Claims Representative II
Claims representative job in Baltimore, MD
Davies Claims North America seeks an experienced Claims Representative to manage claims related to MTA operations, including minor property damage and complex bodily injury. Reporting to the MTA Claims Supervisor, this role involves investigation, litigation management, and reserve evaluation for claims exceeding $25,000.
Key Responsibilities:
Handle a caseload of 150+ files, some with multiple claimants
Investigate claims, manage litigation, and maintain detailed documentation
Evaluate reserves and issue timely reports
Uphold company values: Dynamic, Innovative, Connected, Collaborative
Perform additional duties as assigned
Requirements:
High school diploma or equivalent
Minimum 3 years of experience in auto property damage, bodily injury, and general liability claims
Proficiency in Microsoft Office
Familiarity with Medicare reporting requirements (Section 111)
Benefits:
Medical, dental, and vision coverage
401(k) with employer match
Paid holidays and time off
Life, short-term, and long-term disability insurance
Claims Analyst
Claims representative job in Washington, DC
At least twenty-four (24) Medicaid related Claims Analyst and Claims Processors are needed for a long-term project in DC. These positions are 100% onsite and located downtown, near Farragut North Metro Station.
The Midtown Group is teaming up with a leading technology company to support a D.C. government department that offers its residents a Medicaid program. Our collective goal is to modernize and optimize DC's Medicaid program while offering outstanding customer support. Our venture is focused on improving outcomes, enhancing provider experiences, and safeguarding program integrity. For this project, our partner will provide technology, and we will provide people and expertise across several functions, including contact center operations.
Claims Analyst and Claims Processors will support D.C. medical providers who need assistance with Medicaid benefits.
These positions are in-person, located in Downtown D.C. There are no plans to move to hybrid or fully remote models. Interviews begin on Tuesday, 12/9/25, and these engagements are expected to start on 1/16/26 and may continue for up to two or three years or longer.
Key job tasks
Claims/Financial Analyst/Processors have several job responsibilities, and some of the critical ones are:
· Handle refund checks and state warrants received from healthcare providers and the State agency.
· Contact providers, verbal and in writing, to resolve check-related issues.
· Receive and respond to client inquiries.
· Responsible for handling the Accounts Receivable transfer process, setting up expenditures, setting up Accounts Receivable transactions, and placing and recoupment caps using the Medicaid system.
· Responsible for analyzing financial data to ensure accurate reporting.
· Research highly complex claims processing or financial transactions.
· Process adjustments and voids.
· Ensure SLAs are compliant with client and Midtown Group expectations
· Other duties as assigned.
Performance measurement
The Midtown Group measures performance in a number of ways, with the key ones being:
Quality Assurance assessments: may have their calls monitored and assessed at any time during a shift. We and our partner monitor and assess our CSRs regularly. CSRs are expected to maintain or exceed a QA pass rate of 90%+. Calls are considered to have failed if a CSR misses or incorrectly performs any critical element of the job. These items are well-covered in training and reinforced during pre-shift and individual coaching sessions.
Call handling metrics are a good measure of performance and the three focus areas are:
Percent of your shift that you are either on a call or available to take a call.
Length of call. We are here to provide efficient, professional assistance, so a consistent track record of very long or very short calls is generally frowned upon.
Percent of calls that you transfer. This often indicates that a CSR is unable or unwilling to assist callers.
Attendance
Minimum requirements
· High School Diploma or equivalent, 2-year post-high school Degree, or bachelor's degree.
· A minimum of two years of previous experience for a government or private sector operations center in a similar or related field.
· Two to four years of working experience in claims processing and financial analysis.
· Organization skills to balance/prioritize work with the ability to multi-task.
· Proficiency with basic help desk software, computer software and Microsoft Office applications.
· Problem-solving skills to bring inquiries to effective resolution.
· Customer service skills, with an emphasis on written and oral communication, to professionally and efficiently respond to inquiries.
Other important skills
The ability to provide operational excellence is extremely important to both the Midtown Group and our client. If you have the service gene - if helping others is in your DNA - we are happy to have you join us.
Our most effective and successful Claims/Financial Analyst/Processors exhibit the following skills:
· Conduct themselves with professionalism, empathy, patience, courtesy, and tact, at all times.
· Communicate effectively, clearly, and professionally.
· Quickly and effectively process transactions and analyze financial data, to a high standard. Operational quality is very important to us.
· Know when and how to collaborate and escalate to quickly and effectively address and resolve issues.
· Effectively collect and handle sensitive data and personal information, as needed.
· Exercise good judgment at all times.
· Deal well with conflict, as well as complex and emotional situations.
· Be flexible, and able to work independently.
Hours, project duration, etc.
The contact center operating hours are Monday through Friday, from 8:00am to 5:00pm ET. However, schedules will be between the hours of 7:45am to 5:15pm ET, to allow for pre-shift sessions and last-minute contacts/wrap up.
The contact center is closed on Federal holidays. Candidates must be able to work 40 hours per week.
The base period for this contract is through November 2026, with two further annual option periods. So, this contract could run until November 2028.
Experienced Outside Property Claim Representative - Washington, DC
Claims representative job in Washington, DC
ATTENTION MILITARY AFFILIATED JOB SEEKERS
- Our organization works with partner companies to source qualified talent for their open roles. The following position is available to
Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers
. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps.
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Compensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range
$67,000.00 - $110,600.00
What Is the Opportunity?
This position could be eligible for a sign on bonus.
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
What Will You Do?
Handles 1st party property claims of moderate severity and complexity as assigned.
Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
Broad scale use of innovative technologies.
Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
Establishes timely and accurate claim and expense reserves.
Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
Writes denial letters, Reservation of Rights and other complex correspondence.
Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
Meets all quality standards and expectations in accordance with the Knowledge Guides.
Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
Manages file inventory to ensure timely resolution of cases.
Handles files in compliance with state regulations, where applicable.
Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
Identifies and refers claims with Major Case Unit exposure to the manager.
Performs administrative functions such as expense accounts, time off reporting, etc. as required.
Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
May provides mentoring and coaching to less experienced claim professionals.
May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
Must secure and maintain company credit card required.
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
Perform other duties as assigned.
Additional Qualifications/Responsibilities
What Will Our Ideal Candidate Have?
Bachelor's Degree preferred.
General knowledge of estimating system Xactimate preferred.
Two or more years of previous outside property claim handling experience preferred.
Interpersonal and customer service skills - Advanced
Organizational and time management skills- Advanced
Ability to work independently - Intermediate
Judgment, analytical and decision making skills - Intermediate
Negotiation skills - Intermediate
Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate
Investigative skills - Intermediate
Ability to analyze and determine coverage - Intermediate
Analyze, and evaluate damages -Intermediate
Resolve claims within settlement authority - Intermediate
Valid passport preferred.
What is a Must Have?
High School Diploma or GED required.
A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required.
Valid driver's license required.
What Is in It for You?
Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
Experienced Outside Property Claim Representative
Claims representative job in Washington, DC
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$67,000.00 - $110,600.00
**Target Openings**
1
**What Is the Opportunity?**
This position could be eligible for a sign on bonus.
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
**What Will You Do?**
+ Handles 1st party property claims of moderate severity and complexity as assigned.
+ Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
+ Broad scale use of innovative technologies.
+ Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
+ Establishes timely and accurate claim and expense reserves.
+ Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
+ Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
+ Writes denial letters, Reservation of Rights and other complex correspondence.
+ Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
+ Meets all quality standards and expectations in accordance with the Knowledge Guides.
+ Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
+ Manages file inventory to ensure timely resolution of cases.
+ Handles files in compliance with state regulations, where applicable.
+ Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
+ Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
+ Identifies and refers claims with Major Case Unit exposure to the manager.
+ Performs administrative functions such as expense accounts, time off reporting, etc. as required.
+ Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
+ May provides mentoring and coaching to less experienced claim professionals.
+ May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
+ CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
+ Must secure and maintain company credit card required.
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
+ This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree preferred.
+ General knowledge of estimating system Xactimate preferred.
+ Two or more years of previous outside property claim handling experience preferred.
+ Interpersonal and customer service skills - Advanced
+ Organizational and time management skills- Advanced
+ Ability to work independently - Intermediate
+ Judgment, analytical and decision making skills - Intermediate
+ Negotiation skills - Intermediate
+ Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate
+ Investigative skills - Intermediate
+ Ability to analyze and determine coverage - Intermediate
+ Analyze, and evaluate damages -Intermediate
+ Resolve claims within settlement authority - Intermediate
+ Valid passport preferred.
**What is a Must Have?**
+ High School Diploma or GED required.
+ A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required.
+ Valid driver's license required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Stop Loss & Health Claim Analyst
Claims representative job in Baltimore, MD
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.
Job Description:
The Opportunity:
This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim.
The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources.
How you will contribute:
* Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim
* The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions
* Maintain claim block and meet departmental production and quality metrics
* An awareness of industry claim practices
* Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records
* Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc.
* Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process
* Establish cooperative and productive relationships with professional resources
What you will bring with you:
* Bachelor's degree preferred
* A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing
* Demonstrated ability to work as part of a cohesive team
* Strong written and verbal communication skills
* Knowledge of Stop Loss Claims and Stop Loss industry preferred
* Demonstrated success in negotiation, persuasion, and solutions-based underwriting
* Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism
* Overall knowledge of health care industry
* Proficiency using the Microsoft Office suite of products
* Ability to travel
Salary Range: $54,900 - $82,400
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Job Category:
Claims - Life & Disability
Posting End Date:
30/01/2026
Auto-ApplyClaims Analyst (Level II)
Claims representative job in Cockeysville, MD
Since 1991, Collabera has been a leading provider of IT staffing solutions and services. We are known for providing the best staffing experience and taking great care of our clients and employees. Our client-centric model provides focus, commitment and a dedicated team to help our clients achieve their business objectives. For consultants and employees, we offer an enriching experience that promotes career growth and lifelong learning.
Position Details:
Industry: Financial Services
Work Location: Hunt Valley, MD
Job Title: Claims Analyst (Level II)
Duration: 6+ months (Strong possibility of extension)
Available Shift/s:
• 11:00 am - 8:00 pm; Saturday, Monday, Tuesday, Thursday, Friday
Job Description:
• Receives incoming calls and assists customers with questions or issues regarding potential billing dispute and/or fraudulent related activity on their credit card account.
• Takes appropriate action based on an evaluation of the customer's needs which may include, filing a new claim(s), updating and follow-up on existing claim(s), and/or reviewing appeals on denied claims.
• Takes personal ownership to ensure that customer requests are processed quickly and efficiently, while maintaining compliance with industry regulations and bank procedures.
• Responsibilities include but are not limited to: initiating claims using multiple systems and tools, providing first call resolution on inquiries, and may assist the customer in resolving disputes directly with the merchant.
• May debit or credit customer's accounts, as appropriate.
• May research and resolve other general customer account inquiries as appropriate and/or escalate issues on the customer's behalf while providing world class customer service.
• Understand and adhere to established service level agreements and set appropriate expectation with the clients and customers regarding the claims process.
Job Requirements:
• Ideal candidate will have credit card knowledge in a customer service contact center.
Qualifications
MUST HAVE
claims and/or customer service (call center environment) experience.
Knowledge with
credit card
in a customer service contact center.
Flexible with the work schedule.
Senior Claims Analyst
Claims representative job in Washington, DC
Owner's project management firm is seeking an experienced SENIOR CLAIMS ANALYST for work on construction claims. Candidates qualifications must include demonstrated experience with:
Furnishes reports with supporting information necessary to resolve disputes or defend against the claims,
Prepares and assembles appeal files,
Participates in meetings or negotiations with claimants,
Appears in legal proceedings,
Prepares cost estimates for use in claims negotiations,
Prepares risk assessments/analysis relative to claim exposures,
Prepares findings of fact and other documentation required by the CO.
Provides litigation support to include court boards, timelines, diagrams, static and electronic illustrations and three dimensional models.
Candidates should have demonstrated ability to work cooperatively and productively as a member of a project or claims defense team. Candidates must have 15 years experience and a Bachelor's Degree in Engineering, or Construction/Project Management. CCM and either P.E. or CPA necessary though all three are preferred.
Submit resumes and project list in MS Word or PDF format:
Please No Calls
Independent Insurance Claims Adjuster in Baltimore, Maryland
Claims representative job in Baltimore, MD
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
Auto-ApplyField Claims Adjuster
Claims representative job in Baltimore, MD
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.
Field Property Adjuster
Claims representative job in Baltimore, MD
Job DescriptionDescription:
Capstone ISG is one of the nation's fastest growing Independent Adjustment firms. As we continue to grow our business, we are looking for people who offer inspiration and innovation, as well as have an internal drive. Our team members are focused on customer service and are dedicated to making Capstone a fun and rewarding place to work.
Our Field Property Adjuster specializes in investigating and adjusting residential and commercial property claims. Our focus is high quality claim investigation and resolution. We're seeking a conscientious individual with high attention to detail, excellent decision-making, ability to work well under pressure, solid organizational and time management skills to balance diverse tasks including on site investigations in a standard work day.
5+ Years Experience in and around the Baltimore Area.IA Experience is preferred
Benefits Include:
Competitive salary with annual raises
Quarterly performance bonuses
Profit Sharing
Medical, Dental, Vision
401 (k)
Short and Long Term Disability
Life Insurance
Sick, Vacation and Holiday Pay
Fitness Membership Reimbursement
Company paid training
Primary Responsibilities:
Conducts field investigations to resolve residential and commercial property claims.
Examines and applies claims forms, policies and endorsements, client instructions and other records to determine coverage and client exposure.
Adjusts all elements of Property Loss claims of varying levels of severity and complexity.
Sets loss reserves.
Prepares written reports by collecting and summarizing information required by client.
Prepares settlement letters, denial letters, Reservations of Rights and other letters as needed.
Maintains expected case load.
Maintains company reputation and integrity of work product by complying with federal and state regulations and service standards.
Maintains professional and technical knowledge through continuing education.
May assist less-experienced adjusters with claims handling when requested
Participates in special projects or performs duties in other areas if requested.
Documents damage and prepares written estimates using Xactimate software.
Handles content inventories to include moderate to complex pricing analysis and prepares claim inventory reports.
Conducts subrogation investigations.
Engages and manages consultants/independent contractors to assist in determining facts, causation, damage and exposure.
Keeps the client and the insured informed about the claim status with clear, timely and accurate written/oral communication.
Negotiates settlement of claims of varying complexity under the direction of the Claims Manager or Supervisor.
Travels to loss locations in assigned territory
Records time and expense charges to bill clients.
Maintains adjuster license(s) when required.
Requirements:
Requires a high school diploma; advanced education beyond high school preferred or an equivalent combination of education and experience.
Previous experience as a claims adjuster or must complete Capstone specified adjuster training if no experience.
If previous adjuster experience, working knowledge of Xactimate is preferred.
Must be licensed, or have the ability to obtain license(s), as required by state and local jurisdictions to adjust insurance claims.
Must have valid driver's license.
Skills and Competencies:
Ability to work in a high volume, fast paced environment managing multiple tasks.
Ability to provide excellent service to policyholders and clients.
Ability to efficiently operate a computer and related claims and business software.
Effective analytical and problem-solving skills necessary to make decisions and resolve conflict
Good verbal and written communication skills.
Good attention to detail.
Strong analytical and mathematical ability.
Ability to work independently in a virtual environment when required.
Good organizational and time management skills.
Physical Demand Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this position, auto travel is required.
Ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a vehicle. Ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics. Ability to work in a confined or restricted area. Kneeling, crouching, crawling, standing, sitting, walking, pushing, pulling, etc. as is required to inspect claims. Ability to work outdoors, exposed to all weather conditions.
Claims Specialist
Claims representative job in Washington, DC
This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously submitted appeals.
DUTIES AND RESPONSIBILITIES:
Investigates Claims Denials.
Handles large volumes of documents, including accurately scanning and mailing documents.
Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement.
Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
Is comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals.
Opens, sorts, and imports incoming correspondence into the office database.
Navigates through various computer systems and applications to find information about insurance claims.
Greets and assists onsite guests.
Answers calls for Claim status and Appeal status.
Performs any other administrative duties as may be necessary.
Performs other related duties as assigned by management.
QUALIFICATIONS:
Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
Other skills required :
Previous experience in office administration or another related field.
Basic working knowledge of the US healthcare system.
Ability to prioritize and multitask.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office, including Word and Excel.
Highly attentive to detail.
Excellent organizational and time management skills.
Clear, concise, and logical writing style.
Computer-savvy, able to learn new applications/software quickly.
Please remove paragraph before using in Workplace
COMPETENCIES: Select which competency categories are necessary for this position. We strongly recommend diversity and ethics to be included in each . Then select an additional 3-5 of the most critical competencies for the specific job title.
Please note: You may remove complete statements and complete sub-title sections however the verbiage/content may not be altered nor can wording be inserted as this is standard in all ADP Job Descriptions and are compliant.
COMPETENCIES:
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results.
Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
Auto-ApplyIP Litigation (IT/Engineering) #20502
Claims representative job in Washington, DC
Large GP Firm with Cravath level compensation. A top firm for Emerging Companies and Venture Capital. Per Fortune Magazine: "One of the best places to work in the US." On the American Lawyer's "A List." Active at the PTAB.
REQUIREMENTS
Seeking candidates with at least a basic understanding of and keen interest in patent law who isn't afraid to stand up in court or take a deposition (and preferably has actually done both), is comfortable speaking directly with clients and opposing counsel, enjoys thinking creatively and working on a team, and is willing to actively participate in the strategic development of the case.
Candidates should have significant patent litigation experience in U.S. District Court and before the Patent Trial and Appeal Board (post-grant proceedings), including participating in underlying case analyses; conducting factual and legal research; drafting pleadings; participating in discovery on infringement, validity, and damages issues, including depositions and expert discovery; researching and drafting dispositive and discovery motions and claim construction briefing; and participating in pre-trial and trial activities. Ideal candidates will have: (i) undergraduate or master's degree in electrical engineering, mechanical engineering, computer science and/or physics; (ii) experience working within the Intellectual Property department of a comparable law firm; and (iii) a high level of academic achievement from a law school institution. ITC experience would be a plus. Candidates should have excellent writing skills.
SUMMARY
Vanguard Intellectual Partners (Vanguard-IP) specializes in the placement of IP/Patent professionals nationwide.
Our concentrated focus in these areas enables us to more deeply understand our clients' technical needs, and our candidates' individual talents and career interests. Our broad network of long-term client relationships gives us a competitive edge.
Our recruiters all have 10+ years of IP recruiting experience, and an exceptional record of success. We have superior knowledge of the IP job market, and offer trusted career advice for our candidates. We also have the resources and high-level contacts to get your resume noticed by the people who matter.
We look forward to speaking with you, and learning more about what you are seeking in your next opportunity.
CONFIDENTIALITY
At Vanguard-IP, we respect the confidentiality of every candidate who contacts us. Furthermore, we will always obtain expressed authorization before submitting your resume to any of our clients.
**Should you have an interest in exploring opportunities in another location, we have hundreds of openings in other markets. Please apply now and our team would be happy to review your information for this or other openings in your location of interest.
Outside Property Claim Representative Trainee
Claims representative job in Washington, DC
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$52,600.00 - $86,800.00
**Target Openings**
1
**What Is the Opportunity?**
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington, DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
**What Will You Do?**
+ Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel.
+ The on the job training includes practice and execution of the following core assignments:
+ Handles 1st party property claims of moderate severity and complexity as assigned.
+ Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates.
+ Broad scale use of innovative technologies.
+ Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate.
+ Establishes timely and accurate claim and expense reserves.
+ Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
+ Negotiates and conveys claim settlements within authority limits.
+ Writes denial letters, Reservation of Rights and other complex correspondence.
+ Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
+ Meets all quality standards and expectations in accordance with the Knowledge Guides.
+ Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
+ Manages file inventory to ensure timely resolution of cases.
+ Handles files in compliance with state regulations, where applicable.
+ Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
+ Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
+ Identifies and refers claims with Major Case Unit exposure to the manager.
+ Performs administrative functions such as expense accounts, time off reporting, etc. as required.
+ Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
+ May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
+ Must secure and maintain company credit card required.
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards.
+ This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience.
+ Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic.
+ Verbal and written communication skills -Intermediate.
+ Attention to detail ensuring accuracy - Basic.
+ Ability to work in a high volume, fast paced environment managing multiple priorities - Basic.
+ Analytical Thinking - Basic.
+ Judgment/ Decision Making - Basic.
+ Valid passport.
**What is a Must Have?**
+ High School Diploma or GED and one year of customer service experience OR Bachelor's Degree.
+ Valid driver's license.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Claims Analyst (Level II)
Claims representative job in Cockeysville, MD
Since 1991, Collabera has been a leading provider of IT staffing solutions and services. We are known for providing the best staffing experience and taking great care of our clients and employees.
Our client-centric model provides focus, commitment and a dedicated team to help our clients achieve their business objectives. For consultants and employees, we offer an enriching experience that promotes career growth and lifelong learning.
Position Details:
Industry: Financial Services
Work Location: Hunt Valley, MD
Job Title: Claims Analyst (Level II)
Duration: 6+ months (Strong possibility of extension)
Available Shift/s:
• 11:00 am - 8:00 pm; Saturday, Monday, Tuesday, Thursday, Friday
Job Description:
• Receives incoming calls and assists customers with questions or issues regarding potential billing dispute and/or fraudulent related activity on their credit card account.
• Takes appropriate action based on an evaluation of the customer's needs which may include, filing a new claim(s), updating and follow-up on existing claim(s), and/or reviewing appeals on denied claims.
• Takes personal ownership to ensure that customer requests are processed quickly and efficiently, while maintaining compliance with industry regulations and bank procedures.
• Responsibilities include but are not limited to: initiating claims using multiple systems and tools, providing first call resolution on inquiries, and may assist the customer in resolving disputes directly with the merchant.
• May debit or credit customer's accounts, as appropriate.
• May research and resolve other general customer account inquiries as appropriate and/or escalate issues on the customer's behalf while providing world class customer service.
• Understand and adhere to established service level agreements and set appropriate expectation with the clients and customers regarding the claims process.
Job Requirements:
• Ideal candidate will have credit card knowledge in a customer service contact center.
Qualifications
MUST HAVE claims and/or customer service (call center environment) experience.
Knowledge with credit card in a customer service contact center.
Flexible with the work schedule.
Independent Insurance Claims Adjuster in Silver Spring, Maryland
Claims representative job in Silver Spring, MD
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
Auto-ApplyField Claims Adjuster
Claims representative job in Germantown, MD
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.
Claims Specialist
Claims representative job in Washington, DC
SUMMARY:
This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously submitted appeals.
DUTIES AND RESPONSIBILITIES:
Investigates Claims Denials.
Handles large volumes of documents, including accurately scanning and mailing documents.
Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement.
Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
Is comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals.
Opens, sorts, and imports incoming correspondence into the office database.
Navigates through various computer systems and applications to find information about insurance claims.
Greets and assists onsite guests.
Answers calls for Claim status and Appeal status.
Performs any other administrative duties as may be necessary.
Performs other related duties as assigned by management.
QUALIFICATIONS:
Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
Other skills required:
Previous experience in office administration or another related field.
Basic working knowledge of the US healthcare system.
Ability to prioritize and multitask.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office, including Word and Excel.
Highly attentive to detail.
Excellent organizational and time management skills.
Clear, concise, and logical writing style.
Computer-savvy, able to learn new applications/software quickly.
Please remove paragraph before using in Workplace
COMPETENCIES: Select which competency categories are necessary for this position. We strongly recommend diversity and ethics to be included in each . Then select an additional 3-5 of the most critical competencies for the specific job title.
Please note: You may remove complete statements and complete sub-title sections however the verbiage/content may not be altered nor can wording be inserted as this is standard in all ADP Job Descriptions and are compliant.
COMPETENCIES:
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results.
Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
Trainee Field Property Adjuster
Claims representative job in Pikesville, MD
Job DescriptionDescription:
Founded in 2003, Capstone ISG Inc. is committed to delivering precise, high-quality claims services to insurance carriers, government entities, and the Lloyd's market. As part of our continued national expansion, we are looking to train an entry-level Field Adjuster in the Baltimore market. This is a great opportunity to launch a career in claims adjusting with strong long-term growth potential. Capstone is dedicated to developing talent from within, offering a clear path for advancement as you gain experience and expertise. We value quality, consistency, and hands-on learning-and combine cutting-edge technology with exceptional customer service to support our clients and team members alike.
Role Description
This is a full-time Location Based remote role in Baltimore. As an Entry-Level Field Adjuster, you will be trained to investigate and evaluate property and casualty insurance claims in the field. You'll learn to inspect damage, assess coverage, determine liability, and prepare detailed reports for insurance carriers. This position offers a mix of office and on-site work, and is ideal for individuals who enjoy problem-solving, working independently, and engaging with clients face-to-face.
MANDATORY PAID 30 DAY -IN PERSON TRAINING IN CHARLOTTE, NC- ACCOMMODATIONS AND TRAVEL PROVIDED -
Benefits Include:
Competitive salary with annual raises
Quarterly performance bonuses
Medical, Dental, Vision
401 (k)
Short and Long Term Disability
Life Insurance
Sick, Vacation and Holiday Pay
Fitness Membership Reimbursement
Company paid training
Primary Responsibilities:
Conducts field investigations to resolve residential and commercial property claims.
Examines and applies claims forms, policies and endorsements, client instructions and other records to determine coverage and client exposure.
Adjusts all elements of Property Loss claims of varying levels of severity and complexity.
Sets loss reserves.
Prepares written reports by collecting and summarizing information required by client.
Prepares settlement letters, denial letters, Reservations of Rights and other letters as needed.
Maintains expected case load.
Maintains company reputation and integrity of work product by complying with federal and state regulations and service standards.
Maintains professional and technical knowledge through continuing education.
May assist less-experienced adjusters with claims handling when requested
Participates in special projects or performs duties in other areas if requested.
Documents damage and prepares written estimates using Xactimate software.
Handles content inventories to include moderate to complex pricing analysis and prepares claim inventory reports.
Conducts subrogation investigations.
Engages and manages consultants/independent contractors to assist in determining facts, causation, damage and exposure.
Keeps the client and the insured informed about the claim status with clear, timely and accurate written/oral communication.
Negotiates settlement of claims of varying complexity under the direction of the Claims Manager or Supervisor.
Travels to loss locations in assigned territory
Records time and expense charges to bill clients.
Maintains adjuster license(s) when required.
Requirements:
Requires a high school diploma; advanced education beyond high school preferred or an equivalent combination of education and experience.
Previous experience as a claims adjuster or must complete Capstone specified adjuster training if no experience.
If previous adjuster experience, working knowledge of Xactimate is preferred.
Must be licensed, or have the ability to obtain license(s), as required by state and local jurisdictions to adjust insurance claims.
Must have valid driver's license.
Skills and Competencies:
Ability to work in a high volume, fast paced environment managing multiple tasks.
Ability to provide excellent service to policyholders and clients.
Ability to efficiently operate a computer and related claims and business software.
Effective analytical and problem-solving skills necessary to make decisions and resolve conflict
Good verbal and written communication skills.
Good attention to detail.
Strong analytical and mathematical ability.
Ability to work independently in a virtual environment when required.
Good organizational and time management skills.
Physical Demand Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this position, auto travel is required.
Ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a vehicle. Ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics. Ability to work in a confined or restricted area. Kneeling, crouching, crawling, standing, sitting, walking, pushing, pulling, etc. as is required to inspect claims. Ability to work outdoors, exposed to all weather conditions.
Field Claims Adjuster
Claims representative job in Washington, DC
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.
Independent Insurance Claims Adjuster in York, Pennsylvania
Claims representative job in York, PA
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
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