Job Description: Senior Claims Specialist - CGL/Auto

Location: Duluth, GA

Job Summary

Seeking a motivated and experienced Senior Claims Specialist to manage complex claims involving Commercial General Liability (CGL) and Auto coverage. The role emphasizes expertise in claims adjustment practices, exceptional customer service, and attention to detail.

Key Responsibilities

• Claim Handling: Investigate, analyze, and resolve moderately complex to complex CGL and Auto claims in accordance with procedures and best practices.
• Customer Service: Provide prompt and professional responses to claimants, policyholders, and key stakeholders.
• Investigation: Conduct thorough investigations, secure necessary documentation, and collaborate with external parties, including legal counsel, medical professionals, and engineers, to determine liability and resolve disputes.
• Negotiations: Negotiate settlements equitably within financial and legal guidelines to optimize outcomes.
• Compliance: Ensure all claim handling adheres to applicable laws, regulations, and company procedures.
• Documentation & Reporting: Maintain accurate claim documentation, prepare detailed reports, and inform management of developing trends and significant loss exposures.
• Team Collaboration: Work closely with underwriting, special investigation units, and legal teams to assess risk and develop effective solutions.
• Training & Mentorship: Offer guidance and mentorship to junior adjusters to foster skill development and professional growth.

Qualifications

• Education: Bachelor’s degree or equivalent professional experience.
• Experience: A minimum of 5-7 years of claims adjustment experience, with a focus on CGL and Auto claims.
• Licensure: Active claims adjuster license(s) in the state of Georgia.
• Technical Skills: Proficient in claims management systems, Microsoft Office Suite (Word, Excel, Outlook), and related software.
• Knowledge: In-depth understanding of insurance policies, risk management principles, and relevant regulations.
• Analytical Skills: Strong problem-solving, analytical, and critical-thinking capabilities to evaluate claims, subrogation opportunities, and fraud risks effectively.
• Communication: Exceptional verbal and written communication skills.
• Customer-Centric Mindset: Ability to build and maintain strong customer and internal partner relationships.
• Organization: Ability to prioritize and manage multiple projects in a fast-paced environment.

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.

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Overview:
A well-established Third-Party Administrator (TPA) is seeking an experienced Senior Workers’ Compensation Claims Adjuster to join their team supporting New England. This role is fully remote and requires a seasoned claims professional who can independently manage a complex Vermont workers’ compensation caseload while delivering excellent service to both the client and injured workers.

The ideal candidate will have strong knowledge of Vermont workers’ compensation statutes, proven experience handling litigated and complex claims, and the ability to manage claims from inception through resolution.

Compensation:

• $80,000 - $95,000/year
• Annual Bonus Potential
• 100% Remote Work Environment
• Comprehensive benefits package
• Opportunity to support a stable, long-term dedicated account
• Collaborative and supportive claims leadership team

Job Requirements:

• 5+ years of Workers’ Compensation Claims Adjusting experience, within the New England jurisdictions is rquired
• Strong understanding of CT, ME, or VT Workers’ Compensation regulations and claims procedures.
• Experience handling complex and litigated claims.
• Prior experience working for a TPA or insurance carrier preferred.
• Strong organizational, analytical, and negotiation skills.
• Ability to manage a full caseload independently in a remote work environment.
• Active Connecticut adjuster license or ability to obtain quickly.

Key Responsibilities:

• Manage a full caseload of New Engalnd workers’ compensation claims from inception to closure.
• Investigate claims thoroughly to determine compensability and appropriate reserves.
• Ensure all claims are handled in compliance with New England workers’ compensation laws and regulatory requirements.
• Coordinate and communicate with injured workers, employers, medical providers, attorneys, and other stakeholders.
• Establish and adjust reserves based on claim developments and exposure.
• Direct medical management, including coordination with nurse case managers when appropriate.
• Evaluate claims for settlement opportunities and participate in negotiations when necessary.
• Manage litigated claims, working closely with defense counsel to develop strategies and control costs.
• Maintain accurate claim documentation and provide timely claim updates to the client.
• Deliver high levels of customer service to a dedicated client account while meeting all service standards and KPIs.

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Overview:
A well-established Third-Party Administrator (TPA) is seeking an experienced Senior Workers’ Compensation Claims Adjuster to join their team supporting New York. This role is fully remote and requires a seasoned claims professional who can independently manage a complex Vermont workers’ compensation caseload while delivering excellent service to both the client and injured workers.

The ideal candidate will have strong knowledge of Vermont workers’ compensation statutes, proven experience handling litigated and complex claims, and the ability to manage claims from inception through resolution.

Compensation:

• $80,000 - $95,000/year
• Annual Bonus Potential
• 100% Remote Work Environment
• Comprehensive benefits package
• Opportunity to support a stable, long-term dedicated account
• Collaborative and supportive claims leadership team

Job Requirements:

• 5+ years of Workers’ Compensation Claims Adjusting experience, within the New York jurisdictions is required
• Strong understanding of NY Workers’ Compensation regulations and claims procedures.
• Experience handling complex and litigated claims.
• Prior experience working for a TPA or insurance carrier preferred.
• Strong organizational, analytical, and negotiation skills.
• Ability to manage a full caseload independently in a remote work environment.
• Active Connecticut adjuster license or ability to obtain quickly.

Key Responsibilities:

• Manage a full caseload of New York workers’ compensation claims from inception to closure.
• Investigate claims thoroughly to determine compensability and appropriate reserves.
• Ensure all claims are handled in compliance with New England workers’ compensation laws and regulatory requirements.
• Coordinate and communicate with injured workers, employers, medical providers, attorneys, and other stakeholders.
• Establish and adjust reserves based on claim developments and exposure.
• Direct medical management, including coordination with nurse case managers when appropriate.
• Evaluate claims for settlement opportunities and participate in negotiations when necessary.
• Manage litigated claims, working closely with defense counsel to develop strategies and control costs.
• Maintain accurate claim documentation and provide timely claim updates to the client.
• Deliver high levels of customer service to a dedicated client account while meeting all service standards and KPIs.

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Position Overview

We are seeking an experienced Executive General Adjuster (EGA) specializing in Large Loss Commercial Property claims to investigate, evaluate, negotiate, and resolve complex commercial property losses. This individual will handle high-severity, high-exposure claims involving significant property damage, business interruption, and complex coverage considerations.

The ideal candidate will have extensive field adjusting experience, a strong technical understanding of commercial property policies, and the ability to independently manage large and complex losses from initial inspection through final resolution.

This is an excellent opportunity for a seasoned property claims professional who excels in complex loss investigations, client relationship management, and delivering technically sound claim outcomes.

Salary

• $105,000 - $125,000+/year Based on experience
• Quarterly bonuses based off of billings
• Full medical benefits

Job Description:

1. Independently investigate, evaluate, and adjust complex, high-value commercial property losses.
2. Conduct on-site inspections of large commercial and industrial properties to assess damage, determine scope, and establish repair or replacement costs.
3. Manage large-loss claims involving commercial buildings, manufacturing facilities, warehouses, retail properties, habitational risks, and other complex commercial exposures.
4. Evaluate building damage, business interruption, extra expense, equipment breakdown, and other associated commercial property exposures.
5. Interpret commercial property insurance policies, including coverage provisions, exclusions, endorsements, and applicable limitations.
6. Establish appropriate reserves based on exposure assessments and ongoing claim developments.
7. Prepare detailed investigation reports, estimates, recommendations, and claim documentation.
8. Coordinate and collaborate with engineers, contractors, forensic accountants, consultants, and other industry experts.
9. Negotiate settlements with policyholders, public adjusters, attorneys, brokers, and other involved parties.
10. Maintain consistent communication with carrier clients, insureds, and other stakeholders throughout the claim lifecycle.
11. Manage litigation-related exposures and work closely with defense counsel when necessary.
12. Ensure claims are handled in accordance with applicable regulatory requirements, industry standards, and client guidelines.

Requirements:

• 10+ years of commercial property claims adjusting experience, preferably handling large-loss and complex commercial property claims.
• Demonstrated experience independently managing high-severity property claims with significant financial exposure.
• Strong knowledge of commercial property insurance policies, coverage analysis, and loss evaluation.
• Experience handling complex building damage, structural losses, business interruption, and time-element exposures.
• Proficiency in estimating and claims management platforms such as Xactimate, XactAnalysis, or similar systems.
• Strong negotiation, investigation, analytical, and problem-solving skills.
• Excellent written and verbal communication skills, including the ability to prepare comprehensive technical reports.
• Ability to manage multiple complex assignments while maintaining attention to detail and timely claim resolution.
• Active adjuster licenses in applicable jurisdictions, with the ability to obtain additional licenses as needed.
• Willingness and ability to travel regularly for on-site inspections and claim investigations.

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Job Description: Senior Claims Adjuster - Homeowners Property

Job Summary

Seeking an experienced Senior Claims Adjuster - Homeowners Property to handle complex property claims efficiently while ensuring a high level of service and accuracy. This role requires strong technical expertise in claims adjusting and a proactive approach to resolving claims with policyholders, contractors, and other stakeholders.

Responsibilities

• Investigate, evaluate, and resolve complex homeowners property claims, ensuring claims are settled according to policy terms and state regulations.
• Analyze property damage to assess coverage applicability, estimate losses, and establish reserves.
• Collaborate with insureds, contractors, legal representatives, and third-party vendors to facilitate timely claims resolution.
• Perform site inspections or virtual evaluations, thoroughly documenting findings with relevant records and photographs.
• Mentor junior claims adjusters in effective claims handling and technical proficiency.
• Maintain accurate, organized case management records and prepare detailed reports for all claims.
• Utilize claims management systems and tools to streamline processes and ensure compliance.
• Clearly communicate claims outcomes to clients, providing updates and addressing any concerns throughout the process.
• Monitor industry updates, regulatory changes, and best practices to maintain compliance and stay informed.
• Identify potential fraudulent claims and initiate a specialized investigation as required.
• Participate in catastrophe response efforts, including travel to impacted areas as necessary.

Qualifications/Requirements

Education & Certification:

• High school diploma or GED required; bachelor's degree in insurance, business administration, or related field preferred.
• Possession of active state adjuster’s license(s) or ability to obtain licensing within a defined timeframe.

Experience & Skills:

• 5-7 years of experience in homeowners claims adjusting, with in-depth knowledge of property claims and construction terminology.
• Proficiency in estimating software.
• Highly developed negotiation, problem-solving, and decision-making skills.
• Strong communication skills with a focus on customer service and issue resolution.
• Ability to handle and prioritize multiple claims efficiently in a dynamic environment.

Additional Requirements:

• Comprehensive understanding of federal and state insurance regulations applying to property claims.
• Willingness to travel up to 25% for on-site inspections and catastrophe response with minimal notice.

Perks and Benefits

• Competitive compensation and benefits package.
• Professional development opportunities and career growth potential.
• Access to cutting-edge tools and innovative technologies.
• Collaborative work environment that prioritizes delivering exceptional service.

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.

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Our client, who is a leading insurance company dedicated to providing exceptional service and coverage to their policyholders, is currently seeking a talented and detail-oriented Medical Only Insurance Claims Adjuster to join their claims team.

Position Overview:

As a Medical Only Insurance Claims Adjuster, you will be responsible for managing a caseload of medical-only claims, ensuring timely and accurate processing. You will collaborate with medical providers, policyholders, and other stakeholders to facilitate the efficient resolution of claims while maintaining a high level of customer service.

Salary/Benefits:

• $37,000 - $42,000/+year (Based on experience)
• Comprehensive health, dental, and vision insurance
• 401k retirement savings plan with company match
• Professional development opportunities
• Employee wellness programs

Key Responsibilities:

• Manage a caseload of medical-only insurance claims from inception to resolution.
• Review medical records, bills, and other documentation to determine coverage and eligibility.
• Communicate with medical providers, policyholders, and other parties involved in the claims process to gather information and facilitate resolution.
• Provide timely updates and responses to inquiries regarding claim status and coverage.
• Evaluate medical bills and expenses to determine reimbursement amounts in accordance with policy coverage and guidelines.

Qualifications:

• 1-3 years of experience as a Medical Only Claims Adjuster or related healthcare field
• Knowledge of medical terminology, billing practices, and healthcare regulations.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Detail-oriented with the ability to prioritize and manage multiple tasks effectively.

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• $90K - $100K Annually (based on experience)
• Annual bonus potential
• Flex schedule and ability to work remotely

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. 

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Senior Claims Examiner - General Liability

Job Summary

Seeking a highly skilled and experienced Senior Claims Examiner - General Liability to join a team. This role involves investigating, evaluating, and resolving complex general liability claims, including litigated cases. The ideal candidate will have a strong background in high-exposure claims, litigation management, and a deep understanding of insurance policies and liability concepts.

Compensation Package

• Salary Range: $81,000 - $114,000 annually
• Comprehensive benefits package

Responsibilities

• Investigate, evaluate, and determine settlement value or denial of liability for severe to major-level general liability claims.
• Establish and regularly review appropriate reserves for indemnity and expenses to ensure adequacy.
• Provide recommendations for reserve adjustments on claims outside of authority levels.
• Prepare comprehensive reports and communicate claim trends or policy issues to management.
• Manage the litigation process, including the retention of counsel and adherence to litigation guidelines (budgeting, bill review, and payment).
• Document and manage claims from inception to closure.
• Adjust general liability property damage claims as necessary.

Qualifications/Requirements

• Education: AA/AS or BA/BS preferred but not required.
• Experience: Minimum of 8-10 years of complex/major claims experience, including proficiency in investigating and resolving severe to major casualty and general liability claims.
• High-exposure general liability and litigation experience required.
• Must possess an active adjuster license in your domiciled state or designated home state.
• Minimum of one adjuster license in NY, TX, or FL is required. Additional state adjuster licenses may be required within 180 days of hire.
• Maintain licenses and fulfill continuing education requirements in all applicable states.
• Strong knowledge of property and casualty insurance policies, insurance tort laws, codes, and procedures.
• Familiarity with medical and legal terminology, as well as liability concepts.

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Senior General Liability Claims Adjuster

Job Summary
Seeking an experienced and detail-oriented Senior General Liability Claims Adjuster to join a growing team. This fully remote position is ideal for candidates. The individual in this role will be responsible for managing a portfolio of General Liability and Commercial Auto claims, ensuring timely and accurate resolution in accordance with company standards.

Compensation Package

• Salary Range: $78,000 – $92,000 annually (commensurate with experience).
• Competitive benefits package, paid time off, professional development opportunities, etc.

Responsibilities

• Manage a diverse portfolio of General Liability and Commercial Auto claims.
• Handle primarily property damage claims, with some bodily injury exposures.
• Oversee litigated files and coordinate with defense counsel as needed.
• Ensure compliance with all internal guidelines and applicable regulations.
• Collaborate with internal teams and external partners to achieve effective claim outcomes.
• Maintain detailed and organized claim documentation throughout the process.

Qualifications/Requirements

• Minimum of 5 years of experience handling General Liability claims.
• Active Adjuster’s License required.
• Strong understanding of liability claims and litigation management.
• Excellent negotiation, communication, and analytical skills.
• Ability to work independently in a remote environment while maintaining high accuracy and service standards.
• Proficiency with claims management systems and Microsoft Office Suite.

• Previous Hawaii General Liability experience highly preferred.

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.

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 #LI-PR1

Technical Claim Director - Casualty Major Case Unit

Job Summary

Seeking a highly skilled and experienced Technical Claim Director to join a Casualty Major Case Unit. This role involves managing high-exposure, complex bodily injury and property damage claims across the United States (excluding New York). The ideal candidate will possess a strong background in general liability claims, exceptional analytical skills, and the ability to develop and implement effective claim resolution strategies. This is a hybrid position requiring three days per week onsite.

Compensation Package

• Base Salary: $130,000 - $180,000 (depending on experience) + bonus opportunities
• Competitive benefits package, 401(k), paid time off, professional development opportunities, etc.

Responsibilities

• Manage high-exposure, complex bodily injury and property damage claims across the U.S. (excluding New York).
• Conduct thorough fact investigations, coverage analyses, injury/damages evaluations, and litigation management.
• Develop and implement claim resolution strategies, including independent handling of mediations and trials.
• Select, retain, and direct defense counsel for litigated cases.
• Collaborate with underwriting teams on industry trends, case law, and statutory developments.
• Lead special projects and other duties as assigned.
• Occasional travel for mediations and trials as necessary.

Qualifications/Requirements

• Education: Bachelor’s degree in business administration, insurance, or a related field. A Juris Doctorate with relevant insurance coverage or defense litigation experience is a plus.
• Experience: Minimum of 8 years of relevant legal or insurance-related experience with general liability claims.
• Expertise:
  • Extensive experience handling general liability claims involving bodily injury and property damage with significant exposure under both primary and excess policies.
  • Strong knowledge of case law, statutes, and procedures impacting general liability claims.
  • Experience with claims involving various insurance risks and policies (e.g., construction, premises liability, security, marine).
• Skills:
  • Proactive investigation and strategic claim-handling abilities.
  • Strong risk transfer identification and pursuit skills.
  • Superior writing and communication skills for effective collaboration with insureds, claimants, underwriters, and management.

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