Claim Specialist jobs at Philadelphia Insurance Companies - 871 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. Personal Injury Protection Claims Examiner - Marlton, NJ Salary: $27.47 per hour / $55,350 annually What sets GEICO apart from our competition? One key factor is our ability to provide outstanding customer service during the insurance claims process. We are looking for Personal Injury Protection (PIP) Claims Examiners in our Marlton, NJ office to deliver our promise to be there and assist our customers throughout the often complicated medical aspects of auto insurance claims. We're seeking outstanding associates who want to kickstart a fulfilling career with one of the fastest-growing auto insurers in the U.S. As a PIP Claims Examiner, you will investigate medical necessity and determine casualty. You will consult with involved parties, secure medical information and review insurance contracts, associated reports and billing documentation. We will rely on you to evaluate the validity of personal injury insurance claims and monitor case files over the course of treatment. This job is a great fit for people who are continuous life learners, as PIP Claims Examiners are consistently challenged to learn more and increase their knowledge of our industry and company. Plus, GEICO encourages a promote-from-within culture, so there is plenty of room to grow your career and be rewarded for your hard work and determination. Bring your passion for helping others and a desire to make impact and start a rewarding career with GEICO today! Qualifications & Skills: Bachelor's degree preferred Prior insurance claims experience preferred, but not required Personal injury, bodily injury or workers' compensation experience preferred Solid analytical, customer service and multi-tasking skills Strong attention to detail, time management and decision-making skills #geico200 Annual Salary $27.47 - $42.73 The above annual salary range is a general guideline. Multiple factors are taken into consideration to arrive at the final hourly rate/ annual salary to be offered to the selected candidate. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations. 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 a @geico.com 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 ***********************. 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.

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. Personal Injury Protection Claims Examiner - Richardson, TX Salary: $25.44 - $32.05 per hour / $51,261.60 - $64,580.75 annually What sets GEICO apart from our competition? One key factor is our ability to provide outstanding customer service during the insurance claims process. We are looking for Personal Injury Protection (PIP) Claims Examiners in our Richardson, TX office to deliver our promise to be there and assist our customers throughout the often complicated medical aspects of auto insurance claims. We're seeking outstanding associates who want to kickstart a fulfilling career with one of the fastest-growing auto insurers in the U.S. As a PIP Claims Examiner, you will investigate medical necessity and determine casualty. You will consult with involved parties, secure medical information and review insurance contracts, associated reports and billing documentation. We will rely on you to evaluate the validity of personal injury insurance claims and monitor case files over the course of treatment. This job is a great fit for people who are continuous life learners, as PIP Claims Examiners are consistently challenged to learn more and increase their knowledge of our industry and company. Plus, GEICO encourages a promote-from-within culture, so there is plenty of room to grow your career and be rewarded for your hard work and determination. Bring your passion for helping others and a desire to make impact and start a rewarding career with GEICO today! Qualifications: Prior insurance claims experience preferred, but not required Personal injury, bodily injury or workers' compensation experience preferred Solid analytical, customer service and multi-tasking skills Strong attention to detail, time management and decision-making skills #geico200 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.

Introduction At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they're free to grow, lead, and innovate. You'll be backed by our digital ecosystem: a client-centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips. Here, you're not just improving clients' risk profiles, you're building trust. You'll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve. If you're ready to bring your unique perspective to a place where your work truly matters; think of Gallagher. Overview Keenan is a leading insurance brokerage and consulting firm serving hospitals, public agencies, and California school districts. Specializing in employee benefits, workers' compensation, loss control, financial services, and property & liability, Keenan is committed to delivering innovative solutions that protect and empower the communities we serve. As part of Gallagher, a global leader in insurance, risk management, and consulting, you'll be joining a team that's passionate about helping individuals and organizations thrive. The Senior Claims Examiner will administer indemnity claims and handle complex claim issues. Use strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation. This is a remote position located in California. How you'll make an impact Maintain current diary. Identify, prevent and mitigate potential penalties. Update claim notes in computer. Provide timely reporting of excess files to the Reinsurance Manager. Report SIU/Fraud. Identify and pursue subrogation. Complete Rehab forms/benefit notices/SJDB/RTW form. Refer all PRIME deletions only to office designee. Update reserves no later than 30 days of receipt of information modifying the financial exposure of a claim. Prepare for and attend file reviews. Accept or deny delayed claims within 90 days. Request settlement authorization/notification within 30 days of a final P&S report and prior to the MSC date. Complete Stipulation and/or Compromise and Release paperwork. Maintain 100% closing ratio on active accounts and reduce run off accounts by 25% annually. Prepare legal referrals, provide direction to and monitor defense attorney. Return all phone calls within 24 hours. Complete instruction sheets for Assistant/Technician/Claims entry clerk. Review mail daily. Correct error report daily. Maintain client/claimant satisfaction. Update Unit Stat forms. Oversee new set-ups, reserves and instruction sheets. Prepare cover letters to AME/defense QME, AOE/COE evaluations. Negotiate outstanding liens. Make 3-point contact. File Answer/Application. Interaction with nurse on case management. Other duties assigned. About You Required: High school diploma and 5 years related claims experience required. Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements. Extensive knowledge of accepted industry standards and practices. Computer experience with related claims and business software. Preferred: Bachelor's degree preferred. Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses. Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation. Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you'll get, depending on your job level these benefits may improve: Medical/dental/vision plans, which start from day one! Life and accident insurance 401(K) and Roth options Tax-advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave Other benefits include: Digital mental health services (Talkspace) Flexible work hours (availability varies by office and job function) Training programs Gallagher Thrive program - elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing Charitable matching gift program And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it's embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees' diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

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.

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.

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.

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.

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.

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: ***********************************

Responsible for non‐complex electronic and paper claim submissions to insurance payers. Coordinates required information for filing secondary and tertiary claims reviews and analyzes claims for accuracy, i.e. diagnosis and procedure codes are compatible and accurate. Makes charge corrections or follows up with appropriate parties as needed to ensure billing invoice is correct. Follows up with payers on unresponded claims. Works denied claims by following correct coding and payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request guidance on more complex billing issues and cross training for other payers and tasks. Responds to a variety of questions from insurance companies, government agencies and all Guthrie Medical Group offices. Partners with CRC and other Guthrie departments to field billing inquiries. Answers all correspondence from insurance carriers including requests for supportive documentation. Education, License & Cert: High school diploma required; CPC, CCA, RHIA, RHIT certification in medical billing and coding or Associates degree preferred. Experience: Strong organizational and customer service skills a must. Experience with office software such as Word and Excel required. Previous experience performing in a high volume and fast paced environment. Essential Functions: 1. Works pre‐AR edits, paper claims, reports and work queues as assigned to ensure accurate and timely claim submission to individual payers. Reports possible payer or submission issues. 2. Works closely with a Denial Resolution Specialist or Billing Specialist II mentor to cross train on various payers and tasks to expand insurance billing knowledge and skills. 3. Follows up on rejected and/or non‐responded claims as assigned. Utilizes internal rejection protocols, coding knowledge, reimbursement policies, payer guidelines and other sources in order to research rejections to secure appropriate payment. 4. Provides back up to Central Charge Entry and Cash Applications. Manually enters charges, posts and distributes insurance and patient payments. 5. Promptly reports payer, system or billing issues. 6. Utilizes Epic system functions accurately to perform assigned tasks. Ex: charge corrections, invoice inquiry, billing edits, insurance eligibility. 7. Exports and prepares spreadsheets, manipulating data fields for project work. 8. Identifies and provides appropriate follow up for claims that require correction or appeal. 9. Provides timely resolution of credit balance as identified and/or assigned. 10. Requests adjustments on invoices that have been thoroughly researched and/or were unable to reach payment resolution. Documents support on request forms and performs adjustments within policy guidelines. Other Duties: 1. Provides feedback related to workflow processes in order to promote efficiency. 2. Answers phone calls and correspondence providing request information. Documents action taken and provides appropriate follow up. 3. Acquires and maintains knowledge of and performs within the compliance of the Guthrie Clinic's Corporate Revenue Cycle policies and insurance payer regulations and guidelines. 4. Demonstrates excellent customer service skills for both internal and external customers. 5. Maintains strict confidentiality related to patient health information in accordance with HIPAA regulations. 6. Assists with and completes projects and other duties as assigned.

Overview Workers' Compensation Claim Consultant (CA Jurisdiction Only) - Remote Salary: $77,000-$87,000 annually Schedule: Monday-Friday, 8:00 AM-4:30 PM PST Experience Required: 5+ Years (Litigated & Some Complex Claims) 🚨 Please Note This is not an HR, risk management, or consulting position. This is an experienced California Workers' Compensation adjusting role requiring hands-on claim investigation, evaluation, negotiation, and settlement. Candidates must have direct experience investigating, evaluating, reserving, negotiating, and resolving claims as an adjuster or adjuster supervisor within a carrier, TPA, or similar claims environment. Applicants without hands-on adjusting experience will not be considered. Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We're seeking an experienced Workers' Compensation Claim Consultant to handle California jurisdiction claims for a multi-account desk supporting clients in the trucking & warehouse, valet/shuttle services, and staffing agency industries. This fully remote position requires strong litigated claim handling experience, the ability to independently manage complex files, and a commitment to CCMSI's best practice standards. You'll join a collaborative team of four other consultants, working together to deliver high-quality, timely, and accurate claim service to our clients. Responsibilities When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems. Conduct timely 3-point contact per CCMSI best practices. Investigate, evaluate, and adjust California workers' compensation claims with independence and sound judgment. Establish, maintain, and justify detailed reserve levels. Administer indemnity and award payments in accordance with CA jurisdictional requirements. Negotiate settlements consistent with corporate standards, client instructions, and state law. Maintain a current and thorough diary, ensuring all deadlines and statutory requirements are met. Pursue subrogation recovery as applicable. Prepare claim status reports, reserve analyses, and updates for client meetings. Conduct claim reviews with clients and participate in discussions as needed. Communicate effectively with injured workers, employers, providers, and attorneys throughout the claim lifecycle. Ensure all documentation meets CCMSI best practice requirements. Qualifications Qualifications - Required 5+ years of California WC adjusting experience, including litigated files and some complex exposure. Adjuster designation required. Strong working knowledge of California WC laws, timelines, benefits, and litigation processes. Proficiency with Microsoft Office (Word, Excel, Outlook). Excellent written and verbal communication skills, critical thinking, and decision-making ability. Nice to Have SIP certification preferred. Strong documentation habits per CCMSI best practices. Experience presenting or conducting client reviews. Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Work Environment & Travel Remote role reporting to the Irvine, CA branch. Occasional travel to the office may be required for rare mandatory in-office meetings. Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions • Compliance & audit performance - adherence to jurisdictional and client standards • Timeliness & accuracy - purposeful file movement and dependable execution • Client partnership - proactive communication and strong follow-through • Professional judgment - owning outcomes and solving problems with integrity • Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompJobs #CaliforniaAdjuster #RemoteJobs #ClaimsConsultant #InsuranceCareers #AdjusterLife #NowHiring #LI-Remote We can recommend jobs specifically for you! Click here to get started.

Overview Workers' Compensation Claim Consultant (CA Jurisdiction Only) - Remote Salary: $77,000-$87,000 annually Schedule: Monday-Friday, 8:00 AM-4:30 PM PST Experience Required: 5+ Years (Litigated & Some Complex Claims) 🚨 Please Note This is not an HR, risk management, or consulting position. This is an experienced California Workers' Compensation adjusting role requiring hands-on claim investigation, evaluation, negotiation, and settlement. Candidates must have direct experience investigating, evaluating, reserving, negotiating, and resolving claims as an adjuster or adjuster supervisor within a carrier, TPA, or similar claims environment. Applicants without hands-on adjusting experience will not be considered. Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We're seeking an experienced Workers' Compensation Claim Consultant to handle California jurisdiction claims for a multi-account desk supporting clients in the trucking & warehouse, valet/shuttle services, and staffing agency industries. This fully remote position requires strong litigated claim handling experience, the ability to independently manage complex files, and a commitment to CCMSI's best practice standards. You'll join a collaborative team of four other consultants, working together to deliver high-quality, timely, and accurate claim service to our clients. Responsibilities When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems. Conduct timely 3-point contact per CCMSI best practices. Investigate, evaluate, and adjust California workers' compensation claims with independence and sound judgment. Establish, maintain, and justify detailed reserve levels. Administer indemnity and award payments in accordance with CA jurisdictional requirements. Negotiate settlements consistent with corporate standards, client instructions, and state law. Maintain a current and thorough diary, ensuring all deadlines and statutory requirements are met. Pursue subrogation recovery as applicable. Prepare claim status reports, reserve analyses, and updates for client meetings. Conduct claim reviews with clients and participate in discussions as needed. Communicate effectively with injured workers, employers, providers, and attorneys throughout the claim lifecycle. Ensure all documentation meets CCMSI best practice requirements. Qualifications Qualifications - Required 5+ years of California WC adjusting experience, including litigated files and some complex exposure. Adjuster designation required. Strong working knowledge of California WC laws, timelines, benefits, and litigation processes. Proficiency with Microsoft Office (Word, Excel, Outlook). Excellent written and verbal communication skills, critical thinking, and decision-making ability. Nice to Have SIP certification preferred. Strong documentation habits per CCMSI best practices. Experience presenting or conducting client reviews. Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Work Environment & Travel Remote role reporting to the Irvine, CA branch. Occasional travel to the office may be required for rare mandatory in-office meetings. Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions • Compliance & audit performance - adherence to jurisdictional and client standards • Timeliness & accuracy - purposeful file movement and dependable execution • Client partnership - proactive communication and strong follow-through • Professional judgment - owning outcomes and solving problems with integrity • Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompJobs #CaliforniaAdjuster #RemoteJobs #ClaimsConsultant #InsuranceCareers #AdjusterLife #NowHiring #LI-Remote

Applications to be submitted by January 05, 2026 Compensation Grade: P14 Compensation Details: Minimum: $53,357.00 - Maximum: $53,357.00 Annually Positions with a designated work location in New York City, Nassau, Rockland, Suffolk, or Westchester Counties will receive a $4,000 annual downstate adjustment (pro-rated for part-time positions). Department (OHEHR) AI - AIDS Institute Job Description: Responsibilities The New York State Department of Health, AIDS Institute has established eight Uninsured Care Programs, of which some of these programs have the most comprehensive drug and service coverage in the country. The programs provide access to medical services and medications for all New York State residents with or at risk of acquiring HIV/AIDS. The programs bridge the gap between Medicaid coverage and private insurance and serve as a transition to Medicaid by providing interim assistance to individuals eligible for but not yet enrolled in Medicaid or assistance in meeting spenddown requirements. The Insurance and Claims Specialist I will be responsible for APIC reimbursement processing; pharmacy, primary care, home care and APIC payment processing; handle complex fiscal hotline calls; assist providers and participants with the coordination of benefits; assist with staff training; other appropriate related duties. Minimum Qualifications Bachelor's degree in a related field; OR an Associate's degree in a related field and two years of general office, secretarial, or administrative experience; OR four years of such experience. Preferred Qualifications At least one year of experience in a health care program providing services to people living HIV/AIDS. At least two years of customer service experience in a financial or medical field. At least two years of medical claims or insurance experience. Knowledge of COBRA, HIPAA, and coordination of benefits. Conditions of Employment Grant funded position. Compliance with funding requirements such as time and effort reporting, grant deliverables, and contract deliverables, is required. Valid and unrestricted authorization to work in the U.S. is required. Visa sponsorship is not available for this position. Prior to hire, all HRI employees must reside within a reasonable commuting distance of their official work location and must also be located in, or willing to relocate to, one of the following states: New York, New Jersey, Connecticut, Vermont, or Massachusetts. Telecommuting will not be available. HRI participates in the E-Verify Program. Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans ********************** About Health Research, Inc. Join us in our mission to make a difference in public health and advance scientific research! At Health Research, Inc. (HRI), your work will contribute to meaningful change and innovation in the communities we serve! At HRI, we are on a mission to transform the health and well-being of the people of New York State through innovative partnerships and cutting-edge public health initiatives. As a dynamic non-profit organization, HRI plays a crucial role in advancing the strategic goals of the New York State Department of Health (DOH), Roswell Park Comprehensive Cancer Center (RPCCC), and other health-related entities. HRI offers a robust, comprehensive benefits package to eligible employees, including: Health, dental and vision insurance - Several comprehensive health insurance plans to choose from; Flexible benefit accounts - Medical, dependent care, adoption assistance, parking and transit; Generous paid time off - Paid federal and state holidays, paid sick, vacation and personal leave; Tuition support - Assistance is available for individuals pursuing educational or training opportunities; Retirement Benefits - HRI is a participating employer in the New York State and Local Retirement System and offers optional enrollment in the New York State Deferred Compensation Plan. HRI provides a postretirement Health Benefits Plan for qualified retirees to use towards health insurance premiums and eligible medical expenses; Employee Assistance Program - Provides educational and wellness programs, training, and 24/7 confidential services to assist employees, both personally and professionally; And so much more!

Marketing Statement: TM Claims Service (TMCS) is an independent global claims management firm established in 1987 to provide clients with a broad range of claims related services in the areas of transportation, product liability and overseas travel accident insurance. As part of the Tokio Marine Group of companies TM Claims Service provides claims handling services throughout the US and the Americas. Founded in 1879, Tokio Marine is recognized as Japan's oldest insurer and one of the largest insurance groups in the world. Tokio marine has offices in 38 countries staffed by more than 15000 employees outside of Japan. ($34.00 to $47.00 hourly) Job Summary: Adjust Marine and Inland Marine claims, which includes surveyor appointment, reserve notification, and file maintenance. Understand claims relative to loss history and application of special claims procedures as may be required for individual accounts. Responsible for pursuing recovery against liable carriers. Essential Job Functions: Process and adjust ocean and inland marine claims. Determine liability and/or necessity of surveyor with availability for occasional travel to loss sites. Review survey reports or supporting documentation for determining loss. Determine whether coverage exists for loss. Prepare necessary correspondence with assured/claimant/broker inclusive of loss control and damage prevention reporting. Handle tasks that require a high level of organization and attention to detail. Conclude all settlement agreements. Responsible for protecting all rights against third parties and/or responsible parties which may be liable. Such responsibility may include direct recovery handling. Comply with MCD business plan by conducting self audits, meet expectations of TMM/TMNF audits, and follow SLR procedures. Participate in training seminars and additional technical training courses. Responsible for complying with proper internal controls as necessary to conduct job functions and/or carry out responsibilities and/or administrative activities at Company. Qualifications: College degree preferred Strong PC skills, including Word and Excel Strong written and oral communication skills Auto industry experience preferred Minimum 3 years claims handling experience. Ability to work as part of a team EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.

Job Description The Field Adjuster will investigate and evaluate daily property claims for clients pursuant to client and company direction. Provide timely, accurate, fair, and professional service to all clients and insured parties while maintaining a high level of production. Essential Functions: Handles all assigned claims promptly and effectively, with minimal need for direction and oversight. Inspect damaged property and determine claim related damage. Makes decisions within delegated authority as outlined in company policies and procedures. Understands insurance coverage and applies appropriate claims practices to resolve claims in alignment with company guidelines. Sets and relays adequate reserves according to carrier guidelines. Maintains current knowledge of insurance policies and carrier guidelines. Maintains current knowledge of local industry repair procedures and local market pricing. Submits severe incident reports, insured to value (ITV) reports and other information to claims management as needed. Delivers outstanding customer service experience to all internal, external, current, and prospective customers nationwide. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service. Perform other duties as assigned. Job Requirements: Bachelors preferred; High School required. Must have a valid adjuster license for state residing/covering. Must have a valid driver's license to travel to insureds locations. 2-3 years of experience with property claims required. Experience preparing estimates with Symbility required. Xactimate preferred. Knowledge of insurance policies, theories, and practices. General understanding of construction concepts and principles strongly preferred. Must have the ability to climb ladders, get in attics/crawlspaces, get on roofs, kneel, bend, etc. Must complete continuing education credits where required to maintain licensing. Strong investigative, analytical, and problem-solving skills Capability to plan, organize and manage time efficiently. Ability to work within specific client guidelines concerning both service timelines and preparation of estimates.

Job Description The Field Adjuster will investigate and evaluate daily property claims for clients pursuant to client and company direction. Provide timely, accurate, fair, and professional service to all clients and insured parties while maintaining a high level of production. Essential Functions: Handles all assigned claims promptly and effectively, with minimal need for direction and oversight. Inspect damaged property and determine claim related damage. Makes decisions within delegated authority as outlined in company policies and procedures. Understands insurance coverage and applies appropriate claims practices to resolve claims in alignment with company guidelines. Sets and relays adequate reserves according to carrier guidelines. Maintains current knowledge of insurance policies and carrier guidelines. Maintains current knowledge of local industry repair procedures and local market pricing. Submits severe incident reports, insured to value (ITV) reports and other information to claims management as needed. Delivers outstanding customer service experience to all internal, external, current, and prospective customers nationwide. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service. Perform other duties as assigned. Job Requirements: Bachelors preferred; High School required. Must have a valid adjuster license for state residing/covering. Must have a valid driver's license to travel to insureds locations. 2-3 years of experience with property claims required. Experience preparing estimates with Symbility required. Xactimate preferred. Knowledge of insurance policies, theories, and practices. General understanding of construction concepts and principles strongly preferred. Must have the ability to climb ladders, get in attics/crawlspaces, get on roofs, kneel, bend, etc. Must complete continuing education credits where required to maintain licensing. Strong investigative, analytical, and problem-solving skills Capability to plan, organize and manage time efficiently. Ability to work within specific client guidelines concerning both service timelines and preparation of estimates.

The Field Adjuster will investigate and evaluate daily property claims for clients pursuant to client and company direction. Provide timely, accurate, fair, and professional service to all clients and insured parties while maintaining a high level of production. Essential Functions: Handles all assigned claims promptly and effectively, with minimal need for direction and oversight. Inspect damaged property and determine claim related damage. Makes decisions within delegated authority as outlined in company policies and procedures. Understands insurance coverage and applies appropriate claims practices to resolve claims in alignment with company guidelines. Sets and relays adequate reserves according to carrier guidelines. Maintains current knowledge of insurance policies and carrier guidelines. Maintains current knowledge of local industry repair procedures and local market pricing. Submits severe incident reports, insured to value (ITV) reports and other information to claims management as needed. Delivers outstanding customer service experience to all internal, external, current, and prospective customers nationwide. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service. Perform other duties as assigned. Job Requirements: Bachelors preferred; High School required. Must have a valid adjuster license for state residing/covering. Must have a valid driver's license to travel to insureds locations. 2-3 years of experience with property claims required. Experience preparing estimates with Symbility required. Xactimate preferred. Knowledge of insurance policies, theories, and practices. General understanding of construction concepts and principles strongly preferred. Must have the ability to climb ladders, get in attics/crawlspaces, get on roofs, kneel, bend, etc. Must complete continuing education credits where required to maintain licensing. Strong investigative, analytical, and problem-solving skills Capability to plan, organize and manage time efficiently. Ability to work within specific client guidelines concerning both service timelines and preparation of estimates.

The Total Loss Adjuster will handle first and third party total loss claims for all vehicle types including private passenger autos, trailers, RV's, motorcycles, boats, farm equipment, construction equipment, commercial vehicles and commercial trucking. The Total Loss Adjuster makes and maintains a connection with the customer by understanding and meeting their needs; exhibits empathy and proactively follows up with the customer. Researches and responds to a variety of customer communications, concerns, or issues ranging from simple to complex. Documents the claim file with notes, evaluations and decision making process. Evaluates, validates and negotiates simple to complex total losses. Key Responsibilities: Investigating, evaluating, and negotiating claims, in order to reach a fair and equitable settlement Negotiates settlement of claims with insureds, claimants and attorneys while following established, authorized settlement authority. Uses compassionate communication and persuasive negotiation to ensure a positive customer experience Reviews claim details, coverage limits, the estimate and all associated charges to confirm Total Loss Evaluation Handles all claims within the guidelines of the states' Fair Claims Practices Acts and other Regulations. Will act as specialist in knowledge of Salvage and Title laws of the various states to facilitate legal transfer of title and claim resolution Communicates with Lien Holders, Body shops, tow facilities and other vendors to secure information needed to bring claim to a conclusion Controls associated claims for Rental/Loss of Use and storage Ensure timeliness and KPI's are being met Work closely with the MD appraisers to ensure accurate and timely evaluations Ensure claim files are properly documents and all documents are attached Request documents needed to process titles and salvage of vehicles Monitor Copart website for receipt of title documents Maintains an up-to-date dairy Identifies subrogation and SIU opportunities and follows Company procedures to notify the appropriate company personnel of same Ensure compliance with Hallmark Best Practices Adjusts reserves to accurately reflect the exposure Issue payments to the appropriate parties Other Responsibilities: Attend and participate in team meetings Attends and successfully completes all assigned training in a timely manner Complete continuing education and maintain state licensing for states which require a license Qualifications: Decisive and purposeful Strong moral character and work ethic Independent and self starting Strong verbal communication skills Shows initiative, exhibits a “can do” attitude, and provide ideas while working within a team environment Able to work in a high volume, collaborative, fast paced environment while managing multiple priorities Highly organized Detail oriented with strong analytical skills and sound judgement Excellent time management skills to meet deadlines and prioritize Problem solver Adaptive and flexible Strong negotiation skills Education, Experience, Knowledge and Skills: Excellent verbal and written communication skills. Strong interpersonal skills Demonstrated proficiency of technology including, Microsoft Suite Software (Word, Excel, Power Point, Outlook), Total Loss Manager, ACD, vendor databases and other required web-enabled applications Ability to operate business technology Superior telephone skills Excellent math skills Ability to draft business correspondence, using correct punctuation, spelling and grammar Experience investigating, evaluating, negotiating and settling simple to complex Auto claims strongly preferred Knowledgeable of laws and regulations as it applies to auto insurance industry Bilingual preferred Hallmark Financial Services is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.