Claims representative jobs in Toledo, OH - 24 jobs
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Senior Claims Adjuster
Senior Litigation Adjuster
CVS Health 4.6
Claims representative job in Oregon, OH
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position SummaryAs a Senior Litigation Adjuster in Risk Management, you will be responsible for managing litigation against CVS and overseeing outside counsel defending CVS in premises lawsuits filed throughout the United States.
Responsibilities Include:- Utilizing legal skills and knowledge to oversee and manage complex premises lawsuits against CVS from the initiation of suit through resolution.
- Analyzing case files and internal materials and utilizing resources across CVS to investigate and discern key issues in each case.
- Developing and implementing a litigation strategy in each case to most efficiently resolve or defend that case.
- Assessing the value of all cases through investigation of the pertinent allegations, evaluating the defenses and issues present in each case, and setting appropriate financial reserves.
- Reviewing discovery responses, pleadings, motions, etc.
drafted by defense counsel.
- Providing reporting to key internal stake holders and leadership on case developments.
- Developing relationships with internal colleagues for fact-finding and key litigation activities.
- Participating in internal meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases.
Required Qualifications- 2+ years of litigation experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier.
- Ability to travel and participate in legal proceedings, arbitrations, trials, etc.
Preferred Qualifications- Experience overseeing or defending premises litigation.
- 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.
- Experience overseeing and answering written discovery, reviewing pleadings and case filings.
- Ability to influence and work collaboratively with senior leaders, CVS's in-house legal counsel and outside defense counsel.
- Ability to positively and aggressively represent the company at mediation, arbitration and trial.
- Ability to work independently and in an environment requiring teamwork and collaboration.
- 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 full docket of litigated claims.
- Strong written and verbal communication skills, ability to summarize complex issues in a concise, cogent manner.
- Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new claims software programs and systems.
Education- Verifiable Bachelor's degree or equivalent work experience required.
- JD degree highly desired.
Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988.
00 - $122,400.
00This 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 *************
cvshealth.
com/us/en/benefits We anticipate the application window for this opening will close on: 02/28/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$47k-122.4k yearly 6d ago
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Senior Claims Examiner, New York Labor Law
Arch Capital Group Ltd. 4.7
Claims representative job in Garden City, MI
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
The Claims Division is seeking a team member to join the Casualty Team as Senior Claims Examiner, New York Labor Law. In this role, the responsibilities include but not limited to actively manage a caseload and provide oversight to third-party administrator claims handlers for commercial New York Labor Law cover, liability, and damage claims.
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 strategy to resolve matters of liability and damages of a particular case
* Maintain contact with the TPA claim staff, business line leader, underwriter, and defense counsel, program manager and broker
* Investigate claim and review the insureds' materials, pleadings, and other relevant documents
* Identify and review of 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
* Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation 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 insured, counsel, underwriters, brokers, and senior management regarding claims
Experience & Required Skills
* Three to five (3-5) years of working experience with commercial accounts supporting primary and/or excess claims experience handling New York Labor Law claims
* Energy Casualty, Construction and/or Rail experience is a plus
* 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
* Ability to take part in active strategic discussions
* 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 25%
* This position is a hybrid role with 3 days in office
Education
* Bachelor's degree required; Juris Doctorate degree preferred
* Proper 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.
For NYC, Jersey City: $123,400 - $150,000/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.
14400 Arch Insurance Group Inc.
$123.4k-150k yearly Auto-Apply 10d ago
Analyst, Claims Research
Molina Healthcare 4.4
Claims representative job in Ann Arbor, MI
Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution.
**Essential Job Duties**
- Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects.
- Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams.
- Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests.
- Assists with reducing rework by identifying and remediating claims processing issues.
- Locates and interprets claims-related regulatory and contractual requirements.
- Tailors existing reports and/or available data to meet the needs of claims projects.
- Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors.
- Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes.
- Seeks to improve overall claims performance, and ensure claims are processed accurately and timely.
- Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance.
- Works collaboratively with internal/external stakeholders to define claims requirements.
- Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing.
- Fields claims questions from the operations team.
- Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims.
- Appropriately conveys claims-related information and tailors communication based on targeted audiences.
- Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members.
- Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance.
- Supports claims department initiatives to improve overall claims function efficiency.
**Required Qualifications**
- At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience.
- Medical claims processing experience across multiple states, markets, and claim types.
- Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs.
- Data research and analysis skills.
- Organizational skills and attention to detail.
- Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
- Ability to work cross-collaboratively in a highly matrixed organization.
- Customer service skills.
- Effective verbal and written communication skills.
- Microsoft Office suite (including Excel), and applicable software programs proficiency.
**Preferred Qualifications**
- Health care claims analysis experience.
- Project management experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $22.81 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$22.8-46.4 hourly 13d ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claims representative job in Toledo, OH
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.
$42k-52k yearly est. Auto-Apply 6d ago
Senior Claims Specialist - CA Workers' Compensation
Great American Insurance Group (DBA 4.7
Claims representative job in Oregon, OH
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.
* --------------------------------------------
When is the last time you felt like you made a difference to your employer and in the job you do? Been awhile? Never? Our employees at Strategic Comp DO make a difference and feel appreciated for it. In fact, we received 98% rating for overall job satisfaction from the participants in our last employee survey, clearly indicating the passion and energy our staff has for our company and for the job they do!
Currently we have an opening for a Senior Claims Specialist in your territory. Are you innovative, high energy, resilient, determined, assertive, clever, and competitive? Do you see each new claim as a puzzle to work and a challenge to be won? Does this sound like you? If so, this might be the right job for you.
Here's who we are. Strategic Comp is part of Great American Insurance Group, which was established in 1872. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses. The members of the Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG's common stock is listed and traded on the New York Stock Exchange ("NYSE") and NASDAQ under the symbol "AFG".
Here's what we do. We insure workers' compensation coverage for large companies, using our deductible program. Our service in claims and loss control is second to none. We've found that a large majority of our customers feel the way our employees do. Our renewal retention is 90+%, meaning they enjoy working with us too!
Here's what you would be doing if hired for the Senior Claims Specialist position. Your role would be to investigate and adjust workers' compensation claims with high potential exposure. We take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their territory's comp laws but also enjoys the role of putting that experience to good use. Because we focus on outcomes and not just processes, we look for the adjuster who is very skilled at developing strategies to bring claims to resolution. The person hired for this position will work from an office in their home within the Pacific Region with occasional travel to claims reviews and meetings.
Responsibilities
* Investigating losses
* Analyzing coverage, determining compensability and benefits
* Establishing reserves and negotiating settlements
* Conducting meetings on the phone with insureds and claimants
* Preparing large loss reports to both internal and external audiences
* Attending settlement conferences as assigned
* Working closely with defense attorneys and other vendors including medical case management, surveillance, etc.
Physical Requirements
* Sedentary - requires prolonged sitting, continuous use of computer
* Occasional Travel - may require overnight travel to tri-annual claim reviews and/or departmental meetings
Qualifications
* A minimum of 10 to 13 years of California workers' compensation claims adjusting experience with higher exposure claims is required
* Must have current license to adjust workers' compensation claims in California
* Strong consideration will be given to candidates with industry designations including Associate in Claims
* You must be a great communicator, in both written and verbal form, and be able to work with a variety of internal and external contacts
#LI-StrategicComp
Business Unit:
Strategic Comp
Salary Range:
$110,000.00 -$120,000.00
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.
$110k-120k yearly Auto-Apply 31d ago
Claims Examiner | Public Entity Liability | Ohio
Sedgwick 4.4
Claims representative job in Toledo, OH
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
Claims Examiner | Public Entity Liability | Ohio
Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?
+ Enjoy flexibility and autonomy in your daily work, your location, and your career path. This role is open to a work-at-home, remote, telecommuter setting in Ohio, with occasional travel required.
+ Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
+ Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
**ARE YOU AN IDEAL CANDIDATE?** No day is ever the same assisting our public entity clients with their claims! If you are an agile examiner with 5+ years of experience handling both 3rd party liability and 1st party property claims, we want to talk to you! This examiner will primarily handle liability for Ohio/Nebraska and the following lines of coverage: General Liability, Auto Liability, Employment Practices Liability, Law Enforcement Liability and Public Officials Liability.
**PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
+ Assesses liability and resolves claims within evaluation.
+ Negotiates settlement of claims within designated authority.
+ Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
+ Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
+ Prepares necessary state fillings within statutory limits.
+ Manages the litigation process; ensures timely and cost effective claims resolution.
+ Coordinates vendor referrals for additional investigation and/or litigation management.
+ Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
+ Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
+ Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
+ Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
+ Ensures claim files are properly documented and claims coding is correct.
+ Refers cases as appropriate to supervisor and management.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATION**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
**Experience**
Five (5) years of claims management experience or equivalent combination of education and experience required.
**Skills & Knowledge**
+ Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
+ Excellent oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Analytical and interpretive skills
+ Strong organizational skills
+ Good interpersonal skills
+ Excellent negotiation skills
+ Ability to work in a team environment
+ Ability to meet or exceed Service Expectations
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical:** Computer keyboarding, travel as required
**Auditory/Visual:** Hearing, vision and talking
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is _$80,000 to $95,000 USD annual salary_ . 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.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
\#LI-REMOTE #claimsexaminer #remote
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**
$80k-95k yearly 11d ago
Bodily Injury Claims Specialist
Auto-Owners Insurance Co 4.3
Claims representative job in Toledo, OH
We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury ClaimsRepresentative. The position requires the person to:
* Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss.
* Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage.
* Follow claims handling procedures and participate in claim negotiations and settlements.
* Deliver a high level of customer service to our agents, insureds, and others.
* Devise alternative approaches to provide appropriate service, dependent upon the circumstances.
* Meet with people involved with claims, sometimes outside of our office environment.
* Handle investigations by telephone, email, mail, and on-site investigations.
* Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute.
* Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials.
* Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule.
* Assist in the evaluation and selection of outside counsel.
* Maintain punctual attendance according to an assigned work schedule at a Company approved work location.
Desired Skills & Experience
* A minimum of three years of insurance claims related experience.
* The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision.
* The ability to effectively understand, interpret and communicate policy language.
* The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues.
Benefits
Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of 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.
* Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
#LI-DNI #IN-DNI
$44k-60k yearly est. Auto-Apply 60d+ ago
Independent Insurance Claims Adjuster in Flat Rock, Michigan
Milehigh Adjusters Houston
Claims representative job in Flat Rock, MI
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.
$47k-59k yearly est. Auto-Apply 60d+ ago
CLAIMS SPECIALIST
Community Health Services 3.5
Claims representative job in Fremont, OH
Come to work with us at Community Health Services! We offer full-time benefits, 10 paid holidays, no weekend hours and so much more! We are looking for a full-time Claims Specialist to work in our Fremont office. CHS employs those who are eager to grow professionally, gain great experience, and work with a terrific team. The Claims Specialist will be responsible for performing general finance functions, entering encounters, processing and recording claims and all other duties as assigned.
Hours for this position are:
Mondays 7am-7pm, Tuesdays through Thursdays 8am-5pm, Fridays 8am-1pm
Qualified candidates must have the following to be considered for employment:
* Associate's degree from an accredited college or university
* Experience in accounting/bookkeeping
* Demonstrates ability to organize and implement general accounting and bookkeeping procedures for a healthcare organization
* Ability to work with clinic personnel and patients in a courteous, cooperative manner
* Ability to function as part of a team
* Must have excellent customer service skills
* Must have excellent multi-tasking, problem solving, and decision-making skills
* Ability to follow instructions with attention to detail
* Demonstrates professional relationship skills, and a strong work ethic
* Prioritizes responsibilities, takes initiative, and possesses excellent organizational skills
* Demonstrates effective communication skills
* Ability to work with a culturally diverse group of people
At CHS, we value our team and the critical role they play in patient care. If you're dependable, detail-oriented, and passionate about making a difference in your community, we'd love to hear from you. CHS is a drug-free/nicotine free organization. Candidates must pass a drug and nicotine screening upon employment offer.
$40k-52k yearly est. 41d ago
Claims Specialist
Community and Rural Health Services
Claims representative job in Fremont, OH
Come to work with us at Community Health Services! We offer full-time benefits, 10 paid holidays, no weekend hours and so much more!
We are looking for a full-time Claims Specialist to work in our Fremont office. CHS employs those who are eager to grow professionally, gain great experience, and work with a terrific team. The Claims Specialist will be responsible for performing general finance functions, entering encounters, processing and recording claims and all other duties as assigned.
Hours for this position are:
Mondays 7am-7pm, Tuesdays through Thursdays 8am-5pm, Fridays 8am-1pm
Qualified candidates must have the following to be considered for employment:
Associate's degree from an accredited college or university
Experience in accounting/bookkeeping
Demonstrates ability to organize and implement general accounting and bookkeeping procedures for a healthcare organization
Ability to work with clinic personnel and patients in a courteous, cooperative manner
Ability to function as part of a team
Must have excellent customer service skills
Must have excellent multi-tasking, problem solving, and decision-making skills
Ability to follow instructions with attention to detail
Demonstrates professional relationship skills, and a strong work ethic
Prioritizes responsibilities, takes initiative, and possesses excellent organizational skills
Demonstrates effective communication skills
Ability to work with a culturally diverse group of people
At CHS, we value our team and the critical role they play in patient care. If you're dependable, detail-oriented, and passionate about making a difference in your community, we'd love to hear from you. CHS is a drug-free/nicotine free organization. Candidates must pass a drug and nicotine screening upon employment offer.
$30k-52k yearly est. 16d ago
Saginaw Michigan Field Property Claim Specialist
AAA Southern New England 4.3
Claims representative job in Ann Arbor, MI
Eligible candidates for this role should reside within a commutable distance of Saginaw, Michigan. Saginaw Michigan Field Property Claim Specialist - AAA Auto Club Group Reports to: Claim Manager II What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.
* Review assigned claims,
* Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.
* Complete complex coverage analysis.
* Ensure all possible policyholder benefits are identified.
* Create additional sub-claims if needed.
* Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential.
* Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
* Evaluate the financial value of the loss.
* Approve payments for the appropriate parties accordingly.
* Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
* Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
* Utilize strong negotiating skills.
Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates.
Supervisory Responsibilities:
None
How you will benefit:
* A competitive annual salary between $65,700 - $82,000
* ACG offers excellent and comprehensive benefits packages, including:
* Medical, dental and vision benefits
* 401k Match
* Paid parental leave and adoption assistance
* Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
* Paid volunteer day annually
* Tuition assistance program, professional certification reimbursement program and other professional development opportunities
* AAA Membership
* Discounts, perks, and rewards and much more
We're looking for candidates who:
Required Qualifications (these are the minimum requirements to qualify)
Education:
* Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
* Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent
* CPCU coursework or designation
* Xactware Training
* Complete ACG ClaimRepresentative Training Program or demonstrate equivalent knowledge or experience.
* In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states.
* Must have a valid State Driver's License
Ability to:
* Lift up to 25 pounds
* Climb ladders.
* Walk on roofs.
Experience:
* Three years of experience or equivalent training in the following:
* Negotiation of claim settlements
* Securing and evaluating evidence
* Preparing manual and electronic estimates
* Subrogation claims
* Resolving coverage questions
* Taking statements
* Establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Advanced knowledge of:
* Fair Trade Practices Act as it relates to claims
* Subrogation procedures and processes
* Intercompany arbitration
* Handling simple litigation
* Advanced knowledge of building construction and repair techniques
Ability to:
* Handle claims to the line Claim Handling Standards
* Follow and apply ACG Claim policies, procedures and guidelines
* Work within assigned ACG Claim systems including basic PC software
* Perform basic claim file review and investigations
* Demonstrate effective communication skills (verbal and written)
* Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
* Analyze and solve problems while demonstrating sound decision-making skills
* Prioritize claim related functions
* Process time sensitive data and information from multiple sources
* Manage time, organize and plan workload and responsibilities
* Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc.
* Research analyze and interpret subrogation laws in various states
* May travel outside of assigned territory which may involve overnight stay
Preferred Qualifications:
Education:
* Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
* Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent
* CPCU coursework or designation
* Xactware/Xactimate Training or equivalent
Work Environment
This position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.
Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit ***********
Important Note:
ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
$65.7k-82k yearly Auto-Apply 20d ago
Claims Analyst
United Road 4.6
Claims representative job in Romulus, MI
United Road is the most diversified finished vehicle logistics provider in North America. We employ approximately 1,800 professionals, operating out of nearly 75 locations strategically positioned in every region of the United States, creating a superior and efficient national service network.
Our competitive advantage lies in our ability to provide timely, professional and dependable automobile transport delivery and logistics services. Leveraging our collective strengths, local operational control capitalizes on immediate and regional market knowledge, name recognition, and personal and customer relationships enjoyed by each division. At the same time, United Road's leadership experience, industry leading technology, national purchasing power, and investments in equipment, ensures that we excel in customer service, create an attractive, supportive environment for our employees and provide for the stability and growth of the company as a whole.
Job Description
The Claims Analyst will support the Risk Management/Quality Department in analytical, reporting and record keeping functions. The primary responsibility of this position is to analyze each cargo claim based on investigation findings and documentation to determine claim validity to for best resolution.
The Claims Analyst aids the Cargo Claims Manager in achieving the department's goals and initiatives.
Job Duties
Manage cargo claims; gather all facts concerning a claim and
provide direction to facilitate claim resolution by working directly with claim adjusters, internal/external legal counsel, industry consultants and insurance companies to mitigate losses and ensure claims are resolved in a timely, cost effective manner
Investigate the nature of the incident, collect all necessary documents, determine claim validity, determine and communicate resolution
Track and report outstanding claims, determining equitable settlements and managing daily work queues.
Maintain customer cargo claim aging on assigned accounts within customer guidelines
Process check requests
Communicate and support recommendation for carriers to be placed on hold
Generate, analyze and distribute weekly claim report
Process rebuttals, negotiations, and declinations for claim settlement
Quality support including but not limited to assisting with preparation, follow up and documentation for weekly calls
Accountable to achieve quotas and goals as assigned
Optimize work processes by investigating and employing best practices with a focus on continuous improvement
Other duties assigned as business needs require
Skills Required
Ability to succeed in a fast-paced environment and work under pressure
Proficiency in web-based programs (TCM, OVISS, etc.)
Proficient use of Microsoft Products, with emphasis on Word, Excel, and Outlook
Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy
Adept at queries, report writing and presenting findings
Ability to exercise good judgement in a variety of situations
Ability to solve problems and think quickly under pressure
Effective oral and written communication skills
Process improvement catalyst
Demonstrated poise, tact, and diplomacy
Maintain a positive work atmosphere by acting and communicating in a manner which facilitates the success of business operations in order to meet company demands and expectations
Qualifications
Two years of claims handling experience in transportation industry preferred
Two year college degree preferred
Additional Information
Please apply online at:
**************************************************************************
All your information will be kept confidential according to EEO guidelines.
$44k-70k yearly est. 1d ago
Claims Examiner
Harris Computer Systems 4.4
Claims representative job in Oregon, OH
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-60k yearly est. Auto-Apply 37d ago
Claims Processor OR Claims Representative I OR Claims Representative II
Goodville Mutual Casualty Company 3.7
Claims representative job in Napoleon, OH
This position is responsible for processing Super Service claims according to company guidelines with settlement authority up to $3,500, as well as providing claims customer service to agents, policyholders, and claimants.
Functions:
Process first party auto claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
Receive incoming loss reports, verify policy coverages, and document for review by CSR and Subro Claims Supervisor.
Verify policy coverage of assigned losses.
Investigate and evaluate assigned Super Service claims for proper settlement.
Assign independent adjusters and appraisers when necessary.
Pursue subrogation, salvage, and third-party liability contribution.
Notify CSR and Subro Claims Supervisor of all claims that exceed settlement authority of $3,500.
Establish proper reserves on assigned claims.
Issue payments to vendors with prior management/ClaimsRepresentative approval.
Assist CSRs with end of day, month-end, and quarterly reports.
Report claim complaints, questionable claim submissions and possible fraud to CSR and Subro Claims Supervisor.
Perform other duties as assigned by CSR and Subro Claims Supervisor.
Requirements
High school or equivalent education required.
Ability to learn basic knowledge of insurance coverages written by the company required.
Effective communication skills required.
Ability to understand basic insurance terms and law required.
Ability to learn through on-the-job training required.
Ability to work effectively with company computer systems required.
Willingness to participate in insurance related study courses preferred.
Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required.
Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required.
Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required.
Ability to perform the essential functions of the job with or without reasonable accommodation required.
$27k-42k yearly est. 60d+ ago
Analyst, Claims Research
Molina Healthcare Inc. 4.4
Claims representative job in Ann Arbor, MI
Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution.
Essential Job Duties
* Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects.
* Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams.
* Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests.
* Assists with reducing rework by identifying and remediating claims processing issues.
* Locates and interprets claims-related regulatory and contractual requirements.
* Tailors existing reports and/or available data to meet the needs of claims projects.
* Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors.
* Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes.
* Seeks to improve overall claims performance, and ensure claims are processed accurately and timely.
* Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance.
* Works collaboratively with internal/external stakeholders to define claims requirements.
* Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing.
* Fields claims questions from the operations team.
* Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims.
* Appropriately conveys claims-related information and tailors communication based on targeted audiences.
* Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members.
* Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance.
* Supports claims department initiatives to improve overall claims function efficiency.
Required Qualifications
* At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience.
* Medical claims processing experience across multiple states, markets, and claim types.
* Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs.
* Data research and analysis skills.
* Organizational skills and attention to detail.
* Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
* Ability to work cross-collaboratively in a highly matrixed organization.
* Customer service skills.
* Effective verbal and written communication skills.
* Microsoft Office suite (including Excel), and applicable software programs proficiency.
Preferred Qualifications
* Health care claims analysis experience.
* Project management experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $22.81 - $46.42 / HOURLY
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$22.8-46.4 hourly 14d ago
Senior Claims Specialist - OR & CA Workers' Compensation
Great American Insurance Group (DBA 4.7
Claims representative job in Oregon, OH
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.
* --------------------------------------------
When is the last time you felt like you made a difference to your employer and in the job you do? Been awhile? Never? Our employees at Strategic Comp DO make a difference and feel appreciated for it. In fact, we received 98% rating for overall job satisfaction from the participants in our last employee survey, clearly indicating the passion and energy our staff has for our company and for the job they do!
Currently we have an opening for a Senior Claims Specialist in your territory. Are you innovative, high energy, resilient, determined, assertive, clever, and competitive? Do you see each new claim as a puzzle to work and a challenge to be won? Does this sound like you? If so, this might be the right job for you.
Here's who we are. Strategic Comp is part of Great American Insurance Group, which was established in 1872. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses. The members of the Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG's common stock is listed and traded on the New York Stock Exchange ("NYSE") and NASDAQ under the symbol "AFG".
Here's what we do. We insure workers' compensation coverage for large companies, using our deductible program. Our service in claims and loss control is second to none. We've found that a large majority of our customers feel the way our employees do. Our renewal retention is 90+%, meaning they enjoy working with us too!
Here's what you would be doing if hired for the Senior Claims Specialist position. Your role would be to investigate and adjust workers' compensation claims with high potential exposure. We take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their territory's comp laws but also enjoys the role of putting that experience to good use. Because we focus on outcomes and not just processes, we look for the adjuster who is very skilled at developing strategies to bring claims to resolution. The person hired for this position will work from an office in their home in Oregon with occasional travel to claims reviews and meetings.
Responsibilities
* Investigating losses
* Analyzing coverage, determining compensability and benefits
* Establishing reserves and negotiating settlements
* Conducting meetings on the phone with insureds and claimants
* Preparing large loss reports to both internal and external audiences
* Attending settlement conferences as assigned
* Working closely with defense attorneys and other vendors including medical case management, surveillance, etc.
Physical Requirements
* Sedentary - requires prolonged sitting, continuous use of computer
* Occasional Travel - may require overnight travel to tri-annual claim reviews and/or departmental meetings
Qualifications
* A minimum of 10 to 13 years of Oregon and California workers' compensation claims adjusting experience with higher exposure claims is required
* Must have current license to adjust workers' compensation claims in California
* Strong consideration will be given to candidates with industry designations including Associate in Claims
* You must be a great communicator, in both written and verbal form, and be able to work with a variety of internal and external contacts
#LI-StrategicComp
Business Unit:
Strategic Comp
Salary Range:
$105,000.00 -$115,000.00
Benefits:
Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs.
We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees.
Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.
$105k-115k yearly Auto-Apply 56d ago
Independent Insurance Claims Adjuster in Ann Arbor, Michigan
Milehigh Adjusters Houston
Claims representative job in Ann Arbor, MI
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.
$47k-59k yearly est. Auto-Apply 60d+ ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claims representative job in Ann Arbor, MI
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.
$48k-58k yearly est. Auto-Apply 5d ago
Claims Analyst
United Road 4.6
Claims representative job in Romulus, MI
United Road is the most diversified finished vehicle logistics provider in North America. We employ approximately 1,800 professionals, operating out of nearly 75 locations strategically positioned in every region of the United States, creating a superior and efficient national service network.
Our competitive advantage lies in our ability to provide timely, professional and dependable automobile transport delivery and logistics services. Leveraging our collective strengths, local operational control capitalizes on immediate and regional market knowledge, name recognition, and personal and customer relationships enjoyed by each division. At the same time, United Road's leadership experience, industry leading technology, national purchasing power, and investments in equipment, ensures that we excel in customer service, create an attractive, supportive environment for our employees and provide for the stability and growth of the company as a whole.
Job Description
The Claims Analyst will support the Risk Management/Quality Department in analytical, reporting and record keeping functions. The primary responsibility of this position is to analyze each cargo claim based on investigation findings and documentation to determine claim validity to for best resolution. The Claims Analyst aids the Cargo Claims Manager in achieving the department's goals and initiatives.
Job Duties
Manage cargo claims; gather all facts concerning a claim and provide direction to facilitate claim resolution by working directly with claim adjusters, internal/external legal counsel, industry consultants and insurance companies to mitigate losses and ensure claims are resolved in a timely, cost effective manner
Investigate the nature of the incident, collect all necessary documents, determine claim validity, determine and communicate resolution
Track and report outstanding claims, determining equitable settlements and managing daily work queues.
Maintain customer cargo claim aging on assigned accounts within customer guidelines
Process check requests
Communicate and support recommendation for carriers to be placed on hold
Generate, analyze and distribute weekly claim report
Process rebuttals, negotiations, and declinations for claim settlement
Quality support including but not limited to assisting with preparation, follow up and documentation for weekly calls
Accountable to achieve quotas and goals as assigned
Optimize work processes by investigating and employing best practices with a focus on continuous improvement
Other duties assigned as business needs require
Skills Required
Ability to succeed in a fast-paced environment and work under pressure
Proficiency in web-based programs (TCM, OVISS, etc.)
Proficient use of Microsoft Products, with emphasis on Word, Excel, and Outlook
Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy
Adept at queries, report writing and presenting findings
Ability to exercise good judgement in a variety of situations
Ability to solve problems and think quickly under pressure
Effective oral and written communication skills
Process improvement catalyst
Demonstrated poise, tact, and diplomacy
Maintain a positive work atmosphere by acting and communicating in a manner which facilitates the success of business operations in order to meet company demands and expectations
Qualifications
Two years of claims handling experience in transportation industry preferred
Two year college degree preferred
Additional Information
Please apply online at:
**************************************************************************
All your information will be kept confidential according to EEO guidelines.
$44k-70k yearly est. 60d+ ago
Claims Examiner, Commercial Insurance
Arch Capital Group Ltd. 4.7
Claims representative job in Garden City, MI
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 as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing medium-high severity commercial liability claims 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
* 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%
* Hybrid schedule, 3 days a week in office
Education
* Bachelor's degree required.
* Minimum of 3 years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims
* 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.
$95,000 - $150,000/year based on experience level
* 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.
How much does a claims representative earn in Toledo, OH?
The average claims representative in Toledo, OH earns between $27,000 and $55,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.
Average claims representative salary in Toledo, OH