Overview:

Seeking a detail-oriented and experienced WC Subrogation Claims Adjuster. The successful candidate will be responsible for reviewing and pursuing subrogation on a current case load, evaluating legal liability for recovery, and effectively communicating with various stakeholders in a professional manner.

Responsibilities:

• Review and pursue subrogation on a current case load
• Evaluate legal liability for recovery, including duty owed, breach of duty, proximate cause, and damages
• Identify and pursue alternative avenues of recovery
• Direct claims investigation when necessary to establish a proper foundation for recovery potential
• Identify gaps in investigation and take initiative to complete investigations
• Communicate effectively with policyholders, insurance adjusters, underwriters, attorneys, and agents
• Establish accurate recovery projection based on liability and damages
• Maintain and control subrogation pursuit through collaboration with attorneys, vendors, and insureds
• Utilize a diary system to proactively move claims toward recovery resolution
• Perform other duties as assigned

Qualifications:

• Florida Claims Adjuster License
• 3+ years of subrogation experience
• Worker’s Compensation subrogation experience required
• Auto & Property subrogation experience strongly preferred
• High School Diploma or equivalent required, 2-year college degree or higher preferred

Day-to-day:

The successful candidate will be responsible for reviewing and pursuing subrogation cases, evaluating legal liability for recovery, communicating with various stakeholders, and collaborating with attorneys, vendors, and insureds to control subrogation pursuit.

Benefits:

• Competitive salary: $70,000 - $80,000/year (DOE)
• Bonus program based on net profit, paid out twice a year
• Remote work opportunity

#LI-MW1

Company Overview

Our client is a respected third-party administrator (TPA) providing comprehensive claims management solutions to commercial clients nationwide. They are seeking a Senior Commercial General Liability Claims Examiner to handle complex liability claims with a focus on habitational and commercial real estate exposures.

COMPENSATION:

• $80,000 - $95,000/year (based on experience)
• Comprehensive benefits package including medical, dental, vision, and 401(k)
• Paid time off and paid holidays
• Fully remote work environment with flexibility

JOB QUALIFICATIONS:

• 5+ years of Commercial General Liability claims handling experience
• Demonstrated experience handling habitational and/or commercial real estate liability claims
• Prior experience working for a TPA or in a high-volume commercial claims environment preferred
• Strong litigation management and settlement negotiation skills
• Ability to independently manage a full caseload with minimal supervision

JOB RESPONSIBILITIES:

• Independently manage complex Commercial General Liability (CGL) claims, including litigated matters
• Handle claims arising from habitational and commercial real estate exposures (e.g., apartments, condos, mixed-use properties, office buildings)
• Conduct thorough investigations including coverage analysis, liability evaluation, and damages assessment
• Establish and manage reserves in accordance with client guidelines and best practices
• Coordinate with defense counsel on litigated claims, including strategy, discovery, and settlement evaluation
• Evaluate and negotiate settlements within assigned authority
• Communicate effectively with insureds, claimants, attorneys, and clients
• Ensure compliance with applicable jurisdictional regulations and client-specific service instructions
• Document claim activity accurately and timely within the claims management system
• Identify subrogation opportunities and potential fraud indicators

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

#LI-MW1

Senior Complex Claims Specialist - MPL

Job Summary

Seeking a highly skilled and experienced Senior Complex Claims Specialist to join a dynamic and growing Claims team. This role is an individual contributor position responsible for managing Miscellaneous Professional Liability (MPL) claims from inception to resolution. The successful candidate will handle mid to high severity claims, negotiate settlements, and collaborate with internal and external stakeholders to achieve optimal outcomes. This position requires a strong technical background, exceptional analytical skills, and the ability to mentor and lead within the claims team.

Compensation Package

• Salary Range: $140,000 - $170,000 annually, plus a 10% performance-based bonus.
• Comprehensive benefits package, 401(k), paid time off, professional development opportunities, etc.

Responsibilities

• Handle and resolve high-severity MPL claims with minimal supervision.
• Draft complex technical coverage analyses and correspondence.
• Act as a subject matter expert within the claims team.
• Lead litigation strategies, including attending trials and mediations.
• Investigate claims, negotiate settlements, and utilize alternative dispute resolution methods.
• Identify and address emerging exposures and claims trends.
• Detect and manage suspected fraudulent claims in collaboration with the special investigations unit.
• Maintain accurate and comprehensive claim documentation in compliance with company policies and regulatory requirements.
• Mentor and provide guidance to other team members.
• Develop and deliver training content for the claims team and underwriters.
• Analyze claim documentation and legal filings to ensure proper handling.

Qualifications/Requirements

• Minimum of 10 years of claims handling experience.
• A Juris Doctor (JD) degree from an ABA-accredited law school may supplement claims handling experience.
• Proven ability to positively influence high-severity claims outcomes through investigation, negotiation, and litigation leadership.
• Expert knowledge of MPL coverage and litigation processes.
• Strong negotiation and analytical skills.
• Demonstrated experience mentoring and training team members.
• Excellent verbal and written communication skills.
• Bachelor’s degree from an accredited college or university preferred.
• Adjuster licensing required within 90 days of employment.

#LI-BC1

Senior Claims Representative - Professional Liability

Job Summary

Seeking a highly skilled and experienced Senior Claims Representative specializing in Professional Liability to join a dynamic team. This is a full-time, 100% remote position with a temporary assignment of approximately three months, with the potential for permanent conversion based on performance and departmental needs. The successful candidate will manage a diverse portfolio of professional liability claims, including both litigated and non-litigated cases, for a variety of professions. This role requires exceptional analytical, organizational, and communication skills, as well as the ability to thrive in a fast-paced, collaborative environment.

Compensation Package

• Hourly Rate: $50 - $65 per hour
• Type: Temp-to-Hire (3-month assignment with potential for permanent placement)
• Additional Benefits: Competitive compensation based on qualifications, geographic location, and other considerations permitted by law.

Responsibilities

• Manage an active caseload of litigated and non-litigated claims of varying complexity under miscellaneous professional liability coverages.
• Evaluate coverage issues and identify risk transfer opportunities.
• Recognize exposures and ensure reserves are adequate and timely.
• Develop and implement resolution strategies, including settlement valuation and obtaining settlement authority.
• Proactively manage litigation, including expert selection, planning, budgeting, and collaboration with defense counsel.
• Participate in mediations and other legal proceedings as needed, within settlement authority limits.
• Maintain accurate and thorough documentation of claim files in accordance with established guidelines.
• Manage allocated loss adjustment expenses through strategic handling and coordination with the billing unit.
• Maintain adjuster licenses as required.
• Communicate effectively with internal and external stakeholders.
• Occasionally travel to attend mediations, trainings, trials, and other related meetings.

Qualifications/Requirements

Education & Licensing:

• Bachelor’s degree required.
• Active home state adjuster license required.
• Industry designations such as AIC, SCLA, or CPCU are a plus.

Experience:

• Minimum of 3 years of experience handling professional liability claims preferred.
• At least 1 year of experience managing litigated claims.

Skills & Abilities:

• Strong analytical, organizational, and time management skills.
• Excellent written and verbal communication skills.
• Ability to work independently and meet deadlines in a fast-paced environment.
• Proficiency in MS Word, Excel, and internet applications.
• Highly detail-oriented with the ability to prioritize tasks effectively.
• Strong interpersonal skills and the ability to work collaboratively in a virtual office environment.
• Ability to execute sound judgment in sensitive situations and respond promptly to inquiries with a sense of urgency.

#LI-BC1

Claims Compliance Analyst

Job Summary

Seeking a highly skilled and experienced Claims Compliance Analyst to join a growing team. This role is integral to ensuring compliance with claims regulations across all 50 states and federal jurisdictions. You will work closely with internal claims teams, legal departments, and third-party administrators to maintain best-in-class claims practices and regulatory compliance. 

Compensation Package

• Salary Range: $90,000 - $130,000 per year (based on experience)
• Benefits Include:
  • Competitive benefits package, 401(k), paid time off, professional development opportunities, etc.

Responsibilities

As a Claims Compliance Analyst, your key responsibilities will include:

• Maintaining a centralized 50-state claims compliance library.
• Assisting with internal audits and regulatory reviews.
• Ensuring adherence to claims best practices.
• Analyzing data and file trends to identify potential compliance issues and developing solutions.
• Providing compliance support to internal teams and external vendors.

Qualifications/Requirements

The ideal candidate will possess the following qualifications:

• A minimum of 10 years of experience in claims compliance, insurance regulation, or legal operations.
• A Juris Doctor (J.D.) degree is strongly preferred; advanced insurance compliance certification is a plus.
• Experience with multiple lines of business in a 50-state claims environment.
• Knowledge of Medicare Secondary Payer requirements and Section 111 reporting.
• Strong research and policy writing skills.
• Excellent collaboration, project management, and problem-solving abilities.

#LI-TS1

California Workers Compensation Adjuster (Permanent)

Job Summary

Seeking a highly skilled and experienced Workers Compensation Claims Adjuster to join a team. This role involves managing all aspects of workers compensation claims, including determining compensability, verifying coverage, administering disability and medical benefits, negotiating claim resolutions, and providing exceptional service to injured employees, employers, and medical/legal professionals.

Compensation Package

• Medical, dental, and vision insurance
• Life insurance
• 401(K) with company match
• Opportunities for professional growth and development in a supportive and collaborative environment

Responsibilities

• Receive and manage newly reported claims
• Maintain and update claim notes throughout the lifespan of claims
• Record claim information in an electronic database
• Conduct interviews with claimants, insureds, medical professionals, and witnesses to determine claim validity
• Communicate claim compensability decisions to claimants, employers, and medical providers
• Set appropriate reserves based on the nature and extent of injuries
• Calculate lost time wages and administer disability payments
• Coordinate independent medical examinations and prepare relevant documentation
• Maintain regular correspondence with claimants, insureds, and nurse case managers
• Review and process medical bills through third-party vendors for additional discounts
• Collaborate with claimants and insureds to facilitate early return-to-work
• Partner with legal counsel to protect insured interests on litigated claims
• Attend settlement conferences, mediations, and hearings on behalf of the company or insured
• Review and approve defense attorney bills within authority
• Provide relevant loss information to underwriting and risk management teams
• Respond to state requests for health cost disputes, applications for hearings, and penalty assessment letters
• Identify subrogation opportunities and pursue recovery
• Lead claim reviews with clients as requested
• Perform other duties as assigned

Qualifications/Requirements

• Minimum of 10 years of experience adjusting Workers Compensation Claims in California
• SIP Certification is required
• Bilingual proficiency in Spanish and English is required
• Current with Continuing Education Units (CEUs)
• Proficiency in the Microsoft Office suite
• In-depth knowledge of California workers compensation laws
• Strong understanding of medical terminology and treatment progression
• Excellent oral and written communication skills
• Exceptional attention to detail and organizational abilities
• Proven negotiation skills for resolving issues and settlements
• Strong customer service orientation with a commitment to timely responses
• Adaptability to changing technologies and new systems
• Ability to establish and maintain effective working relationships with others

#LI-BR1

As a Personal Lines Auto Appraiser, you will play a crucial role in clients' insurance claim processes by accurately assessing and determining the value of damaged or totaled vehicles. Your expertise will help ensure fair settlements for policyholders while adhering to company guidelines and industry regulations.

Salary/Benefits

• $70,000 - $85,000+/year (based on experience)
• 20 days of PTO
• 100% Company paid medical benefits to employee AND family
• 401k company matches 100% up to the first 3%
• Company vehicle provided

Job Description

• Complete virtual estimates utilizing customer & vendor provided photos.
• Complete in-person field inspection of personal & commercial vehicles, motorcycles, fixed property, and complete repair estimates.
• Make total loss determinations and complete evaluations, if necessary.
• Negotiate supplements with body shops in a timely manner
• Review policy to verify coverage and limits and make payment determinations.

Requirements

• 2-5 years of experience as an Auto Appraiser
• Strong knowledge of personal auto insurance policies, coverage, and regulations.
• Claims handling experience a plus!
• Bilingual in Spanish a plus!

#LI-MW1

Position Overview

Our client, a well-established Third-Party Administrator (TPA), is seeking an experienced Senior California Workers’ Compensation Claims Adjuster to manage a full caseload of California workers’ compensation claims. This role is fully remote and ideal for a seasoned professional who can independently handle complex claims while delivering high-quality service to clients and injured workers.

Compensation Package

• $90,000 - $115,000/year (based on experience)
• 100% remote work environment
• Comprehensive benefits package
• Supportive and collaborative team culture
• Long-term stability with a reputable TPA
  
  

Qualifications

• 5+ years of experience handling California Workers’ Compensation claims
• Strong knowledge of California workers’ compensation laws and regulations
• Ability to independently manage complex and litigated claims
• Excellent written and verbal communication skills
• Strong organizational and time management abilities
• Proficiency with claims management systems and standard claims technology

Key Responsibilities

• Manage a full caseload of California workers’ compensation claims from inception through closure
• Investigate claims, determine compensability, and establish appropriate reserves
• Handle complex and litigated claims in compliance with California workers’ compensation laws and regulations
• Coordinate with injured workers, employers, attorneys, medical providers, and other stakeholders
• Prepare and maintain accurate claim documentation and reports
• Ensure timely and compliant claims handling, including benefit administration and settlement negotiations
• Provide excellent customer service while maintaining productivity and quality standards

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer’s discretion.

#LI-MW1

#INDTJG-CTT

Sr. Claims Specialist - Multi-Line Adjuster

Job Summary

Seeking a highly skilled and experienced Sr. Claims Specialist - Multi-Line Adjuster to join a team. This is a hybrid role requiring three days per week in the office. The ideal candidate will have extensive experience in handling General Liability, Commercial Auto, Property Damage, Bodily Injury, and Litigation claims. If you are a dedicated professional with a strong background in claims management and a commitment to excellence, encourage you to apply.

Compensation Package

• Salary: $80,000 - $95,000 per year
• Benefits:
  • 28 days of Paid Time Off (PTO) to start
  • 37.5-hour work week
  • Personal Performance Incentive Bonus (discretionary)
  • Annual salary reviews for potential increases
  • 401(k) plan with company match
  • Comprehensive benefits starting the 1st of the month following your start date

Responsibilities

• Manage a caseload of 100-125 claims, including litigation cases.
• Handle a variety of claims, including General Liability, Commercial Auto, Property Damage, Liability, Total Loss, and Bodily Injury.
• Conduct thorough investigations, evaluate coverage, and determine liability.
• Collaborate with internal and external stakeholders to resolve claims efficiently and effectively.
• Maintain compliance with all applicable regulations and company policies.
• Provide exceptional customer service to clients and policyholders.

Qualifications/Requirements

• Minimum of 5+ years of experience handling General Liability, Commercial Auto, Property Damage, Liability, Total Loss, Bodily Injury, and Litigation claims.
• Active Adjuster License is required.
• Strong knowledge of insurance coverage and claims processes.
• Ability to manage a diverse caseload with professionalism and efficiency.
• Excellent communication and interpersonal skills.
• A collaborative and adaptable attitude to handle varying claims on a day-to-day basis.

#LI-BC1