Senior claims representative work from home jobs

Who We Are Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we're shaping a healthier, more engaged future. Responsibilities Ready to Lead Complex Healthcare Data Integrations That Power Enterprise Excellence? We're seeking a strategic, technically adept professional who can serve as technical and analytical lead for managing complex healthcare claims data integrations across multiple platforms and partners. As our Senior Claims Integration Specialist, you'll oversee the end-to-end lifecycle of claims ingestion, transformation, and validation while mentoring team members and optimizing integration workflows. What makes this role different: ✓ Technical leadership: Configure, design, and optimize integration workflows while leading root-cause analysis for data anomalies ✓ Mentorship opportunity: Guide junior team members on best practices in claims data management and automation ✓ Cross-platform expertise: Ensure data quality, compliance, and operational stability across Personify's entire claims ecosystem ✓ Strategic impact: Combine technical proficiency with strategic mindset to enhance process efficiency, scalability, and accuracy What You'll Actually Do Lead carrier partnerships: Serve as primary liaison with healthcare carriers to establish and maintain data exchange partnerships while communicating and enforcing universal data specifications. Manage data ingestion: Collaborate on analysis of inbound healthcare claims data feeds to identify and triage validation or data quality issues using SQL and transformation logic. Optimize integration workflows: Map carrier-specific data fields into company's universal data model while implementing ingestion processes ensuring data integrity and compliance with internal standards. Troubleshoot complex issues: Understand and troubleshoot ingestion pipelines, resolving data quality issues and ingestion failures while diagnosing root causes of data anomalies. Ensure system accuracy: Verify claims data is accurately processed and routed to all relevant internal systems including client servicing platforms, analytics tools, and operational dashboards. Implement quality controls: Execute robust data validation, reconciliation, and quality control processes while monitoring ingestion performance and proactively resolving discrepancies. Maintain comprehensive documentation: Create and maintain requirement documentation including business rules, file mapping, and transformation process specifications for all inbound claims files. Collaborate strategically: Partner with product, operations, technology, data engineering, and architecture teams to support downstream use cases and optimize database structures. Qualifications What You Bring to Our Mission The educational foundation: Bachelor's or Master's degree in Health Informatics, Information Systems, Business/Statistics/Information Science, or related field 3+ years experience in healthcare data integration, claims processing, or payer-provider data exchange The technical expertise: Strong understanding of healthcare claims formats (EDI 837, NCPDP, proprietary formats) and wide variety of claims formats and coding standards (CPT, ICD, DRG) Strong SQL skills with ability to write and tune complex queries against large-scale datasets Proven experience managing external partnerships and internal cross-functional teams Familiarity with data warehousing, ETL tools, and cloud-based data platforms is plus The strategic competencies: Data architecture mastery: Design and optimize data models to support scalable ingestion and integration of healthcare claims data Schema translation expertise: Translate complex or varying carrier-specific schemas into normalized structures aligned with enterprise data standards Cross-functional collaboration: Work effectively with carriers and internal departments to ensure claims data is structured for downstream applications Industry standards knowledge: Knowledge of industry standard specifications such as FHIR, HL7, and EDI preferred The professional qualities: Excellent communication and project management skills Self-motivated with critical thinking and problem-solving abilities Strong understanding of data governance, master data management (MDM), and data quality frameworks preferred Proven ability to bridge technical and business domains to deliver data-driven solutions Experience with claims data reconciliation and migration projects preferred Experience working in or with analytics-focused organizations, data consultancies, or enterprise data platforms preferred Why You'll Love It Here We believe in total rewards that actually matter-not just competitive packages, but benefits that support how you want to live and work. Your wellbeing comes first: Comprehensive medical and dental coverage through our own health solutions (yes, we use what we build!) Mental health support and wellness programs designed by experts who get it Flexible work arrangements that fit your life, not the other way around Financial security that makes sense: Retirement planning support to help you build real wealth for the future Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage Growth without limits: Professional development opportunities and clear career progression paths Mentorship from industry leaders who want to see you succeed Learning budget to invest in skills that matter to your future A culture that energizes: People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable The practical stuff: Competitive base salary plus that rewards your success Unlimited PTO policy because rest and recharge time is non-negotiable Benefits effective day one-because you shouldn't have to wait to be taken care of Ready to create a healthier world? We're ready for you. No candidate will meet every single qualification listed. If your experience looks different but you think you can bring value to this role, we'd love to learn more about you. Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice. In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $68,000 to $85,000. Note that compensation may vary based on location, skills, and experience. This position is eligible for 10% target bonus/variable compensation as well as health, dental, vision, mental health and other benefits. We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing. #WeAreHiring #PersonifyHealth Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to **************************. All of our legitimate openings can be found on the Personify Health Career Site.

This role ensures timely and accurate processing of claims, supports internal and external audits, and contributes to operational efficiency. The Sr. Associate works cross-functionally to resolve issues and maintain high standards of data integrity and client service. BA/BS degree in business administration with an emphasis in accounting/finance or equivalent work experience Advanced degree or industry certification preferred 3 years of experience in life claims administration and adjudication Understanding of claim treaty provisions, adjudication thresholds, and regulatory compliance. Strong analytical and decision-making skills with attention to detail and accuracy. Strong problem-solving skills and the ability to navigate and resolve complex issues. Strong analytical and organizational skills. Proficiency in claims systems and reporting tools. Ability to work independently and collaboratively across teams. Excellent communication and problem-solving skills. Pay Range for roles performed in NC: $72,000-$88,000 base salary per year. Actual salaries may vary based on various factors including but not limited to location, experience, role and performance. The range listed is just one component of SCOR's total compensation package for employees. Other rewards may include annual bonuses, short- and long-term incentives. In addition, we provide a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement saving plan, paid holidays and paid time off. Perform adjudication of life claims for assigned clients, including standard and contestable cases. Review claim documentation such as death certificates, claimant statements, and policy records to verify eligibility. Assess claim validity based on treaty terms, policy provisions, and underwriting guidelines. Assist with performance of client adjudication audits for assigned clients to ensure compliance with treaty terms and adjudication standards. Serve as liaison to clients for claim-related inquiries Review and approve claims in accordance with claim payment approval hierarchy. Review, enhance, and sign settlements to ensure timely client payments Process claim refunds appropriately and timely. Monitor workflow and identify potential claims processing issues. Work cross-functionally to resolve system impediments to claim payment processing. Identify opportunities for improvement and contribute to process enhancements. Assist with internal and external audits and ensure all ICS controls are properly documented. Establish requirements for system enhancements and log tickets for tracking, testing, and implementation. Creation and maintenance of reports allowing for analysis of claim workflow and data fields to ensure accuracy of claim data. Analyze client trending data to understand financial results and identify potential future impact. Produce ad-hoc reports and claims metrics for management and other stakeholders. Perform monthly and quarterly reporting requirements for performance measurement and to meet quarter end deliverables. May perform other duties as required.

Are you looking for an opportunity to join a claims team with a fast-growing company that has consistently outpaced the industry in year over year growth? Liberty Mutual has an excellent claims opportunity available. As a Commercial Insurance Claims Representative, you will review and process simple and straightforward Commercial claims within assigned authority limits consistent with policy and legal requirements. In addition to a wide range of benefits, as a direct employee, your insurance education and training are paid by Liberty Mutual. The preference is for the candidates to be located close to a hub and be in the office a minimum of 2 days/week (Hubs: Plano, TX, Suwanee, GA, Westborough, MA, Hoffman Estates, IL, Indianapolis, IN and Eugene. OR, and Phoenix, AZ) although candidates from any location will be considered. Please note this policy is subject to change. Responsibilities: Investigates claim using internal and external resources including speaking with the insured or other involved parties, analysis of reports, researching past claim activity, utilizing evaluation tools to make damage and loss assessments. Extensive and timely direct interaction with Insured's, Claimants, Agent's and Internal Customers. Determines policy coverage through analysis of investigation data and policy terms. Notifies agent and insured of coverage or any issues. Establishes claim reserve requirements and makes adjustments, as necessary, during the processing of the claims. Determines and negotiates settlement amount for damages claimed within assigned authority limits. Writes simple to moderately complex property damage estimates or review auto damage estimates. Takes statements when necessary and works with the Field Appraisal, Subrogation, Special Investigative Unit (SIU) as appropriate. Maintains accurate and current claim file/damage documentation and diaries throughout the life cycle of claim cases to ensure proper tracking and handling consistent with established guidelines and expectations. Alerts Unit Leader to the possibility of fraud or subrogation potential for claims being processed. Qualifications Bachelor's Degree preferred. High school diploma or equivalent required. 1-2 years of experience. Claims handling skills preferred. Strong customer service and technology skills. Able to navigate multiple systems, strong organizational and communication skills. License may be required in multiple states by state law. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

Oak View Group Oak View Group is the global leader in venue development, management, and premium hospitality services for the live event industry. Offering an unmatched, 360-degree solution set for a collection of world-class owned venues and a client roster that includes the most influential, highest attended arenas, convention centers, music festivals, performing arts centers, and cultural institutions on the planet. Overview Working in conjunction with the VP, Risk Management: The Claims Director position has a responsibility to manage the day-to-day and long-term operations of the OVG Corporate International Insurance Claims Department. This role pays an annual salary of $115,000-$140,000 and is bonus eligible Benefits for Full-Time roles: Health, Dental and Vision Insurance, 401(k) Savings Plan, 401(k) matching, and Paid Time Off (vacation days, sick days, and 11 holidays) This position will remain open until January 9, 2026. Responsibilities Manages, plans, and coordinates insurance claims process to control risks and losses. Duties & Responsibilities Team leadership: Guide and manage a team to achieve high-level claims operations, claims vendors, TPA's Policy and claims procedures establishment: Create and maintain policies and procedures for the management of claims occurring across the organization that are consistent with the corporate claims strategy and loss control. Claims management: Oversee the claims process, including coverage reviews, claim verification, and adjudication. Manage the administration of general liability, errors & omissions, property, workers' compensation, cyber and vehicle claims to ensure that claims are being settled fairly, consistently, and in the best interest of the company. Collaboration: Work collaboratively with insurance brokers, carriers and project teams to ensure overall compliance with the company's Risk Management goals, policies and procedures. Financial Management: Timely, accurate payment and adjudication of claims Process improvement: Set up a process of continuous improvement. Develop and implement processes to increase the efficiency and effectiveness of the claims department. Customer service: Ensure that internal and external customers receive excellent service Claims representation: Represent the department and company Claims advice: Provide professional advice to customers, senior management, and departments on all aspects of the claim management and reporting Risk management: Assist with the development of the organization's risk management process. Identification of new opportunities for lowering the total cost of risk. Communication: Articulate complex concepts and issues through oral and written communications and consult with senior management in establishing corporate policies and procedures to manage and control corporate claims risks. Other duties as assigned. Qualifications Candidate Requirements: 10+ years of P&C claims management experience with a claims department, insurance carrier or TPA Extensive knowledge of commercial insurance claim operations and insurance coverage. Bachelor's degree in insurance, Accounting, Business Administration or equivalent. Strong PC skills (MS Office Suite). Knowledge of risk management practices, policies and programs. Excellent written communication, negotiation and presentation skills. Ability to relate well to others both inside and outside the organization and build effective business relationships. Demonstrated analytical ability, leadership and problem-solving skills. Strong written verbal communication skills. Ability to exercise sound judgement and work independently and in a team environment Ability to lead projects and process design and lead and direct the work of others. Must demonstrate consistency, accuracy and follow through. Must demonstrate a customer service mindset Ability to work under tight time constraints, handle sensitive data and multi-task so that deadlines can be met. Highly organized and able to prioritize and manage time efficiently with the ability to handle stress in a fast-paced, deadline driven environment. Empathetic, resilient, ability to flourish in a fast-paced environment Any of the following certifications are a plus: CCP, CPCU, RPLU, ARM, CISR, AU, PMP Claims management experience on all commercial lines of insurance a plus International claims experience a plus Strengthened by our Differences. United to Make a Difference At OVG, we understand that to continue positively disrupting the sports and live entertainment industry, we need a diverse team to help us do it. We also believe that inclusivity drives innovation, strengthens our people, improves our service, and raises our excellence. Our success is rooted in creating environments that reflect and celebrate the diverse communities in which we operate and serve, and this is the reason we are committed to amplifying voices from all different backgrounds. Equal Opportunity Employer Oak View Group is committed to equal employment opportunity. We will not discriminate against employees or applicants for employment on any legally recognized basis (“protected class”) including, but not limited to veteran status, uniform service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other protected class under federal, state, or local law.

Scheduled Hours 40 Analyzes and evaluates complex incident reports and lawsuits, reviews medical records and interviews involved individuals to obtain needed information. Prepares complex investigative analytical reports for Director and Legal Counsel regarding potentially compensable incidents covered by the Self-Insured Professional Liability Program, and other reports as requested by Senior Management. Coordinates case development, case management, and participates in office management. Job Description Primary Duties & Responsibilities: * Conducts internal claims investigations, plans defense strategies and negotiates disposition of assigned files with guidance of legal counsel. Conducts meetings with physicians, analyzes medical record information and event reports; directs approved legal counsel and other legal personnel involved in the defense; evaluates liability and financial exposure, approves expert witness reviews; responds to discovery requests and answers interrogatories; coordinates witness preparations; makes recommendations for resolution of claim; and coordinates meetings with Director, defense counsel and Office of General Counsel to perform decision tree analysis to determine case value. Attends mediation, arbitration, and/or trial. * Prepares and submits required reports to Department Heads, Office of General Counsel, Director of Risk Management, excess insurance carriers, and when applicable, coordinates with external agency investigations, i.e., professional Board inquiries. Responds to general claim inquiries. * Establishes indemnity and expense reserves based on the reserving policy. Negotiates settlements within authority. Reviews and approves defense counsel related invoices and expenses. * Provides consultation and guidance on healthcare issues such as medical record release, subpoena responses, termination/transfer of care, patient complaints, and physician billing issues including accounts in litigation. Arrange for attorneys to attend depositions with physicians when necessary. Mentors less experienced claims managers. * Performs other duties as assigned. Working Conditions: Job Location/Working Conditions * Normal office environment Physical Effort * Typically sitting at a desk or a table Equipment * Office equipment The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time. Required Qualifications Education: Bachelor's degree Certifications/Professional Licenses: No specific certification/professional license is required for this position. Work Experience: Analyzing Or Interpreting Medical Or Other Technical Evidence That Compares In Level Of Complexity To Medical Treatment (5 Years) Skills: Not Applicable Driver's License: A driver's license is not required for this position. More About This Job Preferred Qualifications: * Analytical ability to evaluate facts and formulate questions in order to define problems and critical events in the medical care rendered. * General knowledge of The Joint Commission and patient safety standards, diagnosis and treatment of human disease and injury, medical therapies, procedures and standard of medical care. * Knowledge of methods and techniques of individual case study, recording and file maintenance. * Seven years' experience in medical malpractice claims management. Preferred Qualifications Education: No additional education unless stated elsewhere in the job posting. Certifications/Professional Licenses: No additional certification/professional licenses unless stated elsewhere in the job posting. Work Experience: No additional work experience unless stated elsewhere in the job posting. Skills: Analytical Thinking, Defining Problems, Detail-Oriented, Disease Diagnosis, Disease Management, Group Presentations, Injury Treatment, Joint Commission Regulations, Organizational Savvy, Patient Safety, Report Preparation Grade G13 Salary Range $65,900.00 - $112,700.00 / Annually The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget. Questions For frequently asked questions about the application process, please refer to our External Applicant FAQ. Accommodation If you are unable to use our online application system and would like an accommodation, please email **************************** or call the dedicated accommodation inquiry number at ************ and leave a voicemail with the nature of your request. All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship. Pre-Employment Screening All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening. Benefits Statement Personal * Up to 22 days of vacation, 10 recognized holidays, and sick time. * Competitive health insurance packages with priority appointments and lower copays/coinsurance. * Take advantage of our free Metro transit U-Pass for eligible employees. * WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%. Wellness * Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more! Family * We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We've got you covered. * WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us. For policies, detailed benefits, and eligibility, please visit: ****************************** EEO Statement Washington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the University's policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information. Washington University is dedicated to building a community of individuals who are committed to contributing to an inclusive environment - fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply.

Claims Manager (Professional Liability) Counterpart is an insurtech platform reimagining management and professional liability for the modern workplace. We believe that when businesses lead with clarity and confidence, they become more resilient, more innovative, and better prepared for what's ahead. That's why we built the first Agentic Insurance™ system - where advanced AI and deep insurance expertise come together to proactively assess, mitigate, and manage risk. Backed by A-rated carriers and trusted by brokers nationwide, our platform helps small businesses grow with confidence. Join us in shaping a smarter future, helping businesses Do More With Less Risk . As a Claims Manager (Professional Liability), you will be responsible for managing a large and diverse caseload of professional liability claims. In this role, you will apply and further develop your expertise by investigating, evaluating, and resolving claims in a way that reinforces our brand and values. You will also play a vital part in supporting the advancement of our systems and processes through ongoing feedback and collaboration with internal partners. In addition, you will be a key feedback provider for our active claims management processes and systems. Your input will help to shape and improve how we fulfill our mission of providing world-class service through tightly managing legal costs, making data-driven decisions when analyzing a claim's value, and ensuring that other potentially responsible parties pay their fair share. YOU WILL Achieve or exceed claims management case load and goals, applying sound judgment and legal knowledge to produce efficient and fair outcomes. Complete accurate and timely investigations into the coverage, liability, and damages for each claim assigned to you. Actively manage each claim assigned to you in a way that produces the most timely and cost-effective resolution. Build and maintain positive and productive working relationships with internal and external customers, including policyholders, brokers, carrier partners, and Risk Engineers (underwriters). Direct and monitor assignments to experts and outside counsel, and hold those vendors accountable for meeting or exceeding our service standards. Support our data collection efforts and models by effectively using our Agentic Claim Experience (ACE) system to fully and accurately capture critical details about each claim assigned to you. Identify and escalate insights into emerging claims trends across industries, geographies, and key business segments. Offer user-level feedback and insights to support the continuous improvement of our claim handling processes, guidelines, and systems. Ensure that every touchpoint with our insureds and brokers is representative of our brand, mission, and vision. YOU HAVE At least 10 years of professional experience, with at least 5 years of experience litigating or managing professional liability claims. Previous carrier experience is a plus. Bachelor's degree required; law degree (J.D.) and professional designations (RPLU, AIC, etc.) highly preferred. Must possess all required state claim adjuster licenses, or be able to obtain them within 90 days of hire. Proven ability to work both independently on complex matters and collaboratively as a team player to assist others as needed. High level of personal initiative and leadership skills. Exceptional time management, problem solving and organizational skills. Comfort and skill operating in a paperless claims environment. Familiarity with Google Workplace is preferred, but not required. Willingness to quickly adapt to change and use creative thinking and data-driven insights to overcome obstacles to resolution. Strong communication skills, both verbal and written. Ability to succeed in a full remote workplace environment, and travel as necessary (approximately 10-15%). WHO YOU WILL WORK WITH Eric Marler, Head of Claims: An industry veteran, Eric has more than 20 years of experience working with or for insurers offering management liability solutions. He is a licensed attorney who began his career in private practice before transitioning in-house. Prior to joining Counterpart, Eric held leadership roles at Great American Insurance Group and The Hanover Insurance Group. Jaclyn Vogt, Senior Claims Manager: Jaclyn is a licensed adjuster with over 15 years of experience handling Employment Practices Liability, Management Liability and Workers Compensation claims. Jaclyn received her bachelor's degree from Centre College. Katherine Dowling, Claims Manager: Katherine is a licensed attorney, mediator and adjuster with over a decade of experience handling professional liability and management liability litigation and claims. Katherine practiced law for several years with two of Atlanta's largest insurance defense firms prior to joining a wholesale specialty insurance carrier where she managed complex Professional Liability and Commercial General Liability claims. WHAT WE OFFER Stock Options: Every employee is able to participate in the value that they create at Counterpart through our employee stock option plan. Health, Dental, and Vision Coverage: We care about your health and that of your loved ones. We cover up to 100% of your monthly contributions for health, dental, and vision insurance and up to 80% coverage for family members. 401(k) Retirement Plan: We value your financial health and offer a 401(k) option to help you save for retirement. Parental Leave: Birthing parents may take up to 12 weeks of parental leave at 100% of their regular pay following the birth of the employee's child, and can choose to take an additional 4 unpaid weeks. Non-birthing parents will receive 8 weeks of parental leave at 100% of their regular pay. Unlimited Vacation: We offer flexible time off, allowing you to take time when you need it. Work from Anywhere: Counterpart is a fully distributed company, meaning there is no office. We allow employees to work from wherever they do their best work, and invite the team to meet in person a couple times per year. Home Office Allowance: As a new employee, you will receive a $300 allowance to set up your home office with the necessary equipment and accessories. Wellness stipend: $100 per month to spend toward an item or service that supports your wellness (i.e. massage or gym membership, meditation app subscription, etc.) Book stipend: To support your intellectual development, we offer a book stipend that allows you to purchase books, e-books, or educational materials relevant to your role or professional interests. Professional Development Reimbursement: We provide up to $500 annually for you to invest in relevant courses, workshops, conferences, or certifications that will enhance your skills and expertise. No working birthdays: Take your birthday off, giving you the opportunity to relax, enjoy your special day, and spend time with loved ones. Charitable Contribution Matching: For every charitable donation you make, we will match it dollar for dollar, up to a maximum of $150 per year. This allows you to amplify your charitable efforts and support causes close to your heart. COUNTERPART'S VALUES Conjoin Expectations - it is the cornerstone of autonomy. Ensure you are aware of what is expected of you and clearly articulate what you expect of others. Speak Boldly & Honestly - the only failure is not learning from mistakes. Don't cheat yourself and your colleagues of the feedback needed when expectations aren't being met. Be Entrepreneurial - control your own destiny. Embrace action over perfection while navigating any obstacles that stand in the way of your ultimate goal. Practice Omotenashi (“selfless hospitality”) - trust will follow. Consider every interaction with internal and external partners an opportunity to develop trust by going above and beyond what is expected. Hold Nothing As Sacred - create routines but modify them routinely. Take the time to reflect on where the business is today, where it needs to go, and what you have to change in order to get there. Prioritize Wellness - some things should never be sacrificed. We create an environment that stretches everyone to grow and improve, which is fulfilling, but is only one part of a meaningful life. Our estimated pay range for this role is $150,000 to $180,000. Base salary is determined by a variety of factors, including but not limited to, market data, location, internal equitability, and experience. We are committed to being a welcoming and inclusive workplace for everyone, and we are intentional about making sure people feel respected, supported and connected at work-regardless of who you are or where you come from. We value and celebrate our differences and we believe being open about who we are allows us to do the best work of our lives. We are an Equal Opportunity Employer. We do not discriminate against qualified applicants or employees on the basis of race, color, religion, gender identity, sex, sexual preference, sexual identity, pregnancy, national origin, ancestry, citizenship, age, marital status, physical disability, mental disability, medical condition, military status, or any other characteristic protected by federal, state, or local law, rule, or regulation.

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. Build Your Career With Purpose at CCMSI At CCMSI, we don't just adjust claims-we support people. As one of the nation's largest employee-owned Third Party Administrators and a certified Great Place to Work , we empower our employee-owners with manageable caseloads, meaningful work, and opportunities to grow. When you join us, you join a team that values collaboration, client care, and long-term career development. 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 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. 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. Performance Metrics Your success in this role is measured by: Quality and accuracy of claim handling. Meeting deadlines and maintaining current diary/workflows. Consistent adherence to best practice standards. Ability to collaborate and communicate effectively with clients, team members, and claim stakeholders. What We Offer Employee Ownership: As an Employee-Owned Company (ESOP), every employee has a stake in our success. Time Off: 4 weeks of paid time off in your first year, plus 10 paid holidays. Comprehensive Benefits: Medical, Dental, Vision, Life, Short- and Long-Term Disability, Critical Illness, and 401(k). Career Growth: Robust internal training and professional development opportunities. Supportive Culture: We believe in manageable caseloads, collaboration, and maintaining a healthy work-life balance. 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: • Act with integrity • Deliver service with passion and accountability • Embrace collaboration and change • Seek better ways to serve • Build up others through respect, trust, and communication • Lead by example-no matter their title 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.

The Workers Comp Legal Claims department is looking for a Worker's Compensation Subrogation Representative I. Reporting to the Supervisor, Workers' Compensation Legal Subrogation, the Worker's Compensation Subrogation Representative is responsible for the daily management and resolution of Workers' Compensation Subrogation Claims in New Jersey. Leveraging technical expertise, the Worker's Compensation Subrogation Representative will be tasked with efficient handling of negotiations and resolution of Workers' Compensation liens while collaborating with other departments and policyholders to proactively share knowledge and expertise. Demonstrate flexibility and pursue challenging tasks. Schedule: Monday through Friday, with work from home opportunities after training is complete. Specific hours are subject to selected start time between 8am-9am pending supervisory approval Essential Duties and Responsibilities: Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and predictable onsite attendance is an essential function of the job. Manage the negotiation and resolution of New Jersey Workers' Compensation liens; Interface with internal and external stakeholders, including policyholders, attorneys and insurance carriers; Produce lien correspondences, review of policy and litigation documents relative to third party actions, ensure quality claim documentation; Evaluate New Jersey Workers' Compensation claims and identify subrogation potential; Assist in onboarding and training of subrogation team members; Support Workers' Compensation Claims as needed Required Qualifications: Knowledge, skills & abilities, experience, minimum & desired education, certification and/or license requirements. Experience in Workers' Compensation Claims; Demonstrated skills in MS Word, Excel and other applications; Ability to accurately organize and examine legal and claims documents; Strong verbal and written communication skills with strong attention to detail and customer service; Strong organizational skills with the ability to manage competing priorities; Ability to work independently and collaboratively; Must have the ability to prioritize and proactively manage a large case load; Preferred Qualifications: Workers' Compensation claims or legal experience preferred; Subrogation experience preferred Compensation: Salary is commensurate with experience and credentials. Pay Range: $49,871-$57,881 Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses. Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.

Follow up on insurance denials and aged claims, submit claims to secondary payers, and ensure accurate billing information is submitted. Answer all information requests from those payers, and trace all claims to those payers making sure they have been paid or denied appropriately in a timely manner. Re-submit claims to government agencies, medical service bureaus, and insurance companies. Submit claims appeals with supporting documentation as necessary and resolve aged insurance balances. Act as resource for billing office staff. Providence caregivers are not simply valued - they're invaluable. Join our team at Swedish Health Services DBA Swedish Medical Group and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: + 2 years medical (or healthcare) insurance follow up experience. Why Join Providence Swedish? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our mission of improving the health and wellbeing of each patient we serve. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Providence Swedish is the largest not-for-profit health care system in the greater Puget Sound area. It is comprised of eight hospital campuses (Ballard, Edmonds, Everett, Centralia, Cherry Hill (Seattle), First Hill (Seattle), Issaquah and Olympia); emergency rooms and specialty centers in Redmond (East King County) and the Mill Creek area in Everett; and Providence Swedish Medical Group, a network of 190+ primary care and specialty care locations throughout the Puget Sound. Whether through physician clinics, education, research and innovation or other outreach, we're dedicated to improving the wellbeing of rural and urban communities by expanding access to quality health care for all. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), please click here where you can access an email link to submit your concern. Requsition ID: 395637 Company: Swedish Jobs Job Category: Claims Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Admin Support Department: 3908 PHYSICIANS BILLING WA Address: WA Seattle 1730 Minor Ave Work Location: Swedish Metropolitan Park East-Seattle Workplace Type: Remote Pay Range: $26.30 - $40.25 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Job Description Casualty Claims Representative Harrison Gray Search has been engaged by a mission-driven insurance organization to identify a skilled Claims Representative to join their team in East Lansing, MI. This is a meaningful opportunity to work with a trusted organization that protects Michigan public schools. As a Casualty Claims Representative, you'll handle the full lifecycle of general and professional liability claims-investigating, evaluating, and resolving cases while working closely with school districts and legal partners. Why You'll Want This Role: Purposeful Work: Help safeguard Michigan public schools and support their staff through claims resolution. Top-Tier Benefits: 100% employer-paid medical, dental, and vision, generous PTO, and paid parental leave. Respected Workplace: Recognized as one of Business Insurance's Best Places to Work. What You'll Do: Manage and resolve assigned casualty claims, including investigation, analysis, negotiation, and settlement. Monitor and collaborate with external investigators, attorneys, and medical/legal vendors. Evaluate liability, coverage, and damages; set and adjust reserves accordingly. Represent the organization in mediations, facilitate strategy sessions, and document case activity thoroughly. Ensure timely movement of claims via an internal diary system and claim handling standards. What You Bring: Bachelor's degree plus 2+ years handling general liability and professional liability claims (or equivalent experience). Strong knowledge of complex claims handling, coverage analysis, and liability assessment. Skilled communicator with high emotional intelligence and professionalism. Comfortable working in a fast-paced, collaborative environment with school district representatives, legal professionals, and internal teams. Willingness to travel occasionally and work remotely as needed. If you're looking for meaningful claims work that supports the greater good-and you're ready to join a high-performing, purpose-driven team - apply today!

":"* This is a full-time, remote position working from 9:45am to 6:15pm CST American Guardian Warranty Services, Inc. (AGWS), an affiliate of Reynolds and Reynolds, is seeking Claims Adjuster - Automotive for our growing team. In this role you will work remotely and be responsible for investigating, evaluating and negotiating minor to complex vehicle repair costs to accurately determine coverage and liability. You will take inbound calls to determine coverage based on contracts in order to appropriately resolve customer issues. Responsibilities will include, but are not limited to: -\tAnswering inbound calls -\tProvide information about claim processing and explain the different levels of contract coverage and terms -\tAccurately establish, review and authorize claims -\tEntering claim and contract information into the AGWS' system A home office package will be provided for this position. This includes two computer monitors, a laptop, keyboard and mouse. ","job_category":"Customer Service","job_state":"TX","job_title":"Remote - Claims Adjuster - Automotive","date":"2025-11-18","zip":"75201","position_type":"Full-Time","salary_max":"55,000. 00","salary_min":"50,000. 00","requirements":"2+ years of experience as an automotive mechanic within a service department, dealership, or independent shop~^~2+ years of experience adjusting automobile mechanical claims~^~ASE certification is a plus~^~Must have a quiet designated work space to work from home~^~Must have reliable internet with at least a download speed of 50mbps~^~Must be able to work effectively under pressure in a fast paced environment~^~Strong communication skills~^~Strong organizational and multi-tasking skills~^~High school diploma","training":"On the job","benefits":"We strive to offer an environment that provides our associates with the right balance between work and family. We offer a comprehensive benefits package including: - Medical, dental, vision, life insurance, and a health savings account - 401(k) with up to 6% matching - Professional development and training - Promotion from within - Paid vacation and sick days - Eight paid holidays - Referral bonuses Reynolds and Reynolds promotes a healthy lifestyle by providing a non-smoking environment. Reynolds and Reynolds is an equal opportunity employer. ","

Job DescriptionTitle: Casualty Claims Representative Reports To: Claims Manager Department: Property/Casualty and Workers' Compensation (PC/WC) SET SEG is looking for a Casualty Claims Representative who will be responsible for the investigation, negotiation, adjustment, and resolution of designated PC claims. This position reports to the Claims Manager. WHO WE ARE School Employers Trust (SET) is a non-profit company that was created after a monumental shift in school funding happened in 1965. SET, which began in 1971, served as an employee benefits association focused on offering comprehensive and affordable employee benefit solutions to Michigan public schools and their employees. Two years later, its partner organization School Employers Group (SEG) was formed to administer compensation and fringe benefits for SET. As schools were faced with more challenges related to insurance, SEG evolved and grew into a company that provides workers' compensation and property/casualty services for Michigan public schools. Today, SET SEG continues to expand and find creative ways to meet the specialized needs of its members. This, coupled with a superior member experience, is why SET SEG has maintained its position as an industry leader in the school insurance market. We value those who proactively solve challenges, simplify the complex, thrive in a fast-paced setting, have a customer-first mentality, and seek a collaborative and inclusive work environment. We are also listed on the Business Insurance Best Places to Work. We offer 100% employer paid insurance (medical, dental, and vision), Paid Time off (PTO), and paid parental leave. Our passion is delivering peace of mind to Michigan public schools and we look for team members who are motivated by our cause. To learn more, visit: ******************* WHO YOU ARE You are energized by working with a collaborative team and industry peers to support Michigan public schools through their challenges. You seek understanding and are motivated to tackle projects and problems with the customer in mind. You anticipate needs and preempt challenges and concerns, delivering increasingly relevant customer experiences over time. You value a culture that is rooted in mutual respect, where you can learn from different perspectives and roles. Primary Responsibilities: Manages, investigates, evaluates, negotiates, and adjusts assigned claims in adherence to guidelines within authority Ensures adequacy of reserves and recommends reserve increases on cases in excess of authority Monitors outside investigators and performs outside investigations when assigned. Provides oversight of medical, legal damage estimates, and miscellaneous invoices to determine if they are reasonable and related to designated claims Negotiates any disputed bills or invoices for resolution Assigns litigated claims to approved law firms and/or individual attorneys and monitors progress Follows a uniform system of reserving by reviewing incoming litigation, establishing initial reserves and completing reserve reports Negotiates settlements in accordance with claim handling standards while also considering member preferences when appropriate Attends facilitations/mediations as assigned Manages diary system to move losses to conclusion in a timely manner Participates in strategy sessions with internal business units such as Underwriting and Loss Control Other duties as assigned by the Claims Manager Required Qualifications: Bachelor's Degree plus two years of experience adjusting general liability and professional liability claims or an equivalent combination of education and experience Must have knowledge of coverage, liability, and complex claims handling procedures Ability to handle complex case-related tasks in a fast-paced and changing environment Excellent interpersonal skills and the ability to work in a strong team environment Must be highly organized and detail oriented Must be dependable, reliable, and able to achieve high levels of professionalism when handling cases and interacting with school district representatives and their employees, attorneys, families of injured and fellow employees Must be able to create and maintain high levels of confidentiality when dealing with proprietary information and sensitive situations Must have strong cognitive and analytical skills Ability to initiate, receive, understand, and reply to written and oral communication (verbal, written, telephone, e-mail, etc.) Ability to travel and work remotely on a periodic basis Physical Demands / Work Environment Several hours per day at a sit/stand desk, average mobility to move around an office environment; able to spend several hours per day at a computer. Occasional in-state travel may be required. Punctual, regular, and consistent attendance is required. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Powered by JazzHR 6mnEbh2mom

If you're excited about this role but don't meet every qualification, we still encourage you to apply! At Grange, we value growth and are committed to supporting continuous learning and skill development as you advance in your career with us. Summary: In this role you will be responsible for investigating, evaluating and negotiating settlement of assigned Commercial General Liability Property Damage claims in accordance with best practices to promote retention or purchase of insurance from Grange Enterprise. What You'll Be Doing: Pursuant to line of business strategies and good faith claim settlement practices, investigates, evaluates, negotiates, and resolves (within authorized limits) assigned claims. Demonstrates technical proficiency, allowing for the handling of more complex claims with minimal supervision. Establishes and maintains positive relationships with both internal and external customers, providing excellent customer service. Assists in building business partner relationships with agents, insureds and Commercial Lines through regular and effective communications. May include face-to-face as needed. Will be the “point person” (when required) for certain identified large customer accounts where specialized communication and handling are required. Establishes and maintains proper reserving through proactive investigation and ongoing review. Assist other departments (when required) with investigations. May be assigned general liability claims during high volume workload periods. Demonstrates effectiveness and efficiencies in managing diary system and handling workload with limited supervision or direction. What You'll Bring To The Company: High school diploma or equivalent education plus five (5) years of claims experience. Bachelor's degree preferred. For property focused role, at least two (2) years handling commercial general liability property claims handling exposures or frontline property claims handling experience preferred. Preference to those candidates with Construction Defect experience. Must possess strong communication and organization skills, critical thinking competencies and be proficient with personal computer. Demonstrated ability to interact with customers and agents in a professional manner. State specific adjusters' license may be required. About Us: Grange Insurance Company, with $3.2 billion in assets and more than $1.5 billion in annual revenue, is an insurance provider founded in 1935 and based in Columbus, Ohio. Through its network of independent agents, Grange offers auto, home and business insurance protection. Grange Insurance Company and its affiliates serve policyholders in Georgia, Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and Wisconsin and holds an A.M. Best rating of "A" (Excellent). Grange understands that life requires flexibility. We promote geographical diversity, allowing hybrid and remote options and flexibility in work hours (role dependent). In addition to competitive traditional benefits, Grange has also created unique benefits based on employee feedback, including a cultural appreciation holiday, family formation benefits, compassionate care leave, and expanded categories of bereavement leave. Who We Are: We are committed to an inclusive work environment that welcomes and values diversity, equity and inclusion. We hire great talent from various backgrounds, and our associates are our biggest strength. We seek individuals that represent the diversity of our communities, including those of all abilities. A diverse workforce's collective ideas, opinions and creativity are necessary to deliver the innovative solutions and service our agency partners and customers need. Our core values: Be One Team, Deliver Excellence, Communicate Openly, Do the Right Thing, and Solve Creatively for Tomorrow. Our Associate Resource Groups help us create a more diverse and inclusive mindset and workplace. They also offer professional and personal growth opportunities. These voluntary groups are open to all associates and have formed to celebrate similarities of ethnicity/race, nationality, generation, gender identity, and sexual orientation and include Multicultural Professional Network, Pride Partnership & Allies, Women's Group, and Young Professionals. Our Inclusive Culture Council, created in 2016, is focused on professional development, networking, business value and community outreach, all of which encourage and facilitate an environment that fosters learning, innovation, and growth. Together, we use our individual experiences to learn from one another and grow as professionals and as people.  We are committed to maintaining a discrimination-free workplace in all aspects, terms and conditions of employment and welcome the unique contributions that you bring from education, opinions, culture, beliefs, race, color, religion, age, sex, national origin, handicap, disability, sexual orientation, gender identity or expression, ancestry, pregnancy, veteran status, and citizenship.

Company Details Berkley Small Business Solutions (BSB) is committed to providing small business customers with the next generation of small business solutions, including offering operational, underwriting, and marketing opportunities. We offer insurance products to Small Business Owners for transportation and other main street businesses. We leverage underwriting expertise, data, and analytics, and automation for risk assessment, selection, pricing retention. We champion our customers, distribution always seeking a smarter way to provide a more efficient and better user experience. We are a proud member of W. R. Berkley Corporation, one of the largest commercial lines property casualty insurance holding companies in the United States. With the resources of a large Fortune 500 corporation and the flexibility of a small company, we exclusively work with select independent agents to bring technology solutions that help them build their business. Responsibilities The position is responsible for handling low-complexity claims involving physical damage, property damage, total loss, fuel spills, medical payments, and cargo damage resulting from commercial auto claims. This position will work closely with insureds and stakeholders to ensure timely and accurate claims resolution and provide exceptional customer service. Customer Service Act with urgency in establishing initial and subsequent contact with all parties and key stakeholders. Update appropriate parties as needed, providing new facts as they become available and explaining impact of those facts upon the liability analysis and settlement options. Collaborate with vendors to ensure timely appraisal and evaluation of damages. Coverage Analyze coverage by applying policy information to facts or allegations of each loss. Communicate coverage decisions to insured and stakeholders and update coverage analysis as new facts warrant it. Ensure compliance with jurisdictional requirements, including timeliness of communicating coverage disposition. Data Integrity Maintain discipline in securing and updating information throughout the life of the claim. Ensure data is complete and comply with statutory requirements for reporting. Reserving Establish and maintain appropriate initial, subsequent loss, and expense reserves. Ensure supporting rationale for each reserve is documented within the electronic claim file. Act with urgency in collaborating with internal stakeholders regarding significant changes within claim reserving. Investigation Directly investigate each claim through prompt and strategic contact with appropriate parties including policyholders, witnesses, claimants, law enforcement agencies, agents, medical providers, and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders. Take recorded and/or written statements when appropriate. Evaluate all claims for recovery potential. Directly handle recovery efforts and/or engage and direct Company resources for recovery efforts. Evaluation and Resolution Utilize diary management system to ensure all claims are handled timely and in compliance with jurisdictional requirements and Company guidelines. Collaborate with external vendors, e.g., appraisers and independent adjusters. Manage total loss claims process including vehicle appraisal procedures, diminished value, vendor networks, subrogation demands, salvage procedures and heavy equipment appraisals. May perform other functions as assigned. Remote work arrangements may be considered for qualified candidates who are open to travel as needed. Qualifications 1+ years of casualty claim handling experience; trucking experience preferred. Excellent interpersonal and communication skills. Strong problem-solving and organizational skills. Computer proficiency, including working knowledge of Microsoft Office products. Previous experience in customer service role, or a related field, is preferred but not required. Willingness to learn and expand knowledge. Position will require that Claims Representative obtain independent adjuster's licenses for all states that have requirement, including but not limited to: AL, CT, GA, FL, ME, MS, NY, NC, SC, TN, TX. Licenses must be obtained within 90 days of hire and require course work, testing, and background checks that may include fingerprinting Education College degree preferred or equivalent work experience. Additional Company Details **************************** The Company is an equal employment opportunity employer We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. • Salary Range: 75k - 90k • Eligible for annual discretionary bonus • Benefits: Health, Dental, Annual Bonus Potential, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Requirements 2+ years handling property insurance claims required Candidate must have an active Xactimate account Can handle partial and full assignments Commercial and personal lines experience preferred A qualified candidate must have their own transportation, equipment and software Good writing and technology skills

A dynamic organization supplying quality claims outsource solutions to insurance carriers, countrywide is seeking multi-line adjusters in your area. There are many competing vendors in our marketplace, but we are not your typical “vendor”. Our company was built by insurance company claims executives to support insurance companies' claim operations to help them meet their organizations goal of providing quality claims solutions at a reasonable cost. We excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Position Summary: A national independent insurance adjusting firm has immediate openings for Multi-Line Claims adjusters that possess the ability to work remotely and have the experience to handle both property and liability claims. The candidate must possess the ability to adjust commercial and residential property losses and must also have a working knowledge of how to determine negligence and assess damages. The candidate should be able to perform all tasks with modest supervision. The candidate must possess the ability to understand coverage, how to investigate a variety of property and negligence claims, how to value and estimate property damage as well as the ability to evaluate Bodily Injury damages for settlement. Requirements: Minimum 5 years first-party commercial and/or residential property and liability adjusting experience Maintain own current estimating software; Xactimate preferred Working computer; internet access and Microsoft Word required Must demonstrate strong time management and customer service skills Ability to take recorded statements in the field or with legal representatives Experience in preparing Statements of Loss, Proofs of Loss, and denial letters State adjuster's license where required Must have valid driver's license Knowledge and Skills: In-depth knowledge of property and liability insurance coverage and industry standards Prepare full captioned reports by collecting and summarizing information required by client Strong verbal and written communications skills Prompt, reliable, and friendly service Must submit to background check; void in states where prohibited Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations Responsibilities: Completes residential and commercial field property inspections utilizing Xactimate software and general liability field investigations to determine negligence and damages Investigate claims by obtaining recorded statements from insureds, claimants or witnesses; by interviewing fire, police or other governmental officials as well as inspecting claimed damages Recommend claim reserves based on investigation, through well supported reserve report Obtain and interpret official reports Review applicable coverage forms and endorsement, providing thorough analysis of coverage and any coverage issues in well documented initial captioned report to client Maintain acceptable product quality through compliance with established Best Practices of client Preferred but Not Required: College Degree AIC, or other professional designations All candidates must pass a full background check

JOIN THE ASSURANCEAMERICA TEAM Do you want to be part of an organization where you are valued, and your ideas and opinions have an impact? Join the AssuranceAmerica team. For more than 25 years, AssuranceAmerica has provided superior property and casualty insurance products through contracted independent agents and directly to customers. Our team succeeds through diversity of thought, experiences, skills, and backgrounds. Liability Adjuster II The Liability Adjuster II is responsible for managing a caseload of complex liability and coverage claims, including those involving minor bodily injuries. This role requires the execution of thorough investigations to gather all necessary facts, along with a strong understanding of policy language to ensure accurate and timely coverage and liability determinations. While working with a degree of autonomy, the Adjuster will collaborate with their supervisor for guidance on more nuanced or high-exposure cases. About the ROLE Each day at AssuranceAmerica is different, but as a Liability Adjuster II you will: Conduct thorough investigations and evaluations of coverage, liability, and damages across all lines of personal automobile insurance/. Accurately assess exposure and evaluate injury claims in a fair, consistent, and equitable manner based on the facts and extent of damages. Negotiate timely and appropriate settlements, ensuring all required documentation is obtained to support proper claim resolution and closure. Manage low-complexity, attorney-represented injury claims with sound judgement and attention detail, maintaining compliance with internal guidelines and industry standards. Control expenses and adhere to company reserving philosophy by maintaining proper reserves on all pending claims/potential exposures. Meet and maintain general file handling goals and procedures as outlined by the company including maintaining a 1:1 closing ratio and status on diary reviews. Properly utilize underwriting and policy systems and understand its features and functionality, as needed. Attend any available seminars and classes applicable to this position and the skills required to meet the job duties and responsibilities. Continually ask questions and have a desire to develop additional skills to better investigate and evaluate claims. About YOU Excellent communication skills with demonstrative ease with both verbal and written formats. Attention to detail and ability to multi-task. A high degree of motivation and team orientation. Direct, results driven, and dedicated to the success of the business and each other. Required Minimum three years of experience handling auto claims. Minimum of two years of experience handling complex liability and coverage issues and unrepresented bodily injury cases. Preferred Bachelor's degree or equivalent. Non-standard experience. Adjuster's license in relevant state or the ability to obtain one quickly. Bilingual (English-Spanish). Physical Requirements Prolonged periods sitting at a desk and working on a computer. Must be able to lift 15 pounds at times. Must be able to navigate various departments of the organization's physical premises. About US We are direct, results-driven, and dedicated to the success of our business and each other. We are a diverse group of thinkers and doers. We offer many opportunities to grow in your professional skills and career. We fight homelessness by directing 5% of our earnings from each policy we sell to organizations that help those in need. We call it our Generous Policy. WHAT WE OFFER AssuranceAmerica provides these benefits to Associates: Premium healthcare plans: All full-time Associates and part-time Associates working a regular schedule of 30 hours, or more, are eligible for benefits including Medical, Dental, Vision, Voluntary Life, Flexible Spending Accounts, and a Health Savings Account. Employer Paid Benefits: We enroll all eligible Associates in Group Life and AD&D Insurance, Short- and Long-Term Disability Plans, Employee Assistance Program, Travel Assist, and the Benefit Resource Card which includes Teladoc™, Pet Insurance and Health Advocate. Additional Benefits: 401(k) Employer Match: We want to help you prepare for the future, now. All full-time and part-time Associates over age 21 are eligible to participate in the 401(k) Savings Plan. AssuranceAmerica will match 100% of the first 4% of an Associate's contributions. Engagement Events. We make time for fun activities that strengthen Associate relationships in all our locations. Annual Learning Credit: Want to learn something new? We'll reimburse you for approved educational assistance. Time Off: Paid Time Off (PTO), Parental Leave Pay, Volunteer Time Off (VTO), Bereavement Pay, Military Leave Pay, and Jury Duty Pay.

Parker Loss Consultants, LLC To know more, visit us at ************************************* We are seeking a highly motivated Aviation Desk Adjuster to join our team. This position will be responsible for handling aviation-related claims remotely or from a desk environment. The ideal candidate will have strong knowledge of aviation policies, claims management, and technical expertise in assessing damages or losses related to aircraft accidents, repairs, or general aviation incidents. Key Responsibilities: Claims Handling: Review, investigate, and process aviation insurance claims for various types of incidents, including accidents, equipment damage, and liability claims. Claim Evaluation: Assess the validity of claims based on policy terms, including coverage limits, exclusions, and deductibles. Damage Assessment: Analyze aircraft damage reports, repair estimates, and adjust payouts accordingly, coordinating with adjusters, repair shops, and other stakeholders. Coordination: Work closely with underwriters, claims adjusters, and other departments to ensure a smooth and accurate claims process. Documentation: Maintain thorough records of all claims, communication, and decision-making processes. Customer Communication: Effectively communicate with policyholders, legal representatives, and contractors to gather required information and resolve disputes. Compliance: Ensure that all claims are processed in compliance with aviation insurance laws and regulations. Reporting: Provide detailed reports on claim status and updates to senior management. Continuous Learning: Stay up-to-date with industry standards, regulatory changes, and technological advancements in aviation insurance. Qualifications: Education: Bachelor's degree in Insurance, Aviation Management, or a related field (preferred). Experience: Minimum of 3-5 years of experience as a desk adjuster, with a focus on aviation claims (or related experience). Technical Expertise: Strong knowledge of aviation terminology, aircraft types, and industry-specific regulations. Certifications: Relevant certifications such as AIC (Associate in Claims) or other insurance-related qualifications are a plus. Skills: Strong analytical and problem-solving skills Excellent written and verbal communication Ability to work independently and prioritize tasks effectively Proficiency in claims management software (e.g., Xactimate, Guidewire, or similar) Proficient with MS Office Suite (Excel, Word, Outlook) Preferred Attributes: Familiarity with both general aviation and commercial aviation claims. Knowledge of FAA regulations, aircraft repair processes, and aviation safety protocols. Experience with international aviation claims or multi-jurisdictional policies.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Remote **Medical Claims Representative** to join our team in **for a remote position** . This is a US based, W-2 project. All candidates will be paid through NTT DATA only. **Role Responsibilities** **- Pay rate is $18.00** -Processing of Professional claim forms files by provider -Reviewing the policies and benefits -Comply with company regulations regarding HIPAA, confidentiality, and PHI -Abide with the timelines to complete compliance training of NTT Data/Client -Work independently to research, review and act on the claims -Prioritize work and adjudicate claims as per turnaround time/SLAs -Ensure claims are adjudicated as per clients defined workflows, guidelines -Sustaining and meeting the client productivity/quality targets to avoid penalties -Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. -Timely response and resolution of claims received via emails as priority work -Correctly calculate claims payable amount using applicable methodology/ fee schedule **-Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities** **-Time management with the ability to cope in a complex, changing environment** **-Ability to communicate (oral/written) effectively in a professional office setting** **Required Skills/Experience** + 1+ year(s) hands-on experience in **Healthcare Claims Processing** + **Previously performing - in P&Q work environment; work from queue; remotely** + 2+ year(s) using a computer with Windows applications using a keyboard, **navigating multiple screens and computer systems, and learning new software tools** + Key board skills and computer familiarity - + **Toggling back and forth between screens** /can you navigate multiple systems. + Working knowledge of MS office products - Outlook, MS Word and **MS-Excel** . **Preferences** Amisys &/or Xcelys Preferred About NTT DATA: NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com. NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is **$18.00/hourly** . This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.