Claims Adjuster
Farmingdale, NY jobs
Network Adjusters is seeking skilled insurance claims adjusters with experience in General Liability and/or Construction Defect for a third-party liability Construction Defect Claims Adjuster position. In this role, you will manage third-party Construction Property Damage and Liability Insurance claims of varying complexity and severity, specifically within construction development and subcontractor programs.
CONSTRUCTION DEFECT ADJUSTER RESPONSIBILITES:
Knowledge of General Liability and Construction Defect claims.
Provide superior customer service to meet the needs of the insured, claimant, all internal and external customers, including carrier clients.
Fulfill specific client requirements including reporting of claim details and analysis.
Review and analyze coverage and apply policy conditions, provisions, exclusions and endorsements.
Recognize and apply jurisdictional issues that impact the claim (i.e.: negligence laws, financial responsibility limits, immunity, etc.)
Investigate facts to determine liability, other sources of recovery as appropriate by contacting and interviewing appropriate parties.
Manage 3rd party property damages, bodily injury and other claims requiring specialized investigation and utilization of external experts in accordance with local laws.
Effectively manage litigated claims & assigned defense or coverage counsel.
Establish and maintain appropriate claim and expense reserves in a timely fashion.
Develop and continually update a plan of action for file resolution including maintaining an effective diary.
Document claim file activities in accordance with established procedures.
Write denial letters, reservation of rights, tenders and other routine and complex correspondence to insureds and claimants.
Confer with higher level technical claim personnel for guidance and direction to ensure files are handled properly.
Determine settlement amounts based on independent judgment, application of applicable limits and deductibles.
Negotiate settlements within authority limits.
Identify subrogation opportunities.
Meet all quality standards and expectations based on Best Practices.
Assure compliance with state specific regulations.
Effectively manage multiple competing priorities to ensure timely payment, follow-up and claim resolution.
CONSTRUCTION DEFECT ADJUSTER QUALIFICATIONS:
2-5 years of experience in claims handling (preferably 3rd party - general liability).
College/Technical degree or equivalent business experience.
Obtain Adjusters licenses as required to meet business need.
Complete continuing education to maintain licenses.
Strong verbal and written communication skills.
General software skills including MS Word, Outlook and Excel.
Customer service and empathy skills.
Solid analytical and decision-making skills in order to evaluate claims and make sound decisions.
Excellent negotiation skills and ability to effectively handle conflict.
Strong organization and time management skills.
Ability to multi-task and adapt to a changing environment.
Attention to detail, ensuring accuracy.
Strong investigative skills and creativity to achieve optimal results.
Ability to maintain confidentiality.
CONSTRUCTION DEFECT ADJUSTER BENEFITS:
Training/Development and growth opportunities
401(k) with company match / Retirement planning
Paid time off / Company paid holidays
Comprehensive health plans including dental and vision coverage
Flex spending account
Company paid life insurance
Company paid long term disability
Supplemental life insurance
Opportunity to buy into short term disability
Strong work/family and employee assistance programs
This role is located in Farmingdale, NY; no remote or hybrid offers are available at this time.
The starting salary for this position is $75,000 - $100,000, depending on factors such as licensure, certifications, and relevant experience. Become a part of a dynamic, energetic workforce in which you can make a difference.
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All of our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
Claims Specialist/Senior Claims Specialist
Tulsa, OK jobs
Mid-Continent Group - Tulsa, OK or Cincinnati, OH (Hybrid)
Empower Your Career. Make an Impact. Grow with Us.
Mid-Continent Group, a proud member of the Great American Insurance Group, specializes in commercial casualty coverages with a strong focus on general liability for construction, energy, and other complex industries. We offer a broad portfolio of General Liability, Commercial Auto, Inland Marine, and Umbrella products.
Why Join Us?
Fortune 500 Stability + Entrepreneurial Spirit: Be part of a company that combines the agility of a small business with the resources of a Fortune 500 leader.
Hybrid Work Environment: Enjoy the flexibility of working from home and collaborating in our vibrant downtown offices in Tulsa or Cincinnati.
Culture: We celebrate diverse perspectives and foster a workplace where everyone feels empowered to thrive.
Career Growth: With over 35 specialty operations within the Great American Insurance Group, your opportunities to learn, lead, and grow are limitless.
Responsibilities
Manage a portfolio of complex, high-value commercial general liability and auto claims across the U.S.
Lead investigations, evaluate coverage and liability, and drive resolution strategies.
Represent the company in mediations, depositions, and trials.
Collaborate with underwriting and marketing teams to identify trends and improve outcomes.
Serve as a technical expert and strategic advisor within your line of business.
Ensure compliance with all legal and regulatory standards.
Offer expert advice to other members of your team on complex claim file management and demonstrate leadership across the organization.
Qualifications
9+ years of experience handling general liability and/or commercial auto claims.
Strong analytical skills and deep understanding of policy coverage.
Excellent communication, negotiation, and organizational abilities.
Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
Professional designations (e.g., CPCU) are a plus.
Benefits
Competitive compensation and performance-based incentives.
Comprehensive benefits including health, dental, vision, and retirement plans.
Generous paid time off and wellness programs.
Support for continuing education and professional development.
Ready to Make a Difference?
Join a team where your expertise is valued, your voice is heard, and your career can flourish. Apply today and be part of something great.
Claims Representative, PIP
Woodbridge, NJ jobs
In this fast-paced role, the PIP Representatives adjusts first party personal injury claims according to state compliance requirements and guidelines.
RESPONSIBILITIES
will handle Personal Injury Protection claims in multiple states.
The PIP Claim Representative will receive between 3 to 5 first reports a day with a priority on service, patient contact, and claim disposition.
Daily duties include first reports, Image Right tasks, medical bill review, treatment monitoring, reserve assessment and Nursing interaction.
Maintains an effective follow-up system on pending files, prioritize and handle multiple tasks simultaneously, adjust to fluctuating workload, advises injured parties as to the status of the claim.
Investigates and interprets policy provisions and conditions to make a coverage determination.
Functional knowledge of medical terminology and anatomy with a thorough understanding of Personal Injury Protection claim handling regulatory requirements is preferred but not necessary.
The PIP Claim Representative must have the ability to multitask in time sensitive situations.
Ensures that service, loss and expense control are maintained at all times.
Adheres to privacy guidelines, law and regulations pertaining to claims handling.
Candidates must have strong customer service, organization, verbal and written skills and have the ability to work in a small team environment.
QUALIFICATIONS
A Bachelor's Degree (B.A.) from a four-year college or university.
Two (2) to four (4) years related claims experience and/or training.
Basic personal computer skills including working knowledge of Microsoft Office Suite products.
SALARY RANGE
The pay range for this position is $50,000 to $68,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
PERKS & BENEFITS
4 weeks accrued paid time off + 9 paid national holidays per year
Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
Annual 401(k) Employer Contribution
Free onsite gym at our Woodbridge Location
Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
Robust health and wellness program and fitness reimbursements
Various Paid Family leave options including Paid Parental Leave
Tuition Reimbursement
ABOUT THE COMPANY
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
Field Claims Representative
Enterprise, AL jobs
Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated and experienced field claims professional to join our team. This job handles insurance claims in the field under general supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job requires mastery of claims-handling skills and requires the person to:
Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability
Handle multi-line property and casualty claims in an assigned territory with an emphasis on property claims
Become familiar with insurance coverage by studying insurance policies, endorsements and forms
Work toward the resolution of claims, and attend arbitrations, mediations, depositions, or trials as necessary
Ensure that claims payments are issued in a timely and accurate manner
Handle investigations by phone, mail and on-site investigations
Desired Skills & Experience
Bachelor's degree or direct equivalent experience handling property and casualty claims
A minimum of 3 years handling multi-line property and casualty claims with an emphasis on property claims
Field claims handling experience is preferred but not required
Knowledge of Xactimate software is preferred but not required
Above average communication skills (written and verbal)
Ability to resolve complex issues
Organize and interpret data
Ability to handle multiple assignments
Ability to effectively deal with a diverse group individuals
Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents)
Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage
Benefits
Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.
*Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
Claims Adjuster
Denver, CO jobs
Network Adjusters is seeking skilled insurance claims adjusters with experience in General Liability and/or Construction Defect for a third-party liability Construction Defect Claims Adjuster position. In this role, you will manage third-party Construction Property Damage and Liability Insurance claims of varying complexity and severity, specifically within construction development and subcontractor programs.
CONSTRUCTION DEFECT ADJUSTER RESPONSIBILITES:
Knowledge of General Liability and Construction Defect claims.
Provide superior customer service to meet the needs of the insured, claimant, all internal and external customers, including carrier clients.
Fulfill specific client requirements including reporting of claim details and analysis.
Review and analyze coverage and apply policy conditions, provisions, exclusions and endorsements.
Recognize and apply jurisdictional issues that impact the claim (i.e.: negligence laws, financial responsibility limits, immunity, etc.)
Investigate facts to determine liability, other sources of recovery as appropriate by contacting and interviewing appropriate parties.
Manage 3rd party property damages, bodily injury and other claims requiring specialized investigation and utilization of external experts in accordance with local laws.
Effectively manage litigated claims & assigned defense or coverage counsel.
Establish and maintain appropriate claim and expense reserves in a timely fashion.
Develop and continually update a plan of action for file resolution including maintaining an effective diary.
Document claim file activities in accordance with established procedures.
Write denial letters, reservation of rights, tenders and other routine and complex correspondence to insureds and claimants.
Confer with higher level technical claim personnel for guidance and direction to ensure files are handled properly.
Determine settlement amounts based on independent judgment, application of applicable limits and deductibles.
Negotiate settlements within authority limits.
Identify subrogation opportunities.
Meet all quality standards and expectations based on Best Practices.
Assure compliance with state specific regulations.
Effectively manage multiple competing priorities to ensure timely payment, follow-up and claim resolution.
CONSTRUCTION DEFECT ADJUSTER QUALIFICATIONS:
2-5 years of experience in claims handling (preferably 3rd party - general liability).
College/Technical degree or equivalent business experience.
Obtain Adjusters licenses as required to meet business need.
Complete continuing education to maintain licenses.
Strong verbal and written communication skills.
General software skills including MS Word, Outlook and Excel.
Customer service and empathy skills.
Solid analytical and decision-making skills in order to evaluate claims and make sound decisions.
Excellent negotiation skills and ability to effectively handle conflict.
Strong organization and time management skills.
Ability to multi-task and adapt to a changing environment.
Attention to detail, ensuring accuracy.
Strong investigative skills and creativity to achieve optimal results.
Ability to maintain confidentiality.
CONSTRUCTION DEFECT ADJUSTER BENEFITS:
Training/Development and growth opportunities
401(k) with company match / Retirement planning
Paid time off / Company paid holidays
Comprehensive health plans including dental and vision coverage
Flex spending account
Company paid life insurance
Company paid long term disability
Supplemental life insurance
Opportunity to buy into short term disability
Strong work/family and employee assistance programs
We have openings in Denver, Colorado; Farmingdale, New York; and Covington, Kentucky. Remote work may be available for experienced candidates who meet the required criteria.
The starting salary for this position is $75,000 - $100,000, depending on factors such as licensure, certifications, and relevant experience. Become a part of a dynamic, energetic workforce in which you can make a difference.
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All of our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
General Liability Claims Supervisor
Denver, CO jobs
Network Adjusters is seeking an experienced General Liability/Construction Defect Claims Supervisor to join our third-party administrative insurance handling team. As a Claims Supervisor, you will oversee the full claims process in a fast-paced environment, ensuring compliance and service standards are met. You will hire, onboard, train, and develop a team of adjusters specializing in construction defect claims, guiding them in the proper investigation, documentation, and resolution of first and third party claims. This role offers the opportunity to build and grow a talented claims staff, provide technical support, maintain department protocols, and drive strong customer service outcomes while advancing your own leadership career.
QUALIFICATIONS:
Minimum of three years' experience as a supervisor/manager (preferably in insurance claims).
Minimum of 5 years' experience handling general liability or construction defect claims.
Strong leadership skills, with ability to motivate and develop a team.
Superior working knowledge of case law, statutes, and procedures impacting the handling and value of claims.
Ability to prioritize workload and handle multiple tasks.
Analytical and problem-solving abilities, with a keen attention to detail.
Desire to work in a fast-paced environment.
Excellent evaluation and strategic skills required.
Strong claim negotiation skills.
Proficient in MS Office Suite and other business-related software.
Polished and professional written and verbal communication skills.
Bachelor's degree in a relevant field or equivalent work experience.
RESPONSIBILITIES:
Supervise a Team:
Manage a team of claims adjusters, providing guidance, training, and support to ensure high-quality claim assessments and exceptional customer service.
Coverage Analysis:
Examine claim forms, policies, and other records to determine insurance coverage.
Claims Processing:
Oversee the entire claims process, including the evaluation of damages, determination of loss, settlement negotiations and resolution, while ensuring all compliance regulations are adhered to.
Quality Assurance:
Implement and monitor quality control measures (Best Practices) to ensure accurate and consistent claims handling in compliance with company guidelines and industry standards.
Customer Service:
Collaborate with carriers, attorneys, claimants, and internal policyholders to address inquiries, resolve disputes, and ensure a positive claims experience.
Performance Metrics
: Track and analyze key performance metrics to identify areas for improvement, set performance targets, and implement strategies to meet or exceed goals.
Reporting:
Generate and present regular reports to senior management and clients, highlighting department performance, trends, and areas for improvement.
Compliance:
Stay current with industry regulations and best claims practices to ensure that claims processes are compliant with all legal requirements.
BENEFITS:
401(k) with company match / Retirement planning
Paid time off / Company paid holidays
Comprehensive health plans including dental and vision coverage
Flex Spending Account
Company paid life insurance
Company paid long term disability
Supplemental life insurance
Opportunity to buy into short term disability
Family leave
Employee Assistance Program
This role is based in Denver, CO, and we strongly prefer candidates who can work on-site. Remote arrangements may be considered only for exceptionally well-qualified applicants who meet all required criteria.
The starting salary for this position is $110,000 - $140,000, depending on factors such as licensure, certifications, and relevant experience.
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All of our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
Bodily Injury Claims Adjuster
Farmingdale, NY jobs
Network Adjusters is seeking skilled bodily injury insurance claims adjusters for a liability claims adjuster position. As a bodily injury adjuster, you will handle primarily commercial auto and general liability injury claims with varying degrees of complexity and severity. This will include taking statements, analyzing policy language, handling litigated matters and negotiating settlements as needed. Our adjusters handle claims from inception to closure, communicating claim decisions and key developments to policyholders, claimants, attorneys and other involved parties.
CLAIMS ADJUSTER RESPONSIBILITIES:
Provide superior customer service to meet the needs of the insured, claimant, and all internal and external customers (including carrier clients)
Investigate, negotiate, and manage bodily injury claim investigations
Conduct comprehensive interviews, secure testimonies and gather evidence from claimants, witnesses, medical providers, and law enforcement agencies while determining and establishing reserve requirements
Evaluate claims against insurance contracts to interpret how the policy applies and write professional correspondence to involved parties summarizing your analysis
Determine settlement amounts based on independent judgment, application of applicable limits and deductibles, and collaborating with legal counsel when necessary
Review medical records, police reports, and other relevant documents to determine the extent of injuries and liability
Assure compliance with state specific regulations along with meeting all quality standards and expectations based on Network Adjusters' best practices
Ability to work autonomously while maintaining accurate and up-to-date claim files, diaries, and documentation
Utilize conflict resolution and customer service skills to deliver claims decisions with empathy and confidence
CLAIMS ADJUSTER QUALIFICATIONS:
Minimum of 3 years handling bodily injury claims
Strong verbal and written communication skills
General software skills including MS Word, Outlook and Excel
Customer service and empathy skills
Solid analytical and decision-making skills in order to evaluate claims and make sound decisions
Excellent negotiation and investigative skills with ability to effectively handle conflict to achieve optimal results
Strong organization and time management skills
Ability to multi-task and adapt to a changing environment
Attention to detail, ensuring accuracy
Ability to maintain confidentiality
College or technical degree or equivalent business experience (preferred)
Obtain adjusters licenses as required to meet business needs & continuing education to maintain licenses
Knowledge of security industry and/or rideshare industry is beneficial
CLAIMS ADJUSTER BENEFITS:
Training, development, and growth opportunities
401(k) with company match and retirement planning
Paid time off and company paid holidays
Comprehensive health plans including dental and vision coverage
Flex spending account
Company paid life insurance
Company paid long term disability
Supplemental life insurance
Opportunity to buy into short term disability
Strong work/family and employee assistance programs
This role is located in Farmingdale, NY; no remote or hybrid offers available at this time.
The starting salary for this position is $75,000 and up, depending on factors such as licensure, certifications, and relevant experience.
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All of our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
Claims Adjuster/Examiner
Denver, CO jobs
Network Adjusters is seeking experienced claims adjusters with at least 3 years of insurance claims handling experience to join our Disposition Team in a file review role. The Disposition Analyst has two main objectives: assisting in onboarding triage and reviewing new claim programs and reviewing files for closure with the current companies pending.
The Disposition Team reports directly to executive management and works aggressively to review files, determine opportunity for resolution and provide feedback to management. In this role, you'll review complex, high-exposure claims, develop creative solutions, and manage multiple files in a fast-paced environment while ensuring compliance and service standards are consistently met. The ideal candidate is energetic, driven, and proactive, with the ability to manage a wide range of claim types-including Commercial General Liability, Auto, Property Damage, Construction Bodily Injury, Construction Defect, Directors & Officers (D&O), Cyber, and Builder's Risk. While experience in all areas isn't required, you should be a quick learner who can adapt to changing business needs.
DISPOSITION ANALYST RESPONSIBILITIES:
Coverage Analysis:
Examine claim forms, policies, and other records to determine insurance coverage.
Claims Processing:
Deep dive into complex claim files, evaluating damages, determining losses, negotiating settlements, and driving resolutions while upholding all compliance and regulatory standards.
Customer Service:
Collaborate with carriers, attorneys, claimants, and internal policyholders to address inquiries, resolve disputes, and ensure a positive claims experience.
Negotiation:
Communicate with related parties to discuss, negotiate and resolve claims.
Reporting:
Generate and present regular reports to senior management and clients, highlighting trends and areas for improvement.
Compliance:
Stay current with industry regulations and best claims practices to ensure that claims processes are compliant with all legal requirements.
DISPOSITION ANALYST QUALIFICATIONS:
Commercial claims handling experience is required
Minimum of three years handling bodily injury insurance claims
Litigation experience
Active or able to obtain Texas OR Florida Property & Casualty Adjusting License within first 90 days of employment
Able to obtain New York Property & Casualty Adjusting License within first 90 days of employment
Superior working knowledge of case law, statutes, and procedures impacting the handling and value of claims
Ability to prioritize workload and handle multiple tasks
Analytical and problem-solving abilities, with a keen attention to detail
Ability to drive conversations with a firm stance
Excellent evaluation and strategic skills required
Strong claim negotiation skills
Proficient in MS Office Suite and other business-related software
Polished and professional written and verbal communication skills
DISPOSITION ANALYST BENEFITS:
Training, development, and growth opportunities
401(k) with company match and retirement planning
Paid time off and company paid holidays
Comprehensive health plans including dental and vision coverage
Flex spending account
Company paid life insurance
Company paid long term disability
Supplemental life insurance
Opportunity to buy into short term disability
Strong work/family and employee assistance programs
This role is located in Denver, CO; no remote or hybrid offers are available at this time.
The starting salary for this position is $70,000 - $90,000, depending on factors such as licensure, certifications, and relevant experience.
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for almost seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York and Denver to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All of our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
Automotive Claims Adjuster
Oak Brook, IL jobs
We are First Chicago Insurance Company! We currently have offices in Bedford Park, IL, (about one mile south of Chicago Midway Airport), as well as Richardson, Texas (Dallas area). Due to our significant growth, we are pleased to announce that we have a new Claims office in Oak Brook, IL!
If you are an experienced Non-Standard Auto CLAIMS PROFFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFFESSIONAL!!
We are seeking experienced Non-Standard Auto Liability Claims Specialist to join our new office in Oak Brook!
This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First- and Third-Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims.
DUTIES & RESPONSIBILITIES:
Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss
Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim
Honor/decline/negotiate first and third-party liability claims upon completion of coverage/policy investigation and analysis of damages and liability
Work directly with internal and external customers to develop evidence and establish facts on assigned claims
Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims
Prepare and present claim evaluations for the appropriate settlement authority
Notify the Underwriting Department of any adverse information uncovered in the course of the investigation
Familiarity with unfair claim practices in states where we do business
Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service
Provide customer service both to internal and external customers
Handle other duties as assigned
QUALIFICATIONS REQUIRED:
Minimum 2-3 years previous auto insurance or other auto related experience A MUST!
Non-Standard Auto claims handling experience a plus!
Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills
General working knowledge of policies, file procedures, state rules and regulations
Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster
Preferred:
Prior claims experience
Ability to use on-line claims system
Bi-lingual a plus!
First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive:
Competitive Salaries
Flexible Work Schedules
Remote and Hybrid
Commitment to your Training & Development
Medical and Dental
Telemedicine Benefit
401k with a generous company match
Paid Time Off and Paid Holidays
Tuition Reimbursement Training Programs
Wellness Program
Fun company sponsored events
And so much more!
Claims Adjuster
Denver, CO jobs
Network Adjusters is seeking skilled insurance claims adjusters with experience in General Liability, Professional Liability, or Employment & Public Officials Liability for a third-party claims adjuster position. As a claims adjuster you will investigate, evaluate, determine liability, negotiate, and settle assigned multi-line commercial claims in accordance with Network Adjusters' Best Practices. This position provides quality claim handling and exceptional customer service throughout the entire claims process while engaging in indemnity, expense & diary management.
CLAIMS ADJUSTER JOB DESCRIPTION:
Handle primarily third-party liability damage insurance claims with varying degrees of complexity and severity under General Liability, Professional Liability, and Employment Liability & Public Officials Liability coverages. This includes but is not limited to, third party property damage, bodily injuries, wrongful employment practices, wrongful acts, and professional liability claims handling.
CLAIMS ADJUSTER RESPONSIBILITES:
Provide superior customer service to meet the needs of the insured, claimant, all internal and external customers, including carrier clients.
Fulfill specific client requirements including reporting of claim details and analysis.
Review and analyze coverage and apply policy conditions, provisions, exclusions and endorsements.
Recognize and apply jurisdictional issues that impact the claim (i.e.: negligence laws, financial responsibility limits, immunity, etc.)
Investigate facts to establish negligence, determine liability, other sources of recovery as appropriate by contacting and interviewing appropriate parties.
Manage liability and other claim types requiring specialized investigation and utilization of external experts in accordance with local laws.
Establish and maintain appropriate claim and expense reserves in a timely fashion.
Develop and continually update a plan of action for file resolution including maintaining an effective diary.
Document claim file activities in accordance with established procedures.
Write denial letters, reservation of rights, tenders and other routine and complex correspondence to insureds and claimants.
Confer with higher level technical claim personnel for guidance and direction to ensure files are handled properly.
Determine settlement amounts based on independent judgment, application of applicable limits and deductibles.
Negotiate settlements within authority limits.
Identify subrogation opportunities.
Meet all quality standards and expectations based on Best Practices.
Assure compliance with state specific regulations.
Effectively manage multiple competing priorities to ensure timely payment, follow-up and claim resolution.
CLAIMS ADJUSTER QUALIFICATIONS:
College/Technical degree or equivalent business experience.
Minimum of 3 years of claims handling experience in either General Liability, Professional Liability, Employment Liability or Public Officials Liability.
Obtain Adjusters licenses as required to meet business need.
Complete continuing education to maintain licenses.
Strong verbal and written communication skills.
General software skills including MS Word, Outlook and Excel.
Customer service and empathy skills.
Solid analytical and decision-making skills in order to evaluate claims and make sound decisions.
Excellent negotiation skills and ability to effectively handle conflict.
Strong organization and time management skills.
Ability to multi-task and adapt to a changing environment.
Attention to detail, ensuring accuracy.
Strong investigative skills and creativity to achieve optimal results.
Ability to maintain confidentiality.
Knowledge of Security Industry and/or Elevator Industry is beneficial.
CLAIMS ADJUSTER BENEFITS:
Training/Development and growth opportunities
401(k) with company match / retirement planning
Paid time off / company paid holidays
Comprehensive health plans including dental and vision coverage
Flex spending account
Company paid life insurance
Company paid long term disability
Supplemental life insurance
Opportunity to buy into short term disability
Strong work/family and employee assistance programs
We have openings in Farmingdale, New York; Denver, Colorado; and Covington, Kentucky. Remote work may be available for experienced candidates who meet the required criteria.
The starting salary for this position is $85,000 and up, depending on factors such as licensure, certifications, and relevant experience. Become a part of a dynamic, energetic workforce in which you can make a difference. We are committed to encouraging your professional growth through a variety of training and development opportunities.
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for almost seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York and Denver to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All of our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
Claims Supervisor
Denver, CO jobs
Network Adjusters is seeking an
experienced first party property damage Claims Supervisor
to join our expanding team.
As a Property Claims Supervisor, you will play a critical role in our claims department, overseeing the entire claims process in a fast-paced environment to ensure all compliance and service guidelines are met. You will manage a team of Adjusters who specialize in handling Commercial Property losses, ensuring each member of your team is properly investigating, documenting, and resolving their assigned claims. You will offer guidance and support to staff on claims-related technical matters and oversee adherence to department protocols and expectations when dealing with first-party and third-party claims. You will strive to exceed customer service benchmarks, take charge of continued education, and nurture the growth of your team, actively contributing to their career advancement.
Become a part of our dynamic, energetic workforce in which you can make a difference. We are committed to encouraging your professional growth through a variety of development opportunities.
QUALIFICATIONS:
Minimum of five (5) years handling first party property claims; prior claim supervision & commercial claims experience preferred.
Strong leadership skills, with ability to motivate and develop a team.
Superior working knowledge of case law, statutes, and procedures impacting the handling and value of claims.
Ability to prioritize workload and handle multiple tasks.
Analytical and problem-solving abilities, with a keen attention to detail.
Desire to work in a fast-paced environment.
Excellent evaluation and strategic skills required.
Strong claim negotiation skills.
Proficient in MS Office Suite and other business-related software.
Polished and professional written and verbal communication skills.
Bachelor's degree in a relevant field or equivalent work experience.
RESPONSIBILITIES:
Supervise a Team:
Manage a team of claims adjusters, providing guidance, training, and support to ensure high-quality claim assessments and exceptional customer service.
Coverage Analysis:
Examine claim forms, policies, and other records to determine insurance coverage.
Claims Processing:
Oversee the entire claims process, including the evaluation of damages, determination of loss, settlement negotiations and resolution, while ensuring all compliance regulations are adhered to.
Quality Assurance:
Implement and monitor quality control measures (Best Practices) to ensure accurate and consistent claims handling in compliance with company guidelines and industry standards.
Customer Service:
Collaborate with carriers, attorneys, claimants, and internal policyholders to address inquiries, resolve disputes, and ensure a positive claims experience.
Performance Metrics
: Track and analyze key performance metrics to identify areas for improvement, set performance targets, and implement strategies to meet or exceed goals.
Reporting:
Generate and present regular reports to senior management and clients, highlighting department performance, trends, and areas for improvement.
Compliance:
Stay current with industry regulations and best claims practices to ensure that claims processes are compliant with all legal requirements.
BENEFITS:
· 401(k) with company match / Retirement planning
· Paid time off / Company paid holidays
· Comprehensive health plans including dental and vision coverage
· Flex Spending Account
· Company paid life insurance
· Company paid long term disability
· Supplemental life insurance
· Opportunity to buy into short term disability
· Family leave
· Employee Assistance Program
About Network Adjusters, Inc.
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for almost seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York and Denver to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All of our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
Please be advised this position is an in-office role located in Denver, CO. No remote opportunities are available at this time.
The starting salary for this position is $85,000 - $110,000; factors such as licensing, certifications, work, and relative experience will be taken into consideration.
Stop Loss Claims Clerk
Oakbrook Terrace, IL jobs
Claims Clerk
Full TimeSME/Specialist
Oakbrook Terrace, IL, US
Salary Range:$50,500.00 To $57,500.00 Annually
The Claims Clerk will be responsible for accurate, timely screening and distribution of incoming electronic claims correspondence. This role will aid the Analysts in timely processing of the claims and help secure a manageable turnaround time for the entire Claims Department. This position will report to the Claims Manager.
Essential Elements
Manage the Secure File Transfer Portal (SFTP) site ensure all reporting received is processed in a timely manner
Download and pivot reports from Power BI, to locate all possible medical and prescription claims.
Identify and review claims data ensuring data integrity
Distributing claim requests for processing
Convert the PDF claims received into an Excel Template for the Claims Analyst to upload and process
Additional duties as assigned
Requirements
Education and Certifications
Associates degree or commensurate experience required
Experience
Excel, Microsoft Office Suite, Power BI, Clerical functions
Travel Required
May need to travel to the home office quarterly
Hybrid workplace
Claims Adjuster
Santa Clarita, CA jobs
JOB TITLE:Claims Advocate FLSA CLASSIFICATION:Salaried - Exempt
The Claims Advocate plays an essential role in mitigating BBSI's risk related to workers' compensation claims. This role requires exceptional business and customer service acumen and significant experience in workers' compensation claims, including claims handling.
This role will coordinate the essential duties related to the claims advocacy program. Duties and related issues by assisting in the monitoring of new loss intake to confirm an appropriate beginning to each claim, assisting injured workers in navigating the claims process and communicating with external client customers and internal personnel.
REPORTING RELATIONSHIPS: This position reports to the Corporate Claims Manager and interacts with the Corporate Claims team and local branch personnel.
DUTIES AND RESPONSIBILITIES:
Maintain clear focus on mitigating BBSI's financial risk associated with workers' compensation claims.
Understand and articulate BBSI's business objectives internally and with key partners
Written communication with injured workers when new claims are received.
value workers compensation claims.
Serve as a resource responding to questions and concerns from internal and external customers, vendor partners, and injured workers.
Serve as back up to Claim Consultants
members.
activity. Approve reserve activity within authority.
workers compensation claims, including status of the claims. Provide claims
information for the coordination of human resource and safety efforts and
requirements.
relative to workers compensation.
by third parties administrators
CORE TRAITS/COMPETENCIES:
Exceptional business acumen
Customer service acumen
Flexibility and adaptability
Innately curious
Highly developed interpersonal and communication skills
QUALIFICATIONS:
Four-year college degree is preferred, as well as 2-5 years of directly relevant claims experience
Customer service acumen
Bi-lingual (Spanish) would be preferred or familiarity with translation vendors
Multi-Jurisdictional Workers' Compensation experience preferred
Salary and Other Compensation:
The starting hourly rate for this position is between 87,500-95,000. Factors which may affect starting pay within this range may include geography, skills, education, experience, certifications, and other qualifications of the candidate.
This position is also eligible for annual incentive pay equal to 8% of annual regular pay, prorated in the first year, in accordance with the terms of the Company's plan.
Benefits: The Company offers the following benefits for this position, subject to applicable eligibility requirements: medical insurance, health savings account, flexible savings account, dental insurance, vision insurance, 401(k) retirement plan, accidental death and dismemberment, life insurance, voluntary life insurance, voluntary disability insurance, voluntary accident, voluntary critical care, voluntary hospital indemnity, legal, identity & fraud protection, commuter benefits, pet insurance, employee stock purchase program, and an employee assistance program.
Paid Time Off: Accrued sick leave of 1 hour for every 40 hours of work, with maximum based on state or regional requirements; vacation accrues up to 80 hours in the first year, up to 120 hours in years 2-4, and up to 160 hours in the fifth year; 6 paid holidays annually, 4 paid volunteer days annually.
Diversity and Inclusion are critical parts of our corporate culture. BBSI strives to create a workplace where everyone feels included and empowered to bring their full, authentic selves to work, and is treated fairly. BBSI is an equal opportunity employer and makes employment decisions on the basis of merit.
If you meet the above requirements, we welcome the opportunity to learn more about you. For more information, visit us at www. bbsi.com Please apply via this posting and not by contacting our local or corporate offices.
Click here to review the BBSI Privacy Policy: ***********************************
Bodily Injury Claims Adjuster
Denver, CO jobs
Network Adjusters is seeking
skilled bodily injury insurance claims adjusters
for a liability claims adjuster position. Serving the insurance industry for almost seven decades, Network Adjusters, Inc. is a third-party administrative commercial line handling company that has built a reputation as a leading provider of insurance claims administration and independent adjusting services. We exemplify trust, integrity and reliability, and deliver consistent, high-quality claims management. All adjusters are licensed and bonded and operate under our strict standards for "BEST Claims Practices" that meet or exceed industry standards. Become a part of a dynamic, energetic workforce in which you can make a difference. We are committed to encouraging your professional growth through a variety of training and development opportunities.
CLAIMS ADJUSTER JOB DESCRIPTION:
Handle primarily Commercial Auto & General Liability injury claims with varying degrees of complexity and severity
Investigate, evaluate, negotiate, and adjust moderate to complex commercial insurance claims in compliance with all state regulatory requirements
Take statements, analyze policy language, handle litigated matters and negotiate settlements as needed
Handle claims from inception to closure, communicating claim decisions and key developments to policyholders, claimants, attorneys and other involved parties
CLAIMS ADJUSTER RESPONSIBILITIES:
Provide superior customer service to meet the needs of the insured, claimant, all internal and external customers, including carrier clients
Investigative, negotiate & manage bodily injury claim investigations
Conduct comprehensive interviews, securing testimonies and gathering evidence from claimants, witnesses, medical providers, and law enforcement agencies while determining and establishing reserve requirements
Evaluate claims against insurance contracts to interpret how the policy applies and write professional correspondence to involved parties summarizing your analysis
Determine settlement amounts based on independent judgment, application of applicable limits and deductibles, collaborating with legal counsel when necessary
Review medical records, police reports, and other relevant documents to determine the extent of injuries and liability
Assure compliance with state specific regulations along with meeting all quality standards and expectations based on Network's Best Practices
Ability to work autonomously, maintaining accurate and up-to-date claim files, diaries, and documentation
Utilize conflict resolution and customer service skills to deliver claims decisions with empathy and confidence
CLAIMS ADJUSTER QUALIFICATIONS:
Minimum of 1 year handling bodily injury claims
Strong verbal and written communication skills
General software skills including MS Word, Outlook and Excel
Customer service and empathy skills
Solid analytical and decision-making skills in order to evaluate claims and make sound decisions
Excellent negotiation & investigative skills with ability to effectively handle conflict to achieve optimal results
Strong organization and time management skills
Ability to multi-task and adapt to a changing environment
Attention to detail, ensuring accuracy
Ability to maintain confidentiality
College or Technical degree or equivalent business experience (preferred)
Obtain Adjusters licenses as required to meet business needs & continuing education to maintain licenses
Knowledge of Security Industry and/or Rideshare Industry is beneficial
CLAIMS ADJUSTER BENEFITS:
Training/Development and growth opportunities
401(k) with company match / retirement planning
Paid time off / company paid holidays
Comprehensive health plans including dental and vision coverage
Flex spending account
Company paid life insurance
Company paid long term disability
Supplemental life insurance
Opportunity to buy into short term disability
Strong work/family and employee assistance programs
This role is located in Denver, CO; no remote or hybrid offers available at this time.
The starting salary for this position is $70,000+; factors such as licensing, certifications, work, and relative experience will be taken into consideration.
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver, and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All of our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
Claims Analyst
Washington, DC jobs
At least twenty-four (24) Medicaid related Claims Analyst and Claims Processors are needed for a long-term project in DC. These positions are 100% onsite and located downtown, near Farragut North Metro Station.
The Midtown Group is teaming up with a leading technology company to support a D.C. government department that offers its residents a Medicaid program. Our collective goal is to modernize and optimize DC's Medicaid program while offering outstanding customer support. Our venture is focused on improving outcomes, enhancing provider experiences, and safeguarding program integrity. For this project, our partner will provide technology, and we will provide people and expertise across several functions, including contact center operations.
Claims Analyst and Claims Processors will support D.C. medical providers who need assistance with Medicaid benefits.
These positions are in-person, located in Downtown D.C. There are no plans to move to hybrid or fully remote models. Interviews begin on Tuesday, 12/9/25, and these engagements are expected to start on 1/16/26 and may continue for up to two or three years or longer.
Key job tasks
Claims/Financial Analyst/Processors have several job responsibilities, and some of the critical ones are:
· Handle refund checks and state warrants received from healthcare providers and the State agency.
· Contact providers, verbal and in writing, to resolve check-related issues.
· Receive and respond to client inquiries.
· Responsible for handling the Accounts Receivable transfer process, setting up expenditures, setting up Accounts Receivable transactions, and placing and recoupment caps using the Medicaid system.
· Responsible for analyzing financial data to ensure accurate reporting.
· Research highly complex claims processing or financial transactions.
· Process adjustments and voids.
· Ensure SLAs are compliant with client and Midtown Group expectations
· Other duties as assigned.
Performance measurement
The Midtown Group measures performance in a number of ways, with the key ones being:
Quality Assurance assessments: may have their calls monitored and assessed at any time during a shift. We and our partner monitor and assess our CSRs regularly. CSRs are expected to maintain or exceed a QA pass rate of 90%+. Calls are considered to have failed if a CSR misses or incorrectly performs any critical element of the job. These items are well-covered in training and reinforced during pre-shift and individual coaching sessions.
Call handling metrics are a good measure of performance and the three focus areas are:
Percent of your shift that you are either on a call or available to take a call.
Length of call. We are here to provide efficient, professional assistance, so a consistent track record of very long or very short calls is generally frowned upon.
Percent of calls that you transfer. This often indicates that a CSR is unable or unwilling to assist callers.
Attendance
Minimum requirements
· High School Diploma or equivalent, 2-year post-high school Degree, or bachelor's degree.
· A minimum of two years of previous experience for a government or private sector operations center in a similar or related field.
· Two to four years of working experience in claims processing and financial analysis.
· Organization skills to balance/prioritize work with the ability to multi-task.
· Proficiency with basic help desk software, computer software and Microsoft Office applications.
· Problem-solving skills to bring inquiries to effective resolution.
· Customer service skills, with an emphasis on written and oral communication, to professionally and efficiently respond to inquiries.
Other important skills
The ability to provide operational excellence is extremely important to both the Midtown Group and our client. If you have the service gene - if helping others is in your DNA - we are happy to have you join us.
Our most effective and successful Claims/Financial Analyst/Processors exhibit the following skills:
· Conduct themselves with professionalism, empathy, patience, courtesy, and tact, at all times.
· Communicate effectively, clearly, and professionally.
· Quickly and effectively process transactions and analyze financial data, to a high standard. Operational quality is very important to us.
· Know when and how to collaborate and escalate to quickly and effectively address and resolve issues.
· Effectively collect and handle sensitive data and personal information, as needed.
· Exercise good judgment at all times.
· Deal well with conflict, as well as complex and emotional situations.
· Be flexible, and able to work independently.
Hours, project duration, etc.
The contact center operating hours are Monday through Friday, from 8:00am to 5:00pm ET. However, schedules will be between the hours of 7:45am to 5:15pm ET, to allow for pre-shift sessions and last-minute contacts/wrap up.
The contact center is closed on Federal holidays. Candidates must be able to work 40 hours per week.
The base period for this contract is through November 2026, with two further annual option periods. So, this contract could run until November 2028.
Claims Examiner
South Pasadena, CA jobs
This is a hybrid position; the work location will be determined based on the selected candidate's proximity to one of our offices.
Duties/Responsibilities
+ Provides customer service support to lenders, borrowers, insureds, claimants and all internal and customers.
+ On occasion, takes claim information via telephone, fax, e-mail, or regular mail and creates a record of loss in the appropriate claim system.
+ Verifies the claim coverage and reviews submitted claim forms for completeness and accuracy.
+ Sends instructions to the field personnel regarding claim file issues.
+ Utilizes the claim systems to assist customers with inquiries.
+ Enters notes into the claim system regarding conversations or incidences with customers.
+ Directs the efforts of the field adjuster.
+ Provides any required functions relating to the Claims Department at the direction of management.
+ Reviews reports from the field adjusters to ensure that the information and interpretation of the policy language are correct.
+ Corrects any errors seen in the field reports.
+ Interprets policy language and applies that policy language to loss situations.
+ Enters claim and expense payments into the systems that are within their authority.
+ Composes denial letters based upon the facts of the files as it relates to potential coverage issues.
+ Provides any required functions relating to the Claims Department at the direction of management.
+ Participation in audits of claim files.
+ Works with other departmental internal personnel on special projects.
+ Will be required to manage their own pending/case load.
Required Skills & Experience
+ 4-8 years of relevant claims handling experience
+ Proper licensing
+ Strong customer service skills, including the ability to manage demanding requests
+ Experience in commercial property preferred
+ Willingness to help others on our team
About Tokio Marine Highland
Tokio Marine Highland Insurance Services (TMH) is a leading property and casualty underwriting agency. We offer a broad suite of tailored specialty risk management solutions, including private flood, fine art and lender-placed products. At TMH, it's all about our clients. Nationwide, our customers rely on our trusted, industry-leading coverages, supported by compliance expertise, superior claims management and the highest caliber of service.
Founded in 1962, TMH is a wholly owned company of Tokio Marine Kiln, one of the largest carriers in the Lloyd's of London insurance market and a member of the Tokio Marine Group. TMH has operating centers in Chicago, Il, Frisco, Texas, Miami, Fla., and South Pasadena, Calif.
If you're looking to advance your career, TMH is the perfect professional home. At TMH, you'll have a chance to innovate with the world's leading businesses, put your expertise into action on major projects, and work on game-changing initiatives. You'll also make long-lasting professional connections through sharing different perspectives, and you'll be inspired by the best.
Tokio Marine Highland, LLC (TMH) is an Equal Opportunity Employer. TMH's success depends heavily on the effective utilization of qualified people, regardless of their race, ancestry, religion, color, sex, national origin, sexual orientation, gender identity and/or expression, disability, veteran status, or any characteristic protected by law. As a company, we adhere to and promote equal employment opportunities for all.
Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is TMH's policy to provide reasonable accommodation when requested by qualified individuals with disabilities during the recruitment process, unless such accommodation
would cause an undue hardship. To make an accommodation request, please contact *****************************.
Claims Supervisor (Bodily Injury)
Dallas, TX jobs
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
Join a team where your expertise truly matters!Our Casualty Claims department is seeking a highly motivated and experienced Claims Supervisor (Bodily Injury). As a key leader within our Casualty organization, you will be responsible for empowering a team that handles attorney-represented automotive liability claims. Your team will manage:
complex investigations
coverage determinations
liability assessments
bodily injury claim resolutions-through both settlement and litigation.
This role requires advanced knowledge of litigation processes and the ability to strategically support litigated and attorney-represented claims.
If you're passionate about developing talent, driving results, and making an impact in the automotive liability space, we'd love to hear from you.Success in this role is built on the foundation of GEICO's core leadership behaviors:
Ownership: You take responsibility for outcomes in all scenarios.
Adaptability: You navigate dynamic environments with creativity and resilience.
Leading People: You empower individuals and teams to achieve their best.
Collaboration: You build and strengthen partnerships across organizational lines.
Driving Value: You use data-driven insights to align actions with strategic goals.
What You'll Do:
Lead, mentor, and inspire a team of associates to deliver exceptional customer service while building trust.
Leverage your property and casualty insurance expertise to guide team members in resolving complex customer inquiries and claims.
Provide authority on evaluations that exceed your adjusters personal, assigned authority and work with others on claims that exceed your authority
Personalize your leadership approach to develop team members' skills, fostering their growth and ensuring they consistently exceed customer expectations.
Monitor and evaluate team performance using key performance indicators (KPIs) to enhance efficiency, customer satisfaction, and retention.
Hold your team accountable for achieving results, maintaining compliance with insurance regulations, and delivering outstanding service.
Address escalated customer concerns with professionalism and empathy, modeling GEICO's dedication to service excellence.
Collaborate with leadership and cross-functional teams to identify and implement process improvements.
Serve as a resource for team members on insurance-related questions
providing mentorship and training to build their industry knowledge.
What We're Looking For:
Minimum of 2 years of leadership experience in Bodily Injury claims, including direct oversight of litigated cases.
Active Adjuster license (required)
Expertise in Casualty claims, including knowledge of industry regulations and best practices
Strong ability to assess needs and guide associates in negotiating claim settlements as needed
Experienced in the use of various claims tools with ability to assist associates
Strong adherence to compliance and regulatory requirements
Proven ability to motivate, inspire, and develop high-performing teams in a customer-centric environment
Strong results orientation, with a history of meeting or exceeding performance goals
Excellent interpersonal and communication skills, with the ability to adapt leadership styles to diverse individuals and situations
Ability to analyze data and metrics to inform decision-making and improve customer outcomes
Collaborative mindset with a commitment to fostering a culture of inclusivity and excellence
Why Join GEICO?
Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction.
Inclusive Culture: Join a company that values diversity, collaboration, and innovation.
Workplace Flexibility: This is a M-F, 8:00am - 4:30pm position offering a Hybrid work model based in Richardson, TX. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit.
Professional Growth: Access GEICO's industry-leading training programs and development opportunities:
Licensing and continuing education at no cost to you.
Leadership development programs and hundreds of eLearning courses to enhance your skills.
Increased Earnings Potential:
Pay Transparency: The starting salary for this position is between $97,735 annually and $151,700 annually.
Incentives and Recognition:
Corporate wide bonus programs are in place to reward top performers.
Beware of scams! As a recruiter, I will only contact you through ************ email address and will never ask you for financial information during the hiring process. If you think you are being scammed or suspect suspicious activity during the hiring process, please contact us at ...@geico.com.
keywords: litigation, auto liability, liability claims#geico300#LI-AL2
At this time, GEICO will not sponsor a new applicant for employment authorization for this position.
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs.
We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being.
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
Claims Examiner
Rancho Cordova, CA jobs
Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.
Company Culture
We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health.
Honest
Transparent Communication: be open and clear in all interactions without withholding crucial information
Integrity: ensure accuracy in reporting, work outputs and any tasks assigned
Truthfulness: provide honest feedback and report any issues or challenges as they arise
Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior
Ethical
Fair Decision Making: ensure all actions and decisions respect company policies and values
Accountability: own up to mistakes and take responsibility for rectifying them
Respect: treat colleagues, clients and partners with fairness and dignity
Confidentiality: safeguard sensitive information and avoid conflicts of interest
Hardworking
Consistency: meet or exceed deadlines, maintaining high productivity levels
Proactiveness: take initiative to tackle challenges without waiting to be asked
Willingness: voluntarily offer to assist in additional projects or tasks when needed
Adaptability: work efficiently under pressure or in changing environments
Summary:
Government Claims Processor/Examiners are a key part of the department's successful operation. Processor/Examiners are in daily contact with team members, clients and providers. This position reports to the Supervisor, Government Operations. A cheerful, competent and compassionate attitude will directly impact the productivity of the team. Attendance can also directly impact the satisfaction level of our clients and retention of our accounts.
Responsibilities:
Process claims accurately, efficiently and within production requirements
Exhibit an attention to detail and a strong work ethic
Ability to access research tools for accurate claims entry
Be organized and able to manage time and resources efficiently and effectively
Thorough knowledge of coding structures (CPT, HCPCS, Rev codes, ICD 9/10 etc)
Ability to perform arithmetic calculations
Knowledgeable of COB
Familiarity with benefits and benefit calculations
Ability to handle many types of claims pricing (Network, Medicare, UCR etc)
Performs duties in a HIPAA compliant manner
Participate as a Team Member to ensure the smooth operation of the entire department
Maintain guidelines and notes with detail to enable accurate claims examination
Maintain production goals regarding the number of claims entered and accuracy percentages.
Qualifications:
Proficient in the use of desktop computer software.
Excellent communication via written, telephonic and personal
Ability to manage and follow through consistently and accurately
Attention to detail
Completion of all responsibilities in a timely manner
Highly organized work habits
Equal Employment Opportunity Policy Statement
Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.
Claims Representative
Harrisonburg, VA jobs
POSITION MISSION: Provide prompt contact, investigation, and coverage determinations of assigned claims while demonstrating a high level of customer service.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Contact insureds, claimants, and all other relevant parties to facilitate the processing of claims.
Investigate claims promptly according to policy provisions while promoting a high level of customer service.
Demonstrates a comprehensive knowledge of insurance policies and Rockingham guidelines to provide coverage determination through policy interpretations.
Identify claims having potential for increased exposure, such as third-party bodily injury claims, referring to Claims Supervisor as applicable.
Provide policyholders and claimants guidance throughout the claim process.
Maintain an effective claim diary system through accurate documentation of all claim activities in accordance with established procedures.
OTHER DUTIES:
Support claims supervisor as requested
Other duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES:
The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform each essential duty satisfactorily.
Ability to work comfortably and grow in a fast-paced high volume call environment
Experience providing outstanding customer service by showcasing expertise, fostering trust and growing customer satisfaction
Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities
Demonstrate the ability to multitask across multiple platforms routinely
Demonstrates personal computer literacy and effectively uses all relevant company automation.
CORE COMPETENCIES:
Attention to detail
Critical thinking
Time management
Organization
Communication skills
QUALIFICATIONS:
High school diploma or GED required; undergraduate degree preferred.
One year of experience working in the insurance industry preferred.
Proficiency in Microsoft Office products
Strong oral and written communication skills displaying professionalism in language, tone, and style to understand client needs and feedback.
Projects a positive, professional image knowing they represent the company to the customer.
PHYSICAL DEMANDS:
Position operates in a professional office environment and routinely uses standard office and mobile equipment such as computers, phones, and photocopiers.
Largely sedentary role with majority of work performed using a computer and phone.
Please note, this position description is not designed to cover a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
PI54d082a75481-31181-39236173
Claims Processing Expert
Phoenix, AZ jobs
Join Our Team as a Claims Processing Expert!
Are you a data-driven marketer who thrives on turning insights into impactful strategies? We are looking for a Claims Processing Expert to analyze key performance metrics, optimize marketing campaigns, and drive data-backed decision-making.
Why You'll Love This Role:
📊 Data-Driven Impact - Play a critical role in shaping marketing strategies through analytics.
🚀 Career Growth - Access professional development and leadership opportunities.
⏰ Work-Life Balance - Enjoy a flexible schedule with full-time opportunities.
💰 Competitive Compensation - Earn a stable income with performance-based incentives.
Your Responsibilities:
Analyze marketing campaign performance, customer behavior, and market trends.
Develop and track key performance indicators (KPIs) to measure marketing effectiveness.
Provide data-driven insights and recommendations to optimize marketing strategies.
Work with cross-functional teams to ensure data accuracy and consistency.
Utilize analytics tools (Google Analytics, Tableau, etc.) to generate reports and dashboards.
A/B test campaigns and refine strategies based on data insights.
What We're Looking For:
Proven experience in marketing analytics, data analysis, or a related field.
Proficiency in analytics tools such as Google Analytics, Tableau, or SQL.
Strong analytical and problem-solving skills.
Ability to translate complex data into actionable marketing strategies.
Experience with digital marketing metrics, reporting, and performance optimization.
Perks & Benefits:
Professional development and continuous learning opportunities.
Health insurance and retirement plans.
Performance-based bonuses and recognition programs.
Leadership growth and career advancement opportunities.
🚀 Ready to Turn Data into Growth?
If you're passionate about leveraging data to drive marketing success, apply today! Join us and help shape data-driven marketing strategies that make an impact.
Your journey as a Claims Processing Expert starts here-let's optimize for success together!
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