Senior Claims Specialist remote jobs - 519 jobs

Join Our Dynamic Team as a Workers' Comp Claims Oversight Specialist! Claims Oversight Specialist Job Type: Full-time Exempt Salary: $71,000 - $95,000 Who We Are: EmployInsure LLC delivers Engineered Employment Products designed to eliminate gaps from antiquated practices and enable Frictionless Employment for customers across the employment value chain. Our Mission is to inspire and redefine the relationship between industry and individual by transparently connecting all buyers and sellers of talent to create maximum value . Our diverse team is powered by forward-thinkers, innovators, and rapid problem-solvers. We are committed to making a significant impact to scale the company. We believe in fostering a collaborative and inclusive work environment where every voice is heard and valued. EmployInsure is the parent company of its brands; Samuel Hale and Evoove, in exclusive partnership with the PACT. To learn more about us and our family of companies, check out our websites! Home - Samuel Hale - California Workers' Comp Fraud Savings Evoove | Centralized Staffing Solutions The PACT Life - Welcome to The PACT Our Core Values: Entrepreneurial Spirit: A mindset that involves seeking out change, taking risks, and pursuing new opportunities. Quest for a Deeper Understanding: A true professional never stops getting better at their craft. They practice and measure, and debate over their understanding of the truth, embodying a growth mindset. The Stockdale Paradox: We confront the brutal honesty of our current reality while always maintaining an unwavering faith in our ability to overcome all challenges that get in our way. We have toughness, determination, and passionate belief! Job Description: We seek to hire an experienced Claims Oversight Specialist to join our claims oversight team. The ideal candidate will have experience in California workers' compensation, denying, settling, or authorizing payments to workers' comp claims. In this role, you will be responsible for corresponding with policyholders, claimants, witnesses, attorneys, etc., to gather important information to support contested claims. Investigating claims and compiling reports within the given timeframe after receipt of the first injury report Preparing and delivering claims updates and reviews to internal stakeholders and clients Strategically handle investigations and tactically tackle issues Requesting records as required Notifying the employer of his or her claim determination based on findings Collecting and evaluating claims and authorizing payments Keeping in contact with the injured worker and the medical professionals concerning the status of the injury and plans for treatment Contacting the claimant's employers or doctors for additional information if the claim is questionable Assessing settlement decisions and opportunities Being present at mediations, either by phone or in person Ensuring that injured workers are taken care of appropriately and on time Basic Qualifications: 2+ years of direct workers' comp claims experience 1+ years of California workers' comp experience Good time management skills Adequate knowledge of relevant regulations Skilled customer service skills and attention to detail Demonstrated experience investigating workers' comp claims Excellent customer support Extensive claim review experience Prior claim settlement experience Insurance claims management software experience and technical proficiency We Offer a Best-in-Class Professional Benefits Package to Support our Employees: Comprehensive premium Healthcare Coverage: Medical, dental, and vision plans: Employees 100% covered by the company. Low deductibles for spouse/partner and dependents Generous Paid Time Off: Unlimited paid time off policy and paid holidays Profit Sharing Plan: Share in the success of the company Retirement Savings Plans: 401(k) with 5% company match to help you secure your financial future Lifetime pension plan: Vest into our pension plan for a lifetime income Wellness Support: Access to wellness programs, mental health resources, financial counseling, legal support, and employee assistance programs. Professional Growth Opportunities: Learning resources to help you thrive. Death Benefits: Company-paid to protect you and your loved ones. Flexible Work Options: Hybrid or remote work arrangements (where applicable). Exclusive Perks: Employee discounts, commuter benefits, and more. Join us and experience a benefits package designed to empower your well-being, career growth, and personal goals! Samuel Hale is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. Samuel Hale is an E-Verify company. For more information, please review our Participation and Your Right to Work. California Privacy Notice for Job Applicants If you are a California resident, we collect and use the personal information you provide in your application for recruiting, hiring, and compliance purposes in accordance with the CCPA/CPRA. We do not sell or share applicant personal information as those terms are defined by law. For details about what we collect, how we use it, and your privacy rights, please review our California Applicant & Employee Privacy Notice at ********************************* or contact us at ****************************.

Create Music Group is currently looking for self-described viral internet culture enthusiasts to join our Viral Department. Viral Content Claiming Specialist perform administrative tasks such as YouTube copyright claiming and asset onboarding, as well as scope out trending memes and social media videos on a daily basis. This position requires a regular workload of data entry/administration in order to carry out the most basic functions of our department but there are plenty of opportunities for more creative and ambitious pursuits if you are so inclined. This is a full time position which may be done remotely, however our office is located in Hollywood, California, and we are currently only looking for job candidates who are located in California. In the future, you may be encouraged to come into our office for meetings or company functions, so it is best if you are located in the Los Angeles/Southern California area. Through our Viral team, we collaborate with some of the most prominent viral talent from the TikTok and meme world including Supa Hot Fire (Deshawn Raw), Welven Da Great (Deez Nuts), Verbalase, KWEY B, Hoodnews, presidentofugly1, 10k Caash, dimetrees, Zackass, Supreme Patty, The Man with the Hardest Name in Africa, ViralSnare, Adin Ross, and more. YouTube monetization provides an alternative consulting and revenue-generating resource for our clients to grow their audience and earnings. We have helped our clients monetize and collected millions in previously unclaimed revenue for content creators, artists and labels. REQUIREMENTS: 1-3 years work experience Excellent communication skills, both written and verbal Internet culture and social media platforms, especially YouTube Conducting basic level research Organizing large amounts of data efficiently Proficiency with Mac OSX, Microsoft Office, and Google Apps PLUSES: Strong understanding of the online video market (YouTube, Instagram, TikTok) Bilingual - any language, although Spanish, Mandarin, and Russian is preferred RESPONSIBILITIES: We work directly with our clients and their team to help them break down the data and find potential opportunities to build their career. Daily responsibilities include but are not limited to the following. Watching YouTube videos for several hours daily Content claiming Uploading and defining intellectual assets Administrative metadata tasks Researching potential clients Staying on top of accounts for current client roster As this is a remote position, you are required to have your own computer and reliable internet connection. This position may require you to download a great deal of video files (files which may be deleted once onboarding tasks are completed) so please make sure that you have a computer that is up to the task. Laptops are preferable if you would like to come into our office to work (snacks, soft drinks, and Starbucks coffee are provided at our physical office). BENEFITS: Paid company holidays, paid time off, and health benefits (medical, dental, vision, and supplementary policies) are included. TO APPLY: Send us your resume and cover letter (in one file). After you apply, you will be redirected to take our Culture Index survey here. Otherwise, copy and paste the link to your web browser: ********************************************************* Info.php?cfilter=1&COMPANY_CODE=cYEX5Omste Applications without a cover letter and Culture Index survey will not be considered. OPTIONAL: Link relevant social media campaigns and/or writing samples from your portfolio.

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. **$20k Sign-on Eligible** **(Open to remote work location if outside designated Arch office) Position Summary Responsibilities include, actively managing and effectively overseeing large exposure and complex general/auto liability and trucking claims (primary, umbrella and excess) direct handled by Third-party Administrators (“TPA's”) and supporting Arch business stakeholders. Please note this role does require managing any direct reports but is responsible for managing the claims & TPA process. Responsibilities Deliver industry leading technical claim handling/oversight, claim outcomes, business support and customer service. Make claim services an Arch competitive advantage Collaborate with TPA team members, Arch Claim Account Managers (“CAM's”) and other claim professionals to proactively develop and effectively execute on appropriate claim resolution strategies Work closely with underwriters, Legal, Operations, claim professionals, and other Arch functions, to ensure timely and effective communication consistent with Arch Claims' Procedures, striving to achieve optimum claim outcomes Effective and timely communication with insureds and brokers; making exceptional customer service a top priority Coverage analysis, investigation, liability and damage evaluation, timely and accurate indemnity and expense reserving (within specific granted authority), litigation management, vendor management, settlement negotiations, including use of structure settlements where appropriate, and claim resolution Effective claim file documentation, claim coding and diary management Retain and work closely with defense and coverage counsel to create and execute on litigation/coverage strategies and budgets. Analyze and pay legal bills, consistent with claims specific strategy/budget and Arch Claims Litigation Management Guidelines Effective and timely claim reporting (verbal and written) to other claim professionals/management and business stakeholders, per Arch Claims Procedures Attend mediations, trials, other proceedings and meetings Maintains all required state adjustor licenses Assist CAM's and others with TPA management and oversight to include: o TPA claim staff training relating to Arch processes, procedures, expectations, reporting, technical claim handling, litigation/vendor management, legal/regulatory developments, customer service and other topics that may arise o Sharing of claim handling/customer service best practices o Assistance with claim file reviews and claim audits o Regular meetings with TPA claims staff Experience & Required Skills Trucking, construction, emergency service/medical professional liability claim handling experience is a plus TPA management/oversight experience is a plus Excellent customer service skills and service minded Strong analytical and problem-solving skills Strong negotiation skills Exceptional communication (written and verbal), collaboration, influencing, listening, and interpersonal skills to effectively develop productive working relationships both within and outside Arch Able to process large amounts of complex information, distill it down to key issues and decision points and concisely communicate the information verbally and in writing Able to effectively lead strategic discussions and leverage technical knowledge to make sound, cost-effective decisions and recommendations Able to work well independently and in a highly collaborative team environment Adaptable and able to succeed in a rapidly changing workplace Strong Microsoft Excel, PowerPoint and Word skills Willing and able to travel approximately up to 10% of time Education Bachelor's degree required; Juris Doctorate preferred Minimum of 10 years commercial general/auto liability claim handling experience, including responsibility for complex and large exposure claims, or insurance defense/coverage practicing attorney with similar law firm experience #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $145,000 - $160,000/year Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.

*5 years WC experience combined in WC *Remote (Must live in CA) *California License SIP not needed but is a plus *4850 (if not can train) *Bilingual (Not necessarty but a plus) $80-$94k

Why MSI? We thrive on solving challenges. As a leading MGA, MSI combines deep underwriting expertise with insurer and reinsurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers' unique needs. We have a passion for crafting solutions for the important risks facing individuals and businesses. We offer an expanding suite of products - from fully-digital embedded renters coverage to high-value homeowners insurance to sophisticated commercial coverages, such as cyber liability and habitational property - delivered through agents, brokers, wholesalers and other brand partners. Our partners and customers count on us to deliver exceptional service through a dedicated team that makes rapid resolutions a priority. We simplify the insurance experience through our advanced technology platform that supports every phase of the policy lifecycle. Bring on your challenges and let us show you how we build insurance better. MSI handles third-party claims involving bodily injury and property damage under various homeowner's insurance policies and renter's insurance policies nationwide. We are looking for an experienced individual to join our Liability Claims Team as a Sr. Claims Examiner. The Sr Claims Examiner is considered an expert in managing insurance claims and will be handling claims with high severity and complexity, both pre-suit and in suit. The Sr Claims Examiner must have the experience and technical knowledge needed to manage a complex case load from inception to resolution while providing our customers and business partners superior service at all times. The ability to develop relationships and effectively communicate with others is a key factor to succeeding in this role. Having a strategic vision coupled with tactical execution to achieve results, in accordance with goals and objectives, is also critical to the overall success of this position. The Sr Claims Examiner must be able to work with little to minimal supervision in a fast-paced environment. PRIMARY RESPONSIBILITIES: Directly handles third-party claims involving complex and severe bodily injury or property damage from initial assignment through to resolution of claim, including negotiating settlements. Evaluates and analyzes insurance policies in order to make coverage determinations. Drafts Reservation of Rights letters and coverage disclaimers as warranted. Makes prompt contact with policy holders, claimants and other appropriate parties to gather information, take recorded statements, and conduct thorough investigations. Investigates claims to determine validity and the potential for liability against insureds. Evaluates damages (both bodily injuries and property damages) to determine potential exposures and sets appropriate reserves. Works a claim load efficiently and independently with little to no supervision. Sets timely file reserves in compliance with company's reserving philosophy and continues to evaluate pending reserves throughout the life of the claim. Manage defense counsel which includes assisting in claim strategy, evaluating potential exposure, reviewing invoices, and attending mediations and settlement conferences as necessary. Engages experts, as needed, to assist in the evaluation of the claim and monitors experts and vendors' performance while controlling expense costs. Drafts reports for large losses and reports to Leadership as required. Evaluates, negotiates and determines settlement values in settlement of claims. Communicates with all interested parties throughout the life of the claim including proactively discussing coverage decisions, the need for additional information, and settlement amounts with interested parties. Establishes and maintains an organized diary system to ensure all claims are appropriately handled in a timely manner. Adheres to all state/local regulations including the NJ/PA Unfair Claims Practices and Guidelines. Handles all claims in accordance with Best Practices and provides Best-In-Class customer service to insureds, agents, claimants, and business partners. Responsible for monitoring and completing assigned claims inventory. Acquires and maintains multiple state adjuster's licenses and maintains continuing education requirements. Develops and maintains relationships with external and internal stakeholders. Identifies questionable risks, red flags and fraud indicators and alerts the Special Investigation Unit when applicable. Identifies opportunities for subrogation and ensures recovery interests are protected. Acts as a mentor for less experienced Claims Examiners. Updates and maintains well drafted claim file notes with proper documentation throughout the life of the file. Assists with special projects when required. KNOWLEDGE, SKILLS & ABILITIES: Ability to communicate clearly, professionally, and provide superior customer service over the phone and through written correspondence. Strong organizational and time management skills. Strong writing skills. Excellent analytical, investigative, and negotiation skills. Proficient with Microsoft Office, Teams, Word, Excel and various other computer skills with the ability to learn and utilize new computer systems and other technologies. EDUCATION & EXPERIENCE: Bachelor's degree or equivalent work experience 10+ years of casualty claims adjusting experience First-Party Property experience is a plus Insurance designations preferred Must have a State Adjuster License(s) (California, Florida licenses are desirable) with a willingness to expand licenses as needed. #LI-BM1 #LI-REMOTE Click here for some insight into our culture! The Baldwin Group will not accept unsolicited resumes from any source other than directly from a candidate who applies on our career site. Any unsolicited resumes sent to The Baldwin Group, including unsolicited resumes sent via any source from an Agency, will not be considered and are not subject to any fees for any placement resulting from the receipt of an unsolicited resume.

**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $70,400.00 - $116,200.00 **Target Openings** 7 **What Is the Opportunity?** This role is eligible for a sign-on bonus. This position is hybrid and will have the option to work from home up to 2 days per week. This position will office out of the Diamond Bar or Irvine, CA locations. Under general supervision, manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery. The Injured worker is working modified duty and receiving ongoing medical treatment. The injured worker has returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. Independently handles all assigned claims up to and including most complex where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and job is no longer available. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered. **What Will You Do?** + Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability. + Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions. + Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment in collaboration with internal nurse resources where appropriate. + Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome. Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). + Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome + Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. + Prepare necessary letters and state filings within statutory limits. Pursue all offset opportunities, including apportionment, contribution and subrogation. + Evaluate claims for potential fraud. Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment. + Proactively manage moderate to complex litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations. + Negotiate settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction. Apply deep technical expertise to assist in the resolution of highly complex claims. Mentor other Claim Professionals + Participate in Telephonic and/or onsite File Reviews. Respond to inquiries - verbal and written. Keep injured worker apprised of claim status + Act as technical resource to others. + Participate in Telephonic and/or onsite File Reviews. Respond to inquiries - verbal and written. Keep injured worker apprised of claim status. Act as technical resource to others. Engage specialty resources as needed. + Performs other assigned duties which may include: Applies deep technical/subject matter expertise to assist in the resolution of complex claims. Acts as an independent mentor to other Claim Professionals. May be dedicated to and apply skills necessary to manage special account relationships (sensitive or complex). May primarily manage a specialized inventory of Workers' Compensation claims. + Acts as an independent mentor to other Claim Professionals Applies deep technical/subject matter expertise to assist in the resolution of complex claims + Acts as an independent mentor to other Claim Professionals + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. + Maintain Continuing Education requirements as required. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Education/Course of Study: Work Experience: + Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. + Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. Ability to effectively present file resolution to internal and/or external stakeholders. + Negotiation: Advanced evaluation, negotiation and case resolution skills. Ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. + General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract. + Principles of Investigation: Intermediate investigative skills including the ability to take statements. Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss. + Value Determination: Advanced ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. + Settlement Techniques: Advanced ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package. + Legal Knowledge: Thorough knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. + Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed. + WC Technical: + Advanced ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. + Advanced knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. + Customer Service: + Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes + Teamwork: + Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result + Planning & Organizing: + Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals **What is a Must Have?** + High school diploma or equivalent required + Minimum of 2 years Workers Compensation claim handling experience **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .

Come join our amazing team and work remote from home! The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring the proper incurred losses were identified and the financial reconciliation is accurately completed on all liquidated loans. Key reviewer of loss analysis decisions which include validating the determined responsibility and root cause for avoidable losses, ensuring they meet quality expectations and reflect proper decision rationale and supporting evidence and identify any bill back opportunities. Perform all duties in accordance with the company's policies and procedures, all US state and federal laws and regulations, wherein the company operates. The target pay for this position is $23.00/hr - $26.50/hr. What you'll do: Review reconciliation of all loan advances once the GSE or Government Mortgage Insured “expense” claim has been paid. Confirm all prior tasking in LoanServ has been completed as well as update approval tasks as required per job aid upon the date the action occurs. Issue corrections identified during the Quality Review Process, communicating findings to Loss Specialist for remediation. Ensure Loss Specialist provides corrections as needed. Responsible for learning new skills and expand job knowledge to better perform assigned duties. Maintain monthly performance in alignment with quality expectations. Analyze multiple data elements in order to confirm the proper decision rationale and approve evidentiary support is included and written summaries are accurate. Validate research on incurred losses, using analytical skills and subject matter knowledge to confirm responsibility and bill back opportunities. Responsible for staying abreast of relevant changes to GSE or Government Mortgage Insured guidelines, industry standards and client expectations. Ensure timely completion of projects and tasks when assigned. If unable to meet a deadline, the deadline must be renegotiated prior to the initial deadline date. Look for opportunities to improve the department's processes and procedures, to reduce costs and eliminate non-essential and manual processes and activities. Keep Team Lead and Supervisor informed of all trends and problems including, but not limited to, exceptions identified in review of Loss Analysis processes. Moderate working knowledge of all Default Servicing processes up to and including Loss Mitigation, Bankruptcy, Foreclosure, Conveyance and Claims in addition to mortgage servicing state, federal and agency guidelines and timelines. Moderate background in financial and loss analysis including ability to determine: all funds/advances due CMS have been recovered. Moderate ability to conduct quality assurance reviews. Preferred Accounting Background--Must possess the ability to complete financial reconciliations. Moderate computer skills with MS Word, Excel. Strong attention to details and excellent time management and organizational skills. Comprehensive writing skills, including proper punctuation and grammar, organization, and formatting. Ability to work under general direction to accomplish department goals and reduce/mitigate financial loss to CMS and its Clients. Ability to substantiate facts and properly document them. Ability to work effectively and develop rapport with all levels of staff, management, Investors/Insurers and 3rd parties. Ability to make decisions that have moderate impact to immediate work unit. Ability to identify urgent matters requiring immediate action and properly escalating them. Ability to handle multiple tasks under pressure and changing priorities. What you'll need: High School diploma required; Associate/Bachelor Degree in accounting or other related field preferred. Two (2) or more years' quality assurance experience. Three (3) or more years' Loan Servicing platform experience for all default related activities such as Foreclosure, Bankruptcy, Default MI Claims, Loss Mitigation, etc. Previous FHA, VA, USDA and PMI claims experience preferred Our Company: Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you'll consider joining our growing team of uniquely talented professionals as we transform residential real estate. To read more visit: *************************** What We Offer: Comprehensive healthcare plans for you and your family. Plus, a discretionary 401(k) match of 50% of the first 4% of pay contributed. Access to several fitness, restaurant, retail (and more!) discounts through our employee portal. Customized training programs to help you advance your career. Employee referral bonuses so you'll get paid to help Carrington and Vylla grow. Educational Reimbursement. Carrington Charitable Foundation contributes to the community through causes that reflect the interests of Carrington Associates. For more information about Carrington Charitable Foundation, and the organizations and programs, it supports through specific fundraising efforts, please visit: carringtoncf.org. Notice to all applicants: Carrington does not do interviews or make offers via text or chat. #LI-SY1

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. $20k Sign-on Eligible (Open to remote work location if outside designated Arch office) Position Summary Responsibilities include, actively managing and effectively overseeing large exposure and complex general/auto liability and trucking claims (primary, umbrella and excess) direct handled by Third-party Administrators ("TPA's") and supporting Arch business stakeholders. Please note this role does require managing any direct reports but is responsible for managing the claims & TPA process. Responsibilities * Deliver industry leading technical claim handling/oversight, claim outcomes, business support and customer service. Make claim services an Arch competitive advantage * Collaborate with TPA team members, Arch Claim Account Managers ("CAM's") and other claim professionals to proactively develop and effectively execute on appropriate claim resolution strategies * Work closely with underwriters, Legal, Operations, claim professionals, and other Arch functions, to ensure timely and effective communication consistent with Arch Claims' Procedures, striving to achieve optimum claim outcomes * Effective and timely communication with insureds and brokers; making exceptional customer service a top priority * Coverage analysis, investigation, liability and damage evaluation, timely and accurate indemnity and expense reserving (within specific granted authority), litigation management, vendor management, settlement negotiations, including use of structure settlements where appropriate, and claim resolution * Effective claim file documentation, claim coding and diary management * Retain and work closely with defense and coverage counsel to create and execute on litigation/coverage strategies and budgets. Analyze and pay legal bills, consistent with claims specific strategy/budget and Arch Claims Litigation Management Guidelines * Effective and timely claim reporting (verbal and written) to other claim professionals/management and business stakeholders, per Arch Claims Procedures * Attend mediations, trials, other proceedings and meetings * Maintains all required state adjustor licenses * Assist CAM's and others with TPA management and oversight to include: o TPA claim staff training relating to Arch processes, procedures, expectations, reporting, technical claim handling, litigation/vendor management, legal/regulatory developments, customer service and other topics that may arise o Sharing of claim handling/customer service best practices o Assistance with claim file reviews and claim audits o Regular meetings with TPA claims staff Experience & Required Skills * Trucking, construction, emergency service/medical professional liability claim handling experience is a plus * TPA management/oversight experience is a plus * Excellent customer service skills and service minded * Strong analytical and problem-solving skills * Strong negotiation skills * Exceptional communication (written and verbal), collaboration, influencing, listening, and interpersonal skills to effectively develop productive working relationships both within and outside Arch * Able to process large amounts of complex information, distill it down to key issues and decision points and concisely communicate the information verbally and in writing * Able to effectively lead strategic discussions and leverage technical knowledge to make sound, cost-effective decisions and recommendations * Able to work well independently and in a highly collaborative team environment * Adaptable and able to succeed in a rapidly changing workplace * Strong Microsoft Excel, PowerPoint and Word skills * Willing and able to travel approximately up to 10% of time Education * Bachelor's degree required; Juris Doctorate preferred * Minimum of 10 years commercial general/auto liability claim handling experience, including responsibility for complex and large exposure claims, or insurance defense/coverage practicing attorney with similar law firm experience #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $145,000 - $160,000/year * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.

DETAILS Complex Claims Specialist - Property & Casualty Department: Property and Casualty Claims Reports To: Claims Supervisor FLSA Status: Exempt Job Grade: 14 Career Ladder: Next step in progression could include Claims Supervisor ATHENS ADMINISTRATORS Since our founding in 1976, Athens Administrators has been a recognized leader in third-party claims administration services. However, more important than what we do is how we do it. Athens employees provide service that translates into real and lasting benefits-every single day! With offices throughout the United States, Athens Administrators offers Workers' Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a third-generation family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. We are so proud that our employees have consistently voted Athens as a Best Place to Work! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Complex Claims Specialist to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). This position does allow for work from home if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week. The Complex Claim Specialist is responsible for the review, investigation, analysis, and processing of complex claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure and often entail litigation and complex coverage. There is particular emphasis on runoff program claims for this desk. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Advanced knowledge in the following areas: 1) Complex Auto or General Liability claims handling concepts, practices and techniques, to include but not limited to complex coverage issues, and product line knowledge, 2) advanced, functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills. Analyze, investigate, and evaluate losses to determine appropriate layers of coverage, settlement value and disposition strategy, including claim merits or denial of liability Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to clients and senior level management Manage the litigation process through the retention of selected counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment Document and manage claims (i.e.: statements, diaries, write reports) from inception to closure Ensure appropriateness of all coverage memorandums and payments Coordinate and work with dedicated vendor services such as law professionals, industry experts, county officials and client executives to manage professional claims and communications Facilitate interactions between insured entities, claimants, client contacts, and attorneys in resolution of severe and complex claims Lead and conduct comprehensive claim reviews and case analysis discussions with various committees or district level authorities Provide superior customer service to all layers of authorities within the county Meet with clients, attend hearings, and assist senior management with planning, forecasting and new business opportunities that may arise in the servicing of the account. May assist management in hiring other account dedicated examiners Provide guidance and serve as a technical expert to less experienced examiners May conduct meetings or training sessions to help develop less experienced examiners Attend all required meetings and educational seminars for professional development Maintain required licenses ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Possesses a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL preferred Additional State Adjuster License(s), may be required within 180 days Maintain licenses and continuing education requirements in all states Relies on extensive experience and judgement to plan and accomplish goals with a minimum of 10 years complex/major claims experience, including proficiency in investigation and resolution of severe to major casualty and general liability claims Experience with relevant insurance laws, codes, and procedures Experience with property and casualty insurance policies, insurance tort laws, codes, and procedures Understanding Auto and General Liability exposure and unique coverage endorsements Understanding of medical, legal terminology and liability concepts Proficiency in investigation and resolution of severe to major level casualty claims Time Management and project management skills Strong negotiation and litigation management skills Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at *************************************************

The Senior Claims Examiner works in conjunction with Fidelity Life's third-party administrator and the Claims Manager to analyze, evaluate, and settle incontestable life, contestable life and accidental death benefit (ADB) claims. The Senior Claims Examiner is expected to review and adjudicate claims in accordance with established departmental and statutory guidelines. Key Responsibilities: * Communicate effectively and respectfully with customers, attorneys, and co-workers via phone, e-mail, online chat, and in person. * Review newly reported claims and log them on the pending claims log. * Document each claim file thoroughly in accordance with departmental procedures, including notes on claim review, information obtained, and final decisions. * Review and interpret insurance policy provisions to ensure accurate and timely claim decisions. * Review any adverse decisions, and decisions outside authority limit, with the Claims Manager. Consult with the Legal Department as needed. * On claims within the Senior Claims Examiner's authority limit (500,000), confirm benefits and statutory interest are calculated correctly. * Respond to inquiries from customers and attorneys regarding claim matters, consulting with the Claim Director and/or Legal Department as needed. * Work with Fidelity Life's Underwriting Department on contestable claim referrals and other complex claims as needed. * Handle and log specific State and NAIC policy locator searches. * Mentor and support third-party claims administration staff. * Monitor trends in claims experience, escalate issues to management, and recommend or implement corrective actions. Keep management abreast of any trends in claims experience, unfavorable or otherwise. * Work on special projects and other duties as assigned by the Claims Manager. * Perform quarterly claim audits focusing on third-party claim handling. * Assist FLA Sarbanes-Oxley audit team, internal audit team, external reinsurance representatives and external state regulators with claim audits or market conduct exams. * Handle Department of Insurance claim complaints or requests in a timely and professional manner. * Stay current on all laws, regulations, and industry updates that impact claim handling and compliance * Support FLA actuarial or Finance teams in reserve setting, claims trend analyses or other requests. * Participate in continuous improvement initiatives and suggest proactive changes to operations based on data-driven insights * Help track and analyze claim durations, denial rates, appeal outcomes, and financial impact * Support M&A activity, if applicable Qualifications: * 5+ years of life claims experience, with proven proficiency in adjudicating contestable and/or accidental death benefit claims (preferred). Skills: * Demonstrate knowledge of medical terminology, regulatory compliance including but not limited to unfair claims practices, and privacy requirements. * Ability to meet deadlines while performing multiple functions. * Proficient in MS Office applications and the Internet. * Ability to proactively analyze and resolve problems. * Attention to detail. * Flexibility and willingness to adapt to changing responsibilities. * Excellent written communication, interpersonal and verbal skills. * Ability to perform basic mathematical calculations including addition, subtraction, multiplication, division and percentages. * Proactive and outside-the-box thinker. * Independent and organized work style. * Ability to maintain strong performance while working remotely and independently, if applicable. * Strong judgment and discretion when handling highly confidential business, employee, and customer information. * Team player and creative, critical thinker highly desired. Licenses + Certifications: * Completion of LOMA courses and/or courses offered by the ICA Claims Education program is preferred but not required. * Legal or Paralegal Certifications optional but useful Essential Functions: * This position primarily involves remote desk work, requiring the ability to remain in a stationary position (e.g., sitting at a computer) for extended periods of time. * Regular use of standard office equipment such as a computer, keyboard, mouse, and video conferencing tools is essential. * Must be able to communicate effectively in both virtual and in-person settings, including the ability to participate in video calls, phone calls, and written correspondence. * Occasional travel (estimated at 1-3 times per year) is required for in-person meetings, conferences, or vendor visits. Travel may involve transportation by air, train, or car, and may require overnight stays. * When traveling or attending events, the employee may need to navigate various environments, including office buildings, hotels, or convention centers. * Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this role. Compensation & Benefits: We believe in taking care of our employees and their families. We offer a comprehensive benefits package designed to support your health, well-being, and financial future. Here's a look at what we provide: * Salary Range: $70,720 - $91,520 * Medical Insurance: Choose from a variety of plans to fit your healthcare needs. * Dental Insurance: Coverage for preventive, basic, and major dental services. * Employer-Paid Vision: Comprehensive eye care coverage at no cost to you. * Employer-Paid Basic Life and AD&D Insurance: Peace of mind and additional protection. * Employer-Paid Short-Term and Long-Term Disability Insurance: Financial support in case of illness or injury. * 401(k) Plan: Save for your future with a company match to help you grow your retirement savings. * PTO and Sick Time accrue each pay period: Take time off when you need it * Annual Bonus Program: Performance-based bonus to reward your hard work. EEOC/Other: eFinancial/Fidelity Life Association is an equal opportunity employer and supports a diverse workplace. As an eFinancial/Fidelity Life employee, you will be eligible for Medical and Dental Insurance, Health Savings Accounts, Flexible Spending Accounts (Health, Dependent Care & Transit), Vision Care, 401(K), Short-term and Long-term Disability, Life and AD&D coverages. Remote work is not available in the following States: California, Colorado, Connecticut, and New York. #FidelityLifeAssociation #hiring #LI-Remote #IND-Corporate

The Senior Claims Examiner works in conjunction with Fidelity Life's third-party administrator and the Claims Manager to analyze, evaluate, and settle incontestable life, contestable life and accidental death benefit (ADB) claims. The Senior Claims Examiner is expected to review and adjudicate claims in accordance with established departmental and statutory guidelines. Key Responsibilities: Communicate effectively and respectfully with customers, attorneys, and co-workers via phone, e-mail, online chat, and in person. Review newly reported claims and log them on the pending claims log. Document each claim file thoroughly in accordance with departmental procedures, including notes on claim review, information obtained, and final decisions. Review and interpret insurance policy provisions to ensure accurate and timely claim decisions. Review any adverse decisions, and decisions outside authority limit, with the Claims Manager. Consult with the Legal Department as needed. On claims within the Senior Claims Examiner's authority limit (500,000), confirm benefits and statutory interest are calculated correctly. Respond to inquiries from customers and attorneys regarding claim matters, consulting with the Claim Director and/or Legal Department as needed. Work with Fidelity Life's Underwriting Department on contestable claim referrals and other complex claims as needed. Handle and log specific State and NAIC policy locator searches. Mentor and support third-party claims administration staff. Monitor trends in claims experience, escalate issues to management, and recommend or implement corrective actions. Keep management abreast of any trends in claims experience, unfavorable or otherwise. Work on special projects and other duties as assigned by the Claims Manager. Perform quarterly claim audits focusing on third-party claim handling. Assist FLA Sarbanes-Oxley audit team, internal audit team, external reinsurance representatives and external state regulators with claim audits or market conduct exams. Handle Department of Insurance claim complaints or requests in a timely and professional manner. Stay current on all laws, regulations, and industry updates that impact claim handling and compliance Support FLA actuarial or Finance teams in reserve setting, claims trend analyses or other requests. Participate in continuous improvement initiatives and suggest proactive changes to operations based on data-driven insights Help track and analyze claim durations, denial rates, appeal outcomes, and financial impact Support M&A activity, if applicable Qualifications: 5+ years of life claims experience, with proven proficiency in adjudicating contestable and/or accidental death benefit claims (preferred). Skills: Demonstrate knowledge of medical terminology, regulatory compliance including but not limited to unfair claims practices, and privacy requirements. Ability to meet deadlines while performing multiple functions. Proficient in MS Office applications and the Internet. Ability to proactively analyze and resolve problems. Attention to detail. Flexibility and willingness to adapt to changing responsibilities. Excellent written communication, interpersonal and verbal skills. Ability to perform basic mathematical calculations including addition, subtraction, multiplication, division and percentages. Proactive and outside-the-box thinker. Independent and organized work style. Ability to maintain strong performance while working remotely and independently, if applicable. Strong judgment and discretion when handling highly confidential business, employee, and customer information. Team player and creative, critical thinker highly desired. Licenses + Certifications: Completion of LOMA courses and/or courses offered by the ICA Claims Education program is preferred but not required. Legal or Paralegal Certifications optional but useful Essential Functions: This position primarily involves remote desk work, requiring the ability to remain in a stationary position (e.g., sitting at a computer) for extended periods of time. Regular use of standard office equipment such as a computer, keyboard, mouse, and video conferencing tools is essential. Must be able to communicate effectively in both virtual and in-person settings, including the ability to participate in video calls, phone calls, and written correspondence. Occasional travel (estimated at 1-3 times per year) is required for in-person meetings, conferences, or vendor visits. Travel may involve transportation by air, train, or car, and may require overnight stays. When traveling or attending events, the employee may need to navigate various environments, including office buildings, hotels, or convention centers. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this role. Compensation & Benefits: We believe in taking care of our employees and their families. We offer a comprehensive benefits package designed to support your health, well-being, and financial future. Here's a look at what we provide: Salary Range: $70,720 - $91,520 Medical Insurance: Choose from a variety of plans to fit your healthcare needs. Dental Insurance: Coverage for preventive, basic, and major dental services. Employer-Paid Vision: Comprehensive eye care coverage at no cost to you. Employer-Paid Basic Life and AD&D Insurance: Peace of mind and additional protection. Employer-Paid Short-Term and Long-Term Disability Insurance: Financial support in case of illness or injury. 401(k) Plan: Save for your future with a company match to help you grow your retirement savings. PTO and Sick Time accrue each pay period: Take time off when you need it Annual Bonus Program: Performance-based bonus to reward your hard work. EEOC/Other: eFinancial/Fidelity Life Association is an equal opportunity employer and supports a diverse workplace. As an eFinancial/Fidelity Life employee, you will be eligible for Medical and Dental Insurance, Health Savings Accounts, Flexible Spending Accounts (Health, Dependent Care & Transit), Vision Care, 401(K), Short-term and Long-term Disability, Life and AD&D coverages. Remote work is not available in the following States: California, Colorado, Connecticut, and New York. #FidelityLifeAssociation #hiring #LI-Remote #IND-Corporate

Experienced WC Claim Adjuster - California ADR Program (CA | Remote | SIP Required) Schedule: Monday-Friday, 8:00 AM-4:30 PM PT Salary Range: $80,000-$85,000 annually 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 The Workers' Compensation Claim Consultant is responsible for handling California workers' compensation claims for a single dedicated Alternate Dispute Resolution (ADR) client account. This role requires California jurisdiction experience and an active CA Adjuster's License, along with the Self-Insurance Administrator Certificate (SIP). You'll join a team of 10 adjusters and play a key role in ensuring quality claim handling through compliance with client guidelines, state laws, and CCMSI claim standards. Important - Please Read Before Applying This is a true insurance claims adjusting role, not an HR, benefits, safety, consulting, or administrative position. 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. 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. Investigate, evaluate, and adjust assigned California workers' compensation claims in compliance with jurisdictional requirements and ADR processes. Establish and monitor reserves, authorize claim payments, and negotiate settlements within authority and client guidelines. Review medical, legal, and vendor invoices to confirm accuracy and appropriateness. Maintain thorough documentation and diary updates in the claim system. Communicate effectively with clients, claimants, and involved parties throughout the claim process. Participate in claim reviews, hearings, and mediations as needed. Ensure compliance with state laws, CCMSI claim handling standards, and client-specific requirements. Qualifications Required Three or more years of experience adjusting California workers' compensation claims California Adjuster's License Self-Insurance Administrator Certificate (SIP) Strong written and verbal communication skills Proficiency with Microsoft Office Suite (Word, Excel, Outlook) Nice to Have Experience with Alternate Dispute Resolution (ADR) claims Strong organization, multitasking, and customer service skills Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. 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 hourly rate 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. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. 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. #CaliforniaAdjuster #WorkersCompensation #ADRClaims #InsuranceCareers #ClaimsConsultant #CaliforniaJobs #RemoteAdjuster #SIPCertified #InsuranceProfessionals #ClaimsManagement #CareerGrowth #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #LI-Remote We can recommend jobs specifically for you! Click here to get started.

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ***************** How YOU will make a Difference: As a Claims Specialist, you'll be at the heart of our mission to deliver exceptional service. Working alongside a dedicated team, you'll ensure the accurate and timely processing of medical, dental, vision, and short-term disability claims that HMA administers for our members. Your role goes beyond handling claims, you'll be a key player in shaping a positive healthcare experience for our members. Every claim you interact with helps someone navigate their healthcare journey with confidence, making your work both meaningful and impactful. What YOU will do: Carefully research discrepancies, process returned checks, issue refunds, and manage stop payments with precision. This ensures financial accuracy and builds trust with both clients and members. Manage high-importance claims and vendor billing with urgency and attention to detail. Review and reply to appeals, inquiries, and other communications related to claims. Work with third-party organizations to secure payments on outstanding balances. Process case management and utilization review negotiated claims Spot potential subrogation claims and escalate them appropriately. Actively contribute to team success by assisting colleagues when workloads peak, sharing knowledge, and fostering a collaborative environment. Requirements High school diploma required 3-5+ years of claims processing experience 2+ years of BCBS claims processing experience Strong interpersonal and communication skills Strong attention to detail, with high degree of accuracy and urgency Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving Previous success in a fast-paced environment Benefits Compensation: The base salary range for this position in the greater Seattle area is $28/hr - $32/hr for a level II and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: *****************

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.

Porch Group is a leading vertical software and insurance platform and is positioned to be the best partner to help homebuyers move, maintain, and fully protect their homes. We offer differentiated products and services, with homeowners insurance at the center of this relationship. We differentiate and look to win in the massive and growing homeowners insurance opportunity by 1) providing the best services for homebuyers, 2) led by advantaged underwriting in insurance, 3) to protect the whole home. As a leader in the home services software-as-a-service (“SaaS”) space, we've built deep relationships with approximately 30 thousand companies that are key to the home-buying transaction, such as home inspectors, mortgage companies, and title companies. In 2020, Porch Group rang the Nasdaq bell and began trading under the ticker symbol PRCH. We are looking to build a truly great company and are JUST GETTING STARTED. Job Title: Liability Claims Examiner Location: United States Workplace Type: Remote Homeowners of America is a provider of Personal Lines Insurance products. We're always looking to add talented and passionate people to our team. We value the knowledge that comes from experienced individuals with diverse backgrounds and strengths that can contribute to the various departments within our company. Our shared values are no jerks, no egos, be ambitious, solve each problem, care deeply and together we win. Summary The Liability Claims Examiner is responsible for managing complex and litigated 3rd party claims arising under homeowners' insurance policies. This role involves investigating losses, evaluating coverage, assessing liability exposures, and directing litigation strategies to achieve fair and timely resolution of claims. The examiner will work closely with insureds, claimants, field adjusters, defense counsel, experts, and internal stakeholders ensuring compliance with company guidelines and regulatory requirements while mitigating risk and controlling costs. Liability Claims Examiners are responsible for requesting payments, documenting files, and preparing and issuing claim payment letters or denial letters when appropriate. What you Will Do As A Liability Claims Examiner Responsibilities: May include any or all the following. Other duties may be assigned. Investigate and Evaluate Claims: Review policy language, coverage issues, and liability exposures. Analyze incident reports, statements, expert opinions, and other evidence to determine liability and damages. Handles claims from all types of policies, including homeowners, dwelling fire, tenant, condo, and renters. Confers with legal counsel on claims involving coverage, legal, or complex matters Effectively manage difficult or emotional customer situations Litigation Management: Direct and oversee defense counsel in litigated matters, including strategy development, budgeting, and case progression. Attend mediations, settlement conferences, and trials as needed. Evaluate litigation reports and provide recommendations for resolution. Negotiation and Settlement: Negotiate settlements within authority limits to achieve equitable outcomes. Collaborate with legal counsel to resolve complex coverage and liability disputes. Financial Oversight: Establish and adjust reserves based on claim developments and litigation exposure. Monitor litigation costs and ensure adherence to budget guidelines. Seeking out and utilizing top vendors that build quality, increase efficiency, and reduce cost Communication and Documentation: Maintain accurate and detailed claim files, including litigation plans and correspondence. Communicate effectively with insureds, claimants, attorneys, and internal teams. Enters claims payments when applicable and maintains clean, concise, and accurate file documentation Manages correspondence and communication with various parties involved in the claim Draft and prepare letters and other correspondence related to the claim Compliance and Best Practices: Ensure adherence to claims handling guidelines, regulatory requirements, and ethical standards. Identify opportunities for process improvement and cost containment. Take on assignments and duties as requested by the management team What you Will Bring As A Liability Claims Examiner Bachelor's degree or equivalent experience Minimum 5+ years of liability claims experience, with a strong focus on litigated 3rd party claims Appropriate state adjuster license and continuing education credits In-depth knowledge of homeowners liability and med pay coverage, policy language, and litigation processes Strong negotiation, analytical, and decision-making skills Excellent written and verbal communication skills Ability to manage multiple complex cases and meet deadlines in a fast-paced environment Proficiency in claims management systems and Microsoft Office suite (Outlook, Word, Excel, PowerPoint) Works with integrity and ethics Exceptional customer service skills Effectively manages difficult or emotional customer situations Ability to read, write, and interpret routine correspondence, policies, and reports Makes decisions and completes activities in a confident and timely manner Follows Claims Handling Guidelines, policies and procedures Maintains confidentiality Works independently, with the ability to assess workload and plan accordingly to meet competing deadlines Cultivates environment of teamwork and collaboration Comprehensive and up-to-date knowledge of General Liability and P&C insurance, contractual policy language requirements and the implications of that language as it pertains to denial of claims Demonstrated commitment to continuing education in the industry through licensing or designations applicable to property and liability insurance field is preferred. Certificates, Licenses, Registrations Appropriate state adjuster license and continuing education credits. The application window for this position is anticipated to close in 2 weeks (10 business days) from December 17th, 2025. Please know this may change based on business and interviewing needs. At this time, Porch Group does not consider applicants from the following states for remote positions: Alaska, Arkansas, Delaware, Hawaii, Iowa, Maine, Mississippi, Montana, New Hampshire, and West Virginia. What You Will Get As A Porch Group Team Member Pay Range*: Annually$67,500.00 - $94,500.00 *Please know your actual pay at Porch will reflect a number of factors among which are your work experience and skillsets, job-related knowledge, alignment with market and our Porch employees, as well as your geographic location. Our benefits package will provide you with comprehensive coverage for your health, life, and financial wellbeing. Our traditional healthcare benefits include three (3) Medical plan options, two (2) Dental plan options, and a Vision plan from which to choose. Critical Illness, Hospital Indemnity and Accident plans are offered on a voluntary basis. We offer pre-tax savings options including a partially employer funded Health Savings Account and employee Flexible Savings Accounts including healthcare, dependent care, and transportation savings options. We provide company paid Basic Life and AD&D, Short and Long-Term Disability benefits. We also offer Voluntary Life and AD&D plans. Both traditional and Roth 401(k) plans are available with a discretionary employer match. Headspace is part of our employer paid wellbeing program and provides employees and their families access to on demand guided meditation and mindfulness exercises, mental health coaching, clinical care and online access to confidential resources including will preparation. Brio Health is another employer paid wellbeing tool that offers quarterly wellness challenges and prizes. LifeBalance is a free resource to employees and their families for year-round discounts on things like gym memberships, travel, appliances, movies, pet insurance and more. Our wellness programs include flexible paid vacation, company-paid holidays of typically nine per year, paid sick time, paid parental leave, identity theft program, travel assistance, and fitness and other discounts programs. #LI-JS1 #LI-Remote What's next? Submit your application and our Porch Group Talent Acquisition team will be reviewing your application shortly! If your resume gets us intrigued, we will look to connect with you for a chat to learn more about your background, and then possibly invite you to have virtual interviews. What's important to call out is that we want to make sure not only that you're the right person for us, but also that we're the right next step for you, so come prepared with all the questions you have! Porch is committed to building an inclusive culture of belonging that not only embraces the diversity of our people but also reflects the diversity of the communities in which we work and the customers we serve. We know that the happiest and highest performing teams include people with diverse perspectives that encourage new ways of solving problems, so we strive to attract and develop talent from all backgrounds and create workplaces where everyone feels seen, heard and empowered to bring their full, authentic selves to work. Porch is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected veteran status, or any other characteristic protected by applicable laws, regulations, and ordinances. Porch Group is an E-Verify employer. E-Verify is a web-based system that allows an employer to determine an employee's eligibility to work in the US using information reported on an employee's Form I-9. The E-Verify system confirms eligibility with both the Social Security Administration (SSA) and Department of Homeland Security (DHS). For more information, please go to the USCIS E-Verify website.

We are united in our mission to make a positive impact on healthcare. Join Us! South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2024 2024 Black Book Awards, ranked #1 EHR in 11 Specialties 2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold) 2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara) Who we are: We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany. ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine! Your Role: Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates Input and update patient account information and document calls into the Practice Management system Special Projects: Other duties as required to support and enhance our customer/patient-facing activities Skills & Requirements: High School Diploma or GED required Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST Minimum of 1-2 years of previous healthcare administration or related experience required Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs) Manage/ field 60+ inbound calls per day Bilingual is a requirement (Spanish & English) Proficient knowledge of business software applications such as Excel, Word, and PowerPoint Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone Ability and openness to learn new things Ability to work effectively within a team in order to create a positive environment Ability to remain calm in a demanding call center environment Professional demeanor required Ability to effectively manage time and competing priorities #LI-SM2 ModMed Benefits Highlight: At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits: India Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk, Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees, Allowances: Annual wellness allowance to support your well-being and productivity, Earned, casual, and sick leaves to maintain a healthy work-life balance, Bereavement leave for difficult times and extended medical leave options, Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave, Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind. United States Comprehensive medical, dental, and vision benefits 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep. Generous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.

Our client is seeking to add a Senior Commercial Auto Litigation Claims Examiner to their team. This individual will be responsible for overseeing complex commercial auto claims, with a strong focus on litigated matters and severe casualty exposures. The role requires managing the claim process from initial intake through final resolution, including evaluating coverage, directing litigation strategy, and negotiating settlements across multiple jurisdictions. This position offers the ability to work fully remote. Key Responsibilities: Investigate, evaluate, and resolve litigated Commercial Auto claims from inception through closure. Analyze liability, damages, and legal exposure to determine appropriate resolution strategies. Establish timely and appropriate reserves based on investigation and litigation progression. Partner with defense counsel, insureds, and other experts to effectively manage claims and litigation costs. Conduct coverage analysis and issue detailed coverage position letters when necessary. Prepare reports and updates for senior leadership, clients, and other stakeholders. Maintain consistent communication with policyholders, attorneys, and internal teams throughout the claim lifecycle. Ensure timely file documentation in compliance with company, client, and regulatory standards. Negotiate settlements in line with company/client authority and jurisdictional requirements. Stay current on evolving laws, regulations, and litigation trends impacting commercial auto liability. Requirements: 10+ years of Commercial Auto / Trucking Bodily Injury Litigation claims handling experience. Must have 4+ years of Commercial Trucking experience. Strong knowledge in MCS 90 is strongly desired. Active Adjuster's License required. Proven experience managing litigated claims and working directly with defense counsel. Strong negotiation, litigation management, and analytical skills. Excellent written and verbal communication skills, including drafting detailed coverage letters and litigation reports. Highly organized, self-motivated, and able to independently manage a remote workload. Proficient in Microsoft Office and claims management systems. Salary & Benefits: $90,000 - $120,000+ annually (depending on experience) Comprehensive Medical, Dental, and Vision coverage 401(k) with company match Paid Time Off and holiday benefits Professional development and career advancement opportunities

As a Claims Specialty Adjuster, you will provide efficient and effective disposition of assigned claims through timely investigation, evaluation, and negotiation. This adjuster works well under moderate supervision using company best practices. They must execute files within their authority to make appropriate decisions regarding coverage, settlement, and liability. The Specialty Adjuster handles claims involving fire, theft, vandalism, marine, specialty products, coverage, collision (1st and 3rd), various other comprehensive losses and a variety of complex claims. This position investigates coverage, evaluates, and settles damages and effectively resolves claims to conclusion in a timely manner. In this role this adjuster is responsible for taking recorded statements, reviewing policies for coverage, settling claims including total losses and writing Reservation of Rights and Coverage disclaimer letters, when appropriate. The person in this role takes ownership of their personal brand, stays professional and works well individually and within a dynamic team atmosphere. Ready to get in the driver's seat? Join us! What you'll do Makes timely and appropriate contacts with necessary parties, determines, and completes appropriate level of investigation for coverage determination. Determines exposure, establishes adequate initial reserves, and makes timely adjustment to reserve(s) as required. Determines settlement value and negotiates proper settlement of claims within authority. Provides recommendations for settlement and disposition of claims exceeding authority level. Pursues subrogation when appropriate. Handles first party auto property damage losses and occasionally third-party property damage losses. Demonstrates strong negotiating skills Controls expenses and expense reserves on storage, towing, appraisals, vendors, or legal counsel Problem solves complaints or questions Demonstrating technical learning and skill Exemplifies strategic agility Submit timely large loss reports and occasional Large Loss reporting Authority/Accountability Level: A Specialty Adjuster is capable of analyzing and determining exposure for fire, theft, vandalism, and a variety of complex claims. This person must exercise discretion to identify and resolve coverage issues, identify potential fraud, and settle losses as appropriate. A Specialty adjuster will process approximately 600-800 lines annually and is responsible for reporting out to various departments within the business. This Job Is Responsible for Producing the Following Results: Maintaining stellar customer service tracked through company measurements Handles claims for fire, vandalism, theft, complex coverage in personal lines Meets or exceeds individual goals to help the department reach its targets Making appropriate coverage and/or settlement decisions Setting timely reserves Consistently produces quality work product Completing thorough investigations in order to determine coverage, liability, and settlement Analyzes facts to justify the assistance of SIU, O&C's, or legal counsel Ability to take quality recorded statements from many parties Identifies Red Flags Ability to write accurate Reservation of Rights letters and Coverage declinations Manages expenses Pursues recovery as applicable Fueling engagement within the team and department This might describe you Must be detail oriented and show a high level of accuracy Excellent verbal and written communication skills Knowledgeable in insurance products and expertise Exercise decisiveness and execution within their authority Must have ability to work individually and as a team Ability to maintain confidential information Strong problem-solving skills Strong time management and organizational ability Must possess a keen interest in self-development Needs to be reliable, accountable, and trustworthy Must be able to motivate and lead others Demonstrate proficiencies with computer software & multitasking Must maintain impeccable attendance Must be licensed and bondable Familiarity of public company requirements, including Sarbanes Oxley and key regulations, if applicable. Other things to note This position is open to U.S. remote work. Say hello to Hagerty Hagerty is an automotive enthusiast brand and the world's largest membership organization. Along with being a best-in-class provider of specialty insurance for enthusiasts, Hagerty is also home to the Hagerty Drivers Foundation, Garage + Social, Hagerty Drivers Club, Marketplace and so much more. Committed to saving driving for future generations, each and every thing Hagerty does is dedicated to the love of the automobile. Hagerty is a rapidly growing company that values a winning culture. We provide meaningful work for and invest in every single team member. At Hagerty, we share the road. We are an inclusive automotive community where all are welcomed, valued and belong regardless of race, gender, age, or car preference. We are united by our shared passion for driving, our commitment to preserve car culture for future generations and our desire to make a positive impact in the world. If you reside in the following jurisdictions: Illinois, Colorado, California, District of Columbia, Hawaii, Maryland, Minnesota, Nevada, New York, or Jersey City, New Jersey, Cincinnati or Toledo, Ohio, Rhode Island, Vermont, Washington, British Columbia, Canada please email ********************** for compensation, comprehensive benefits and the perks that set us apart. #LI-Remote EEO/AA US Benefits Overview Canada Benefits Overview UK Benefits Overview If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

Shape Your Future With UsGeneral Re Corporation, a subsidiary of Berkshire Hathaway Inc., is a holding company for global reinsurance and related operations, with more than 2,000 employees worldwide. It owns General Reinsurance Corporation and General Reinsurance AG, which conducts business as Gen Re. Gen Re delivers reinsurance solutions to the Life/Health and Property/Casualty insurance industries. Represented in all major reinsurance markets through a network of 38 offices, we have earned superior financial strength ratings from each of the major rating agencies. Gen Re currently offers an excellent opportunity for a Claims Specialist in our Life Health Global Claims unit to work remotely based out of our Stamford, CT office. Role Description The Claim Specialist is responsible for the delivery of the reinsurance claim risk management on multiple lines of business to both internal and external Gen Re clients. This includes, but is not limited to, the risk assessment of reinsurance liability and may include client training development and delivery, audit activities as well as representing the company and/or speaking at various industry conferences, as requested. Responsibilities: Responsible timely decision making and accuracy of reinsurance determinations on multiple lines of claim submissions. Incumbent contributes to the accurate and efficient adjudication of claims by supporting the department and client's investigation or coaching/mentoring on claims in all ranges of complexity to ensure compliance with policy provisions, state/federal regulations and reinsurance treaties in effect. Maintains a working knowledge of state and federal regulatory issues and keeps on the cutting edge of changes within the incumbent's area of expertise. Deliver high levels of customer service to internal and external customers in a professional, reliable and responsive manner. The incumbent works with claims management to develop, prioritize and execute a claim management strategy for each assigned client. Responsible for influencing a variety of constituents at various levels and not within one's direct employ. Thus, being accountable for the effective development, ongoing maintenance and consistent application of client communications and relationships. As an expert claim resource within a specific line of business, the Claim Specialist monitors national verdict/settlement trends and legal developments pertaining to their particular line of business. The incumbent researches, drafts and publishes articles and training oriented to educating clients on best practices gleaned. Responds to ad hoc reporting /projects from manager. Timely and accurate reporting of statistical information to management. Provides a broad range of regular (monthly/quarterly) management information in support of the Claims Department. Responsible for synthesizing a large amount of information from a variety of sources. May participate in client / TPA due diligence activities such as supporting audit activity, identifying emerging trends and themes not only in the client's inventory but within the industry; supporting manager with industry gleaned best practices via building and delivering customer specific training programs and seminars; emphasizing and implementing technical solutions to business needs to achieve desired improvements when asked. May participate in client meetings or with prospective accounts. Role Qualifications and Experience Prior claims experience in insurance and/or reinsurance operations. Prior experience managing claims (preferably LTC or Income Protection) thereby equipping the incumbent with the ability to assess reinsurer responsibility in its broadest sense (e.g. reviewing and offering risk management insights and recommendations on facultative and consultative claim submissions). Experience auditing claim files. Audit work of reinsured claims remotely or in client locations is an expectation. The audit process requires the ability to quickly adapt to the multitude of imaged systems in use by clients. The audit process may involve analyzing and verifying coverage and/or corresponding payments issued. The audit process may consist of managing internal and external communication with client executives in various areas such as claims, financial and legal resources, actuarial resources, etc. Thus, demonstrating an ability to emphasize and implement solutions to help clients manage risk and developing an in-depth knowledge of the management and organization of each assigned account. Holds insurance adjuster's license or a willingness to secure same within 1 year of hire Strong working knowledge of key coverage lines especially health (Long Term Care, Individual Disability) type claims Strong written and verbal communication skills Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously or as an effective member of a team Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to detail Flexibility to travel for business purposes, approximately less than 10 trips per year Strong client relationship, influencing and interpersonal skills Proven initiative, prioritization, presentation, and training abilities. Experience with and proficiency in Microsoft Suite of Products (WORD, EXCEL, PowerPoint), Visio, Power BI, developing and running queries etc. Salary Range 91,000.00 - 152,000.00 USD The annual base salary range posted represents a broad range of salaries around the US and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. Our Corporate Headquarters Address General Reinsurance Corporation 400 Atlantic Street, 9th Floor Stamford, CT 06901 (US) At General Re Corporation, we celebrate diversity and are committed to creating an inclusive environment for all employees. It is the General Re Corporation's continuing policy to afford equal employment opportunity to all employees and applicants for employment without regard to race, color, sex (including childbirth or related medical conditions), religion, national origin or ancestry, age, past or present disability , marital status, liability for service in the armed forces, veterans' status, citizenship, sexual orientation, gender identity, or any other characteristic protected by applicable law. In addition, Gen Re provides reasonable accommodation for qualified individuals with disabilities in accordance with the Americans with Disabilities Act.