Claim Processor jobs at Matrix Absence Management, Inc.

FCE Benefit Administrators, Inc. is seeking a detail-oriented and motivated Medical Claims Processor to join our dynamic and growing team. The ideal candidate will be responsible for the accurate and timely processing of a wide range of claims while ensuring compliance with company standards and regulatory requirements. This role requires strong attention to detail, effective communication skills, and the ability to work efficiently in a fast-paced environment. Key Responsibilities Accurately process a variety of claim types, including Medical, Vision, Dental, HRA, Critical Illness, and Accident claims. Manage the entire claim lifecycle, including adjustments, voids, and payment reissues. Conduct audits on processed claims to ensure accuracy and compliance with policies. Serve as a point of contact for claim-related inquiries from members, providers, and internal AE (Account Executive) and CS (Customer Service) teams. Handle escalated client questions and issues via phone and email with professionalism and urgency. Participate in special projects and organizational initiatives as assigned. Assist with training and mentoring team members (for more experienced candidates). Education High school diploma or equivalent required. Associate's degree or vocational training in a related field (e.g., Medical Billing & Coding, Business Administration) preferred. Experience 1-3 years of experience in medical claims processing, data entry, customer service, or a general administrative role required. Technical Skills Proficiency in Microsoft Office Suite (Excel, Word, Outlook). Strong data entry capabilities and 10-key proficiency. Familiarity with claims management platforms or Electronic Health Record (EHR) systems preferred. Soft Skills Exceptional attention to detail and strong organizational abilities. Clear written and verbal communication skills. Strong problem-solving and critical thinking abilities. Ability to work independently while managing a high volume of tasks in a fast-paced environment. Commitment to maintaining confidentiality and handling sensitive information with integrity. Working Conditions Standard office environment. Prolonged periods of sitting and computer use may be required. Ability to lift up to 20 lbs occasionally (e.g., handling physical records or mail). Benefits Offered We understand that top talent is attracted to organizations offering competitive compensation, comprehensive benefits, and opportunities for professional growth. FCE offers a robust benefits package including: Medical, Dental, and Vision Coverage Disability Insurance 401(k) with Company Match Flexible Spending Accounts (FSA) Health Savings Account (HSA) Contributions Fitness Membership Discounts Company-paid Life Insurance Tuition/Professional Development Reimbursement Employee Assistance Programs Paid Time Off (PTO) About FCE Benefit Administrators, Inc. With nearly 30 years of experience, FCE Benefit Administrators, Inc. has helped hundreds of For-Profit and Not-For-Profit organizations achieve full compliance under the Service Contract Act (SCA), Davis-Bacon Act (DBA), Javits-Wagner-O'Day (JWOD), and related federal legislation. As trusted experts in government contracts, we specialize in the administration of bona-fide fringe benefit plans through an irrevocable funding arrangement, ensuring full compliance with SCA requirements. Equal Opportunity Employer FCE is an equal opportunity employer and is committed to creating an inclusive and diverse workplace.

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.

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. What Makes This Opportunity Exciting? Are you a seasoned professional with a track record ininsurance claims? As an Experienced Claims Specialist at GEICO, you'll leverage your expertise to manage cases and contribute to your team's success. You'll be at the heart of our commitment to outstanding customer service. You'll manage multiple steps impacting the claims life cycle, providing guidance, support, and solutions to policyholders during times of uncertainty. Your expertise and compassion will make a meaningful impact on their lives while contributing to GEICO's reputation for excellence. Claims Processing: Efficiently and accurately handle insurance claims, ensuring adherence to company policies and procedures. Customer Service: Communicate professionally and empathetically with customers, addressing concerns and questions about their claims. Investigation: Conduct thorough investigations to determine the extent of coverage and assess any potential fraud. Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Workplace Flexibility: After completing a comprehensive 5-month in-office training and orientation, transition to a hybrid work model with the best of both worlds-spend 80% of your time in the office and 20% working remotely. Plus, take advantage of the GEICO Flex Program, which offers up to four additional weeks of remote work annually for even greater flexibility. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Access to GEICO Strive Program, providing associates with tuition assistance and access to high-quality education to advance their career. Incentives and Recognition: Pay Transparency: The starting salary for an Experienced Claims Specialist is between $31.62 per hour / $63,714 annually and $33.11 per hour / $66,736 annually. Sign-On Bonuses: $1,500 for active Florida All-Lines Adjuster License (6-20). Evening Shift Differentials: Earn a +10% pay differential for eligible shifts. Weekend Shift Differentials: Earn a +20% pay differential for eligible shifts. Additional Perks: Health & Wellness: Comprehensive healthcare and well-being support available on Day 1. 401(k) Match: From day one, you'll be automatically enrolled in our 401(k) plan with a 6% pre-tax contribution. We match 100% of your contributions, up to 6% of your eligible earnings, with employer contributions added to your account each paycheck and vesting immediately. What We're Looking For: A passion for providing outstanding customer service. Strong interpersonal, communication, and problem-solving skills. Adaptability and attention to detail in a dynamic environment. 2+ years of prior claims experience in the insurance industry. Active Florida All-Lines Adjuster License (6-20) required. High School Diploma required, College degree (2-4 year) preferred. Ability to prioritize and multi-task, while navigating through multiple business applications. Computer proficiency, including familiarity with Microsoft Office Suite. Flexibility to work evenings, weekends, and holidays as needed. #geico600 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 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

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. What Makes This Opportunity Exciting? Are you a seasoned professional with a track record in insurance claims? As an Experienced Claims Specialist at GEICO, you'll leverage your expertise to manage cases and contribute to your team's success. You'll be at the heart of our commitment to outstanding customer service. You'll manage multiple steps impacting the claims life cycle, providing guidance, support, and solutions to policyholders during times of uncertainty. Your expertise and compassion will make a meaningful impact on their lives while contributing to GEICO's reputation for excellence. Claims Processing: Efficiently and accurately handle insurance claims, ensuring adherence to company policies and procedures. Customer Service: Communicate professionally and empathetically with customers, addressing concerns and questions about their claims. Investigation: Conduct thorough investigations to determine the extent of coverage and assess any potential fraud. Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Workplace Flexibility: After completing a comprehensive 5-month in-office training and orientation, transition to a hybrid work model with the best of both worlds-spend 80% of your time in the office and 20% working remotely. Plus, take advantage of the GEICO Flex Program, which offers up to four additional weeks of remote work annually for even greater flexibility. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Access to GEICO Strive Program, providing associates with tuition assistance and access to high-quality education to advance their career. Incentives and Recognition: Pay Transparency: The starting salary for an Experienced Claims Specialist is between $31.62 per hour / $63,714 annually and $33.11 per hour / $66,736 annually. Sign-On Bonuses: $1,500 for active Florida All-Lines Adjuster License (6-20). Evening Shift Differentials: Earn a +10% pay differential for eligible shifts. Weekend Shift Differentials: Earn a +20% pay differential for eligible shifts. Additional Perks: Health & Wellness: Comprehensive healthcare and well-being support available on Day 1. 401(k) Match: From day one, you'll be automatically enrolled in our 401(k) plan with a 6% pre-tax contribution. We match 100% of your contributions, up to 6% of your eligible earnings, with employer contributions added to your account each paycheck and vesting immediately. What We're Looking For: A passion for providing outstanding customer service. Strong interpersonal, communication, and problem-solving skills. Adaptability and attention to detail in a dynamic environment. 2+ years of prior claims experience in the insurance industry. Active Florida All-Lines Adjuster License (6-20) required. High School Diploma required, College degree (2-4 year) preferred. Ability to prioritize and multi-task, while navigating through multiple business applications. Computer proficiency, including familiarity with Microsoft Office Suite. Flexibility to work evenings, weekends, and holidays as needed. #geico600 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.

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.

Are you graduating in 2026 - or looking to pivot your career? Kinsale Insurance is seeking motivated graduates and career changers for our Associate Claims Examiner role. This entry-level opportunity provides immediate responsibility, structured training, and long-term advancement in the insurance industry. About Kinsale Insurance Kinsale Insurance is an excess and surplus (E&S) lines insurer specializing in hard-to-place, small to medium commercial accounts. Licensed in all 50 states, we write across Property, Casualty, and Specialty lines. Our Claims team plays a critical role in delivering exceptional service and fair resolutions. What You'll Do A typical day as an Associate Claims Examiner may include: Managing a desk of low-to-moderately complex property and liability claims. Investigating and evaluating claims throughout the process. Drafting and issuing coverage correspondence to policyholders. Determining liability, evaluating exposures, and negotiating settlements. Communicating with policyholders, claimants, and other stakeholders. Maintaining accurate and complete claim documentation. Driving claims toward timely resolution. Qualifications A successful candidate has: Associate's or bachelor's degree (or relevant insurance experience). Strong written and verbal communication skills. Analytical and problem-solving ability. Proficiency with Microsoft Office (Word, Excel, Outlook, PowerPoint). Organization and time management skills. Ability to collaborate in a fast-paced environment and manage multiple claims simultaneously. A compelling candidate also has: Negotiation skills with proven results. Proficiency in directing and overseeing investigations. Hiring Timeline Phone screens: October 2025 - January 2026 Interviews: January 2026 Offers extended following interviews Start dates: May, June, or July 2026 Benefits Competitive salary with performance-based bonus opportunities Health, dental, and vision insurance with company HSA contributions Short- and long-term disability coverage Life insurance Matching 401(k), fully vested immediately Generous paid time off and holidays Reimbursement for training and professional development Clear promotion paths and career advancement from within Kinsale values strong financial responsibility. A credit check will be conducted as a part of the selection process for roles that require sound judgement, trustworthiness, or access to sensitive information.

Safety Insurance has become one of the leading property and casualty insurance providers in Massachusetts mainly because of our unwavering commitment to independent agents and their customers. Our success is built on a philosophy of offering the highest quality insurance products at competitive rates and providing the best service at all costs. Through our supportive career, educational and family policies, we enable our employees to be their best. We respect the balance of work and leisure by offering flexible schedules and a 37.5 hour workweek. Safety employees enjoy a positive environment in our convenient downtown office located in the heart of Boston's financial district. Along with our competitive salaries, we offer a comprehensive benefits package including medical and dental insurance, 100% matching 401k retirement plan, 100% tuition reimbursement and much, much more!

Safety Insurance is proud to be one of the leading property and casualty insurance providers in Massachusetts. We are committed to supporting independent agents and their customers through our unwavering dedication to excellence. Our success is built on a simple philosophy: deliver the highest quality insurance products at competitive rates while providing exceptional service at every step. At Safety Insurance, we don't just offer jobs - we offer careers that are challenging, fulfilling, and designed to grow with you. Our people are our greatest asset. A diverse workforce makes us stronger, more innovative, and better equipped to serve our customers. At Safety, we empower our employees to be their best by fostering an inclusive environment and offering resources that support their careers, education, and families. We also understand the importance of work-life balance. That's why we offer hybrid work options, flexible schedules, and a 37.5-hour workweek. Conveniently located in the heart of Boston's financial district, our downtown office is a positive space where employees can stay connected to both each other and the pulse of the city. Safety's benefits go beyond the basics. In addition to competitive salaries, our comprehensive benefits package includes: * 3 weeks accrued paid time off + 11 paid holidays per year * Health insurance (medical, dental, vision) * Annual 401(k) Employer Contribution (up to 8% of your base salary) * 100% tuition reimbursement * Free on-site fitness center * Complimentary coffee and breakfast service * Hybrid work schedules * Working Advantage Discount Program * Employee Assistance Program * …and much more! Join Safety Insurance and discover a career that's built to support your success - both personally and professionally.

Looking for a new career? Interested in changing industries? Searching for opportunities to grow? Are you ambitious and eager to learn? Then, this might be the job for you! We are currently seeking a class of potential Claims Examiners to be trained to become our next generation leaders at TWIA/TFPA.

The Claim Examiner Team Lead is a key resource for the Claim Examiner team, leveraging advanced expertise in claim adjudication, payment integrity and regulatory compliance. This position does not include direct supervisory responsibilities or formal performance reviews. Instead, the Team Lead provides support, coaching, and technical guidance to claim examiners, ensuring accuracy, efficiency, and adherence to CMS and company standards. Acting as a mentor, process improvement lead, and operational reviewer, the Team Lead drives continuous improvement, supports fraud, waste and abuse (FWA) prevention initiatives and collaborates with cross-functional teams to optimize claims processes and professional development. Key Responsibilities: Team Leadership and Enablement Provide direction, mentorship, and technical support for Claim Examiners, fostering a collaborative and high-performance environment. Act as the primary resource for escalated claims and technical questions, offering expert advice and facilitating team learning. Contribute to the development and delivery of training materials and workshops, supporting ongoing professional development. Lead and support onboarding of new Claim Examiners, ensuring effective orientation to claims processes, company policies, and regulatory requirements. Serve as a resource for new team members during their initial training period helping them integrate into the team and build foundation skills. Claim Adjudication and Payment Integrity Utilize in-depth knowledge of claims adjudication processes to ensure accurate and timely processing of Medicare Supplement claims. Review and analyze complex claims for proper application of policy provisions and regulatory requirements. Support payment integrity by verifying claims are processed correctly, assisting in identifying and correcting payment errors, and collaborating on payment integrity reviews. Fraud, Wast, and Abuse (FWA) Prevention Review claims for signs of fraudulent activity or proper hilling practices. Assist in enforcing policies and procedures to prevent, detect and address FWA in claims processing. Conduct investigations into suspected FWA activities and educate team members on prevention strategies. Regulatory Compliance and Quality Assurance Ensure claims processing complies with CMS guidelines, state regulations, and company policies. Conduct regular audits of claims to maintain high standards of quality and compliance. Stay informed about changes in Medicare regulations and communicate updates to the team. Claim Edit Logic Review and Collaboration Serve as an operational reviewer and subject matter expert for claim edit logic, providing input and feedback to technical, compliance, and analytics team. Participate in requirements gathering, validation, and documentation of logic changes, supporting audit readiness and continued improvement. Collaborate with IT and analytics teams on the implementation and optimization of claim edit logic, without direct responsibility for technical development or system configuration. Process Improvement and Operational Excellence Identify opportunities for process improvements and efficiencies in claim indexing, queue management and workflow. Lead or participate in process improvement initiatives, leveraging data analytics and trend analysis to drive operational enhancements. Prepare actionable insights for management review. Stakeholder Collaboration and Enablement Facilitate resolution of complex claims issues and drive alignment with CMS policies. Provide expert guidance and support to claim examiners and customer service representative regarding claim-related inquiries and escalations. Collorate with cross-functional teams (compliance, IT, analytics, customer service) to ensure seamless integration of new rules and system enhancements. Qualifications: Experience: 3+years of experience in healthcare claims analysis, medical coding, payment integrity or healthcare data analytics. Experience with Medicare payment methodologies and reimbursement rules preferred. Experience with clinical coding (CPT, HCPCS, ICD, NDC) and regulatory research preferred. Certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA) or similar preferred credentials. Skills: Technical and Analytical: Advanced proficiency in SQL and Excel; experience with data visualization tools (Tableau, Power BI) and large datasets. Strong analytical, communication and problem-solving skills. Deep understanding of medical coding systems (CPT, HCPCS, ICD, DRG, NCD) and healthcare reimbursement methodologies. Communication and Collaboration: Excellent verbal and written communication skills; able to explain technical concepts to non-technical audiences and document logic/rationale for edits. Ability to work independently and collaboratively in cross-functional teams (technical, business operations, provider facing). Quality and Process Improvement Strong attention to detail and commitment to accuracy in edit development, testing, and documentation. Experience in quality assurance, UAT testing and continuous improvement of claims editing. Problem Solving and Initiative: Demonstrated ability to analyze root causes, troubleshoot issues and propose solutions for claims editing and payment integrity challenges. Proactive in identifying opportunities for edit optimization, regulatory compliance and operational efficiency. Work Environment / Physical Requirements: The work environment is a standard office setting with typical office equipment. This role involves professional collaboration with colleagues and clients. Responsibilities may involve extended periods of sitting, occasional walking between departments or meeting rooms, and periodic standing, reaching, stooping, and lifting office items weighing up to 25 pounds.

DETAILS Claims Examiner II - Commercial Auto Department: Property & Casualty Reports To: Claims Supervisor P&C FLSA Status: Exempt in all states but CA Job Grade: 11 Career Ladder Next step in progression could include Senior Claims Examiner ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Examiner II to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA, and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. As an Inside Property and Casualty Claims Examiner II, this candidate will be responsible for the review, analysis, and process of moderate to severe commercial auto bodily injury claims with an opportunity to handle Commercial Property, Inland Marine, and General Liability claims. These claims are typically moderate exposure and may entail litigation and coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills. Investigate, evaluate, and determine settlement value or denial of liability for moderate to severe level commercial auto claims Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure. Ensure appropriateness of all payments Coordinate and work with a vendor service such as appraiser, independent adjusting firms, contractors, social media and private investigation and various other field service vendors Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims Exchange information with clients, claimants, insurance brokers, inspectors, producers, and account managers Attend meetings and educational seminars for professional development Maintain required licenses Conduct quarterly claim reviews with the client ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL Additional State Adjuster License(s) may be required within 180 days Maintain licenses and continuing education requirements in all states. Minimum of 5 years of commercial auto handling experience Trucking experience preferred Knowledge of tort law, civil procedure, and contract law Knowledge of auto insurance laws, codes, procedures, and liability concepts Knowledge of property and casualty insurance policies Proficiency in investigation and resolution of minor to medium level auto physical damage claims. Low to moderate bodily injury experience required Negotiation skills Relies on extensive experience and judgment to plan and accomplish goals in a fast-paced environment Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here

All Boston Mutual employees who interact with our policyholders, our producers, and our BML associates embrace the principles of our brand and service philosophy. We are all brand ambassadors. Both our words and our behaviors matter. We share a common service philosophy and pride ourselves in living the BML brand promises every day, one interaction at a time. The following statements represent what Boston Mutual stands “FOR” - it is what makes us different and better in the market we serve. We are FOR being a progressive life insurance company offering financial peace of mind to working Americans and their families. We are FOR providing practical and affordable products designed for those we serve. We are FOR making it easy to secure a level of financial protection with a portfolio of products - beginning with life insurance. We are FOR providing a personalized customer experience to our policyholders and producers. We are FOR acting in the best interests of our policyholders, producers, employees and the communities in which we live and serve - representing the goodness of mutuality in all we do. We do our best to: Demonstrate a desire to assist Listen for understanding and respond empathetically Explain things in a manner that is easy to understand Be knowledgeable students of our business Take full ownership to resolve questions and issues Be professional, polite and courteous Leave our customers and associates “better than where we found them” Statement of Position The Life Claim Examiner reports directly to the Life Claim Manager. The Life Claim Examiner is responsible for managing and processing all assigned claims with adherence to company policies and contract provisions in full accordance of the law while demonstrating the highest levels of service professionalism in all they do. The Life Claim Examiner is expected to: Manage their assigned caseload of Life insurance claims and ensures the accuracy and completeness of submitted claims. Processes assigned claims for payment or denial in accordance with established procedures and guidelines, in a timely manner and meeting departmental quality/production standards. Review and process claims, evaluate medical records, and request additional information when needed. Obtains claim information by communicating effectively with internal/external stakeholders verbally and in written form while maintaining a professional demeanor. Interpret and evaluate policy/contract revisions. Review pending claims on a monthly basis. Perform other duties as assigned. JOB REQUIREMENTS AND QUALIFICATIONS Education: High School Diploma, GED or equivalent required. Medical terminology and/or insurance experience preferred. Experience: Claim examiner: Minimum of 1 year of business/office experience. Sr. Claim Examiner: Minimum of 2 years life/medical claims experience required. Knowledge Requirements: Strong business knowledge Excellent written/verbal communication skills. Strong organizational skills that reflect ability to perform and prioritize a high volume of task. Multitasks seamlessly with excellent attention to context, substance, and detail while meeting goals and strict deadlines. Excellent interpersonal skills and the ability to effectively build and extend relationships. Working knowledge of desktop applications such as Outlook, Word and Excel. Certifications/Licensures: N/A ADDITIONAL INFORMATION Regular Working Conditions (Desk job with occasional walking, use of computer with hand and finger motions, close and distance vision, minimal noise level and no exposure to weather conditions) Prolonged Standing Frequent Walking or Stooping Heavy Equipment or Machinery Operation Heavy Lifting Increased Noise Level Exposure to Weather Conditions Travel Required “On Call” Hours Required Other Information:

Job Summary:The Claims Examiner I is responsible for adjudicating individual and group voluntary benefits claims, including Critical Illness, Accident, Hospital Indemnity, Short Term Disability, Short Term Care, and Life products. This role ensures the accurate entry of claims data while conducting thorough reviews and analyses to determine eligibility. As an entry-level position, the Claims Examiner I works closely with more senior examiners to ensure the accurate and timely processing of claims. This role supports the company's mission by maintaining high standards of accuracy and efficiency in claims adjudication.Key Responsibilities: Deliver exceptional service to claimants, internal teams, and external customers, aligning with company values. Process and adjudicate routine claims for Critical Illness, Accident, Hospital Indemnity, Short Term Disability, Short Term Care, and Life products under direct supervision. Investigate, resolve, and make decisions on less complex claims, ensuring full compliance with company policies and industry regulations. Ensure claims are processed in compliance with company policies and industry regulations. Meet or exceed minimum production averages and accuracy targets for payment, procedure, and financial goals. Participate in the development and implementation of policies and procedures to improve claim handling processes. Assist in enhancing claims processes to boost operational efficiency while maintaining compliance. Consistently meet production and accuracy targets, including payment, procedure, and financial goals. Collaborate with team members and other departments to ensure seamless claims handling and customer service. Day-to-Day Activities: Review and enter claims data accurately. Conduct thorough reviews and analyses to determine eligibility. Communicate with claimants and other stakeholders to gather necessary information and provide updates. Research and resolve discrepancies in claims data. Participate in team meetings and training sessions to stay updated on policies and procedures. Contribute to various claims-related projects and process improvement initiatives. Qualifications: High school diploma or equivalent required; Bachelor's degree preferred. Minimum of 1 year of claims experience preferred, with exposure to group and/or individual products. Basic understanding of claims processing and settlement practices. Strong communication and interpersonal skills. Ability to manage multiple priorities and meet deadlines. Basic knowledge of regulatory standards and compliance requirements. Skills: Analytical Skills: Ability to review claim details, medical records, and policy provisions to make informed decisions. Claims examiners must analyze information to determine coverage and benefits accurately. Attention to Detail: Precision in reviewing documentation, identifying discrepancies, and ensuring all required information is present before making a decision. This skill is crucial for accurate claim adjudication. Communication Skills: Strong written and verbal communication abilities to clearly explain claim decisions to stakeholders. Claims examiners must also effectively communicate with internal teams. Time Management: Efficient handling of multiple claims and tasks, ensuring timely adjudication within set deadlines. Time management is vital for managing high workloads and meeting service-level agreements. Problem-Solving: Capacity to address complex claims scenarios, interpret policy language, and find solutions to claims issues. Claims examiners need to resolve questions or disputes related to coverage. Knowledge of Policy Provisions: Deep understanding of policy terms, conditions, and exclusions for accident indemnity, hospital indemnity, short-term care, critical illness, and disability coverage. This is necessary for accurate application of benefits. Regulatory Compliance Awareness: Knowledge of relevant insurance laws and regulations to ensure all claims are handled in compliance with legal and regulatory requirements. Work Environment / Physical Requirements:The work environment is a standard office setting with typical office equipment. This role involves professional collaboration with colleagues and clients. Responsibilities may involve extended periods of sitting, occasional walking between departments or meeting rooms, and periodic standing, reaching, stooping, and lifting office items weighing up to 25 pounds.

Job DescriptionOur client is seeking a skilled Multiline Auto Claims Examiner to join their team. This key role focuses on investigating and resolving moderate to complex auto liability and bodily injury claims, ensuring fair and efficient outcomes while maintaining compliance with all regulatory standards. The ideal candidate will have a strong background in casualty claims, particularly auto liability, and will demonstrate excellent judgment in evaluating exposures and negotiating settlements.Key Responsibilities: Investigate and evaluate Auto Liability and Bodily Injury claims to determine coverage, liability, and damages. Manage claims through all stages, including litigation, negotiation, and settlement. Review and analyze medical records, accident reports, and legal documentation to accurately assess claims. Collaborate with defense counsel and other experts to ensure cost-effective and timely resolutions. Provide clear communication and updates to policyholders, claimants, and brokers. Maintain accurate claim documentation in the claims management system. Ensure all claim handling complies with regulatory requirements and internal company guidelines. Requirements: 3 - 8+ years of experience handling Commercial or Personal Auto Liability and Bodily Injury claims, preferably with an insurance carrier. Active adjuster license strongly preferred. Strong negotiation and litigation management skills with a proven ability to drive equitable settlements. Solid analytical, organizational, and problem-solving skills. Proficiency with claims management software and Microsoft Office Suite. Bachelor's degree preferred. Salary & Benefits: $70,000 to $90,000+ annual base salary (depending on experience) plus bonus potential Generous PTO and paid holidays Competitive 401k with employer matching contributions Comprehensive health, dental, and vision coverage Professional growth opportunities within a supportive team environment

Job DescriptionOur client is seeking a skilled Multiline Auto Claims Examiner to join their team. This key role focuses on investigating and resolving moderate to complex auto liability and bodily injury claims, ensuring fair and efficient outcomes while maintaining compliance with all regulatory standards. The ideal candidate will have a strong background in casualty claims, particularly auto liability, and will demonstrate excellent judgment in evaluating exposures and negotiating settlements.Key Responsibilities: Investigate and evaluate Auto Liability and Bodily Injury claims to determine coverage, liability, and damages. Manage claims through all stages, including litigation, negotiation, and settlement. Review and analyze medical records, accident reports, and legal documentation to accurately assess claims. Collaborate with defense counsel and other experts to ensure cost-effective and timely resolutions. Provide clear communication and updates to policyholders, claimants, and brokers. Maintain accurate claim documentation in the claims management system. Ensure all claim handling complies with regulatory requirements and internal company guidelines. Requirements: 3 - 8+ years of experience handling Commercial or Personal Auto Liability and Bodily Injury claims, preferably with an insurance carrier. Active adjuster license strongly preferred. Strong negotiation and litigation management skills with a proven ability to drive equitable settlements. Solid analytical, organizational, and problem-solving skills. Proficiency with claims management software and Microsoft Office Suite. Bachelor's degree preferred. Salary & Benefits: $70,000 to $90,000+ annual base salary (depending on experience) plus bonus potential Generous PTO and paid holidays Competitive 401k with employer matching contributions Comprehensive health, dental, and vision coverage Professional growth opportunities within a supportive team environment

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency: English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: The incumbent is responsible for investigating, evaluating, negotiating, and resolving personal lines property claims. Responsible for adjusting major and complex losses in their entirety, but may also adjust standard losses. ESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. 1. Responsible for completing coverage investigations and coverage analysis and develop a detailed resolution plan. 2. Responsible for providing exceptional customer service and handles claims in accordance with prescribed authority and best claims practices. 3. Develop relationships with customers via telephone, investigate insurance policy coverage, determine cause of loss, and document activity on each claim to come to a resolution quickly and accurately. 4. Identify, analyze, and resolve coverage issues according to established Company protocol, including thorough policy review and analysis of application to the individual claim. With supervisor approval, negotiate with policyholders to settle claims of limited monetary value. 5. Develop and direct investigative plans. Conduct timely and detailed investigations that include scene investigation (e.g., photos, diagrams, blueprints, maps), statements, official reports (e.g., police, fire, weather, hail), and ownership documents (e.g., tax liens, judgments, encumbrances). Identify alleged and actual damages, identify potential liable parties, recognize and address potential fraud. 6. Conduct thorough damage development, leading to timely and adequate evaluations, including appraisals/estimates, business records, invoices, detailed inventory, purchase records, receipts, credit card statements, and ALE documents. Develop appropriate methods of repair/replacement, verify ownership, and apply any special limitations. 7. Establish voice to voice communication within 24 hours. Maintain effective communications with the Customer at all times. Consistently work within specific time limits and authority. 8. Maintain company reputation and integrity of insurance products by complying with federal and state regulations, Company protocol, and service standards. Maintain current knowledge of regulations and issues, industry activity, and trends. 9. Partner with SIU and Subrogation to identify questionable claims and subrogation opportunities. Assist or prepare files for suit, trial, or subrogation. QUALIFICATIONS Required Qualifications: The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Two years of related, applicable experience 2. Associate's degree (A.A. or A.S.) or equivalent from a two-year college, business school, or technical school 3. Adjusters License for states in which the Company conducts business Preferred Qualifications: 1. Five years of related, applicable experience 2. Fluency in Spanish General Description of Available Benefits for Eligible Employees of CRC Group: At CRC Group, we're committed to supporting every aspect of teammates' well-being - physical, emotional, financial, social, and professional. Our best-in-class benefits program is designed to care for the whole you, offering a wide range of coverage and support. Eligible full-time teammates enjoy access to medical, dental, vision, life, disability, and AD&D insurance; tax-advantaged savings accounts; and a 401(k) plan with company match. CRC Group also offers generous paid time off programs, including company holidays, vacation and sick days, new parent leave, and more. Eligible positions may also qualify for restricted stock units and/or a deferred compensation plan. CRC Group supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC Group is a Drug Free Workplace. EEO is the Law Pay Transparency Nondiscrimination Provision E-Verify

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. Requirements: PI54d082a75481-31181-39236173

Join Our Dynamic Insurance Team - Unlock Your Potential! Are you ready to take control of your future and build a career in one of the most stable and lucrative industries? We are seeking driven individuals to join our thriving insurance team, where you'll receive top-tier training, support, and unlimited income potential. NOW HIRING: ✅ Licensed Life & Health Agents ✅ Unlicensed Individuals (We'll guide you through the licensing process!) We're looking for our next leaders-those who want to build a career or an impactful part-time income stream. Is This You? ✔ Willing to work hard and commit for long-term success? ✔ Ready to invest in yourself and your business? ✔ Self-motivated and disciplined, even when no one is watching? ✔ Coachable and eager to learn? ✔ Interested in a business that is both recession- and pandemic-proof? If you answered YES to any of these, keep reading! Why Choose Us? 💼 Work from anywhere - full-time or part-time, set your own schedule. 💰 Uncapped earning potential - Part-time: $40,000 - $60,000 /month | Full-time: $70,000 - $150,000+++/month. 📈 No cold calling - You'll only assist individuals who have already requested help. ❌ No sales quotas, no pressure, no pushy tactics. 🧑 🏫 World-class training & mentorship - Learn directly from top agents. 🎯 Daily pay from the insurance carriers you work with. 🎁 Bonuses & incentives - Earn commissions starting at 80% (most carriers) + salary 🏆 Ownership opportunities - Build your own agency (if desired). 🏥 Health insurance available for qualified agents. 🚀 This is your chance to take back control, build a rewarding career, and create real financial freedom. 👉 Apply today and start your journey in financial services! ( Results may vary. Your success depends on effort, skill, and commitment to training and sales systems. )