Claims representative jobs in Wilmington, NC - 372 jobs
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Experienced Catastrophe Claims Representative
Auto-Owners Insurance Co 4.3
Claims representative job in Columbia, SC
* There are multiple positions open across the 26 states in which we operate. The current locations for which we are seeking CAT Claim Reps are located in the job posting.*
Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated claims professional to join our team. The position requires the following, but is not limited to:
Frequent travel up to 21 days at a time and is required upon short notice to location of catastrophe, which would most likely be out of state.
Can meet the physical demands required for the position including carrying and climbing a ladder.
Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses.
Familiar with insurance coverage by studying insurance policies, endorsements and forms.
Work towards the resolution of claims, possibly attending arbitrations, mediations, depositions or trials as necessary.
Ensure that claims payments are issued in a timely and accurate manner.
Desired Skills & Experience
Bachelor's degree or equivalent experience
Minimum of 2 years claims handling experience or comparable experience
Field claims experience with multi-line property and casualty claims and wind/hail
Proficient with Xactimate software
Above-average communication skills (written and verbal)
Ability to resolve complex issues
Organize and interpret data
Ability to handle multiple assignments
Possess a valid driver's license
Military experience is considered
Benefits
Competitive salary, matching 401(k) retirement plans, fully funded pension plan, bonus programs, paid holidays, vacation days, personal days, paid sick leave and a comprehensive health care plan.
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.
* Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
$28k-35k yearly est. 7d ago
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Warranty Claims Representative
Cornerstone Building Brands
Claims representative job in Cary, NC
ABOUT THE ROLE The ClaimsRepresentative is responsible for managing warranty claims from initial intake through final resolution while delivering a premier customer experience. This role requires strong analytical skills, clear communication, and the ability to balance accuracy, cost efficiency, and customer satisfaction. The ClaimsRepresentative serves as a key partner to customers, internal teams, and service providers, ensuring claims are processed effectively, documented thoroughly, and resolved in alignment with company standards.
This position will work West Coast hours 8-5 Monday- Friday.
Two days in office three days work from home at any Cornerstone Building Brand Window facility.
WHAT YOU'LL DO
Claim Intake & Validation
Receive, review, and validate incoming warranty claims to determine accuracy and required information.
Initiate clarification calls to customers as needed to complete claim details.
Maintain accurate claim documentation and communication updates within Dynamics 365 CRM.
Claim Management & Resolution
Create detailed work orders for Cornerstone Building Brands (CBB) Technicians and third-party vendors, optimizing cost, efficiency, and service quality.
Monitor claim progress and ensure timely, cost-effective resolutions that enhance customer satisfaction.
Administer service reimbursements and prepare settlement letters when applicable.
Quality Review & Root Cause Analysis
Conduct research to identify root causes of product or service issues.
Collaborate with plant personnel, sales teams, and other departments to support long-term corrective actions and process improvements.
Participate in discussions and initiatives aimed at reducing recurring issues and improving overall product and service quality.
Communication & Reporting
Prepare clear communications and updates for management regarding claim trends, issues, and opportunities.
Ensure documentation and reporting for claims, resolutions, and settlement activities are accurate and complete.
Perform additional duties as assigned to support departmental needs.
SKILLS PREFFERED:
Strong ability to interpret customer claims and apply relevant warranty coverage.
Ability to read and interpret product specifications, drawings, and order confirmations.
Exceptional analytical and problem-solving skills with the ability to identify root causes and recommend solutions.
Strong verbal and written communication skills with a customer-centric approach.
Ability to manage difficult discussions and mitigate customer dissatisfaction effectively.
Strong attention to detail and accuracy in a fast-paced environment.
Ability to work independently while supporting team and departmental goals.
High curiosity, initiative, and willingness to grow in an evolving environment.
Qualifications
Education:
High School Diploma or equivalent required; Bachelor's degree preferred. Professional experience in a claims or service role, preferably within the building materials industry will be considered in lieu of education.
Experience/Technical Skills:
Experience with CRM systems is desired.
Proficiency in Microsoft Excel, Word, and PowerPoint, with the ability to learn new systems quickly.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Why work for Cornerstone Building Brands?
Our teams are at the heart of our purpose to positively contribute to the communities where we
live, work and play
. Full-time* team members receive** medical, dental and vision benefits starting day 1. Other benefits include PTO, paid holidays, FSA, life insurance, LTD, STD, 401k, EAP, discount programs, tuition reimbursement, training, and professional development.
*Full-time is defined as regularly working 30+ hours per week. **Union programs may vary depending on the collective bargaining agreement.
Cornerstone Building Brands 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, age, pregnancy, genetic information, disability, or status as a protected veteran. You can find the Equal Employment Opportunity Poster
here
. You can also view Your Right to Work Poster
here
along with This Organizations Participation in E-Verify Poster
here
. If you'd like to view a copy of the company's affirmative action plan for protected veterans or individuals with disabilities or policy statement, please contact Human Resources at ************ or
[email protected]
. If you have a disability and you believe that you need a reasonable accommodation in order to search for a job opening or to submit an online application, please contact Human Resources at ************ or
[email protected]
. This email is used exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only emails received for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues not related to a disability, will not receive a response.
All your information will be kept confidential according to EEO guidelines.
California Consumer Privacy Act (CCPA) of 2018
Must be at least 18 years of age to apply.
Notice of Recruitment Fraud
We have been made aware of multiple scams whereby unauthorized individuals are using Cornerstone Building Brand's name and logo to solicit potential job-seekers for employment. In some cases, job-seekers are being contacted directly, both by phone and e-mail. In other instances, these unauthorized individuals are placing advertisements for fake positions with both legitimate websites and fabricated ones. These individuals are typically promising high-paying jobs with the requirement that the job-seeker send money to pay for things such as visa applications or processing fees. Please be advised that Cornerstone Building Brands will never ask potential job-seekers for any sort of advance payment or bank account information as part of the recruiting or hiring process.
$31k-45k yearly est. 1d ago
Independent Insurance Claims Adjuster in Wilmington, North Carolina
Milehigh Adjusters Houston
Claims representative job in Wilmington, NC
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
$42k-52k yearly est. Auto-Apply 60d+ ago
Insurance Claims Specialist (Construction Defects and Property Damage)
DPR Construction 4.8
Claims representative job in Raleigh, NC
The Insurance Claims Specialist will be responsible for assisting with the management of all aspects of complex Construction Defect and Property Damage incidents and claims for DPR (and DPR-related entities), as assigned. Reporting: Role reports to Insured Claims Manager and Insured Claims Leader
Specific Duties Include:
Claims & Incident Management (General):
* Initial triage and processing of incidents received from project teams for DPR (and DPR-related entities).
* Input and/or review all incidents reported in DPR's RMIS system.
* Working with the incident triage group to ensure timely and appropriate review of all incidents
* Ensure all necessary information is compiled to properly manage claims. This includes working with the DPR teams to collect relevant documents such as the Prime contract, Subcontracts, Certificates of Insurance, Owner Policy Documents, Project Documents and Project Specific Coverage information, etc.
* Assess all potential risks, as well as identify all contractual risk transfer mechanisms.
* Analyzing potential insurance coverage for all applicable lines of coverage and report, with all appropriate documents and information, potential claims for DPR (and DPR-related entities) to the broker for any applicable program (Traditional, CCIP, OCIP).
* Assist with the development and training of other DPR Workgroups (and DPR-related entities) around CD/PD Best Practices.
Construction Defect & Property Damage (CD/PD) Specific Claims Management:
* Manage all assigned claims in DPR's RMIS system relating to Construction Defect and Property Damage matters for DPR (and DPR-related entities). This would include using all appropriate lines of coverage such as Commercial General Liability, Builder's Risk, Property, Contractor's Pollution Liability and Professional Liability, whether the policies are placed by DPR or our Clients.
* Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements.
* Management of and coordination with DPR's consultants and outside attorneys throughout the claim process.
* Continuously analyze claim-specific details as the claim progresses to devise key strategies in conjunction with all internal stakeholders and outside consultants.
* Proactive management and coordination of all phases of the DPR CD/PD Claims Workflow.
Key Skills:
* Basic working knowledge and familiarity of:
* Commercial General Liability
* Property Insurance (Including Inland Marine and Builder's Risk
* Pollution Liability
* Professional Liability
* Controlled Insurance Programs (CCIP/OCIP)
* RMIS Systems
* Construction Industry Expertise
* Strategic thinking
* Strong written and oral communication skills
* High level of EQ (Soft skills)
* Self-Starter
* Highly organized and responsive; ability to meet deadlines
* Detail Oriented
* Contractual risk assessment
* Dispute management
* Integrity
* Ability to mentor and inspire others
* Team player
* Willingness to understand and advance the DPR Culture
* Proactive Learner
Qualifications:
* 5-7 years relevant construction industry and/or insurance industry experience preferred.
* Previous experience in construction company Risk Management highly desired.
* Position location - TBD based on location of most qualified candidate.
DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world.
Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek.
Explore our open opportunities at ********************
$64k-80k yearly est. Auto-Apply 6d ago
Public Adjuster
The Misch Group
Claims representative job in Charlotte, NC
Job DescriptionDescriptionPosition: Production Public Adjuster (Licensed) Compensation: $75,000 - $100,000 compensation + Performance-based bonuses QUICK FACTS:
Must have Public Adjuster License
Must have experience with Xactimate
Must have network of Condo, Apartment, Property Management partners
Must be able to physically examine all buildings top to bottom (roofs as well)
About the Company:A well-established, industry-leading public adjusting firm is seeking motivated and driven Outside Sales Representatives to join our growing team. We specialize in advocating for policyholders, ensuring they receive fair settlements for property damage claims. Our sales team plays a critical role in developing strong client relationships and driving company growth.
Position Overview:We are looking for a results-oriented Outside Sales Representative with a strong background in direct-to-consumer (D2C) or business-to-business (B2B) sales. This role requires a motivated self-starter who thrives in building and maintaining client relationships while working in a fast-paced, competitive environment.
Key ResponsibilitiesKey Responsibilities:
Identify and pursue new business opportunities with homeowners, contractors, and referral partners.
Educate prospective clients on our services and guide them through the insurance claims process.
Develop and maintain a pipeline of leads through prospecting and networking efforts.
Conduct presentations and training sessions to build brand awareness and establish partnerships.
Provide exceptional customer service to existing clients, ensuring their satisfaction and retention.
Work closely with internal teams to optimize the sales process and improve closing rates.
Maintain accurate records of sales activities and client interactions.
Skills, Knowledge and ExpertiseQualifications & Experience:
3+ years of proven sales experience as a licensed Public Adjuster
Strong ability to generate leads, manage relationships, and close deals.
Bachelor's degree in Business, Marketing, Communications, or equivalent experience.
Familiarity with CRM tools, Microsoft Office Suite, and digital communication platforms.
Highly organized with strong follow-through skills in a fast-paced environment.
Public Adjuster license
BenefitsWhat We Offer:
Extensive training and support to help you succeed.
Flexible work environment with opportunities for growth and career advancement.
A team-oriented culture with strong leadership and professional development opportunities.
If you're a highly motivated sales professional looking for a rewarding career with a company that makes a difference, apply today!
$75k-100k yearly 23d ago
Claims Specialist
Libra Solutions 4.3
Claims representative job in Huntersville, NC
Job Description
When life gets hard, we make it easier! Libra Solutions helps overcome the burdens created by slow-moving legal processes. Combining technical innovation and financial strength, we help speed cumbersome workflows and ease financial barriers for our customers. And our companies are leaders in their industries! Oasis Financial is the largest and most recognized national brand in consumer legal funding. Oasis helps consumers awaiting legal settlements to move forward with their lives. MoveDocs is a personal injury solutions platform that integrates and streamlines medical, financial, and professional services for personal injury cases. Our mission is to improve outcomes for plaintiffs, accelerate settlements for attorneys, and ensure timely payment for providers. We are proud of our mission and passionate about applying technology to the challenge of making healthcare more accessible. We also are the leading inheritance funding provider through Probate Advance, helping heirs access their inheritance immediately, without the lengthy process of probate.
Together, under the Libra Solutions banner, we have relationships with over 40,000 attorneys and over 7,000 healthcare providers nationwide, which gives us an amazing platform to service our customers.
MoveDocs is seeking a Claims Specialist to join our growing Operations team. The successful candidate will be highly motivated to deliver exceptional customer service to various parties within the medical and legal community. This position will function as the primary point of communication with our clients to stay up to date on existing cases and answer client questions. MoveDocs takes pride in providing excellent and expedient service to our clients and the qualified candidate must be self-motivated, able to work autonomously and enjoy working in a fast-paced, high-volume environment.
This role is located in our Huntersville, NC office.
Answers high volume of inbound calls from insurance companies, attorneys, clients and/or medical providers daily
Statuses cases to get updates on pending and ongoing case litigation and/or medical treatment.
Drafts correspondence to defense insurance companies and/or attorneys including demand letters, emails, and faxes
Delivers customer satisfaction through timely, accurate communications
Develops rapport with the attorneys, firms, insurance companies and medical providers
Requirements
High School or GED required
Experience in a high-volume call environment preferred
Knowledge or experience with personal injury, medical billing, or claims a plus
Previous claims and/or personal injury case manager experience preferred
Self-motivated with desire to build great relationships, and to meet and exceed goals
Ability to multitask while on the phone and the computer is a must
Able to adapt to change and pivot easily between tasks
Ability to work quickly and accurately to meet tight deadlines
Possess excellent verbal and written communication skills for communicating with insurance companies, attorneys, and medical providers
Basic computer proficiency and Outlook experience
Benefits
MoveDocs offers competitive compensation, benefits that include medical, dental, vision and life insurance plans, plus 401(k) with company match and paid time off.
$38k-67k yearly est. 15d ago
Daily Property Adjuster - Wilmington, NC
Cenco Claims 3.8
Claims representative job in Wilmington, NC
CENCO Claims is expanding coverage along the North Carolina coast and is seeking a dependable Daily Property Adjuster to handle residential property claims in the Wilmington area. This field-based role offers consistent assignments, flexible scheduling, and strong support from an experienced internal claims team.
What You'll Be Doing
Conduct on-site inspections of residential properties to evaluate wind, storm, and water-related damage
Capture detailed documentation, including photos, measurements, and field notes
Prepare accurate and timely estimates using Xactimate
Communicate clearly and professionally with homeowners and carrier representatives
Manage claim files in accordance with carrier guidelines and industry standards
Provide a positive and professional experience for policyholders throughout the claims process
What We're Looking For
Property claims experience preferred but not required
Familiarity with Xactimate or willingness to learn
Strong organization, communication, and time-management skills
Ability to perform field inspections, including roof climbs and navigating damaged properties
Valid driver's license, reliable transportation, and standard adjusting equipment
Why Work with CENCO Claims
Steady daily residential claim volume throughout Wilmington and surrounding coastal areas
Competitive per-claim compensation
Supportive internal team to assist with questions and file handling
Opportunities for continued work during peak and storm seasons
Established relationships with respected carrier partners
Apply Today
Take the next step toward consistent residential work with a trusted claims partner.
$37k-52k yearly est. Auto-Apply 57d ago
Associate VB Claims Specialist
UNUM Group 4.4
Claims representative job in Columbia, SC
When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide:
* Award-winning culture
* Inclusion and diversity as a priority
* Performance Based Incentive Plans
* Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability
* Generous PTO (including paid time to volunteer!)
* Up to 9.5% 401(k) employer contribution
* Mental health support
* Career advancement opportunities
* Student loan repayment options
* Tuition reimbursement
* Flexible work environments
* All the benefits listed above are subject to the terms of their individual Plans.
And that's just the beginning…
With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today!
General Summary:
Minimum starting hourly rate is $22.60
This is an entry level position within the Voluntary Benefits Claims Organization. This position is responsible for the thorough, fair, objective, and timely adjudication of voluntary benefits claims in conjunction with providing technical expertise regarding applicable regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, health care providers and other specialized internal resources.
Incumbents in this role are considered trainees and are assigned a formal mentor for 6-12 months until they are assessed as capable of independent work. Incumbents are primarily responsible for learning and developing the skills, knowledge, and behaviors necessary to successfully adjudicate assigned claims, in accordance with our claims philosophy and policies and procedures.
Incumbent must demonstrate the ability to effectively manage an assigned caseload, exercise discretion and independent judgment, and appropriately render timely claim decisions while demonstrating strong customer service prior to movement to the exempt level claims specialist role.
Principal Duties and Responsibilities:
* Maintain organizational service standards on all assigned claims demonstrating success in developing and implementing effective strategies to manage a caseload of varying size and complexity.
* Develop an understanding and working knowledge of Voluntary Benefits for Unum and Colonial Life, including products, policies, procedures, and contracts.
* Develop an understanding of the applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders, and waivers, as well as regulatory and statutory requirements for claim products administered.
* Develop skill set to determine appropriate risk management strategies through analyzing and applying technical and complex contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions, and benefits payee.
* Develop problem solving skills by demonstrating analytical and logical thinking resulting in the timely and accurate adjudication of a variety of simple to complex voluntary benefits claims.
* Develop a working knowledge of systems needed for claims adjudication.
* Provide excellent customer service and independently respond to all inquiries within service guidelines.
* Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and referrals/notifications to other areas (i.e., medical assessments, billing, etc.) as appropriate.
* Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively communicate determinations while ensuring compliance with Voluntary Benefits procedures and all legal requirements including state regulations.
* Partner and coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation, when appropriate.
* Ensure a timely and well communicated transfer process when transitioning integrated claims across lines of business, ensuring a coordinated and continuous claims experience for customers.
* Be familiar with specialized workflow requirements and performance standards for any assigned customers.
* May perform other duties as assigned.
Job Specifications:
* 4-year degree preferred or equivalent work experience
* Ability to develop Voluntary Benefits product knowledge and apply a best-in-class service experience
* Medical background, voluntary benefits claims and/or disability management experience preferred
* Possess strong analytical, critical thinking, and problem-solving skills
* Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions, including initial decision and ongoing medical management.
* Able to effectively utilize a broad spectrum of resources, materials, and tools needed to assist with the decision-making process
* Strong service and quality orientation.
* Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc.
* Demonstrated ability to operate with a sense of urgency and make balanced decisions with the highest degree of integrity and fairness.
* Excellent communication skills, written and verbal
* Meets the standards for this position, as defined in the Talent Management framework
~IN3
#LI-LM2022
Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide.
Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status.
The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience.
$40,000.00-$75,600.00
Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans.
Company:
Unum
$40k-75.6k yearly Auto-Apply 13d ago
Complex Liability Claims Specialist - Commercial General Liability
Utica National Insurance Group 4.8
Claims representative job in North Carolina
The Company
At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an “A” rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier.
Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago.
What you will do
The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in multiple jurisdictions. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex commercial general liability is required.
Key responsibilities
Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex liability claims in multiple jurisdictions.
Manage all claims in accordance with Utica National's established claim procedures.
Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level.
Maintain timely and accurate claim reserves in accordance Utica National's reserving philosophy.
Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel's work product and working with defense counsel to efficiently and fairly resolve claims.
Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials.
Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle.
Achieve the service standard of “excellent” during all phases of claims handling.
Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction.
Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling.
What you need
Four year degree or equivalent experience preferred.
Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated casualty claims.
Proven experience negotiating claims and active participation in alternative dispute resolution practices.
Experience with general liability, additional insured considerations and complex coverage determinations.
Licensing
Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment.
Salary range: $103,300 - $140,000
The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications.
Benefits:
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following:
Medical and Prescription Drug Benefit
Dental Benefit
Vision Benefit
Life Insurance and Disability Benefits
401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)
Health Savings Account (HSA)
Flexible Spending Accounts
Tuition Assistance, Training, and Professional Designations
Company-Paid Family Leave
Adoption/Surrogacy Assistance Benefit
Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance
Student Loan Refinancing Services
Care.com Membership with Back-up Care, Senior Solutions
Business Travel Accident Insurance
Matching Gifts program
Paid Volunteer Day
Employee Referral Award Program
Wellness programs
Additional Information:
This position is a full time salaried, exempt (non-overtime eligible) position.
Utica National is an Equal Opportunity Employer.
Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy.
#LI-HL1
$42k-64k yearly est. 48d ago
Claims Specialist
Primeritus Financial Services 4.4
Claims representative job in Raleigh, NC
Primeritus Financial Services is a national leader in repossession management, remarketing, skip tracing, and title services for the automotive finance industry across the United States and Puerto Rico. We provide our clients with comprehensive, outsourced solutions that combine a nationwide network of certified recovery agents, advanced investigative techniques, and a commitment to compliance and customer service. Our approach ensures that collateral is located, recovered, and remarketed quickly, efficiently, and professionally.
As a Claims Specialist, you will be responsible for gathering, investigating, and analyzing information related to automotive damage claims arising from the repossession, transportation, or storage process. You will work directly with clients, vendors, and consumers to facilitate timely resolutions, ensure compliance with applicable laws and company standards, and maintain the integrity of the claims process, the company and its clients. This position requires excellent communication and organizational skills, sound judgment, and the ability to work effectively in a fast-paced, detail-oriented environment. The Claims Specialist will serve as a key point of contact throughout the life cycle of a claim and contribute to the overall quality and accountability of our service delivery. This is a full-time, in-office HYBRID position based in our Raleigh, NC office. Key Responsibilities
Collaborate with internal teams, clients, vendors (recovery agents), and consumers to collect necessary information for claim investigations.
Analyze documentation and supporting evidence to determine claim validity and assist in recommending resolution strategies.
Draft clear and professional communications, including denial letters and settlement agreements, for review by the Claims Manager.
Guide consumers through the formal claims process via inbound calls, providing excellent customer service and maintaining professionalism under pressure.
Maintain accurate records in claims tracking systems, ensuring up-to-date case statuses and documentation.
Support compliance efforts by coordinating with the Vendor Relations team on agent-related concerns.
Conduct audits to ensure vendor and internal adherence to claims policies, industry regulations, and company procedures.
Stay informed on business operations and privacy/security protocols to ensure accurate and compliant claims handling.
Perform other duties as assigned to support the Claims team and company objectives.
Required Qualifications
High School Diploma or equivalent required; Associate's or Bachelor's degree preferred.
3-5 years of administrative experience required; prior experience in claims handling, insurance, repossession, or related industries preferred.
Strong interpersonal and written communication skills with the ability to manage sensitive conversations professionally.
High level of confidentiality, discretion, and sound judgment.
Proficient in Microsoft Office Suite and general office software.
Ability to multitask, prioritize work, and manage time effectively in a deadline-driven environment.
Why Primeritus?
Join a collaborative and growing organization at the forefront of the automotive finance recovery industry. At Primeritus, you'll have the opportunity to make a meaningful impact while working with a team that values accountability, respect, and continuous improvement. Equal Opportunity Employer
Primeritus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, pregnancy, national origin, age, veteran status, or disability status.
$40k-70k yearly est. 8d ago
Liability Adjuster
HDVI
Claims representative job in Anderson, SC
What we do High Definition Vehicle Insurance (HDVI): Technology meets Insurance. HDVI brings telematics, software and data together with commercial trucking insurance, taking transportation insurance and fleet risk management to the next level. Our platform arms fleets with an end-to-end solution that empowers them to save money, mitigate risk, and increase operational efficiencies. Our customers are small to midsize truck fleet operators who benefit from dynamic and transparent pricing - automatically reducing their premiums for safer driving. Leveraging a best-in-class partner ecosystem, HDVI combines magnitude and stability with innovation to revolutionize the commercial trucking insurance space. Why work here HDVI is building the industry defining commercial auto insurance company for the next 100 years. The $50 billion commercial auto industry hasn't seen real innovation for decades and is broken in a number of ways, creating a significant opportunity for HDVI. HDVI is co-founded by a former Esurance co-founder, and has a senior management team with experience building innovative insurance and logistics companies from zero to $1B+ enterprises, and deep expertise in trucking insurance. HDVI is well-funded by leading logistics and mobility-focused venture capital firms and strategic investors including Munich Re, Daimler Trucks and Qualcomm. The HDVI Team is values-driven, data-driven, ambitious, and collaboratively minded with a diverse background of experiences and skills in the insurance and logistics industries. We like challenges and building solutions that improve the quality of life for our customers. We offer generous benefits, including employee stock options, health, dental, vision, 401k, flexible work environment, and unlimited PTO.
About the RoleAs a Liability Adjuster, you will work closely with HDVI's Claims and Fleet Services Teams. The ideal candidate will have extensive knowledge of handling all aspects of Commercial Trucking claims inclusive of but not limited to Third Party Bodily Injury, Third Party Auto Property Damage, First Party Auto Property Damage, Cargo, Truckers General Liability and First Party Medical. You will be responsible for influencing and providing claim resolution and tactical guidance to both internal and external customers in order to achieve world class claims outcomes. The Liability Adjuster role is an associate level position with senior level growth potential as the company expands. What You'll Do
Responsible for the handling First and Third Party Property Damage, and Cargo and Third Party Bodily Injury claims stemming from accidents involving tractor-trailers
Engage with various internal and external partners to drive resolution on high-severity matters that are identified
Be adaptable to various business demands and willing to assist with special claims projects and other duties as assigned
Participate in regular claims reviews with both internal and external customers
Maintain current knowledge of insurance contracts and industry trends by proactively maintaining required adjuster license(s)
Provide technical expertise in response to inquiries from internal and external customers
3+ years experience with handling complex Commercial Trucking claims
Extensive experience across all technical areas of Commercial Auto inclusive of but not limited to Physical Damage, Auto Liability, First Party Medical / Personal Injury Protection and Motor Truck Cargo
Extensive experience with analyzing, determining and applying Coverage for Commercial Auto claims
Advanced experience and capabilities in litigation claims management, including ADR and mediation processes involving Commercial Auto exposures
Experience attending and controlling cases at mediations/settlement conferences, pre-suit, post suit, pretrial and post-trial
Ability to work in a rapidly evolving, high-growth environment with the ability to collaborate across and within different levels of the organization
Experience with large Fleets (250+) with self-insured retentions and/or large deductibles
Excellent communication skills (verbal/written) and strong negotiation skills
Strong time management, organizational and problem-solving skills
Ability to adapt, embrace the unknown and shift priorities
Willingness to look outside your day to day to ensure you keep learning and growing in a startup environment
Preferred Skills
College Education
Active Adjusters License - strongly preferred
Strong analytical, critical thinking, and problem-solving skills
Proficiency in Google Suite, Microsoft Office and Adobe Acrobat
Experience with self-insured retention (SIR), large deductibles and claims involving Independent Owner Operators (IOO)
Benefits
Competitive salary & stock options - we want our success to be yours too
Unlimited PTO with 11 paid holidays each year
Medical, Dental, Vision, Short/Long Term Disability, Basic Life, and AD&D to support you and your well-being
FSA / HSA programs
401(k) retirement plan with company match contribution
Inclusive Parental Leave policy that supports all parents
Wednesdays are standing meeting-free, allowing you to focus on deep work without distractions
Birthday meal reimbursement, because celebrating our employees is part of our company culture
A remote-friendly environment with the opportunity to participate in periodic in-person team offsites
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
$37k-50k yearly est. Auto-Apply 60d+ ago
Inventory Claim Specialist
Kioti Tractor
Claims representative job in Wendell, NC
Inventory Claims Coordinator
Department:
Warehouse Operations - 171032
Reports to:
Inventory Supervisor
Location:
Wendell, NC
Position Status:
Full-time
Status:
Hourly, Non-Exempt
Management Level:
Non-Management
JOB SUMMARY
The Inventory Claims Coordinator serves as a support element and liaison for all distribution centers and the dealer network. This person will be cross trained and gain exposure to many functions including claims processing, inventory investigations, dealer network relationship building and recording claim data.
KEY RESPONSIBILITIES OF JOB
The Inventory Claims Coordinator key responsibilities are outlined below:
Claims:
Resolve and process claim disputes
Technical drawing look-up
Inventory background investigations
Credit and Debit process on claim investigations
Issuing and monitoring call tags
Resolve and process freight claim disputes and tracking reimbursement if applicable
Inventory Management
Provide inventory control reporting and vendor reports
Track claim data and communicate common themes for mitigation
Directly or indirectly locate misplaced parts to help satisfy sale to customer/dealer
Help maintain or relay proper product identification and location accuracy and ability to transfer product to correct location if needed
Other Responsibilities
Determine and record data for KPI's
Promote dealer satisfaction utilizing customer service skills
EDUCATIONAL AND PHYSICAL REQUIREMENTS
High school diploma or GED equivalent required with minimum of 3 years' related experience
Associate or Bachelor degree with a minimum of 1 year experience
1-5 Years of related customer service or inventory experience.
Must be a team player with strong interpersonal communication skills
Good time-management skills and attention to detail
Outstanding written and oral communication skills with the ability to effectively present information
Proficiency in Microsoft programs, including Excel, a plus
SAP experience preferred
SalesForce experience preferred
$31k-55k yearly est. Auto-Apply 60d+ ago
Med Pay Adjuster (Medical Division)
North Carolina Farm Bureau Mutual Insurance Company, Inc. 4.0
Claims representative job in Raleigh, NC
About Us At North Carolina Farm Bureau Insurance, we take pride in our strong, community-oriented roots that began right here in North Carolina. In 1953, our company was born out of the need to provide insurance coverage to our farmers and rural communities. Now, with local offices in each of the 100 counties, we provide services to all North Carolinians across the state. Here at NCFB we are a familiar face in the community with a service oriented mindset that truly sets us apart. Guided by our mission, we are deeply committed to both our neighbors and employees. Helping you is what we do best! If you are passionate about making a meaningful impact and value a people-centered culture, we invite you to join us!
About the Role
Our Claims Department provides outstanding individuals with the opportunity for an exciting and rewarding career. Resolving claims combines the excitement of investigations with the reward of helping people through difficult times.
We are seeking motivated and proactive individuals to join our team. As a Med Pay Adjuster, you will work directly with policyholders, claimants, and other involved parties to investigate, evaluate, and negotiate settlements of medical payments insurance claims.
Education and Experience
Associate's degree or above preferred.
Preference given to applicants with extended education and/or training.
Preference given to applicants with experience handling bodily injury claims of any level.
Required Skills and Abilities
Present a professional and personable attitude and communicate effectively in stressful situations.
Demonstrate exceptional mental resilience and possess strong conflict management skills.
Possess strong written, verbal, and interpersonal communication skills.
Ability to organize and prioritize your workload to demonstrate effective time management towards meeting deadlines.
Demonstrate the strong ability to make decisions and problem solve using logical and analytical skills.
Must be reliable and capable of working independently as well with others.
Location & Commitments
Full-time office role
Reports to our Medical Claims District Claims Office: 5301 Glenwood Avenue, Raleigh.
Must obtain and maintain licensing CE in compliance with N.C. Department of Insurance and N.C. Farm Bureau Mutual Insurance Company requirements.
All offers are contingent on a Background Check.
Responsibilities of the Role
Provide prompt, timely, and professional communication for insureds and claimants.
Appraise and determine covered damages using provided resources.
Investigate losses, verify coverage, and apply policy coverage.
Determine legal liability for losses and damages.
Authorize or deny claim payments based on policy guidelines.
Evaluate and establish reserves for the possible payout amounts.
Adhere to company policies, procedures, and regulatory guidelines.
Maintain current, accurate, and detailed documentation throughout the claims process.
Ensure the protection and proper maintenance of all company equipment assigned to you.
Participate in industry-related conferences and training programs. *Certain training programs are located at the Corporate Office in Raleigh, NC.
This document is intended to outline the essential responsibilities of the position, and does not limit the tasks that may be assigned or amended by the supervisor.
$45k-58k yearly est. 6d ago
Insurance Claims Specialist
National Ondemand
Claims representative job in Burlington, NC
National OnDemand, Inc. is a communications and utilities infrastructure provider delivering service solutions to the Fiber, Wireless, Energy and Technology sectors in the United States. Headquartered in Burlington, North Carolina, the Company provides full turnkey infrastructure solutions - on demand, anywhere across its service footprint and has secured and sustained its current standing in the market through the successful completion of mergers and acquisitions, along with demonstrable, steady organic growth.
Under the supervision Insurance Claims Manager, coordinate and administer workers' compensation program, automotive, property and casualty claims.
Primary Position Duties:
* Process and document all worker's compensation claims and property & casualty claims, ensuring compliance with relevant policies, procedures, and legislation.
* Serve as liaison with external agencies and regulatory bodies in the claims administration and the care and disposition of claimants.
* In coordination with the Insurance Claims Manager, evaluate property and casualty claims to determine liability, damage and exposure.
* Elevate to the Insurance Claims Manager larger, more complex claims.
* Assist the Insurance Claims Manager, the Senior Director of EHS & Compliance, Human Resources, and Legal, in third-party claims, including negotiations and settlement when required.
* Reviews and evaluates all work-related accident reports for completeness and clarity of data; analyzes data, as needed, to ensure compliance with policy and regulatory requirements.
* Determines appropriateness and amount of worker's compensation claims; investigates individual claims for eligibility for workers' compensation benefits; ensures that all legal and procedural requirements are met for the processing of claims to ensure proper and timely payment to employees and medical facilities.
* Provide authoritative advice and counsel to organizational leadership on interpreting and applying for worker's compensation and property & casualty policies, legislation, regulations, and processes.
* Liaison with the organization's insurance broker and providers.
* Coordinates and participates in strategic planning aimed at reducing the incidence of worker's compensation-related injuries.
* Assembles appropriate medical information and facts regarding claims for cases pending litigation; participates in the Workers' Compensation Administration mediation and formal hearings.
* Communicates and interacts with medical professionals, support agencies and others to monitor and assess the progress of rehabilitation efforts and to facilitate either return to work, job restrictions or, depending upon the medical status of the claimant, placement into appropriate alternative positions, ensuring compliance with all appropriate regulations and guidelines.
* Updates organizational leadership on employees' return to full duty status.
* Prepares all necessary forms, records and documentation, including statistical analyses and reports, for all claims, as required by various regulatory agencies.
* Makes recommendations for reducing the frequency and severity of losses using a workers' compensation database and/or other claims data reports; designs and develops databases; performs integrated data analyses and prepares reports.
* Process assigned property and casualty claims and performed other job-related duties as assigned.
* Claims support during Emergency Events.
* Assist EHS & Compliance Administrator as needed.
* Assists the Director of EHS & Risk in developing policies and procedures to reduce risk.
* Performs miscellaneous job-related duties as assigned.
Position Requirements:
* Access-only office environment with reasonable heating and cooling.
* The position will be at a computer workstation much of the time.
* Ability to work extended or irregular hours/days (nights and weekends)
* Prolonged sitting at a computer workstation performing repetitive tasks.
* Ability to occasionally lift, push, or pull up to 25 lbs.
* Must have reliable transportation and a valid driver's license.
* Ability to travel 10% of the time.
Education or Skills:
* Bachelor's Degree in Business Administration; at least four years of directly related experience in claims adjusting, investigations, litigation and/or risk management.
* Completed degree(s) from an accredited institution.
* One or more certifications - Certified Medical Insurance Specialist (CMIS), Certified Risk Insurance Specialist (CRIS), Transportation Risk Insurance Professional (TRIP), Associate in Claims (AIC), or Associate in General Insurance (AINS).
* 4 years of experience in risk management handling various claims processes.
* Ability to liaison with insurance carriers professionally.
* Ability to work independently or with a team at all levels of the organization.
* Ability to maintain confidentiality.
* Ability to professionally represent the organization.
Benefits:
This is a full time position with access to our comprehensive benefits which include paid time off (PTO), medical, dental, vision, short- and long-term disability, and life insurance, an Employee Assistance Program (EAP), and 401(k).
EQUAL OPPORTUNITY EMPLOYER:
NATIONAL OnDemand, Inc. is an equal opportunity employer. The company's policy does not discriminate against any applicant or employee based on race, gender, sex, sexual orientation, gender identity, color, religion, national origin, disability, genetic information, age, veteran status or any other consideration made unlawful by applicable federal, state or local laws. NATIONAL OnDemand, Inc. prohibits harassment of applicants and employees based on any of these protected categories.
$31k-54k yearly est. 19d ago
Claims Specialist
Capsigna
Claims representative job in Charlotte, NC
Responsibilities: Processing fast paced inbound customer service calls. Taking inbound calls from clients Providers, Consumers and Insurance companies regarding medical billing. Resubmitting claims, and answering questions regarding benefits Demonstrates excellent customer service skills with the ability to take ownership in assisting, researching and resolving customer issues.
Performs other duties as assigned.
Requirements
Previous Call Center or Customer Service experience preferred.
Ability to develop rapport and demonstrate a caring attitude.
Clear, distinct oral and written communication skills.
Must be detail oriented.
$30k-54k yearly est. 60d+ ago
Claims Specialist
PRG 4.4
Claims representative job in Charlotte, NC
Project Resources Group (PRG) is seeking a Claims Recovery Specialist for our Charlotte, NC office. Be part of our expanding team focused on recovering third-party property and utility damage claims, primarily in a B2B setting. We're looking for motivated, detail-oriented professionals with strong negotiation skills. Experience in collections or insurance adjusting is highly relevant and transferable. We offer a competitive base salary plus commission. Key Responsibilities
Resolve and negotiate claims recovery of repair and replacement costs on third-party cable/fiber and utility damages across multiple state lines, via phone, email, and letters.
Work directly with liable parties' insurance providers to defend and negotiate claims settlements.
Collaborate with claims departments and management of liable parties, from small businesses to large corporations to municipalities.
Learn, understand, and be able to utilize state dig laws and statutes, 811 excavator requirements, NESC standards, CGA guidelines, etc.
Develop a professional working relationship with damaging parties, on-site field investigators, management, and other personnel.
Conduct 40-50 inbound/outbound calls daily, approximately 2-2.5 hours of total talk time throughout the day.
Enter notes and documentation throughout the recovery process into the company's proprietary Claims Database Tool.
Use a calendar and diary system to coordinate handling claims to be worked twice weekly.
Follow advanced claim handling procedures as detailed by the OPD Claims Manager.
Use photographs, narratives, job costs, site sketches, locate tickets, and other components on-site field investigators provide to visualize and understand the damage scene to defend liability accurately.
Participate in weekly department meetings to discuss individual and team recovery tactics, strategies, and goals.
Maintain a working knowledge of the entire PRG claims recovery process.
Preferred Qualifications
Strong proficiency in Microsoft Word, Outlook, and Excel.
Tech-savvy with the ability to quickly adapt to new software and systems.
Excellent written and verbal communication skills, with an emphasis on professional phone and email correspondence.
Familiarity with the construction, cable, or utility locate industries is advantageous.
Understanding of B2B construction, claims management, recovery, or insurance claim negotiation and settlement processes is preferred.
Ideally, 3-5 years of experience in claims, recovery, and/or the insurance industry.
College education is preferred.
Bilingual in Spanish is a plus.
Compensation and BenefitsWe offer a competitive hourly pay ($19-$23/hour based on experience), plus the potential to earn substantial commissions up to $4,000-$10,000 monthly based on performance. Along with a comprehensive benefits package, including:
Medical, dental, and vision coverage for employees and dependents
401(k) retirement plan, with company match after 1 year
Short-term disability coverage after 1 year
Paid time off and holidays
Additional perks such as company-paid life insurance, and other supplemental insurances available
About PRG
Since 2001, PRG has been a leader in construction management and outside plant damage recovery for the telecommunications and utility industries. With 20+ offices and 800+ employees nationwide, we deliver industry-leading solutions with speed, accuracy, and expertise.
Equal Opportunity EmployerPRG is proud to be an Equal Opportunity Employer. PRG does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, pregnancy-related conditions, and lactation), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, or any other characteristic protected by applicable federal, state, or local law and ordinances.#INDCS
$19-23 hourly Auto-Apply 20d ago
Billing Procedure Claims Specialist
Summit Spine and Joint Centers
Claims representative job in North Carolina
Summit Spine and Joint Centers is a rapidly expanding Pain Management Group looking to add an experienced Medical Billing Specialist to our team. With twelve ambulatory surgery centers and twenty-three clinic locations across the State of Georgia, Summit Spine is winning the race to become the largest comprehensive spine and joint care provider in the state. We are looking for a motivated and hard-working Claims Processor who can join our growing team of professionals. Job Duties:
Audits and ensure claim information is complete and accurate.
claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
Ensures accurate and timely billing of HCFA 1500 claims.
Ensures that files are documented with appropriate information (i.e., date stamped, logged, signed, etc.).
Creates logs for providers of pending medical encounters and or encounters with errors.
Work directly with other billing staff and management to meet end of month closing deadlines.
Able to work with clearinghouse rejections, print, and mail secondaries.
Address inquiries from insurance companies, patients, and providers.
Understands CPT, ICD10, HCPCS coding and modifiers.
Knowledge of third-party payers, HMOs, PPOs, Medicare, Medicaid, Worker's Compensation, etc.
Knowledge of ERAs, EOBs
Knowledge of payer specific/LCD guidelines
Understanding of health plan benefits (deductibles, copays, coinsurance) and eligibility verification
Must be proficient with spreadsheets and word processing applications.
Qualifications:
Minimum of 3 years' experience with medical billing or revenue cycle in a medical setting
Experience with Medicare, Medicaid, Commercial insurance plans, Workers' comp, and Personal Injury cases.
Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management
Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required.
Excellent computer skills and familiarity with Microsoft Office
Comfortable working in a growing, dynamic organization and able to navigate change.
Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment.
Bachelor's degree preferred.
Experience using eClinicalWorks preferred.
Experience with high level procedure billing and coding for Pain Management preferred
The position is full time with competitive salary, PTO, health benefits and 401k match. The ideal candidate will be located in Georgia and able to be present at our administrative office, or near Austin, Texas where other members of the billing team are located.
$31k-54k yearly est. 38d ago
Claims Mitigation & Management Specialist
The Nuclear Company
Claims representative job in Columbia, SC
The Nuclear Company is the fastest growing startup in the nuclear and energy space creating a never before seen fleet-scale approach to building nuclear reactors. Through its design-once, build-many approach and coalition building across communities, regulators, and financial stakeholders, The Nuclear Company is committed to delivering safe and reliable electricity at the lowest cost, while catalyzing the nuclear industry toward rapid development in America and globally.
About the role
The Nuclear Company is looking for an experienced Claims Mitigation & Management Specialist to support the deployment of major nuclear reactor projects. This role will focus on contract formation, administration, and proactive claims prevention. You will work closely with project teams, contract managers, and leadership to identify and address potential risks, respond to claims, and ensure contractual compliance across complex, utility-scale nuclear energy projects.
Responsibilities
Proactively identify potential claims and disputes on projects.
Develop and implement strategies for early claims identification and mitigation.
Provide guidance to project teams on contract administration and documentation.
Conduct detailed forensic analysis of project documentation for claims assessment.
Quantify cost and schedule impacts of potential claims, including delay and disruption.
Prepare comprehensive claims position papers and reports.
Support the negotiation process for claims and disputes.
Assist in preparing for and participating in dispute resolution forums (e.g., mediation, arbitration).
Develop and maintain a robust claims log, tracking all active and potential claims.
Ensure all claims-related documentation is meticulously organized.
Prepare regular reports on claims status, liabilities, and resolution progress.
Work closely with Project Controls, Contracts, and Legal teams on claims management.
Participate in project reviews to provide insights on claims trends.
Experience
Bachelor's degree in Engineering, Construction Management, Quantity Surveying, Law, or a related field.
8+ years of progressive experience in claims management, dispute resolution, or contract administration.
3+ years of focused claims management experience.
Experience on energy mega-projects (utility-scale, high capital, high complexity).
Experience on nuclear energy projects is highly valued.
Demonstrated expertise in contract formation, negotiation, and administration.
Exceptional analytical, critical thinking, and problem-solving skills.
Excellent written and verbal communication and negotiation skills.
Proficiency in project management software, scheduling tools, and advanced Excel.
Ability to work effectively under pressure and manage multiple priorities.
Knowledge of construction law and dispute resolution processes.
Benefits
Competitive compensation packages
401k with company match
Medical, dental, vision plans
Generous vacation policy, plus holidays
Estimated Starting Salary Range
The estimated starting salary range for this role is $121,000 - $143,000 annually less applicable withholdings and deductions, paid on a bi-weekly basis. The actual salary offered may vary based on relevant factors as determined in the Company's discretion, which may include experience, qualifications, tenure, skill set, availability of qualified candidates, geographic location, certifications held, and other criteria deemed pertinent to the particular role.
EEO Statement
The Nuclear Company is an equal opportunity employer committed to fostering an environment of inclusion in the workplace. We provide equal employment opportunities to all qualified applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic. We prohibit discrimination in all aspects of employment, including hiring, promotion, demotion, transfer, compensation, and termination.
Export Control
Certain positions at The Nuclear Company may involve access to information and technology subject to export controls under U.S. law. Compliance with these export controls may result in The Nuclear Company limiting its consideration of certain applicants.
$25k-45k yearly est. Auto-Apply 56d ago
Plant/Manufacturing - Adjuster
Schwarz Partners 3.9
Claims representative job in Rock Hill, SC
STS Packaging, a Schwarz Partners, L.P. Joint Venture company, is currently seeking an Adjuster in Charlotte, NC. The primary responsibility of the Adjuster is to serve as the technical and operational leader for a designated group of bag machines. Duties focus on safety, operational efficiencies, machine uptime, instruction and guidance to the group operators, reporting and the overall performance of the machine group/shift. This position is located at 1201 Westinghouse Blvd in Charlotte, NC. 28273
ESSENTIAL JOB FUNCTIONS FOR THIS POSITION
Proven experience in operating a bag machine per production standards and output
Actively check bag quality (both for defects and predictive changes to bag attributes)
Maintain machine - Make comprehensive machine adjustments and lead major machine adjustments effort as needed to ensure quality and efficiency - See position tier levels for specific tasks
Keep machine running at optimal speeds
Interact, train and mentor all employees within the machine group
Maintain cleanliness of machine group and work area
Convey to the Production Superintendent any pending or current conditions that may impede the output of the machine group.
Oversee the accurate, complete documentation of daily shift paperwork
Perform any and all job assignments/functions as necessary to daily business demands as instructed by Management.
Lead PM activities (via dedicated or rotating schedule)
Maintain a positive, instructive attitude every day to foster employee job satisfaction
Technical Duties Include:
Effectively manage the machine group's performance (all operators)
Maximize uptime through optimal adjustments and time-efficient repair of machine during breakdowns
Mentor group Operators and Adjuster Trainees
Act as the area leader for meeting/exceeding production standards
OTHER SIGNIFICANTJOB FUNCTIONS INCLUDE
Maintains a clean and safe work area and reports unsafe conditions to management for resolution
Adheres to all safety policies, including always wearing required PPE, and sets an example to others for model safety behavior
Detailed understanding of quality defects, including how to detect as well as what to do if observed
Conform to Good Manufacturing Practices (GMP's), and Safe Quality Food (SQF) procedures and policies to assure products are suitable for food contact
Responsible for reporting any product quality or food safety issues to the Quality Manager (SQF Practitioner) or Management Team member
Additional duties as assigned by Production Superintendent
REQUIRED EDUCATION / EXPERIENCE
High School Diploma minimum required
Leadership skills and ability to work as an independent thinker
Proven team-oriented mindset
REQUIRED SKILLS (TECHNICAL, CLERICAL, LANGUAGE, ETC.)
Must follow Safety/GMP/PPE guidelines
Ability to work beyond 8-hour shifts as needed and participate in weekend PM and maintenance efforts as needed; Days of work may be shifted to accommodate a 5 day work week
Production-focused
Take direction from Production Superintendent/General Manager
High level of machine and mechanical knowledge
Read and understand instructions and job information
Excellent math and writing abilities
Desire to accept additional responsibility and learn new tasks
LANGUAGE SKILLS
Fluent in English required
Fluency in Spanish a plus
PHYSICAL DEMANDS
Continuous standing and walking with minimal sitting.
Able to bend, twist, kneel, crawl, and lay down on floor during cleanup/startup of machine - involves frequent, constant, continuous, and repetitious motions
Frequent lifting overhead & carrying of cases that can weigh in excess of 35-lbs
Frequent, regular pushing and pulling of paper rolls in excess of 1,500-lbs
Frequent ladder and stair climbing
WORK ENVIRONMENT
Standard production/manufacturing environment; Plants can be hot noisy, exhibit vibrations have, uneven surfaces mechanical hazards, dust/dirt, odor/fumes; work performed inside.
OTHER INFORMATION
Personal Protective Equipment required for the job: Steel toe shoes, hearing protection, safety glasses, hair nets
Steel toe shoes are provided by employee, all other tools provided by employer
If you would like to be part of a forward-thinking team with a family feel, culture of excellence, and customer-focused reliability, we want you to be a part of our team!
Our organization is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
$29k-37k yearly est. 16d ago
Claims Processing Expert
The Strickland Group 3.7
Claims representative job in Raleigh, NC
Join Our Dynamic Insurance Team - Unlock Your Potential!
Are you ready to take control of your future and build a career in one of the most stable and lucrative industries? We are seeking driven individuals to join our thriving insurance team, where you'll receive top-tier training, support, and unlimited income potential.
NOW HIRING:
✅ Licensed Life & Health Agents
✅ Unlicensed Individuals (We'll guide you through the licensing process!)
We're looking for our next leaders-those who want to build a career or an impactful part-time income stream.
Is This You?
✔ Willing to work hard and commit for long-term success?
✔ Ready to invest in yourself and your business?
✔ Self-motivated and disciplined, even when no one is watching?
✔ Coachable and eager to learn?
✔ Interested in a business that is both recession- and pandemic-proof?
If you answered YES to any of these, keep reading!
Why Choose Us?
💼 Work from anywhere - full-time or part-time, set your own schedule.
💰 Uncapped earning potential - Part-time: $40,000 - $60,000 /month | Full-time: $70,000 - $150,000+++/month.
📈 No cold calling - You'll only assist individuals who have already requested help.
❌ No sales quotas, no pressure, no pushy tactics.
🧑 🏫 World-class training & mentorship - Learn directly from top agents.
🎯 Daily pay from the insurance carriers you work with.
🎁 Bonuses & incentives - Earn commissions starting at 80% (most carriers) + salary
🏆 Ownership opportunities - Build your own agency (if desired).
🏥 Health insurance available for qualified agents.
🚀 This is your chance to take back control, build a rewarding career, and create real financial freedom.
👉 Apply today and start your journey in financial services!
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Results may vary. Your success depends on effort, skill, and commitment to training and sales systems.
)
How much does a claims representative earn in Wilmington, NC?
The average claims representative in Wilmington, NC earns between $26,000 and $52,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.
Average claims representative salary in Wilmington, NC