Senior Claims Representative

Job Summary

Seeking a highly skilled and experienced Senior Claims Representative to join a growing team. This role involves the investigation, evaluation, negotiation, and resolution of property claims with moderate to high complexity and value. The ideal candidate will possess a strong understanding of residential property claims, demonstrate excellent customer service skills, and thrive in a collaborative, team-oriented environment.

Compensation Package

• Salary Range: $65,000 - $80,000 per year
• Bonus: Discretionary annual bonus
• Benefits: Comprehensive benefits package provided

Responsibilities

• Investigate, evaluate, negotiate, and resolve assigned property claims of moderate to high complexity.
• Determine the facts of the loss, coverage applicability, and degree of exposure by unit of coverage.
• Review, analyze, and apply policy conditions, provisions, exclusions, and endorsements pertinent to a variety of losses.
• Establish timely and accurate property claim and expense reserves.
• Communicate professionally with customers, agents, and other stakeholders regarding all aspects of the claims process.
• Serve as a trainer and participate in special projects as assigned.
• Determine settlement amounts based on independent judgment, contractor estimate validation, appraisals, and policy application.
• Negotiate and convey property claim settlements within authority limits.
• Maintain an effective diary system to ensure timely resolution and document claim file activities in compliance with established procedures and state regulations.
• Provide exceptional customer service to meet the needs of insureds, agents, and other internal and external customers.
• Perform other duties as required.

Qualifications/Requirements

• Education: Bachelor’s Degree or equivalent business experience.
• Experience: Minimum of 5 years of progressive experience in adjusting residential and commercial property claims.
• Strong verbal and written communication skills.
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
• Demonstrated ability to work collaboratively in a team-oriented environment.
• Customer service orientation with a focus on empathy and ownership.
• Solid analytical and decision-making skills.
• Preferred Qualifications:
  • Bilingual proficiency.
  • AIC designation or other professional certifications specific to claims.

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Property Unit Manager (Property Claims Manager)

Job Summary

Seeking a highly skilled and experienced Property Unit Manager to join a team. This is an on-site position requiring presence in the office five days a week. The Property Unit Manager will oversee claim representatives handling both outside and inside claim processes in a multi-state and multi-line environment. This role involves granting authority, performing audits, monitoring benchmarks, and ensuring compliance with company policies and state regulations. The ideal candidate will have a strong background in claims management, excellent leadership skills, and a customer-centric approach.

Compensation Package

• Salary Range: $95,000 - $105,000 per year
• Discretionary Annual Bonus
• Comprehensive Benefits Package

Responsibilities

• Attract, retain, and develop talent within the claims department.
• Oversee the orientation and onboarding process for new team members.
• Manage staff performance, provide frequent feedback, and address training needs.
• Develop and execute strategic file management plans to achieve optimal resolution and business results.
• Conduct quality file reviews and implement strategies to improve file quality, customer service, and cost management.
• Leverage data, management information, and technology to support business strategies and improve outcomes.
• Ensure compliance with all state regulations and company policies.
• Develop and maintain effective relationships with colleagues, business partners, customers, agents, and regulatory agencies.
• Participate in business meetings and agency visits as required.
• Overnight travel may be required.
• Perform other duties as assigned.

Qualifications/Requirements

• Education: Bachelor’s Degree or equivalent business experience.
• Experience: Minimum of five (5) years of progressive experience in claims management, with multi-state experience preferred.
• Extensive knowledge of the claims process, including the ability to evaluate large and complex claims.
• Proficiency in Microsoft Office (Word, Excel, PowerPoint).
• Strong analytical, decision-making, and negotiation skills.
• Excellent written and verbal communication skills at all levels.
• Ability to work collaboratively with vendors and team members.
• Valid driver’s license and satisfactory Motor Vehicle Driving Record.
• Spanish-speaking ability is a plus.

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Our insurance carrier client is currently seeking a skilled and experienced Personal Auto Insurance Claims Adjuster to join their Claims Department. This will be a Remote position.

Position Overview:

As a Personal Auto Insurance Claims Adjuster, you will be responsible for investigating, evaluating, and settling personal auto insurance claims. You will work closely with policyholders, third-party claimants, and internal teams to assess liability, determine coverage, and negotiate settlements in accordance with company policies and regulatory requirements.

Key Responsibilities:

• Conduct thorough investigations to determine coverage, liability, and damages related to personal auto insurance claims.
• Gather and analyze relevant information, including accident reports, witness statements, and vehicle inspections.
• Evaluate vehicle damage and injuries to determine the extent of damages and the appropriate settlement amount.
• Collaborate with repair shops, medical professionals, and other experts to assess damages accurately.
• Interpret insurance policies to determine coverage and liability.
• Communicate coverage decisions clearly and effectively to policyholders and claimants.

Qualifications:

• Bachelor's degree in a related field or equivalent work experience.
• 5+ years of experience as a Personal Auto Insurance Claims Adjuster
• Strong knowledge of auto insurance policies, coverage, and regulations.
• Excellent communication and negotiation skills.
• Detail-oriented with strong analytical and problem-solving abilities.

Compensation:

• $60,000 - $85,000/year
• Comprehensive health, dental, and vision insurance

Benefits for Permanent Hires:

• Annual bonus between 5% - 10% based on company and personal performance
• 20 days of PTO
• 100% Company paid medical benefits to employee AND family
• 401k company matches 100% up to the first 3%

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Workers’ Compensation Claims Adjuster – Nevada (Remote)

Job Summary
Seeking an experienced Workers’ Compensation Claims Adjuster to manage a diverse caseload for multiple accounts, including both insurance and self-insured employers. This position requires strong knowledge of Nevada Workers’ Compensation law, as well as experience handling litigated claims. The ideal candidate will possess excellent communication, analytical, and organizational skills, with the ability to manage claims efficiently and deliver superior customer service.

Responsibilities

• Receive and review claim assignments, confirming policy coverage and directing timely acknowledgments of claims.
• Manage a caseload of approximately 100 lost time claims, including 15%–20% litigated files.
• Oversee claims through the full life cycle, ensuring timely and accurate handling in accordance with jurisdictional regulations.
• Investigate claims, gather supporting documentation, and determine compensability.
• Communicate effectively with claimants, employers, medical providers, attorneys, and other stakeholders.
• Develop and execute strategies to resolve claims promptly and within authority levels.
• Maintain detailed and accurate documentation within the claims management system.
• Ensure compliance with all applicable state laws and internal procedures.

Qualifications/Requirements

• Minimum of 3 years of Workers’ Compensation lost time claims handling experience.
• Active Nevada Adjuster License required.
• Must reside in the state of Nevada.
• Strong knowledge of Nevada Workers’ Compensation laws and regulations.
• Proven experience managing litigated claims.
• Excellent customer service and organizational skills.
• High school diploma required; bachelor’s degree preferred.

Compensation Package

• Compensation: $80K - $93K (depending on experience) + bonus opportunities
• Benefits: Competitive benefits package, 401(k), paid time off, professional development opportunities, and more.

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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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 - $92,000/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.

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Job Description:

Our client is seeking to add a Workers’ Compensation Claims Adjuster to their team. This role will consist of handling Workers’ Compensation Lost Time claims from inception to close. Qualified candidates must possess a strong knowledge of Workers Compensation Law and have the ability to work remotely. This is a permanent full-time position.

Responsibilities: 

• Exercises strong investigative and decision-making skills to analyze the claims exposure, to determine the proper course of action and to appropriately settle the workers’ compensation lost time
• Interacts extensively with various parties involved in the claim process
• Able to clearly communicate concise action plans, and present plans for moving the case to conclusion
• Processes claims consistent with clients' and corporate policies, procedures, and company best practices, and also in accordance with any statutory, regulatory and ethical requirements
• Able to recognize and pursue excess insurance recoveries; Incumbents will have the ability to handle a full case load, with proven ability to handle cases of increased severity
• Receives claims assignments, confirms policy coverages and directs acknowledgement of claims

Requirements:

• 1-3+ years of experience handling lost-time claims
• Strong investigative, analytical and negotiation skills are key
• Municipality or government claims handling experience is a HUGE plus
• Excellent Customer Service and Organizational skills
• Candidate must reside in the State of Colorado

Salary/Benefits:

• $ 75,000 - $ 90,000 annual salary
• Flex schedule and ability to work remotely
• Medical & Dental Plan
• 401K plan
• Generous PTO 

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Litigation Specialist, Professional Liability

Job Summary

Seeking a highly skilled and experienced Litigation Specialist with a focus on Professional Liability to join a growing team. This role involves managing complex claims, including hospital and physician medical professional liability cases, with an emphasis on litigation management and coverage analysis. The ideal candidate will possess a strong background in professional and general liability claims, exceptional communication skills, and the ability to navigate high-stakes situations with confidence and professionalism.

Compensation Package

• Base Salary: $120,000 - $140,000 per year
• Annual Bonus: Discretionary, averaging around 9%

Responsibilities

• Manage professional, general, and employment practices liability claims, with a focus on hospital and physician medical professional liability cases.
• Handle complex litigation, including birth injury claims, and provide expert coverage analysis.
• Collaborate with legal teams, insured parties, and other stakeholders to ensure effective resolution of claims.
• Maintain in-depth knowledge of medical practices, hospital policies, legal principles, and healthcare-related statutes and case law.
• Ensure compliance with professional and general liability insurance policies and coverage contracts.
• Provide exceptional communication and negotiation support to navigate challenging, high-stakes situations.
• Utilize strong organizational and analytical skills to prioritize tasks, meet deadlines, and escalate issues when necessary.
• Work effectively in a hybrid work environment, leveraging technology and software tools, including Microsoft Office products.

Qualifications/Requirements

• High School Diploma or G.E.D. required; BA/BS degree strongly preferred.
• Minimum of 7 years of experience handling professional, general, and employment practices liability claims, with specific expertise in hospital and physician medical professional liability cases.
• Experience with birth injury claims and litigation strongly preferred.
• AIC or similar insurance education required.
• CPHRM or similar risk management education required or must be completed within 18 months of hire.
• In-depth knowledge of medical practices, hospital policies, legal principles, and healthcare-related statutes and case law.
• Strong litigation management and coverage analysis skills.
• Experience with Directors and Officers (D&O) and Employment Practices Liability (EPL) claims is highly preferred.
• Exceptional written and verbal communication skills.
• High degree of organization, attention to detail, and problem-solving abilities.

#LI-KT1

About the Opportunity

Our client, a well-established Third Party Administrator (TPA), is seeking an experienced Workers' Compensation Claims Adjuster to join their team on a temporary contract basis. This is an excellent opportunity for an adjuster who thrives in a fast-paced environment and enjoys managing claims from inception through resolution while delivering exceptional customer service.

Although this position is fully remote, candidates must currently reside in Montana.

What's in it for you:

• $35/hr. - $45/hr. based on experience
• Full benefits available

Key Responsibilities:

• Manage a full caseload of Workers' Compensation claims from assignment through closure.
• Conduct thorough investigations to determine compensability and liability.
• Analyze medical documentation and coordinate with medical providers, employers, injured workers, and legal counsel.
• Establish appropriate reserves and adjust reserves throughout the life of the claim.
• Authorize and monitor medical treatment and indemnity benefits in accordance with Montana Workers' Compensation statutes.
• Negotiate settlements when appropriate and prepare files for closure.
• Maintain accurate and timely claim documentation within the claims management system.
• Ensure compliance with all state regulations, client service standards, and internal best practices.
• Provide regular claim status updates to clients and management.

Qualifications:

• 3+ years of Montana Workers' Compensation claims handling experience.
• Active Montana Workers' Compensation Adjuster licensing.
• Previous experience working for a TPA or insurance carrier.
• Strong knowledge of Workers' Compensation laws, coverage analysis, and claims investigation.
• Excellent negotiation, communication, and organizational skills.
• Ability to independently manage a high-volume caseload.
• Proficiency with electronic claims management systems and Microsoft Office.

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#LI-PR1

Position Overview

Our client, a well-established Third-Party Administrator (TPA), is seeking an experienced Future Medical Claims Adjuster to join their growing team. This role is responsible for handling complex workers’ compensation claims involving future medical exposure, ensuring timely and cost-effective resolution while maintaining compliance with California regulations.

Compensation Package

• $60,000 - $90,000/year (based on experience)
• 100% remote work environment
• Comprehensive benefits package
• Supportive and collaborative team culture
• Long-term stability with a reputable TPA
  
  

Qualifications

• 3+ years of California workers’ compensation claims handling experience
• Specific experience handling future medical exposure required
• Strong understanding of California workers’ compensation laws and regulations
• Experience negotiating settlements and working with defense attorneys
• Self-insured or TPA background preferred
• Excellent communication, organizational, and negotiation skills
• Ability to manage a high-volume caseload independently

Key Responsibilities

• Manage a caseload of California workers’ compensation claims focused on future medical exposure
• Evaluate and determine appropriate reserves, including future medical projections
• Coordinate with medical providers, legal counsel, and vendors to facilitate claim resolution
• Review medical reports and treatment plans to assess ongoing exposure and settlement opportunities
• Negotiate settlements, including Compromise & Release (C&R) agreements
• Ensure compliance with California workers’ compensation laws and regulatory requirements
• Maintain detailed and accurate claim documentation
• Provide excellent customer service to clients, claimants, and internal stakeholders

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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#INDTJG-CTT

Oregon Workers' Compensation Claims Adjuster

Job Summary

Seeking a highly skilled and experienced New Mexico Workers' Compensation Claims Adjuster to join a team. This is a fully remote position; The ideal candidate will have a strong background in managing New Mexico workers' compensation claims, ensuring compliance with state statutes and administrative rules, and delivering exceptional customer service.

Compensation Package

• Salary: $80,000 - $90,000 per year
• Bonus: 5% annual target bonus
• Benefits: Comprehensive medical benefits package, 401(k) with company match, and more

Responsibilities

• Manage a caseload of 90-100 New Mexico workers' compensation claims, ensuring compliance with state statutes and administrative rules.
• Conduct thorough investigations, including recorded statements, wage calculations, compensability decisions, and reserve evaluations.
• Coordinate medical treatment, return-to-work efforts, and vocational services as needed.
• Maintain accurate and timely documentation throughout the life of each claim.
• Collaborate with employers, attorneys, nurse case managers, and medical providers to achieve efficient claim outcomes.
• Negotiate settlements and attend mediations or hearings when necessary.
• Ensure all regulatory timeframes and reporting requirements are met, including 801/827 forms and 1502 filings.
• Handle multiple accounts and manage some litigation cases.

Qualifications/Requirements

• Minimum of 5 years of experience handling New Mexico workers' compensation claims.
• Experience handling claims in multiple jurisdictions is a plus
• Strong knowledge of NM workers' compensation statutes and administrative rules.
• Excellent communication, negotiation, and organizational skills.
• Ability to work independently in a remote environment while managing a high-volume caseload.

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