Claims representative jobs in Webster, MA - 124 jobs
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Claims Follow Up Rep
Brown University Health 4.6
Claims representative job in Providence, RI
SUMMARY: Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Review all denied claims, correct them in the system and send correctedppealed claims asbr / written correspondence, fax or via electronic submission. Identify and analyze denials and enact corrective measures as needed to effectivelybr / communicate and resolve payer errors. Continually maintain knowledge of payer specific updates via payer's listservs, providerbr / updates, webinars, meetings and websites. Understand and maintain compliance with HIPAA guidelines when handling patient information Contact internal departments to acquire missing or erroneous information on a claimbr / resulting in adjudication delays or denials. Report to supervisor identification of denial trends resulting in revenue delays. Answers telephone inquiries from 3rd party payers; refer all unusual requests tobr / supervisor. Retrieve appropriate medical records documentation based on third party requests. Refer all accounts to supervisor for additional review if the account cannot be resolvedbr / according to normal procedures. Work with management to improve processes, increase accuracy, create efficiencies andbr / achieve the overall goals of the department. Maintain quality assurance, safety, environmental and infection control in accordancebr / with established policies, procedures, and objectives of the system andbr / affiliates. Perform other related duties as required. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Equivalent to a high school graduate. Knowledge of 3rd party billing to include ICD, CPT, HCPCS and 1500 claim forms. Demonstrated skills in critical thinking, diplomacy and relationship-building. Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings. Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. EXPERIENCE: One to three years of relevant experience in professional billing preferred. Experience with Epic a plus. INDEPENDENT ACTION: Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action. SUPERVISORY RESPONSIBILITY: None
Pay Range:
$19.58-$32.31
EEO Statement:
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
Location:
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903
Work Type:
Monday-Friday 7:30-4
Work Shift:
Day
Daily Hours:
8 hours
Driving Required:
No
$19.6-32.3 hourly 11d ago
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Claims Research & Resolution Representative 2
Humana 4.8
Claims representative job in Providence, RI
**Become a part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that involve customer contact, investigation, and resolution of claims or claims-related financial issues. The position includes moderately complex call center, administrative, operational and customer support assignments. Workload is typically semi-routine assignments along with intermediate level math computations. This is an opportunity to work remotely and use your research, resolution and customer service skills to join a Fortune 100 company with a great culture and outstanding benefits. Humana values associate engagement and well-being. We also provide excellent professional development and continued education.
**The claims inbound call center is comprised of a group of calls / claims / provider** **associates researching the resolution to a pending call.** The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and collection services in the resolution of claims. Responsibilities include:
+ Taking inbound calls to address customer needs which may include complex financial recovery, answering questions, and resolving issues.
+ Recording notes with details of inquiries, comments or complaints, transactions or interactions and taking action accordingly.
+ Escalation of unresolved and pending customer inquiries.
+ Decisions are typically focused on interpretation of area or department policy and methods for completing assignments.
+ Standard policies and practices allow for some opportunity for interpretation / deviation and / or independent discretion. Work is within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization and timing, and works under minimal direction.
**Use your skills to make an impact**
**Required Qualifications**
+ **1 or more years of Call Center or Telephonic customer service experience (within the past 5 years)**
+ **Previous healthcare related experience or education**
+ Basic Microsoft Office (Word, Excel, Outlook, and Teams) skills
+ Strong technical skills with the ability to work across multiple software systems
+ Self-reliance with the ability to resolve issues independently with minimum supervision
+ Ability to use internal system resources (i.e., Mentor) to find a resolution to an issue and/or respond to an inquiry
+ Demonstrated time management and prioritization skills
+ Ability to manage multiple or competing priorities
+ Capacity to maintain confidentiality working remotely out of your home
**Required Work Schedule**
**Training**
+ Virtual training starts on day one of employment and will run for the first 8 to 10 weeks with a schedule of 8:00 AM to 4:30 PM Eastern, Monday - Friday.
+ **Attendance is vital for your success; no time off will be allowed during training.**
+ The initial 180 days of employment as a Claims Research & Resolution Representative 2 constitute an appraisal period. This Appraisal Period is essential to your learning and development, which is why we ask for perfect attendance during both the classroom training and nesting periods.
+ This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. **You must be willing to remain in this position for a period of eighteen (18) months before applying to other Humana opportunities.**
**Work Hours**
+ Following training, must be able to work an assigned 8-hour shift between the hours of 8:00 AM to 6:00 PM Eastern.
+ Overtime _may_ be offered, based on business needs.
**Preferred Qualifications**
+ Bachelor's Degree
+ Prior claims processing experience
+ Overpayment experience
+ Financial recovery experience
+ Previous experience with Mentor software
+ PrePay or Post Pay experience
+ CAS, CIS or CISPRO experience
+ CRM experience
**Additional Information**
****PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) ****
**Work at Home Guidance**
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**Interview Process**
As part of our hiring process for this opportunity, we will be using technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
+ **Text Prescreen:** Shortly after submitting your application, you may receive both a text message and email requesting you to complete 10 to 15 prescreen questions with either yes or no answers. The text message may arrive prior to the email. If you prefer to answer via computer or tablet, wait for the email.
+ **Video Prescreen:** If you are successful with the text prescreen, you will receive another communication to record a Video Prescreen. This is an online video activity using your phone, tablet, or computer; however, most candidates prefer using a computer or tablet.
+ **Interviews:** Some candidates will be invited to interview. If so, the recruiter will reach out to schedule.
+ **Offers:** Finalists from the interview will be contacted by a recruiter to discuss an offer for the job
+ **Note:** Depending on the number of openings, the number of candidates who apply, and the schedules of interviewers and recruiters, this process may take several weeks or less; however, know that we are working hard to proceed as quickly as possible and to keep you informed.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$40,000 - $52,300 per year
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$40k-52.3k yearly 54d ago
Associate PIP Claims Representative
Amica Mutual Insurance 4.5
Claims representative job in Lincoln, RI
Rhode Island Claims 10 Amica Center Blvd, Lincoln, RI 02865 Thank you for considering Amica as part of your career journey, where your future is our business. At Amica, we pride ourselves on being an inclusive and supportive environment. We all work together to accomplish the common goal of providing the best experience for our customers. We believe in trust and fostering lasting relationships for our customers and employees! We're focused on creating a workplace that works for all. We'll continue to provide training, guidance, and resources to make Amica a true place of belonging for all employees. Want to learn more about our commitment to diversity, equity, and inclusion? Visit our DEI page to read about it!
As a mutual company, our people are our priority. We seek differences of opinion, life experience and perspective to represent the diversity of our policyholders and achieve the best possible outcomes. Our office located in Lincoln, RI is seeking an Associate PIP ClaimsRepresentative to join the team!
Job Overview:
The job duties include but are not limited to handling personal lines Personal Injury Protection and Medical Payments insurance claims. Substantial customer contact via the telephone and correspondence is required. Responsibilities include working in an electronic claim file environment, taking claim telephone reports, investigating, negotiating and settling claims and general office functions.
Candidates will be required to obtain a state insurance license and meet continuing education requirements.
Responsibilities:
* Handling personal lines Personal Injury Protection and Medical Payments Insurance Claims
* Substantial customer contact via the telephone and correspondence is required
* Working in an electronic claim file environment, taking claim telephone reports, investigating, negotiating, and settling claims and general office functions
* Candidates will be required to obtain a state insurance license and meet continuing education requirements
Total Rewards:
* Medical, dental, vision coverage, short- and long-term disability, and life insurance
* Paid Vacation - you will receive at least 13 vacation days in the first 12 months, amounts could be greater depending on the role. While able to use prior to accrual, vacation time will accrue monthly.
* Holidays - 14 paid holidays observed
* Sick time - 6 days sick time at hire, 6 additional days sick time at 90 days of employment
* Generous 401k with company match and immediate vesting. Additionally, annual 3% non-elective employer contribution
* Annual Success Sharing Plan - Paid to eligible employees if company meets or exceeds combined ratio, growth and/or service goals
* Generous leave programs, including paid parental bonding leave
* Student Loan Repayment and Tuition Reimbursement programs
* Generous fitness and wellness reimbursement
* Employee community involvement
* Strong relationships, lifelong friendships
* Opportunities for advancement in a successful and growing company
Qualifications
* High School Diploma or equivalent education required
* Maintain state insurance license
* Excellent written and verbal communication skills
* Knowledge of Microsoft Excel, Word, and Outlook
* Previous insurance, claims, and customer service experience preferred
Amica conducts background checks which includes a review of criminal, educational, employment and social media histories, and if the role involves use of a company vehicle, a motor vehicle or driving history report. The background check will not be initiated until after a conditional offer of employment is made and the candidate accepts the offer. Qualified applicants with arrest or conviction records will be considered for employment.
The safety and security of our employees and our customers is a top priority. Employees may have access to employees' and customers' personal and financial information in order to perform their job duties. Candidates with a criminal history that imposes a direct or indirect threat to our employees' or customers' physical, mental or financial well-being may result in the withdrawal of the conditional offer of employment.
About Amica
Amica Mutual Insurance Company is America's oldest mutual insurer of automobiles. A direct national writer, Amica also offers home, marine and umbrella insurance. Amica Life Insurance Company, a wholly owned subsidiary, provides life insurance and retirement solutions. Amica was founded on the principles of creating peace of mind and building enduring relationships for and with our exceptionally loyal policyholders, a mission that thousands of employees in offices nationwide share and support
Equal Opportunity Policy: All qualified applicants who are authorized to work in the United States will receive consideration for employment without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, family status, ethnicity, age, national origin, ancestry, physical and/or mental disability, mental condition, military status, genetic information or any other class protected by law. The Age Discrimination in Employment Act prohibits discrimination on the basis of age with respect to individuals who are 40 years of age or older. Employees are subject to the provisions of the Workers' Compensation Act.
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$40k-50k yearly est. 7d ago
Auto Physical Damage Claim Representative
The Travelers Companies 4.4
Claims representative job in West Bridgewater, MA
Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Job Category
Claim
Compensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range
$55,200.00 - $91,100.00
Target Openings
4
What Is the Opportunity?
This position is responsible for handling low to moderate Personal and Business Insurance Auto Damage claims from the first notice of loss through resolution/settlement and payment process. This may include applying laws and statutes for multiple state jurisdictions. Claim types include multi-vehicle (2 or more cars) auto damage with unclear liability and no injuries. Will also handle more complex Auto Damage claims such as non-owned vehicles, fire/theft, and potential fraud as well as non-auto, property related damage. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.
What Will You Do?
* Customer Contacts/Experience:
* Delivers consistent service quality throughout the claim life cycle, including but not limited to prompt contact, explaining the process, setting expectations, on-going communication, follows-through and meeting commitments to achieve optimal outcome on every file. Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC).
* Coverage Analysis:
* Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements for Auto Damage only claims in assigned jurisdictions. Addresses proper application of any deductibles and verifies benefits available and coverage limits that will apply. Confirms priority of coverage (i.e. primary, secondary, concurrent) and takes into consideration other issues relevant to the jurisdiction.
* Investigation/Evaluation:
* Investigates each claim to obtain relevant facts necessary to determine coverage, causation, extent of liability/establishment of negligence, damages, contribution potential and exposure with respect to the various coverages provided through prompt contact with appropriate parties (e.g.. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, etc.) Takes recorded statements as necessary.
* Recognizes and requests appropriate inspection type based on the details of the loss and coordinates the appraisal process. Maintains oversight of the repair process and ensures appropriate expense handling.
* Refers claims beyond authority as appropriate based on exposure and established guidelines. Recognizes and forwards appropriate files to subject matter experts (i.e., Subrogation, SIU, Property, Adverse Subrogation, etc.).
* Reserving:
* Establishes timely and maintains appropriate claim and expense reserves. Manages file inventory and expense reserves by utilizing an effective diary system, documenting claim file activities to resolve claim in a timely manner.
* Negotiation/Resolution:
* Determines settlement amounts based upon appraisal estimate, negotiates and conveys claim settlements within authority limits to insureds and claimants. As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to insureds and claimants.
* May provide support to other parts of Auto Line of Business (e.g. Total Loss, Salvage, etc.) when needed.
* Insurance License:
* In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
* Perform other duties as assigned.
What Will Our Ideal Candidate Have?
* Bachelor's degree preferred.
* Demonstrated ownership attitude and customer centric response to all assigned tasks
* Ability to work in a high volume, fast paced environment managing multiple priorities
* Attention to detail ensuring accuracy
* Keyboard skills and Windows proficiency, including Excel and Word - Intermediate
* Verbal and written communication skills - Intermediate
* Analytical Thinking- Intermediate
* Judgment/Decision Making- Intermediate
* Negotiation- Intermediate
* Insurance Contract Knowledge-
* Basic
* Principles of Investigation- Intermediate
* Value Determination- Basic
* Settlement Techniques- Basic
What is a Must Have?
* High School Diploma or GED required.
* A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto ClaimRepresentative training program is required.
What Is in It for You?
* Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
* Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
* Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
* Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
* Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
Employment Practices
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit *********************************************************
$55.2k-91.1k yearly 7d ago
Field Claims Representative - Massachusetts
Concord General Mutual Insurance Company 4.5
Claims representative job in Westborough, MA
Our role as a Senior Field ClaimsRepresentative will be responsible for the investigation, evaluation and settlement of assigned claims involving 1st Party Homeowner and Commercial Property claims. This role is a field-based position and will require travel to loss sites to evaluate the damages. This also includes special investigation activities with an emphasis on investigating possible fraudulent activity.
This is a field based position, travel will be required within Central/Eastern Massachusetts, with occasional travel to other areas as required.
Responsibilities
Field appraise losses of all types for both personal lines and commercial lines claims
Take loss reports directly from insureds and/or claimants and/or their representatives.
Appropriately handle incoming correspondence on assigned claim files.
Investigate assigned claims - confirm coverage - verify damages.
Effectively handle portions of claim investigations principally through on-site investigations, as warranted.
Evaluate and settle assigned claims based upon the results of the investigation.
A strong ability to work independently.
Other related duties as assigned by supervisor including but not limited to aiding during CATs or other unusual spikes in claim volume.
Requirements
Bachelor's degree preferred or several years of direct experience
5-7 years of experience handling Property Claims; Commercial Lines experience a plus.
Strong understanding of personal and commercial lines policy forms and coverage analysis.
Multi-line adjuster's license as required in our operating territories.
Demonstrated proficiency in writing detailed structural cost of repair/replacement estimates in Xactimate estimating system and proficient in PC Windows environment.
Demonstrated proficiency in investigating, evaluating and settling contents claims.
Excellent understanding and skill level of claim handling and customer service.
Possess or has ability to timely secure and maintain required multiline adjuster licenses. Knowledge of policy contracts, insurance laws, regulations, and the legal environment in which we operate.
Outside/Field Adjusters - ability to view damages and prepare estimates based on their inspection of the damaged property.
Benefits
At The Concord Group, we're proud to offer a comprehensive benefits package designed to support the wellbeing of our associates. This includes medical, vision, dental, life insurance, disability insurance, and a generous paid time off program for vacation, personal, sick time, and holiday pay. Additional benefits include parental leave, adoption assistance, fertility treatment assistance, a competitive 401(k) plan with company match, gym member/fitness class reimbursement, and additional resources and programs that encourage professional growth and overall wellness.
Why Concord Group Insurance
Since 1928, The Concord Group has been protecting families and small businesses across New England with trusted, personal insurance solutions. The Concord Group is a member of The Auto Owners Group of Companies and is recognized as a leading insurance provider through the independent agency system. Rated A+ (Superior) by AM Best, the company is represented by more than 550 of the best local independent agents throughout Maine, Massachusetts, New Hampshire, and Vermont.
At Concord Group, we believe in more than just insurance, we believe in our people. Our associates thrive in a supportive, collaborative workplace where community involvement, professional growth, and shared values drives everything we do.
Starting your career with The Concord Group means joining a team that values people first and gives you the opportunity to grow, give back, and make a lasting difference in the lives of those we serve.
Compensation
We are dedicated to fair and competitive total compensation package that supports the wellbeing and success of our associates. In addition to this, we offer other components like bonus opportunities. For this position, the anticipated annualized starting base pay range is: $60,000 - $80,000.
Equal Employment Opportunity
The Concord Group is an equal opportunity employer and hires, transfers, and promotes based on ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state, or local law.
The Concord Group participates in E-Verify
$60k-80k yearly Auto-Apply 30d ago
Claim Representative
A.I.M. Mutual Insurance Companies 4.1
Claims representative job in Burlington, MA
Ask Yourself This... Are you someone who thrives working in a fast-paced environment? Do you enjoy providing support to others?
Then join us as a ClaimRepresentative
in Burlington, MA!
What You'll Do
This fast-paced, highly rewarding entry-level position is all about helping people with a focus on customer service, and is the first point of contact when a worker is injured at work. The ClaimRepresentative handles the claim process from beginning to end; working closely with injured workers, employers, doctors, insurance companies, as well as co-workers in other departments within the company. The ClaimRepresentative manages the claim process and treatment plans, with the goal of getting an injured worker back on the job as soon as possible.
This position offers a hybrid working schedule after an initial training period.
We're looking for someone that:
has a college degree,
has experience in a call center or customer service environment,
can organize and prioritize workflows and meet company/industry deadlines,
is self-motivated and once trained, able to work with little direction, and
has or is willing to pursue a professional insurance designation.
At A.I.M. Mutual Insurance Companies, we are committed to building a diverse and inclusive workplace, and we believe that all people are capable of great things. So, if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway!
Who We Are
At A.I.M. Mutual Insurance Companies, we are committed to setting the standard in service excellence. We are guided by our founding principles to help employers effectively manage their workers' compensation program, providing quality services to injured workers and creating safe workplaces. We are one of the largest regional workers' compensation specialists, and we credit our staff for putting their service-oriented work ethic and workers' compensation insurance knowledge into practice, every day, in all they do.
What we do
...
We provide a workers' compensation experience that ensures peace of mind for all.
Why we do it
...
To protect and support the well-being of all New England workers and their families.
How we do it
...
Listening with empathy
Acting with compassion
Doing the right thing
Succeeding through collaboration
We proudly offer robust compensation and benefits packages, including:
35-hour work week
Summer hours June through September
Competitive pay, with opportunities to advance
Medical, dental, vision plans and pet insurance
Employer-sponsored retirement plan with matching employer contribution
Tuition reimbursement
Company-paid life and disability insurance
Paid time off and generous holiday time
A.I.M. Mutual has also earned the 2024 Best Place for Working Parents business designation.
At. A.I.M. Mutual, we recognize the importance of having a highly experienced staff to meet day-to-day customer needs. Come be a part of a great team of people that strives to surpass customer expectations every day. Working for A.I.M. Mutual is not just a job, it's a career.
Thank you for your interest in joining the A.I.M. Mutual Insurance team!
$39k-52k yearly est. 24d ago
Outside Property Claim Representative - West Bridgewater, MA
Msccn
Claims representative job in West Bridgewater, MA
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
$52,600.00 - $86,800.00
What Is the Opportunity?
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 ClaimRepresentative, 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.
Additional Qualifications/Responsibilities
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.
$52.6k-86.8k yearly 18d ago
Workers Comp Claims Representative
Hanover Insurance Group, Inc. 4.9
Claims representative job in Worcester, MA
Our Workers Comp Claims team is currently seeking a ClaimsRepresentative to join our Level One team in our Worcester, MA, Syracuse, NY, or Itasca, IL offices. This is a full-time/non-exempt role. Responsible for the investigation and resolution of complex medical only and lost time claims of low complexity in accordance with policy provisions, best practices and jurisdictional requirements. Includes the input of claim data and guiding insured's and claimants through the claim process and options.
IN THIS ROLE, YOU WILL:
Must have or secure and maintain appropriate states adjuster license(s) and continuing education credits.
Work within specific limits and authority on assignments of moderate technical complexity.
Use discretion and independent judgment in claim handling.
Possess functional knowledge and skills reflective of fully competent practitioner.
Identify possibly suspicious claims.
Investigate, analyze, evaluate and negotiate personal and/or commercial lines claims of minimal to moderate complexity.
Responsible for managing all aspects of each claim and maintaining a high level of productivity, confidentiality and customer service.
Implement and coordinate the most effective management techniques to mitigate loss and expense payments.
Reserving and expense authority levels are moderate.
Work with the Special Investigations Unit, where appropriate.
May be required to have and maintain sufficient home-based internet connection.
WHAT YOU NEED TO APPLY:
Typically has 1 - 3 years experience
Technical knowledge in WC coverages
Excellent written and verbal communication skills
Knowledge of medical terminology
Must possess organizational skills with regard to time management, task prioritization and integration of information from a variety of sources
Excellent and proficient data entry skills
High level of proficiency in Word, Excel and use of the Internet
Ability to meet and/or exceed the goals and metrics of the role on a consistent basis
Self-directed and self-motivated
Possesses strong customer service skills and behaviors
Makes decisions in an informed, confident and timely manner
Maintains constructive working relationships despite differing perspectives
Strong organizational and time management skills
Ability to negotiate skillfully in difficult situations with both internal and external groups
Demonstrates ability to win concessions without damaging relationships
Demonstrates strong written and verbal communication skills.
Promotes and facilitates free and open communication
Understanding of applicable statutes, regulations and case law
Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a timely manner
Easily adapts to new or different changing situations, requirements or priorities
Cultivates an environment of teamwork and collaboration
Operates with latitude for un-reviewed action or decision
Computer experience (MS Office, excel, word, etc)
Proficient using Claims systems (i.e. CSS, PMS, etc.)
Ability to use a personal computer and other standard office equipment
Ability to travel as necessary
Ability to sit and/or stand for extended periods
Workload requirements may routinely call for work hours in excess of 40 hours per week
This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.
$40k-63k yearly est. 54d ago
Auto Physical Damage Claim Representative
Travelers 4.8
Claims representative job in West Bridgewater, MA
Who Are We?
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Job CategoryClaimCompensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range$55,200.00 - $91,100.00Target Openings4What Is the Opportunity?This position is responsible for handling low to moderate Personal and Business Insurance Auto Damage claims from the first notice of loss through resolution/settlement and payment process. This may include applying laws and statutes for multiple state jurisdictions. Claim types include multi-vehicle (2 or more cars) auto damage with unclear liability and no injuries. Will also handle more complex Auto Damage claims such as non-owned vehicles, fire/theft, and potential fraud as well as non-auto, property related damage. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.What Will You Do?
Customer Contacts/Experience:
Delivers consistent service quality throughout the claim life cycle, including but not limited to prompt contact, explaining the process, setting expectations, on-going communication, follows-through and meeting commitments to achieve optimal outcome on every file. Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC).
Coverage Analysis:
Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements for Auto Damage only claims in assigned jurisdictions. Addresses proper application of any deductibles and verifies benefits available and coverage limits that will apply. Confirms priority of coverage (i.e. primary, secondary, concurrent) and takes into consideration other issues relevant to the jurisdiction.
Investigation/Evaluation:
Investigates each claim to obtain relevant facts necessary to determine coverage, causation, extent of liability/establishment of negligence, damages, contribution potential and exposure with respect to the various coverages provided through prompt contact with appropriate parties (e.g.. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, etc.) Takes recorded statements as necessary.
Recognizes and requests appropriate inspection type based on the details of the loss and coordinates the appraisal process. Maintains oversight of the repair process and ensures appropriate expense handling.
Refers claims beyond authority as appropriate based on exposure and established guidelines. Recognizes and forwards appropriate files to subject matter experts (i.e., Subrogation, SIU, Property, Adverse Subrogation, etc.).
Reserving:
Establishes timely and maintains appropriate claim and expense reserves. Manages file inventory and expense reserves by utilizing an effective diary system, documenting claim file activities to resolve claim in a timely manner.
Negotiation/Resolution:
Determines settlement amounts based upon appraisal estimate, negotiates and conveys claim settlements within authority limits to insureds and claimants. As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to insureds and claimants.
May provide support to other parts of Auto Line of Business (e.g. Total Loss, Salvage, etc.) when needed.
Insurance License:
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
Perform other duties as assigned.
What Will Our Ideal Candidate Have?
Bachelor's degree preferred.
Demonstrated ownership attitude and customer centric response to all assigned tasks
Ability to work in a high volume, fast paced environment managing multiple priorities
Attention to detail ensuring accuracy
Keyboard skills and Windows proficiency, including Excel and Word - Intermediate
Verbal and written communication skills - Intermediate
Analytical Thinking- Intermediate
Judgment/Decision Making- Intermediate
Negotiation- Intermediate
Insurance Contract Knowledge-
Basic
Principles of Investigation- Intermediate
Value Determination- Basic
Settlement Techniques- Basic
What is a Must Have?
High School Diploma or GED required.
A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto ClaimRepresentative training program is required.
What Is in It for You?
Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
Employment Practices
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit *********************************************************
$55.2k-91.1k yearly Auto-Apply 60d+ ago
Senior Claims Representative
Liberty Mutual 4.5
Claims representative job in Westborough, MA
Are you looking for an opportunity to join a claims team with a fast-growing company that has consistently outpaced the industry in year over year growth? Liberty Mutual has an excellent claims opportunity available. As a Commercial Insurance ClaimsRepresentative, you will review and process simple and straightforward Commercial claims within assigned authority limits consistent with policy and legal requirements. In addition to a wide range of benefits, as a direct employee, your insurance education and training are paid by Liberty Mutual.
The preference is for the candidates to be located close to a hub and be in the office a minimum of 2 days/week (Hubs: Plano, TX, Suwanee, GA, Westborough, MA, Hoffman Estates, IL, Indianapolis, IN and Eugene. OR, and Phoenix, AZ) although candidates from any location will be considered. Please note this policy is subject to change.
Responsibilities:
Investigates claim using internal and external resources including speaking with the insured or other involved parties, analysis of reports, researching past claim activity, utilizing evaluation tools to make damage and loss assessments.
Extensive and timely direct interaction with Insured's, Claimants, Agent's and Internal Customers.
Determines policy coverage through analysis of investigation data and policy terms. Notifies agent and insured of coverage or any issues.
Establishes claim reserve requirements and makes adjustments, as necessary, during the processing of the claims.
Determines and negotiates settlement amount for damages claimed within assigned authority limits.
Writes simple to moderately complex property damage estimates or review auto damage estimates.
Takes statements when necessary and works with the Field Appraisal, Subrogation, Special Investigative Unit (SIU) as appropriate.
Maintains accurate and current claim file/damage documentation and diaries throughout the life cycle of claim cases to ensure proper tracking and handling consistent with established guidelines and expectations.
Alerts Unit Leader to the possibility of fraud or subrogation potential for claims being processed.
Qualifications
Bachelor's Degree preferred. High school diploma or equivalent required.
1-2 years of experience. Claims handling skills preferred.
Strong customer service and technology skills.
Able to navigate multiple systems, strong organizational and communication skills.
License may be required in multiple states by state law.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in
every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive
benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
California
Los Angeles Incorporated
Los Angeles Unincorporated
Philadelphia
San Francisco
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$94k-150k yearly est. Auto-Apply 5d ago
General Liability Claims Adjuster II
Delhaize America 4.6
Claims representative job in Quincy, MA
Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.
Position Summary
Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners.
Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days.
Applicants must be currently authorized to work in the United States on a full-time basis.
Principle Duties and Responsibilities:
Claims Management
* Manage caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations.
* Monitor and ensure timely execution of all statutory deadlines or legal filings as needed.
* Analyze facts of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines.
* Identify fraud indicators and actively pursue subrogation opportunities.
* Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks.
* Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers.
Financial Impact Administration
* Manage book of claims business (up to $ 2million) with authority to settle/negotiate a single claim within their authority of up to $25,000.
* Communicate ongoing causes of incidents to Safety and Brands.
* Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications.
Basic Qualifications:
* Licensed adjuster (as appropriate by jurisdiction)
* Bachelor's degree or experience handling General Liability claims or equivalent expertise.
* Thorough knowledge of rules, regulations, statutes, and procedures pertaining to general liability claims.
* Knowledge of medical terminology involved in complex claims
* Negotiates resolution of claims of various exposure and complexity
Skills and Abilities:
* Demonstrates relationship building and communication skills, both written and verbal.
* Highly self-motivated, goal oriented, and works well under pressure.
* Customer focused solid understanding of legal procedures, processes, practices and standards in the handling of general liability claims
* Ability to identify problems and effectuate solutions
* Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail
* Able to apply critical thinking when solving problems and making decisions.
ME/NC/PA/SC Salary Range: $63,440-$95,160
IL/MA/MD/NY Salary Range: $72,880 - $109,320
Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws.
#LI-SM1 #LI-Hybrid
At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent.
Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies.
Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work.
We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.
$72.9k-109.3k yearly 60d+ ago
Claims - Field Claims Representative
Cincinnati Financial Corporation 4.4
Claims representative job in Worcester, MA
Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into action, we're looking for extraordinary people to join our talented team. Our service-oriented, ethical, knowledgeable, caring associates are the heart of our vision to be the best company serving independent agents. We help protect families and businesses as they work to prevent or recover from a loss. Share your talents to help us reach for continued success as we bring value to the communities we serve and demonstrate that Actions Speak Louder in Person.
If you're ready to build productive relationships, collaborate within a diverse team, embrace challenges and develop your skills, then Cincinnati may be the place for you. We offer career opportunities where you can contribute and grow.
Build your future with us
The Field Claims department is currently seeking Field ClaimsRepresentatives to service the territory surrounding: Worcester, Massachusetts. The candidate is required to reside within the territory.
This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure accurate settlements.
Be Ready to:
* complete thorough claim investigations
* interview insureds, claimants, and witnesses
* consult police and hospital records
* evaluate claim facts and policy coverage
* inspect property and auto damages and write repair estimates
* prepare reports of findings and secure settlements with insureds and claimants
* use claims-handling software, company car and mobile applications to adjust loss in a paperless environment
* provide superior and professional customer service
* once eligible, become a certified and active Arbitration Panelist
To be an Entry Level ClaimsRepresentative:
Salary: The pay range for this position is $57,750 - $79.800 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance.
Be equipped with:
* be available and communicative during your regular business hours
* a desire to learn about the insurance industry and provide a great customer experience
* the ability to work unsupervised
* excellent verbal and written communication skills
* strong interpersonal skills
* excellent problem-solving, negotiation, organizational and prioritization skills
* preparedness to follow-up with others in a timely manner
* a valid driver's license
Bring education or experience from:
* a bachelor's degree
* AINS, AIC, or CPCU designations preferred
Benefits in addition to compensation include:
* company car
* company stock options, including Restricted Share Units and Incentive based stock options
* paid time off (PTO)
* 401K with 6% company match
To be an Experienced ClaimsRepresentative:
Salary: The pay range for this position is $65,100 - $94,500 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance.
Be equipped with:
* be available and communicative during your regular business hours
* multi-line claims experience preferred
* ability to completely assess auto, property, and bodily injury type damages
* capacity to work unsupervised
* excellent verbal and written communication skills
* strong interpersonal skills
* excellent problem-solving, negotiation, organizational, and prioritization skills
* preparedness to follow-up with others in a timely manner
* a valid driver's license
Bring education or experience from:
* one or more years of claims handling experience
* AINS, AIC, or CPCU designations preferred
* bachelor's degree or equivalent experience required
Benefits in addition to compensation include:
* company car
* company stock options, including Restricted Share Units and Incentive based stock options
* paid time off (PTO)
* 401K with 6% company match
Enhance your talents
Providing outstanding service and developing strong relationships with our independent agents are hallmarks of our company. Whether you have experience from another carrier or you're new to the insurance industry, we promote a lifelong learning approach. Cincinnati provides you with the tools and training to be successful and to become a trusted, respected insurance professional - all while enjoying a meaningful career.
Enjoy benefits and amenities
Your commitment to providing strong service, sharing best practices and creating solutions that impact lives is appreciated. To increase the well-being and satisfaction of our associates, we offer a variety of benefits and amenities.
Embrace a diverse team
As a relationship-based organization, we welcome and value a diverse workforce. We grant equal employment opportunity to all qualified persons without regard to race; creed; color; sex, including sexual orientation, gender identity and transgender status; religion; national origin; age; disability; military service; veteran status; pregnancy; AIDS/HIV or genetic information; or any other basis prohibited by law. All job applicants have rights under Federal Employment Laws. Please review this information to learn more about those rights.
$65.1k-94.5k yearly 5d ago
Senior Claim Adjuster- CGL
Atlantic Casualty Insurance Co 4.2
Claims representative job in Glastonbury, CT
Atlantic Casualty Insurance Company (ACIC) is a recognized Excess and Surplus Lines carrier and proud affiliate of the Auto-Owners Insurance Group since 2016. With authority in all 50 states and Washington, D.C., ACIC provides innovative insurance solutions while maintaining a strong financial foundation, reflected in our A.M. Best rating of A+ (Superior).
Our strength comes from our people. For six consecutive years, we've been certified a Great Place to Work and consistently ranked among Fortune's “100 Best Small and Medium Workplaces”. At ACIC, we foster a culture where everyone belongs. We're a team-supporting one another through leadership development, mentorship programs, career certifications, and comprehensive benefits.
Our benefits include:
Health, Dental & Vision plans (HSA & PPO options)
401(k) with company match + financial advisor access
Tuition reimbursement & student loan assistance
Paid parental leave
Counseling and mental wellness support
Flexible work and in-office schedules
Whether you're just starting your career or looking to grow it, Atlantic Casualty is where talent thrives, and teamwork drives success.
Please visit our Careers Page for more information on the benefits and programs you will enjoy by joining the team at Atlantic Casualty Insurance Company.
************************************************
SUMMARY:
The Senior Claims Adjuster will be capable of independently handling claims in states where ACIC writes business. The Senior Claims Adjuster will have a higher authority level than an adjuster and will have full responsibility for claims within that authority. This position has the authority to assign a local independent appraiser / adjuster for fieldwork in the state where the loss occurred. In those cases, they are responsible for controlling the work done by the I/A.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Analyze, review, and interpret policies to assess coverage and liability.
Establish and maintain proper loss and expense reserves on their claims.
Determine what investigation is necessary on more complicated claims in order to bring a claim to an equitable conclusion for all parties involved.
Responsible for controlling the work done by the independent adjuster/appraiser.
Properly document information in the claim file.
Verify and review damages.
Determine applicability of coverage and liability.
Maintain working diary of assigned claims.
Evaluate and settle claims within assigned authority.
Return all phone calls promptly.
Provide excellent customer service.
Recognize and investigate subrogation.
Handle total losses and process salvage returns.
Daily contact with adjusters and/or insureds and/or claimants and/or attorney and/or vendors and/or agents.
Weekly contact with other department managers.
Deal with and have access to information that is important and must be kept confidential.
Handle claims in litigation as assigned.
Assist in training less experienced adjusters.
Perform other similar or related duties as assigned.
REQUIRED EDUCATION/EXPERIENCE:
A four-year degree from an accredited institution or equivalent experience.
5 years' experience handling claims, including advanced skills in coverage, investigation, litigation, negotiation, damage/injury evaluation, salvage and subrogation.
Knowledge of and adherence to the state laws and regulations governing the handling of property and casualty claims.
Basic understanding of claims, mathematics, construction, auto physical damage, medical terms and legal issues.
State adjuster's license where domiciled.
Non-resident adjuster's license where required in the states where we do business.
Be able to demonstrate time management skills; communication skills, verbal and written; strong computer skills.
MENTAL REQUIREMENTS :
Must be able to clearly define systems and operational problems and draw valid conclusions and recommendations as to how to resolve. Must possess ability to interpret and delegate an extensive variety of instructions in written or diagram form. Reasoning; dealing with problems involving a few variables in standard situations. Must also be able interact on personnel matters in a secure and confidential manner.
PHYSICAL 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle controls and talk or hear. The employee frequently is required to sit and reach with hands and arms. The employee is occasionally required to stand and walk. The employee may infrequently lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate. Works primarily indoors.
TRAVEL: 5%
$70k-100k yearly est. Auto-Apply 34d ago
Claims Casualty Adjuster
Automobile Club of Southern California 4.3
Claims representative job in Providence, RI
The Claims Casualty Adjuster handles low to moderate-complexity claims involving material damage, property, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include liability investigation, coverage evaluation and negotiation of low to moderate-complexity claims in compliance with established company technical and customer service Best Practices. Under moderate supervision, works within specific limits of authority to resolve claims with well-defined procedures.
Job Duties
Communicate and interact with a variety of individuals including insureds and claimants. Explain benefits, coverages, fault and claims process either verbally or in writing in compliance with regulatory and statutory requirements. Recognize and appropriately address common coverage issues.
Conduct phone and/or field investigations to determine liability and damages. May attend and participate in legal proceedings. Identify and obtain statements from insureds, claimants and witnesses.
Evaluate and determine claim values upon receipt and assessment of property, bodily injury and liability data.
Negotiate within settlement authority with insureds and claimants to resolve their first and third party claims.
Handle administrative functions, update database production reports, and document and update claim files via company systems, i.e. CACS, HUON, HOC, GUIDEWIRE, etc.
Verify and interpret/resolve coverage by gathering necessary information to ensure policy applicability. Coordinate with internal and external departments as required.
Independently resolve claim exposures within level of authority.
Respond quickly to customer needs and problems.
Qualifications
Bachelors Equivalent combination of education and experience Preferred
4-6 years Prior claims handling experience. Required
4-6 years Property or Casualty claims administration experience. Preferred
Working knowledge of claims best practices and procedures.
Moderate understanding of building and vehicle repair practices.
General knowledge of insurance, fault assessment, negligence and subrogation principles.
Working knowledge of Microsoft Office suite, general computer software and claims software.
Advanced organization and planning recognition skills required.
Advanced oral and written communication skills required.
Advanced interpersonal skills required.
Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
Associate in Claims - Insurance Institute of America Preferred
An insurance/claims adjuster license may be required for claims administration in specific states. Preferred
Travel Requirements
Occasional travel to off-site business meetings or conferences. (5% proficiency)
The starting pay range for this position is $68,640 - $90,000 annually. Additionally, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.
Remarkable benefits:
• Health coverage for medical, dental, vision
• 401(K) saving plan with company match AND Pension
• Tuition assistance
• PTO for community volunteer programs
• Wellness program
• Employee discounts (membership, insurance, travel, entertainment, services and more!)
Auto Club Enterprises is the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity - we win. All of Us! With our national brand recognition, long-standing reputation since 1902, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value.”
AAA is an Equal Opportunity Employer
$68.6k-90k yearly Auto-Apply 4d ago
Medicare Advantage and DSNP Claims Analyst
Mass General Brigham
Claims representative job in Somerville, MA
Site: Mass General Brigham Health Plan Holding Company, Inc.
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Responsible for extracting knowledge and insights from data in order to investigate business/operational problems through a range of data preparation, modeling, analysis, and/or visualization techniques.
Essential Functions
-Collects, monitors and analyzes Medicare Advantage and D-SNP Claims reporting to ensure timeliness, accuracy and compliance internally to support decisions on day-to-day operations, strategic planning, and/or specific business performance issues.
-Reviews, tracks, and communicates key performance indicators (KPIs) related to regulatory compliance, timeliness, and accuracy.
-Performs data validation of source-to-target data for data visuals and dashboards.
-Creates and updates claim reports.
-Collates, models, interprets, and analyzes data.
- Identifies trends and explains variances and trends in data, recommends actions, and escalates to leaders as appropriate.
-Identifies and documents enhancements to modeling techniques.
-Completes thorough quality assurance procedures, ensuring accuracy, reliability, trustworthiness, and validity of work.
-Provides audit support, both internal and external, which includes supporting the monthly Claims Compliance Monitoring and Organization Determination, Appeals, and Grievances (ODAG/ODR) reporting processes for all Medicare Advantage and D-SNP contracts.
-Works closely with internal departments, including but not limited to Enrollment, Customer Service, Reimbursement Strategy, Benefits, Product, Configuration, IT, and Digital Services to ensure seamless coordination and integration for claims data analysis.
-Collaborate with vendor partners to monitor and analyze claims reporting.
-Identifies operational inefficiencies or process bottlenecks and recommend improvements to enhance workflows, reduce costs, and improve member and provider satisfaction.
-Assist with the implementation and management of new medical health plan products or changes to existing plans.
-Support the creation and maintenance of medical health plan policies, procedures, and workflows to ensure compliance with CMS and EOHHS regulatory requirements.
-Performs other duties as assigned
-Complies with all policies and standards
Qualifications
Education
Bachelor's Degree required; experience can be substituted for degree
Experience
At least 2-3years of medical claims processing and/or data analysis within the health insurance or healthcare industry experience required
Medicare experience required.
Massachusetts Medicaid experience required.
Knowledge, Skills, and Abilities
Healthcare knowledge, particularly as it pertains to medical claims processing data, is preferred but not required.
Working knowledge of relational databases, SQL, Power BI, data visualization, and business intelligence tools such as Tableau.
Knowledge and application of statistical analyses, including variance analysis and statistical significance, are preferred.
Project management skills and/or experience are a plus.
Proficiency with Microsoft Office Suite, including Word, Excel and PowerPoint.
Additional Job Details (if applicable)
Working Conditions
This is a remote role that can be done from most US states
This role is 40 hours/week with five 8-hour days, with a typical schedule of 8:30 am to 5:00 pm
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$62,400.00 - $90,750.40/Annual
Grade
6
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
$62.4k-90.8k yearly Auto-Apply 5d ago
Liability Claims Specialist (Construction Defect)
CNA Financial Corp 4.6
Claims representative job in Glastonbury, CT
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
This individual contributor position works under moderate direction, and within defined authority limits, to manage third party liability construction defect commercial claims with moderate to high complexity and exposure. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
JOB DESCRIPTION:
Essential Duties & Responsibilities:
Performs a combination of duties in accordance with departmental guidelines:
* Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
* Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
* Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols.
* Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
* Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
* Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
* Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
* Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
* Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
* Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
* May serve as a mentor/coach to less experienced claim professionals
May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
* Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
* Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
* Demonstrated ability to develop collaborative business relationships with internal and external work partners.
* Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
* Demonstrated investigative experience with an analytical mindset and critical thinking skills.
* Strong work ethic, with demonstrated time management and organizational skills.
* Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
* Developing ability to negotiate low to moderately complex settlements.
* Adaptable to a changing environment.
* Knowledge of Microsoft Office Suite and ability to learn business-related software.
* Demonstrated ability to value diverse opinions and ideas
Education & Experience:
* Bachelor's Degree or equivalent experience.
* Typically a minimum four years of relevant experience, preferably in claim handling.
* Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
* Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
* Professional designations are a plus (e.g. CPCU)
#LI-KP1
#LI-Hybrid
In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
$54k-103k yearly Auto-Apply 12d ago
Medicare Advantage and DSNP Claims Analyst
Brigham and Women's Hospital 4.6
Claims representative job in Somerville, MA
Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Responsible for extracting knowledge and insights from data in order to investigate business/operational problems through a range of data preparation, modeling, analysis, and/or visualization techniques.
Essential Functions
* Collects, monitors and analyzes Medicare Advantage and D-SNP Claims reporting to ensure timeliness, accuracy and compliance internally to support decisions on day-to-day operations, strategic planning, and/or specific business performance issues.
* Reviews, tracks, and communicates key performance indicators (KPIs) related to regulatory compliance, timeliness, and accuracy.
* Performs data validation of source-to-target data for data visuals and dashboards.
* Creates and updates claim reports.
* Collates, models, interprets, and analyzes data.
* Identifies trends and explains variances and trends in data, recommends actions, and escalates to leaders as appropriate.
* Identifies and documents enhancements to modeling techniques.
* Completes thorough quality assurance procedures, ensuring accuracy, reliability, trustworthiness, and validity of work.
* Provides audit support, both internal and external, which includes supporting the monthly Claims Compliance Monitoring and Organization Determination, Appeals, and Grievances (ODAG/ODR) reporting processes for all Medicare Advantage and D-SNP contracts.
* Works closely with internal departments, including but not limited to Enrollment, Customer Service, Reimbursement Strategy, Benefits, Product, Configuration, IT, and Digital Services to ensure seamless coordination and integration for claims data analysis.
* Collaborate with vendor partners to monitor and analyze claims reporting.
* Identifies operational inefficiencies or process bottlenecks and recommend improvements to enhance workflows, reduce costs, and improve member and provider satisfaction.
* Assist with the implementation and management of new medical health plan products or changes to existing plans.
* Support the creation and maintenance of medical health plan policies, procedures, and workflows to ensure compliance with CMS and EOHHS regulatory requirements.
* Performs other duties as assigned
* Complies with all policies and standards
Qualifications
Education
* Bachelor's Degree required; experience can be substituted for degree
Experience
* At least 2-3years of medical claims processing and/or data analysis within the health insurance or healthcare industry experience required
* Medicare experience required.
* Massachusetts Medicaid experience required.
Knowledge, Skills, and Abilities
* Healthcare knowledge, particularly as it pertains to medical claims processing data, is preferred but not required.
* Working knowledge of relational databases, SQL, Power BI, data visualization, and business intelligence tools such as Tableau.
* Knowledge and application of statistical analyses, including variance analysis and statistical significance, are preferred.
* Project management skills and/or experience are a plus.
* Proficiency with Microsoft Office Suite, including Word, Excel and PowerPoint.
Additional Job Details (if applicable)
Working Conditions
* This is a remote role that can be done from most US states
* This role is 40 hours/week with five 8-hour days, with a typical schedule of 8:30 am to 5:00 pm
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$62,400.00 - $90,750.40/Annual
Grade
6
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
$62.4k-90.8k yearly Auto-Apply 5d ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claims representative job in Worcester, MA
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
$51k-64k yearly est. Auto-Apply 31d ago
Claims Field Senior Property Adjuster - Catastrophe
ACSC Management Services Inc.
Claims representative job in Providence, RI
This position handles moderate to complex claims matters involving homeowner property insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include investigation, damages evaluation, negotiation strategies, and claims resolution of moderate to complex claims. The position employs discretion and independent judgment to ensure compliance with state and federal law and established company Best Practices.
Job Duties
Identify and obtain statements from insureds, vendors and witnesses. Conduct phone and/or field investigations to determine coverage and damages and differentiate between allegations and facts in each loss.
Communicate and interact with a variety of individuals. Explain benefits, coverages, and claims process either verbally or in writing in compliance with regulatory and statutory requirements. Recognize and appropriately address moderate complexity coverage issues.
Evaluate and determine claim values upon receipt and assessment of property damage data.
Negotiate within settlement authority with insureds to resolve first claims.
Update database production reports, and document and update claim files via company systems, i.e. CACS, HUON, HOC, GUIDEWIRE, etc.
Control expenses for areas of responsibility.
Verify and interpret / resolve coverage by gathering necessary information to ensure policy applicability. Objectively discern and address issues that may be questioned in audit. Coordinate with internal and external departments as required.
May attend and participate in legal proceedings.
Respond quickly and effectively to customer needs and problems.
Qualifications
Bachelors Equivalent combination of education and experience
4-6 years Prior claims handling experience. Required
4-6 years Property claims administration experience. Preferred
1-3 years Experience in the construction industry. Preferred
Working knowledge of claims administration best practices and procedures.
Moderate knowledge of insurance, fault assessment, negligence and subrogation principles required.
Comprehensive understanding of vehicle and building repair procedures and third-party liability issues.
Working knowledge of Microsoft Office suite, general computer software and claims software.
Moderate leadership skills necessary.
Advanced organization and planning recognition skills required.
Advanced oral and written communication skills required.
Advanced interpersonal skills required.
Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
An insurance/claims adjuster license may be required for claims administration in specific states.
Remarkable benefits:
• Health coverage for medical, dental, vision
• 401(K) saving plan with company match AND Pension
• Tuition assistance
• PTO for community volunteer programs
• Wellness program
• Employee discounts (membership, insurance, travel, entertainment, services and more!)
Auto Club Enterprises is the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity - we win. All of Us! With our national brand recognition, long-standing reputation since 1902, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value.”
AAA is an Equal Opportunity Employer
$51k-72k yearly est. 8d ago
Property Adjuster Specialist - Field
USAA 4.7
Claims representative job in Springfield, MA
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory requirements. You will recognize and empathize with members' life events, as appropriate.
Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses within your locally assigned territory. Field Adjusters may travel outside of their local territory to respond to claims in other regions when needed. This is an hourly, non-exempt position with paid overtime available.
This is a field-based role in the Springfield, MA area. Candidates who are willing and able to work in this area are encouraged to apply.
What you'll do:
Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability.
Partners with vendors and internal business partners to facilitate complex claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance.
Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics.
Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies.
Determines and negotiates complex claims settlement within authority limits. Develops recommendations and collaborates with management for determining settlement amounts outside of authority limits and accurately manages claims outcomes.
Maintains accurate, thorough, and current claim file documentation throughout the claims process.
Advance knowledge of estimating technology platforms and virtual inspection tools. Utilizes platforms and tools to prepare claims estimates to manage complex property insurance claims.
Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
May be assigned CAT deployment travel with minimal notice during designated CATs.
Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
Works independently solving complex problems with minimal guidance; acts as a resource for colleagues with less experience.
Adjusts complex claims with attorney involvement.
Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations.
May require travel to resolve claims, attend training, and conduct in-person inspections.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
What you have:
High School Diploma or General Equivalency Diploma.
2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
Advanced knowledge of estimating losses using Xactimate or similar tools and platforms.
Proficient knowledge of residential construction.
Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations.
Proficient negotiation, investigation, communication, and conflict resolution skills.
Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills.
Ability to travel 50-75% of the year (local & non-local) and/or work catastrophe duty when needed.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
Successful completion of a job-related assessment may be required.
What sets you apart:
Hands-on experience in the field handling high-severity and complex property claims such as fire, water damage, vandalism, malicious mischief, foreclosures, earth movement, collapse, and liability.
Residential property field adjusting experience with dwelling, structure and additional living expenses.
Experience working directly for a standard insurance carrier handling claims from start to finish (first notice of loss, reviewing policy, making coverage decisions)
Proficient in using estimating platforms and virtual inspection tools like Xactimate, ClaimXperience and XactAnalysis
Insurance industry designations such as AINS (Associate in General Insurance), CPCU (Chartered Property Casualty Underwriter), AIC (Associate in Claims), or SCLA (Senior Claims Law Associate) or actively pursuing
Active Property & Casualty adjuster license
Currently reside in the Springfield or surrounding areas enabling quicker response times for local claims and a better understanding of regional risks
US military experience through military service or a military spouse/domestic partner
Physical Demand Requirements:
May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces.
May need to meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver's license.
May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car.
May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics.
Compensation range: The salary range for this position is: $74,240 - $133,620.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
How much does a claims representative earn in Webster, MA?
The average claims representative in Webster, MA earns between $30,000 and $70,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.
Average claims representative salary in Webster, MA