920.00 - $133,620.00.
**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.
$46k-55k yearly est. 6d ago
Claims Examiner
Harris 4.4
Claims representative job in Oklahoma
Responsibilities & Duties:Claims Processing and Assessment:
Evaluate incoming claims to determine eligibility, coverage, and validity.
Conduct thorough investigations, including reviewing medical records and other relevant documentation.
Analyze policy provisions and contractual agreements to assess claim validity.
Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
Ensure compliance with company policies, procedures, and regulatory requirements.
Maintain accurate records and documentation related to claims activities.
Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
Identify opportunities for process improvement and efficiency within the claims department.
Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
Generate reports and provide data analysis on claims trends, processing times, and outcomes.
Contribute to the development of management reports and presentations regarding claims operations.
$44k-61k yearly est. Auto-Apply 28d ago
Field Claims Investigator
Phoenix Loss Control
Claims representative job in Durant, OK
Job Description
Job Type: Contract Workplace Type: Hybrid (50% remote, 50% fieldwork) Compensation: $22-25/hr plus $.50/mi
Phoenix Loss Control (PLC) is a US-based business services provider in the cable, telecom, and utilities sector. PLC's core service is outside plant damage investigation, recovery, and prevention. Across the US and parts of Canada, we help our clients recover the costs of third-party damage to their infrastructure, such as underground fiber optic or gas lines. PLC currently employs over 140 people, servicing some of the largest cable and telecoms operators (e.g., Comcast, Spectrum, AT&T, and Google). PLC is currently aggressively expanding its business and looking for talented and energetic people to bring onboard to help drive growth.
POSITION SUMMARY
Outside Plant Damage (OPD) costs our clients over 30 million annually. Field investigators are needed to collect, access, and report these damages. This is a part-time, on-call contract job to help support our clients with damage recovery. For our field investigators, each day and every investigation is different. We need inquisitive, self-driven individuals who are comfortable rolling up their sleeves and working in a constantly changing, dynamic environment.
Duties
Conduct on-site field investigations
Write detailed but concise investigation reports using diverse sources of information, types of evidence, witness statements, and costing estimates
Develop and maintain comprehensive knowledge of local and state statutes, laws, and regulations for underground and aerial cables and utility service lines
Remain prepared and willing to respond to damage calls within a timely manner
Complete damage investigations within 7 days and then work with and support our claims managers to complete the investigation and begin the recovery process
Respond to damages same day if received during business hours (if not, first response following day)
Accurately record all time, mileage, and other associated specific items
Requirements
Interpersonal skills to gather information and conduct field interviews with involved parties including contractors and technicians, witnesses, law enforcement, and possible damagers
Smartphone to gather photos, videos, and other information while conducting investigations
Computer, with high-speed internet access, to upload and download reports, research cases, and to interact with our claims system and other databases and portals
Exceptional attention to detail and strong written and verbal communication skills
Proven ability to operate independently and prioritize while adhering to timelines
Strong and objective analytical skills
Valid driver's license, current insurance, and reliable vehicle with ability to respond to damages at any time
Safety vest, work boots, and hard-hat
Preferred Qualifications and Skills
Current or previous telecommunication or utility experience
Knowledge of underground utility locating procedures and systems
Investigation, inspection, or claims/field adjusting
Criminal justice, legal, or military training or work experience
Engineering, infrastructure construction, or maintenance background
Remote location determined at discretion of investigations manager
This is a contract position. There are no benefits offered with this position.
$22-25 hourly 8d ago
Liability Field Adjuster - Oklahoma City, OK
CCMS & Associates 3.8
Claims representative job in Oklahoma City, OK
CCMS & Associates is looking for 1099 Field Liability Adjusters. We are answering a call to action to add to our existing roster. The time is now to get on with our innovative team! We are seeking auto/homeowners/general liability field adjusters with at least 5 years of field experience.
Requirements:
Minimum 5 years auto and/or premise liability adjusting experience
Working computer/laptop - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
State adjusters license (where applicable)
Must have a valid drivers license
Responsibilities:
Conduct in-depth investigations into liability claims to gather facts regarding the loss
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses, and by interviewing fire, police, or other government officials as well as inspecting claimed damages
Inspect damage to property and obtain personal injury information to assist in determining liability
Maintain acceptable product quality through compliance with established best practices
Knowledge and Skills:
In-depth knowledge of property and liability insurance coverage and industry standards
Ability to prepare full-captioned reports by collecting and summarizing required information
Strong verbal and written communication skills
Prompt, reliable, and friendly
Detail-oriented individual to accurately gather and analyze information to avoid errors
Preferred but Not Required:
College degree
Professional designations and certifications
All candidates must pass a full background check (void in states where prohibited)
$44k-59k yearly est. Auto-Apply 60d+ ago
Claims Examiner
Harriscomputer
Claims representative job in Oklahoma
Responsibilities & Duties:Claims Processing and Assessment:
Evaluate incoming claims to determine eligibility, coverage, and validity.
Conduct thorough investigations, including reviewing medical records and other relevant documentation.
Analyze policy provisions and contractual agreements to assess claim validity.
Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
Ensure compliance with company policies, procedures, and regulatory requirements.
Maintain accurate records and documentation related to claims activities.
Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
Identify opportunities for process improvement and efficiency within the claims department.
Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
Generate reports and provide data analysis on claims trends, processing times, and outcomes.
Contribute to the development of management reports and presentations regarding claims operations.