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Claims Adjuster jobs at GuideOne Insurance - 20 jobs

  • Commercial Casualty Claims Adjuster - Remote Opportunity

    Guideone Insurance 4.7company rating

    Claims adjuster job at GuideOne Insurance

    As a Commercial Casualty Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without unnecessary delay. If you are optimistic, enjoy helping others in times of need, and are compassionate about making positive change in the world, this may be the role for you. Accountabilities: This position handles Commercial General Liability, Commercial Trucking, Director's & Officer Liability, Employment Practices Liability, Commercial Auto injuries, Contractor's Pollution Liability, Professional Liability and other Casualty exposures. Investigates coverage and cause of loss on routine to more complicated claims, which includes but is not limited to policy review, interviewing all parties associated with the loss and gathering and analyzing all necessary investigative documentation. Handles non-represented, represented and litigated injury and property damage claims including investigating and evaluating those exposures. Identifies exposures with significate severity to triage to the large loss team. Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage, the language of the policy of insurance, pertinent regulatory and statutory considerations and within granted authority. Prepares written communication, including but not limited to settlement letters, disclaimers of coverage and reservation of rights letters. Maintains effective claim file documentation and diary system. Monitor diary to achieve timely development of file and timely disposition of the claim. Recognizes and pursues recovery opportunities and prepares submissions to SIU when indicated. Assigns and supervises field examiners and vendor resources, including but not limited to independent adjusters, engineers and other experts as needed. Assumes additional duties as defined. As a Commercial Casualty Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without unnecessary delay. If you are optimistic, enjoy helping others in times of need, and are compassionate about making positive change in the world, this may be the role for you. Accountabilities: This position handles Commercial General Liability, Commercial Trucking, Director's & Officer Liability, Employment Practices Liability, Commercial Auto injuries, Contractor's Pollution Liability, Professional Liability and other Casualty exposures. Investigates coverage and cause of loss on routine to more complicated claims, which includes but is not limited to policy review, interviewing all parties associated with the loss and gathering and analyzing all necessary investigative documentation. Handles non-represented, represented and litigated injury and property damage claims including investigating and evaluating those exposures. Identifies exposures with significate severity to triage to the large loss team. Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage, the language of the policy of insurance, pertinent regulatory and statutory considerations and within granted authority. Prepares written communication, including but not limited to settlement letters, disclaimers of coverage and reservation of rights letters. Maintains effective claim file documentation and diary system. Monitor diary to achieve timely development of file and timely disposition of the claim. Recognizes and pursues recovery opportunities and prepares submissions to SIU when indicated. Assigns and supervises field examiners and vendor resources, including but not limited to independent adjusters, engineers and other experts as needed. Assumes additional duties as defined. Required Qualifications: 5 or more years in the handling of Commercial Liability Claims. Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution using best practices. Ability to take responsibility and work independently in a home-based environment. Ability to negotiate skillfully in difficult situations. Willingness to travel periodically. Recommended Qualifications: Environmental claim experience is preferred. Propane Gas Distributors claim experience is preferred Bachelor's degree preferred New York, Florida or Texas claims handling license required If not licensed, willingness to obtain state licensing or certification where required within 30 days of employment Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations and presenting them effectively. Basic computer skills including Microsoft applications Perform work related simple and advanced mathematical problems and calculations Compose written correspondence and factual reports which are well organized and concise, utilizing proper English, grammar, punctuation, and spelling Strong oral and written communication skills. Compensation: $59,400 - $99,000 commensurate with experience, plus bonus eligibility $65,400 - $109,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility Benefits: We are proud to offer a robust benefits suite that includes: Competitive base salary plus incentive plans for eligible team members 401(K) retirement plan that includes a company match of up to 6% of your eligible salary Free basic life and AD&D, long-term disability and short-term disability insurance Medical, dental and vision plans to meet your unique healthcare needs Wellness incentives Generous time off program that includes personal, holiday and volunteer paid time off Flexible work schedules and hybrid/remote options for eligible positions Educational assistance #TMG Skills & Requirements Required Qualifications: 5 or more years in the handling of Commercial Liability Claims. Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution using best practices. Ability to take responsibility and work independently in a home-based environment. Ability to negotiate skillfully in difficult situations. Willingness to travel periodically. Recommended Qualifications: Environmental claim experience is preferred. Propane Gas Distributors claim experience is preferred Bachelor's degree preferred New York, Florida or Texas claims handling license required If not licensed, willingness to obtain state licensing or certification where required within 30 days of employment Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations and presenting them effectively. Basic computer skills including Microsoft applications Perform work related simple and advanced mathematical problems and calculations Compose written correspondence and factual reports which are well organized and concise, utilizing proper English, grammar, punctuation, and spelling Strong oral and written communication skills. Compensation: $59,400 - $99,000 commensurate with experience, plus bonus eligibility $65,400 - $109,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility Benefits: We are proud to offer a robust benefits suite that includes: Competitive base salary plus incentive plans for eligible team members 401(K) retirement plan that includes a company match of up to 6% of your eligible salary Free basic life and AD&D, long-term disability and short-term disability insurance Medical, dental and vision plans to meet your unique healthcare needs Wellness incentives Generous time off program that includes personal, holiday and volunteer paid time off Flexible work schedules and hybrid/remote options for eligible positions Educational assistance #TMG
    $65.4k-109k yearly 14d ago
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  • Commercial Casualty Claims Adjuster - Remote Opportunity

    Guideone Insurance 4.7company rating

    Claims adjuster job at GuideOne Insurance

    As a Commercial Casualty Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without unnecessary delay. If you are optimistic, enjoy helping others in times of need, and are compassionate about making positive change in the world, this may be the role for you. Accountabilities: This position handles Commercial General Liability, Commercial Trucking, Director's & Officer Liability, Employment Practices Liability, Commercial Auto injuries, Contractor's Pollution Liability, Professional Liability and other Casualty exposures. Investigates coverage and cause of loss on routine to more complicated claims, which includes but is not limited to policy review, interviewing all parties associated with the loss and gathering and analyzing all necessary investigative documentation. Handles non-represented, represented and litigated injury and property damage claims including investigating and evaluating those exposures. Identifies exposures with significate severity to triage to the large loss team. Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage, the language of the policy of insurance, pertinent regulatory and statutory considerations and within granted authority. Prepares written communication, including but not limited to settlement letters, disclaimers of coverage and reservation of rights letters. Maintains effective claim file documentation and diary system. Monitor diary to achieve timely development of file and timely disposition of the claim. Recognizes and pursues recovery opportunities and prepares submissions to SIU when indicated. Assigns and supervises field examiners and vendor resources, including but not limited to independent adjusters, engineers and other experts as needed. Assumes additional duties as defined. As a Commercial Casualty Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without unnecessary delay. If you are optimistic, enjoy helping others in times of need, and are compassionate about making positive change in the world, this may be the role for you. Accountabilities: This position handles Commercial General Liability, Commercial Trucking, Director's & Officer Liability, Employment Practices Liability, Commercial Auto injuries, Contractor's Pollution Liability, Professional Liability and other Casualty exposures. Investigates coverage and cause of loss on routine to more complicated claims, which includes but is not limited to policy review, interviewing all parties associated with the loss and gathering and analyzing all necessary investigative documentation. Handles non-represented, represented and litigated injury and property damage claims including investigating and evaluating those exposures. Identifies exposures with significate severity to triage to the large loss team. Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage, the language of the policy of insurance, pertinent regulatory and statutory considerations and within granted authority. Prepares written communication, including but not limited to settlement letters, disclaimers of coverage and reservation of rights letters. Maintains effective claim file documentation and diary system. Monitor diary to achieve timely development of file and timely disposition of the claim. Recognizes and pursues recovery opportunities and prepares submissions to SIU when indicated. Assigns and supervises field examiners and vendor resources, including but not limited to independent adjusters, engineers and other experts as needed. Assumes additional duties as defined. Required Qualifications: 5 or more years in the handling of Commercial Liability Claims. Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution using best practices. Ability to take responsibility and work independently in a home-based environment. Ability to negotiate skillfully in difficult situations. Willingness to travel periodically. Recommended Qualifications: Environmental claim experience is preferred. Propane Gas Distributors claim experience is preferred Bachelor's degree preferred New York, Florida or Texas claims handling license required If not licensed, willingness to obtain state licensing or certification where required within 30 days of employment Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations and presenting them effectively. Basic computer skills including Microsoft applications Perform work related simple and advanced mathematical problems and calculations Compose written correspondence and factual reports which are well organized and concise, utilizing proper English, grammar, punctuation, and spelling Strong oral and written communication skills. Compensation: $59,400 - $99,000 commensurate with experience, plus bonus eligibility $65,400 - $109,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility Benefits: We are proud to offer a robust benefits suite that includes: Competitive base salary plus incentive plans for eligible team members 401(K) retirement plan that includes a company match of up to 6% of your eligible salary Free basic life and AD&D, long-term disability and short-term disability insurance Medical, dental and vision plans to meet your unique healthcare needs Wellness incentives Generous time off program that includes personal, holiday and volunteer paid time off Flexible work schedules and hybrid/remote options for eligible positions Educational assistance #TMG Skills & Requirements Required Qualifications: 5 or more years in the handling of Commercial Liability Claims. Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution using best practices. Ability to take responsibility and work independently in a home-based environment. Ability to negotiate skillfully in difficult situations. Willingness to travel periodically. Recommended Qualifications: Environmental claim experience is preferred. Propane Gas Distributors claim experience is preferred Bachelor's degree preferred New York, Florida or Texas claims handling license required If not licensed, willingness to obtain state licensing or certification where required within 30 days of employment Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations and presenting them effectively. Basic computer skills including Microsoft applications Perform work related simple and advanced mathematical problems and calculations Compose written correspondence and factual reports which are well organized and concise, utilizing proper English, grammar, punctuation, and spelling Strong oral and written communication skills. Compensation: $59,400 - $99,000 commensurate with experience, plus bonus eligibility $65,400 - $109,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility Benefits: We are proud to offer a robust benefits suite that includes: Competitive base salary plus incentive plans for eligible team members 401(K) retirement plan that includes a company match of up to 6% of your eligible salary Free basic life and AD&D, long-term disability and short-term disability insurance Medical, dental and vision plans to meet your unique healthcare needs Wellness incentives Generous time off program that includes personal, holiday and volunteer paid time off Flexible work schedules and hybrid/remote options for eligible positions Educational assistance #TMG
    $65.4k-109k yearly 14d ago
  • E&S Litigation Claims Manager - Remote

    Selective Insurance 4.9company rating

    Branchville, NJ jobs

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview Selective Insurance is seeking a E&S Litigation Claims Manager who proactively manages a litigation claims unit in our Excess & Surplus Lines unit in accordance with Company claim policies, practices and procedures within delegated authority. Candidate is responsible for the management of the E&S Litigation Claims Specialist; driving optimum claims outcomes, supporting operational goals and objectives while delivering superior customer service to our policyholders and agents, all in support of our commitments to our stakeholders. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements. Candidate will be responsible for assisting staff with resolution of coverage issues and working with Legal and outside coverage counsel in the resolution of coverage litigation. Responsibilities Plans, controls and coordinates claims activity and workflow within claims unit/department in order to maintain the highest professional customer service and technical standards, and to ensure work is produced in a timely fashion and that all deadlines are met. Ensures the timely settlement of claims and maintains acceptable closing ratios for the department. Prepares operating budget for unit/department and monitors and controls expenses. Recommends claims procedural changes and plans, organizes and implements these changes in accordance with company guidelines. Keeps current on all changes affecting work production. Maintains override capability, authorizes settlements up to designated authority limits, and submits recommendations to designated officials for those claims in excess of authority level. Oversees combined loss ratio and productivity numbers and ensures they are in compliance with company standards. Oversees and controls allocated claims expenses. Provides performance management activities for personnel measured against business objectives and claims activity. Plans reviews and conducts claims reviews and settlement conferences. Mediates complaints and disputes regarding claim resolution. Must be able to drive an automobile to travel within territory. Car travel represents approximately 0-10% of employee's time and a valid driver's license. Qualifications Knowledge and Requirements Ability to lead a team of litigation claims specialist with varying degrees of experience. Excellent people and management skills to properly performance manage staff and assist with training initiatives. Ability to analyze reports and trend analysis to identify issues. Experience in E&S claims, complex coverage analysis and significant large loss evaluations preferred. Superior communication, strategic thinking and problem-solving skills. Excellent presentation skills. Moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint). Sufficient keyboarding proficiency to enter data accurately and efficiently. Must have valid state-issued driver's license in good standing and be able to drive an automobile. Education and Experience College degree preferred. Law degree preferred, but not required, 10+ years claims experience and 3-5 year's claims supervisory experience. Experience handling or supervising E&S Claims and/or experience handling coverage litigation preferred. Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $135,000.00 - USD $204,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $135k-204k yearly 5d ago
  • Auto Physical Damage Claim Rep (Remote)

    Selective Insurance 4.9company rating

    Branchville, NJ jobs

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview Join Our Team as an Auto Physical Damage Claim Representative at Selective! As an Auto Physical Damage Claim Representative at Selective you will play a crucial role in ensuring our customers receive the best service possible. As part of this role, you will manage auto claims from start to finish. You will investigate all claim details by gathering information from insureds, claimants, witnesses, and repair shop personnel to conclude settlement or denial of the claim. As an Auto Physical Damage Claim Rep you will ensure claims are processed within company policies, procedures, and individual's prescribed authority with exceptional standards of performance. You will work in a collaborative and supportive environment, where you will have access to ongoing training and future development opportunities. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements. *Please also note, there are two weeks of mandatory onsite trainings. The week of 3/9/2026 will be held in our Charlotte, NC office and the week of 4/6/2026 will be held in our Richmond, VA office. Responsibilities Investigate claims through various methods of communication with claim parties. Analyze information obtained through investigation in order to evaluate assigned claims to determine the extent of loss and liability. Review/analyze policy forms to determine the appropriate coverage for a loss, including limits and deductibles. Escalate claims appropriately when outside scope of handling for this position. Establish and continuously review reserves and input claim information in the Claims System. Update the claims system on a continual basis to accurately reflect status of assigned file and to initiate percentage of negligence on the part of the insured to determine "chargeability". Document claim activity and maintain control of work through documentation and diary/task system. Review and approve expenses incurred to investigate process and handle a claim. Recognizes fraudulent claims activity that would be subject to SIU referral in accordance with company guidelines and subsequent referral to law enforcement or regulatory agencies. Direct customer to approved car rental vendor, aggressively manage car rental expenses, set up appropriate inspection and repair assignments, and process immediate removal of total loss vehicles to salvage yard. Close claim by issuing check or denial. Issue appropriate letters based on state regulations and company directives. Process incoming calls and correspondence from insureds, claimants and agents regarding questions or problems associated with claims. Interact with underwriters and agents on claim resolution. Utilize vendors and other resources as necessary to assist with resolving disputed claims. Explore subrogation opportunities on all claims assigned. May handle low complexity property losses. Qualifications Knowledge and Requirements Understanding of Commercial and Personal Automobile policy language and endorsements. Adjuster licenses in states requiring same (obtain within 3 months of hire). Exceptional customer service skills. Education and Experience College degree preferred. 1-3 years of claim handling experience preferred. Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $42,000.00 - USD $58,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $42k-58k yearly 5d ago
  • Liability Claims Specialist-E&S (Remote)

    Selective Insurance 4.9company rating

    Branchville, NJ jobs

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview The purpose of this position is to provide direct handling of the company's Garage auto property damage claims with a focus on First and Third party claims including Garagekeeper coverage. The position will involve both attorney represented and non-represented claimants. Responsibilities of this position include coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims. This position may also entail handling of bodily injury and general liability claims and/or willingness to learn same. The individual in this position will also ensure claims are processed within company policies, procedures, and within the individual's prescribed authority with exceptional standards of performance. Responsibilities Receives assigned auto claims and independently reviews/analyzes the policy forms and endorsements to determine applicable coverages, limits, deductibles and settlement calculations, as well as subrogation recovery opportunity. Investigate coverage and issue applicable coverage letters. Gathers appropriate documentation to support the claimed damages through phone/email contact with customers, vendors, and police departments (includes estimates, proof of ownership/value, required company forms, reports, invoices, etc.) Reviews damage documentation to determine loss amount. Negotiates settlements based on documentation presented, vendor contact/discussions, personal knowledge and experience, customer discussions and policy language. Documents claim files, establishes and updates reserves throughout the life of the claim, maintains suspense system, processes expenses, prepares checks, updates MCS, and sends appropriate letters based on state regulations and company directives. Explores salvage and subrogation potential, as well as arbitration opportunity. Continuously reviews and analyzes investigative information to determine if file is eligible for fraud/SIU handling. Enlists the assistance of vendors and/or other resources to help with remediation services or future analysis of auto damage or settlement values. Ensures compliance with company, state and federal regulations. Qualifications Knowledge and Requirements Adjuster licenses in states requiring same Effective verbal and written communication skills Strong time management and organizational skills Negotiation and claim disposition skills with proven problem-solving ability Strong judgment and decision making skills Self-starter with ability to work independently Moderate proficiency with standard business-related software Education and Experience College degree preferred 1-5 years of Commercial and or Personal Lines Auto experience preferred Industry training/designations preferred Understanding of Garage Auto/Auto Dealer policy language and endorsements preferred Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $72,000.00 - USD $109,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $72k-109k yearly 2d ago
  • Complex Claims Specialist - E&S (Remote)

    Selective Insurance 4.9company rating

    Branchville, NJ jobs

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview Selective Insurance is seeking an E&S Complex Claims Specialist to handle the company's most complex and challenging claims. This is a fully remote position. Responsibilities of this position include coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims. Candidate must possess strong litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The individual in this position will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority with exceptional standards of performance. This individual should possess strategic though process skills to effectively and efficiently manage loss exposures. Job duties will include communication and collaboration with key stakeholders, training, development and providing thought leadership where requested. In addition, position may require travel to mediations, arbitrations, settlement conferences, trials or other proceedings which may account for up to 20% of the specialist time. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements. Responsibilities Effectively evaluate and resolve coverage issues for all lines of business and all liability claim types. Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information. Effectively and efficiently manage vendors and expenses. Timely analyze information in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assign medical or other experts to case and arrange for medical examinations when necessary. Effectively evaluate, negotiate and resolve claims within delegated authority (ranging from $100,000 to $400,000) utilizing the appropriate denials or releases. Provide required reports to claims, underwriting, reinsurance and actuarial on significant exposure cases. Report on all cases going to trial on a timely basis and attend portions of trials when warranted or where requested by management. Ensure proper referrals and timely updates to appropriate Reinsurer(s). Ability to handle or oversee Extra-Contractual, EPLI, Social Services and E&O claims against the Company. Must be able to drive an automobile to travel within territory. Car travel represents approximately 10-25% of employee's time and a valid driver's license. Qualifications Knowledge and Requirements Experience in complex coverage analysis and significant large loss evaluations. Experience with E&S claim preferred but not required. Superior communication and strategic negotiation and claim disposition skills along with proven problem-solving skills. Excellent presentation skills and moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint). Sufficient keyboarding proficiency to enter data accurately and efficiently. Multi-State licensing with strong understanding of Medicare reporting & compliance preferred. Must have valid state-issued driver's license in good standing and be able to drive an automobile. Education and Experience College degree preferred. 8+ Casualty claims handling experience A minimum of 5 years handling cases of a complex nature with a primary P&C carrier. New York Labor Law experience required. Habitability, assault and battery and Coverage B experience preferred. Carrier experience preferred. Ability to write coverage letters is required. Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $108,000.00 - USD $163,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $72k-104k yearly est. 6d ago
  • Auto Physical Damage Claim Rep (Remote)

    Selective Insurance Group, Inc. 4.9company rating

    Remote

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview Join Our Team as an Auto Physical Damage Claim Representative at Selective! As an Auto Physical Damage Claim Representative at Selective you will play a crucial role in ensuring our customers receive the best service possible. As part of this role, you will manage auto claims from start to finish. You will investigate all claim details by gathering information from insureds, claimants, witnesses, and repair shop personnel to conclude settlement or denial of the claim. As an Auto Physical Damage Claim Rep you will ensure claims are processed within company policies, procedures, and individual's prescribed authority with exceptional standards of performance. You will work in a collaborative and supportive environment, where you will have access to ongoing training and future development opportunities. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements. * Please also note, there are two weeks of mandatory onsite trainings. The week of 3/9/2026 will be held in our Charlotte, NC office and the week of 4/6/2026 will be held in our Richmond, VA office. Responsibilities * Investigate claims through various methods of communication with claim parties. Analyze information obtained through investigation in order to evaluate assigned claims to determine the extent of loss and liability. * Review/analyze policy forms to determine the appropriate coverage for a loss, including limits and deductibles. Escalate claims appropriately when outside scope of handling for this position. * Establish and continuously review reserves and input claim information in the Claims System. * Update the claims system on a continual basis to accurately reflect status of assigned file and to initiate percentage of negligence on the part of the insured to determine "chargeability". * Document claim activity and maintain control of work through documentation and diary/task system. * Review and approve expenses incurred to investigate process and handle a claim. Recognizes fraudulent claims activity that would be subject to SIU referral in accordance with company guidelines and subsequent referral to law enforcement or regulatory agencies. * Direct customer to approved car rental vendor, aggressively manage car rental expenses, set up appropriate inspection and repair assignments, and process immediate removal of total loss vehicles to salvage yard. * Close claim by issuing check or denial. Issue appropriate letters based on state regulations and company directives. Process incoming calls and correspondence from insureds, claimants and agents regarding questions or problems associated with claims. Interact with underwriters and agents on claim resolution. Utilize vendors and other resources as necessary to assist with resolving disputed claims. Explore subrogation opportunities on all claims assigned. * May handle low complexity property losses. Qualifications Knowledge and Requirements * Understanding of Commercial and Personal Automobile policy language and endorsements. * Adjuster licenses in states requiring same (obtain within 3 months of hire). * Exceptional customer service skills. Education and Experience * College degree preferred. 1-3 years of claim handling experience preferred. Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $42,000.00 - USD $58,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $42k-58k yearly 15d ago
  • Marine Claims Adjuster

    Engle Martin 4.2company rating

    Remote

    TITLE: Marine Claims Consultant DEPARTMENT: EIMC REPORTS TO: Team Leader or Director of Marine Claims STATUS: Regular, full-time; exempt SUMMARY OF JOB PURPOSE EIMC, an Engle Martin company, is an independent marine consulting services company providing supply chain loss control and claims investigation expertise to insurers, brokers, 3PLs and industrial partners. The Marine Consultant effectively determines and communicates the extent of loss or damage associated with ocean marine claims in a variety of business classes. PRIMARY JOB RESPONSIBILITIES Independently opens and handles assigned cases within basic limits of complexity. Identifies, recommends, and pursues appropriate mitigation strategy with supervisory oversight as necessary. Expands knowledge base to include broader analysis of terms, clauses, and coverage. Independently selects appropriate company templates as required based on independent recognition of client requirements. Routinely produces clear, concise, and grammatically correct reports which require minimal review/editing; defers to senior level team members for assistance. Engages in peer review with others as directed. Reviews time and expenses with attention paid to estimates and client intent. Pursues and completes Lloyds Agency Module 3: Cargo Claims & Recoveries credentialing. Develops a higher-level understanding of market levers and influences. Granted supervised authority to communicate with clients beyond routine case correspondence; demonstrates timely reliability to clients. Attends company meetings and trainings with enthusiasm. Identifies potentially valuable case studies from personal field experience and works with management to share those cases through supervised contributions to presentations. Establishes and maintains positive working relationships with other members of the organization across departments, divisions, and locations. Maintains the confidentiality of proprietary and sensitive information, exercising sound judgment and discretion in any disclosure of information related to EM, EIMC, and its endeavors. Adheres to all applicable State Insurance Regulation requirements and other applicable laws, regulations, and standards. REQUIRED EDUCATION & EXPERIENCE Bachelor's degree preferred Prior experience in ocean marine claim adjusting or other insurance-related work preferred DESIRED KNOWLEDGE, SKILLS & ABILITIES Ability to understand claims adjudication process Excellent written and verbal communication skills Ability to manage multiple priorities and meet deadlines Passionate about providing exceptional customer service Skilled in analyzing, interpreting, and reporting pertinent information, discerning the essential from the non-essential Strong research and investigative skills Conflict resolution and persuasion abilities Organized and detail oriented Excellent problem solving and critical thinking skills Ability to work both independently and as part of a team WORKING CONDITIONS Work is conducted primarily in a remote location or in an indoor office environment with protection from weather conditions and with exposure to noise typical of an office or administrative setting. PHYSICAL ACTIVITIES AND REQUIREMENTS Work requires light lifting (10 - 20 lbs.), standing, walking, stooping, kneeling, reaching, fingering (keyboarding) and repetitive hand motion, grasping, talking, and hearing at normal speaking levels. Work requires visual acuity to read and prepare data and figures, type words and numbers, view information on a computer terminal, read, operate office machines, and determine the accuracy and thoroughness of work.
    $45k-57k yearly est. Auto-Apply 60d+ ago
  • Property Field Claims Specialist- DC/Northern Virginia (Remote)

    Selective Insurance Group, Inc. 4.9company rating

    Remote

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview Selective Insurance is seeking a Property Field Claims Specialist to cover the DC/Northern Virgina territory. This is a fully remote position and includes a company vehicle. No relocation assistance is offered with this role so you must reside in the nearby area or be willing to relocate at your own expense. It is the responsibility of this position to provide superior property claims service to all regions by handling Property and Inland Marine claims, generally with dollar exposures of $25,000 to $100,000. This person will investigate the claim, estimate the property damages, select and deploy experts, obtain appropriate claim documentation, and effect accurate settlement within the prescribed authority and standards of performance. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements. Responsibilities * Handles property/inland marine claims for assigned region with availability to assist as needed in all other regions. * Evaluates and settles property-related damages (primarily) between $25,000 and $100,000 (aggregate). This position will occasionally handle losses that exceed $100,000 in aggregate claim value. * Handles typical Business Income losses. * This position will join the LLU as part of the corporate catastrophe team. As catastrophe needs arise throughout our claims organization, the PCS will serve as an initial responder for catastrophe claim events within the various regions. * Responsible for all coverage determinations, negotiations, reserving and settlement within established authority. * Provides coverage and/or estimating assistance to regional CMS' as may be required by management. * Responds to all legal, regulatory or appeals situations or requests. * Must be able to drive an automobile to travel within territory. Car travel represents approximately 75% of employee's time. * Handles property/inland marine claims for the assigned region with availability to assist as needed in all other regions. * Evaluates and settles property-related damages (primarily) between $25,000 and $100,000 (aggregate). This position will occasionally handle losses that exceed $100,000 in aggregate claim value. * Handles typical Business Income losses. * This position will join the LLU as part of the corporate catastrophe team. As catastrophe needs arise throughout our claims organization, the PCS will serve as an initial responder for catastrophe claim events within the various regions. * Responsible for all coverage determinations, negotiations, reserving and settlement within established authority. * Responds to all legal, regulatory or appeals situations or requests. * Car travel represents approximately 75% of employee's time. Qualifications Knowledge and Requirements * Must have the ability to work varying shifts. * Have knowledge of and proficiency in standard business and claim-specific computer software programs and the ability to keyboard in an efficient and productive manner. Must have valid state-issued driver's license in good standing and be able to drive an * automobile. Education and Experience * College degree preferred. * Prefer 5 years property claims experience, thorough knowledge of Commercial and Personal Lines coverages and computer-based damage estimating. Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $72,000.00 - USD $109,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $72k-109k yearly 58d ago
  • Senior Property Adjuster (Commercial Insurance) - Hawaii

    Engle Martin 4.2company rating

    Remote

    SUMMARY OF JOB PURPOSE: The Senior Property Adjuster effectively determines and communicates the extent of loss or damage associated with commercial property claims in a variety of business classes. The Senior Property Adjuster is typically assigned loss or damage assessments in a moderate cost range, based on incumbent's experience and demonstrated ability for handling larger or more complex claims. PRIMARY JOB RESPONSIBILITIES: Investigates insurance claims in any of a variety of settings, including, but not limited to, retail establishments, private or public office buildings, commercial habilitation, hospitality, corporate facilities, transportation sites, manufacturing sites, governmental facilities, schools, clinics, or hospitals; assesses loss or damage resulting from various events including, but not limited to, inclement or catastrophic weather, earthquakes, fire, vandalism, or accidents. May be called upon to assess time-element and builders' risk losses. Uses a knowledge of property and construction, and/or knowledge of the specific industry or business affected, as typically achieved through significant commercial property loss adjusting experience, personally conducts property inspections and photographs claim sites as necessary to depict and substantiate losses or damage, or the lack thereof. Through interviewing or other methods, obtains necessary information from the claimant and from experts such as architects, engineers, builders, construction workers, police officers, health care practitioners, accountants, and others to fully and accurately assess the extent of the loss. Interacts effectively with, and may be required to coordinate efforts of, diverse team of experts. Works cooperatively with expert witnesses, attorneys, public adjusters, and carrier's examiners as needed to conduct investigations, confirm findings and support evaluations. Applies a thorough understanding of insurance policies and policy interpretation, establishing appropriate loss estimates based on all relevant information and findings; demonstrates understanding of a variety of coverage and loss types. Recommends the reasonable and proper amount the insurance company should pay on a claim. Ensures the accuracy of information collected and reported and guards against fraudulent claims. Prepares accurate, clear, thorough, and concise reports and letters to insurance carriers, providing conclusions and recommendations. Follows established policies, procedures, and processes in preparing information, exercising sound judgment in applying these to potentially costly losses or involved situations, and submits reports and documents in a timely manner and in accordance with insurer's standards and expectations. Effectively uses software systems such as Xactimate as necessary to produce accurate estimates. Maintains accurate, thorough field notes, journal entries, and time and expense records as required. Submits reimbursement reports in keeping with organization and client policies, procedures, and practices and with accepted industry standards. Applies knowledge of both time-and-expense and fee-for-service procedures, according to the stipulations of the agreement with the insurer. Follows EM policy and practices and incorporates sound judgment in formulating recommendations and completing evaluations and reports. Prepares and conducts presentations and produces special reports for insurance carriers as assigned or required. REQUIRED EDUCATION & EXPERIENCE: Bachelor's Degree Preferred 2-5 years' experience in commercial property loss adjusting; experience with catastrophe claims; wide range of experience in various classes and types of business risk, including manufacturing, retail, industrial, habitational, and hospitality. Ability to understand claims adjudication process with sound knowledge of commercial and residential construction industries. Knowledge of property claim law. Active license, or ability to promptly obtain such, in the assigned state(s). Desired Knowledge, Skills & Abilities: Exceptional written and verbal communication skills. Ability to manage multiple priorities and meet deadlines. Passionate about providing exceptional customer service. Skilled in analyzing, interpreting, and reporting pertinent information (discerning the essential from the non-essential). Strong research and investigative skills. Conflict resolution and persuasion abilities Organized and detail oriented. Excellent problem solving and critical thinking skills. Ability to work both independently and as part of a team Microsoft Word, Microsoft Excel, Xactimate, Corelogic, and ability and openness to adapt to new technologies WORKING CONDITIONS: Frequently requires work to be performed at the site of the property damage or loss, including locations where disasters or catastrophes have occurred. May require evening, overnight, and weekend travel and work. During catastrophes, required travel could last 2 weeks or more. The incumbent could be exposed to outside weather and environmental conditions, including, but not limited to, extreme heat, cold, and precipitation. Could also be exposed to inside environmental conditions, including, but not limited to noise, vibrations, proximity to moving mechanical parts, electrical current, heights, chemicals, fumes, odors, dusts, mists, gases, or poor ventilation. The incumbent may be required to work in close quarters, crawl spaces, small, enclosed rooms, narrow aisles, passageways, or other enclosed areas, requiring physical agility and resistance to claustrophobia. The incumbent may be required to work in high areas such as roofs or scaffolding, requiring physical agility, balance, and resistance to acrophobia. PHYSICAL ACTIVITIES AND REQUIREMENTS: In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing property damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder. The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.
    $49k-72k yearly est. Auto-Apply 3d ago
  • Complex Claims Specialist - E&S (Remote)

    Selective Insurance Group, Inc. 4.9company rating

    Remote

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview Selective Insurance is seeking an E&S Complex Claims Specialist to handle the company's most complex and challenging claims. This is a fully remote position. Responsibilities of this position include coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims. Candidate must possess strong litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The individual in this position will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority with exceptional standards of performance. This individual should possess strategic though process skills to effectively and efficiently manage loss exposures. Job duties will include communication and collaboration with key stakeholders, training, development and providing thought leadership where requested. In addition, position may require travel to mediations, arbitrations, settlement conferences, trials or other proceedings which may account for up to 20% of the specialist time. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements. Responsibilities * Effectively evaluate and resolve coverage issues for all lines of business and all liability claim types. * Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information. * Effectively and efficiently manage vendors and expenses. * Timely analyze information in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assign medical or other experts to case and arrange for medical examinations when necessary. * Effectively evaluate, negotiate and resolve claims within delegated authority (ranging from $100,000 to $400,000) utilizing the appropriate denials or releases. * Provide required reports to claims, underwriting, reinsurance and actuarial on significant exposure cases. * Report on all cases going to trial on a timely basis and attend portions of trials when warranted or where requested by management. * Ensure proper referrals and timely updates to appropriate Reinsurer(s). * Ability to handle or oversee Extra-Contractual, EPLI, Social Services and E&O claims against the Company. * Must be able to drive an automobile to travel within territory. Car travel represents approximately 10-25% of employee's time and a valid driver's license. Qualifications Knowledge and Requirements * Experience in complex coverage analysis and significant large loss evaluations. * Experience with E&S claim preferred but not required. * Superior communication and strategic negotiation and claim disposition skills along with proven problem-solving skills. * Excellent presentation skills and moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint). * Sufficient keyboarding proficiency to enter data accurately and efficiently. * Multi-State licensing with strong understanding of Medicare reporting & compliance preferred. * Must have valid state-issued driver's license in good standing and be able to drive an automobile. Education and Experience * College degree preferred. * 8+ Casualty claims handling experience * A minimum of 5 years handling cases of a complex nature with a primary P&C carrier. * New York Labor Law experience required. * Habitability, assault and battery and Coverage B experience preferred. * Carrier experience preferred. * Ability to write coverage letters is required. Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $108,000.00 - USD $163,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $46k-73k yearly est. 6d ago
  • Sr. Commercial Casualty Claims Adjuster - Remote Opportunity

    Guide One Insurance 4.7company rating

    Claims adjuster job at GuideOne Insurance

    As a Commercial Sr. Casualty Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without unnecessary delay. If you are optimistic, enjoy helping others in times of need, and are compassionate about making positive change in the world, this may be the role for you. Accountabilities: * Investigates coverage and cause of loss on routine to more complicated claims, which includes but is not limited to policy review, interviewing all parties associated with the loss and gathering and analyzing all necessary investigative documentation. * Handles non-represented, represented and litigated injury and property damage claims including investigating and evaluating those exposures. Identifies exposures with significate severity to triage to the large loss team. * Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage, the language of the policy of insurance, pertinent regulatory and statutory considerations and within granted authority. * Prepares written communication, including but not limited to settlement letters, disclaimers of coverage and reservation of rights letters. * Maintains effective claim file documentation and diary system. Monitor diary to achieve timely development of file and timely disposition of the claim. * Recognizes and pursues recovery opportunities and prepares submissions to SIU when indicated. * Assigns and supervises field examiners and vendor resources, including but not limited to independent adjusters, engineers and other experts as needed. * Assumes additional duties as defined. Required Qualifications: * 6+ or more years in the handling of Commercial Liability Claims. * Property and casualty claims handling license in 15 states or Independent Adjuster license required (If not licensed, willingness to obtain state licensing or certification where required within 30 days of employment). * Litigation handing. * Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution using best practices. * Ability to take responsibility and work independently in a home based environment. * Ability to negotiate skillfully in difficult situations. * Willingness to travel periodically. Recommended Qualifications: * Bachelors degree preferred and 5 years of commercial casualty experience. * CPCU or SCLA preferred. * Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations and presenting them effectively. * Basic computer skills including Microsoft applications. * Perform work related simple and advanced mathematical problems and calculations. * Compose written correspondence and factual repots which are well organized and concise, utilizing proper English, grammar, punctuation, and spelling. * Strong oral and written communication skills. Compensation: * $72,300 - $120,500 commensurate with experience, plus bonus eligibility * $79,500 - $132,500 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility Benefits: We are proud to offer a robust benefits suite that includes: * Competitive base salary plus incentive plans for eligible team members * 401(K) retirement plan that includes a company match of up to 6% of your eligible salary * Free basic life and AD&D, long-term disability and short-term disability insurance * Medical, dental and vision plans to meet your unique healthcare needs * Wellness incentives * Generous time off program that includes personal, holiday and volunteer paid time off * Flexible work schedules and hybrid/remote options for eligible positions * Educational assistance #TMG
    $79.5k-132.5k yearly 9d ago
  • Claims Specialist II

    Chubb 4.3company rating

    Remote

    The Claim Adjuster is an individual contributor role responsible for successfully and compliantly adjudicating claims, meeting claim execution targets, and delivering a WoW! experience to our Pet Parents every day. Responsibilities: • Adjudicating claims • Meeting or exceeding daily claim targets • Providing guidance, oversight, and final approval authority to non-licensed claims processors from GenPact, AdStrat, or Healthy Paws • Obtaining and maintains advanced adjuster licenses according to state and municipality requirements • Ensuring claims are compliantly processed and adjudicated following standard operating procedures and processes • Identifying process improvement opportunities and implementing solutions • Be a licensed Claim Adjuster or have the experience to become a licensed Claim Adjuster within six months • Property and Casualty License • Ability to effectively communicate with pet parents • Problem solving and decision-making skills • Organizational and time management skills • Basic IT skills - To be successful in this fully remote role, it's important that they feel confident managing basic functions independently-such as attaching files to emails, editing shared documents, troubleshooting simple issues like screensharing, and knowing when to escalate tech concerns to the right person-since all job duties are conducted online. • Outlook, Word, Access and Power Point skills • Experience with ERP or CRM systems a plus Education and experience: • Veterinary knowledge or experience evaluating medical records a plus • 2+ years of customer service or call center experience • High school diploma or equivalent work experience
    $77k-110k yearly est. Auto-Apply 60d+ ago
  • Associate Claim Representative - Workers Compensation

    The Travelers Companies 4.4company rating

    Cleveland, OH jobs

    Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $52,600.00 - $86,800.00 Target Openings 2 What Is the Opportunity? Travelers' Claim Organization is at the heart of our business by providing assurance to our customers and their employees in their time of need. The Travelers Workers Compensation Claim team is committed to partnering with our business insurance customers to help their injured employees return to work as soon as medically appropriate. As an Associate Claim Rep, Workers Compensation, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals. This position focuses on developing your skills and knowledge to successfully manage workers compensation claims. This program can typically last up to 12 months and upon successful completion of this program you will have the skills needed to handle claims independently and progress toward full claims handling responsibility. As part of the hiring process, this position will require 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. What Will You Do? * Actively participate in structured training classes covering insurance policies, specific claim processes, systems, and procedures, including virtual, classroom, and on-the-job training. * Assist in reviewing, investigating, and documenting Workers Compensation claims under close supervision. * Investigate, develop, and evaluate action plans for claim resolution. Assess coverage and determine if a claim is compensable under Workers Compensation including evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews. * Learn how to determine coverage, compensability, and exposure based on policy terms and claim facts. * Gather information from policyholders, claimants, witnesses, and third-party providers. * Communicate and apprise all parties regarding claim status which may include our business customers, injured employees, medical providers, and legal counsel. * Maintain accurate records of claim activity in claim management systems. * Achieve a positive result by returning an injured party to work when appropriate. This may include coordinating medical treatment in collaboration with internal or external resources. * Demonstrate openness to continuous learning, particularly in AI and digital transformation. * Acquire and maintain relevant Insurance License(s) to comply with state and Travelers' requirements within three months of starting the job. * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Previous internship or work experience in insurance, finance, or customer service. * Strong attention to detail and organizational skills. * Ability to manage multiple tasks and prioritize effectively. * Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. * Ability to exercise sound judgement and make effective decisions. * Strong verbal and written communication skills with the ability to convey information clearly and professionally. What is a Must Have? * High School Diploma or GED. * One year of customer service experience OR Bachelor's Degree. 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 *********************************************************
    $52.6k-86.8k yearly 2d ago
  • Bodily Injury Claim Representative - Auto

    The Travelers Companies 4.4company rating

    Independence, OH jobs

    Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $67,000.00 - $110,600.00 Target Openings 1 What Is the Opportunity? This position is responsible for handling Personal and Business Insurance Auto Bodily Injury claims from the first notice of loss through resolution/settlement and payment process. This may include interpreting and applying laws and statutes for multiple state jurisdictions. Claim types include moderate complexity Bodily Injury claims. 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, follow-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) instructions. * Coverage Analysis : * Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements for moderate complexity Bodily Injury liability claims in assigned jurisdictions. Verifies the benefits available, the injured party's eligibility and the applicable limits. Addresses proper application of any deductibles, co-insurance, coverage limits, etc. Confirms priority of coverage (i.e. primary, secondary, concurrent) and takes into consideration issues such as Social Security, Workers Compensation or others relevant to the jurisdiction. Consults with Unit Manager on use of Claim Coverage Counsel. * Investigation/Evaluation: * Investigates each claim to obtain relevant facts necessary to determine coverage, the extent of liability, damages, and contribution potential with respect to the various coverages provided through prompt contact with appropriate parties (e.g. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts). This may also include investigation of wage loss and essential services claims. Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. Takes recorded statements as necessary. Utilizes evaluation documentation tools in accordance with department guidelines. * Identifies resources for specific activities required to properly investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators and to other experts. Requests through Unit Manager and coordinate the results of their efforts and findings. * Recognizes cases based on severity protocols to be referred timely to next level claim professional or Major Case Unit. * 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 in accordance with established procedures to resolve claim in a timely manner. * Negotiation/Resolution: * Determines settlement amounts, negotiates and conveys claim settlements within authority limits to claimants or their representatives. Recognizes and implements alternate means of resolution. As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to claimants. * Handles both unrepresented and attorney represented claims. May manage litigated claims on appropriately assigned cases. Develops litigation plan with staff or panel counsel, track and control legal expenses. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as 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. * 2 years bodily injury liability claim handling experience. * General knowledge and skill in claims handling and litigation. * Basic working level knowledge and skill in various business line products. * Demonstrated ownership attitude and customer centric response to all assigned tasks. * Demonstrated good organizational skills with the ability to prioritize and work independently. * 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- Intermediate. * Principles of Investigation- Intermediate. * Value Determination- Intermediate. * Settlement Techniques- Intermediate. * Medical Knowledge- Intermediate. What is a Must Have? * One-year bodily injury liability claim handling experience or comparable liability claim handling experience, or successful completion of Travelers Claim Representative 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 *********************************************************
    $33k-48k yearly est. 7d ago
  • Claims Tech Specialist - Remote

    Selective Insurance Group, Inc. 4.9company rating

    Remote

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview Selective Insurance is seeking an E&S Liability Claims Technical Specialist to handle both non-litigated and litigated Excess & Surplus General Liability claims. This is a remote position. Responsibilities of this position include investigation, coverage analysis, risk transfer, evaluation, negotiation, and disposition of assigned claims. Must have expertise in handling a claim from start to finish including the initial contact with the insured, doing an investigation, conducting a full coverage review, tendering and responding to tenders, and identifying relevant legal and coverage issues. The individual in this position will also ensure claims are processed within company policies, procedures, and individual's prescribed authority with exceptional standards of performance. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements. Responsibilities * Investigate litigated and non-litigated claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information. Attend mediations and trials as needed. * Analyze information, including depositions, expert reports, attorney evaluations, gained from discovery during litigation and pre-suit investigation in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. * Investigate coverage and draft tenders, responses to tenders, and draft coverage letters. * Process incoming calls and correspondence from insureds, claimants and agents regarding questions or problems associated with claims. Interact with underwriters and agents. * Evaluate, negotiate and settle claims within delegated authority. Handle non-litigation and litigation files from start to finish. * Update MCS on a continual basis to accurately reflect status of each assigned file. Do a full liability and damages analysis. * Receive and approve expenses incurred to investigate, process, and handle a claim. * Prepare check requisitions for all loss and expense payments. * Explore salvage and subrogation potential on all claims. * Prepare for and participate in claims review and settlement conferences. * Close claim by issuing check or disclaimer and secure appropriate releases. Qualifications Knowledge and Requirements * Prior experience handling litigation preferred. * Excellent Customer Service Skills required * Multi State Licensing * Education and Experience * College degree preferred. * Minimum 7 years claims handling experience * Excess Surplus experience is a plus but not necessary. Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $84,000.00 - USD $127,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $36k-46k yearly est. 60d+ ago
  • Return to Work - Workers Compensation Claim Representative

    The Travelers Companies 4.4company rating

    Cleveland, OH jobs

    Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $67,000.00 - $110,600.00 Target Openings 1 What Is the Opportunity? Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery The injured worker is working modified duty and receiving ongoing medical treatment. The injured worker as returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and there has been a change in the current position. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered. What Will You Do? * Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability * Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions. * Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment.in collaboration with internal nurse resources where appropriate. * Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome. * Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits. * Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment. * Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations. * Negotiate settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction. * 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? * 2 years Workers Compensation claim handling experience. * Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. * Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. * Ability to effectively present file resolution to internal and/or external stakeholders. * Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. * General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract. * Principles of Investigation: Intermediate investigative skills including the ability to take statements. * Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss. * Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. * Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package. * Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. * Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed. * WC Technical: * Intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. * Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. * Intermediate knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. * Customer Service: * Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. * Teamwork: * Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. * Planning & Organizing: * Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. * Maintain Continuing Education requirements as required or as mandated by state regulations. What is a Must Have? * High School Diploma or GED. * 1 year Workers Compensation claim handling experience or successful completion of the WC trainee program. 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 *********************************************************
    $33k-49k yearly est. 2d ago
  • Bodily Injury Claim Representative - Auto

    The Travelers Companies 4.4company rating

    Cleveland, OH jobs

    Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $67,000.00 - $110,600.00 Target Openings 1 What Is the Opportunity? This position is responsible for handling Personal and Business Insurance Auto Bodily Injury claims from the first notice of loss through resolution/settlement and payment process. This may include interpreting and applying laws and statutes for multiple state jurisdictions. Claim types include moderate complexity Bodily Injury claims. 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, follow-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) instructions. * Coverage Analysis : * Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements for moderate complexity Bodily Injury liability claims in assigned jurisdictions. Verifies the benefits available, the injured party's eligibility and the applicable limits. Addresses proper application of any deductibles, co-insurance, coverage limits, etc. Confirms priority of coverage (i.e. primary, secondary, concurrent) and takes into consideration issues such as Social Security, Workers Compensation or others relevant to the jurisdiction. Consults with Unit Manager on use of Claim Coverage Counsel. * Investigation/Evaluation: * Investigates each claim to obtain relevant facts necessary to determine coverage, the extent of liability, damages, and contribution potential with respect to the various coverages provided through prompt contact with appropriate parties (e.g. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts). This may also include investigation of wage loss and essential services claims. Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. Takes recorded statements as necessary. Utilizes evaluation documentation tools in accordance with department guidelines. * Identifies resources for specific activities required to properly investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators and to other experts. Requests through Unit Manager and coordinate the results of their efforts and findings. * Recognizes cases based on severity protocols to be referred timely to next level claim professional or Major Case Unit. * 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 in accordance with established procedures to resolve claim in a timely manner. * Negotiation/Resolution: * Determines settlement amounts, negotiates and conveys claim settlements within authority limits to claimants or their representatives. Recognizes and implements alternate means of resolution. As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to claimants. * Handles both unrepresented and attorney represented claims. May manage litigated claims on appropriately assigned cases. Develops litigation plan with staff or panel counsel, track and control legal expenses. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as 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. * 2 years bodily injury liability claim handling experience. * General knowledge and skill in claims handling and litigation. * Basic working level knowledge and skill in various business line products. * Demonstrated ownership attitude and customer centric response to all assigned tasks. * Demonstrated good organizational skills with the ability to prioritize and work independently. * 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- Intermediate. * Principles of Investigation- Intermediate. * Value Determination- Intermediate. * Settlement Techniques- Intermediate. * Medical Knowledge- Intermediate. What is a Must Have? * One-year bodily injury liability claim handling experience or comparable liability claim handling experience, or successful completion of Travelers Claim Representative 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 *********************************************************
    $33k-49k yearly est. 7d ago
  • Field Property Adjuster

    Chubb 4.3company rating

    Cincinnati, OH jobs

    Chubb is looking for an experienced Field Property Claims Adjuster. This position will be responsible for handling field property claims in Cleveland, OH as well as surround areas. The ideal candidate will be located in the Cleveland, OH area. This is a field adjuster role that requires conducting physical site inspections of residential and commercial properties to assess damages and determine coverages. The position involves traveling to various locations for on-site evaluations and is not a desk-based role. Responsibilities Ensure onsite inspection are completed of properties to include investigating facts, evaluating damages, and writing estimates. Investigate and adjust both personal and commercial property claims with exposures up to and over $500,000. Effectively evaluate contract language and identify coverage issues. Promptly and appropriately develop the file to provide accurate and timely investigation and loss analysis. Maintain an active file diary to move file toward resolution. Recognize and pursue recovery. Adhere to all statutory and regulatory fair claims practices. Recognize and identify potential fraudulent claims. Effectively control the use, work product, and expenses of outside vendors such as IA's, engineers or others involved with the claim. Recognize, engage, and oversee additional investigate actions where needed utilizing engineers, accountants, and other expert vendors. Effectively evaluate claim facts and negotiate claim settlements. Develop and maintain strong business relationships with internal and external customers. Successfully contribute to the development and delivery of the team's goals, objectives and results. Supports workload surges and/or Catastrophe Operations as needed to include working overtime during designated CATs. Establish and maintain rapport with business partners including insureds, agents, and underwriters. Provide excellent customer service skills to a diverse client base that results in more than satisfied clients. Conduct site inspections while effectively maintaining ownership of the claim experience including ownership of primary contact with insured and agent, validating coverage, owning the coverage investigation and coverage communication while working with vendors in a remote environment handling claims in the western territory. Strong knowledge of first party, personal and commercial insurance contracts, investigation techniques, legal requirements, and insurance regulations a plus. Experience in commercial claims handling would be preferred. Must have a minimum of 3 years handling structure, field property claims in a remote environment, conducting site inspections, developing scope, addressing coverage, and writing estimates. A 4-year college degree or approximately 5 year equivalent structure, field property claims handling experience required. Demonstrated experience successfully working in a fully remote environment. Mobile Claims/Estimate/Symbility/CoreLogic or similar estimating platform experience preferred. An aptitude for evaluating, analyzing, and interpreting information. Excellent verbal and written communication skills. Innovative thinker with ability to multi-task. Strong customer service skills. Working knowledge in Microsoft Office. Prior experience handling complex claims with large exposures. Ability to work both independently and in a team supportive environment. Empowerment to make decisions within your authority and execute company mission Must have the ability to secure the Property and Casualty Adjusters license within 6 months of employment.
    $43k-56k yearly est. Auto-Apply 49d ago
  • Field Property Adjuster

    Chubb 4.3company rating

    Ohio jobs

    Chubb is looking for an experienced Field Property Claims Adjuster. This position will be responsible for handling field property claims in Cleveland, OH as well as surround areas. The ideal candidate will be located in the Cleveland, OH area. This is a field adjuster role that requires conducting physical site inspections of residential and commercial properties to assess damages and determine coverages. The position involves traveling to various locations for on-site evaluations and is not a desk-based role. Responsibilities Ensure onsite inspection are completed of properties to include investigating facts, evaluating damages, and writing estimates. Investigate and adjust both personal and commercial property claims with exposures up to and over $500,000. Effectively evaluate contract language and identify coverage issues. Promptly and appropriately develop the file to provide accurate and timely investigation and loss analysis. Maintain an active file diary to move file toward resolution. Recognize and pursue recovery. Adhere to all statutory and regulatory fair claims practices. Recognize and identify potential fraudulent claims. Effectively control the use, work product, and expenses of outside vendors such as IA's, engineers or others involved with the claim. Recognize, engage, and oversee additional investigate actions where needed utilizing engineers, accountants, and other expert vendors. Effectively evaluate claim facts and negotiate claim settlements. Develop and maintain strong business relationships with internal and external customers. Successfully contribute to the development and delivery of the team's goals, objectives and results. Supports workload surges and/or Catastrophe Operations as needed to include working overtime during designated CATs. Establish and maintain rapport with business partners including insureds, agents, and underwriters. Provide excellent customer service skills to a diverse client base that results in more than satisfied clients. Conduct site inspections while effectively maintaining ownership of the claim experience including ownership of primary contact with insured and agent, validating coverage, owning the coverage investigation and coverage communication while working with vendors in a remote environment handling claims in the western territory. Strong knowledge of first party, personal and commercial insurance contracts, investigation techniques, legal requirements, and insurance regulations a plus. Experience in commercial claims handling would be preferred. Must have a minimum of 3 years handling structure, field property claims in a remote environment, conducting site inspections, developing scope, addressing coverage, and writing estimates. A 4-year college degree or approximately 5 year equivalent structure, field property claims handling experience required. Demonstrated experience successfully working in a fully remote environment. Mobile Claims/Estimate/Symbility/CoreLogic or similar estimating platform experience preferred. An aptitude for evaluating, analyzing, and interpreting information. Excellent verbal and written communication skills. Innovative thinker with ability to multi-task. Strong customer service skills. Working knowledge in Microsoft Office. Prior experience handling complex claims with large exposures. Ability to work both independently and in a team supportive environment. Empowerment to make decisions within your authority and execute company mission Must have the ability to secure the Property and Casualty Adjusters license within 6 months of employment.
    $44k-58k yearly est. Auto-Apply 49d ago

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