47 claim representative jobs found

SUMMARY:     This is the entry level professional claim handler. Handles medical only and indemnity benefits.  Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.    RESPONSIBILITIES/TASKS: Verifies workers’ compensation coverage of employers and injured employees.   Determines compensability under workers’ compensation by thorough investigation of the claim.   Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits. Facilitates return to work for the injured employee. Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure. Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies. Manages medical bills for...

Job Description: Position Summary: Provides service to all customers and anticipates their need for communication, results and action. Responsible for the prompt, accurate and efficient appraisal and payment of vehicle repair damage and vehicle total loss values, from moderate to severe damage, on all types of vehicles, while exercising independent decision making skills and judgment. Essential Functions: Receives assignment from Claim Representatives electronically on all types of vehicles. Determines best course of action with regards to vehicle damage evaluation (i.e. Desk review, shop estimate/photo review) Using the documentation available, determines the extent of damage and whether the vehicle is repairable or not economical to repair. Verifies the damage to the vehicle is related to the loss facts given by the Claims Representative. Changes reserves, negotiate agreed repair costs with shops, determines total loss vehicle values and issues payment....

Job Description Gap Claims Representative Build the future with us Are you driven by delivering exceptional service and supporting clients with accuracy, empathy, and professionalism? Are you eager to contribute to a company that helps its clients feel confident and secure about their future? As a Gap Claims Representative , you will play a key role in reviewing documentation, resolving GAP claims, and ensuring a seamless and positive customer experience. This position is a great opportunity to showcase your attention to detail, communication skills, and ability to thrive in a fast‑paced environment. Here, people and their development are at the heart of our priorities, fostering an environment that encourages collaboration and innovation. What you’ll accomplish with us As a Gap Claims Representative , you’ll be at the core of our mission. Here are the main responsibilities: Answer incoming calls from the queue and resolve GAP claims in accordance with...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Disability Representative Disability Representative Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you’ll need to live near our dynamic Center of Excellence📍 Irving, TX. 2201 W. Royal Lane Suite 125 Irving, Tx 75063 ✨ What we offer: A stable, consistent work environment —both in-office and virtual A comprehensive training program to help you support employees and customers from some of the...

Description Launch Your Auto Claims Career with a Fortune 100 Company! No Claims Experience Needed, Paid Training & Licensing Included!   Location: Plano, TX   (Must reside within 50 miles of our office) Hybrid Role: Minimum 2 Days Per Month in Office Additional In-Person Training Requirements for first 6 months.   Career Opportunity: Do you thrive in a high-volume, fast-paced environment? Do you enjoy the challenge of a role where no two days are alike? We are looking for positive, high-energy, passionate customer service professionals.  Qualities like these cannot be taught, but they can be sharpened, strengthened and appropriately compensated when you join Liberty Mutual Insurance as an Auto Claims Representative.    As a licensed claims adjuster, you will be fulfilling the promise we made to our customers when they purchased their policy by working with those who have been in an auto accident and need our help. In this role, you will...

Are You Driven?® We Are. We are a company of driven, enthusiastic and determined people. We celebrate achievement and success.  We foster innovation, determination and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make on a daily basis. At GAINSCO, It is our people that set us apart. If you are looking for a place where you can make a difference, perceive how your work impacts the company, and be recognized for your efforts and passion, then GAINSCO is the company for you. Why Join GAINSCO? GAINSCO’s work environment rewards engaged individuals who have a desire to contribute and succeed. That’s because our culture encourages individuals to grow their skills as they build their careers. Come join us and become a champion with GAINSCO. We are seeking a skilled Claims Representative to join our team. In this role, you will be responsible for investigating, evaluating, and claim settlements. You will work directly...

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along with CMS and state guidelines. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently.    ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receiving and analyzing appeal documentation to determine appropriate actions Accurately setting up and initiating the appeals process timely, ensuring information aligns with provided documents Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards Utilize applicable tools and resources to complete setup Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Medicare, Medicaid, and commercial insurance guidelines Strong attention to...

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along with CMS and state guidelines. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently.    ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receiving and analyzing appeal documentation to determine appropriate actions Accurately setting up and initiating the appeals process timely, ensuring information aligns with provided documents Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards Utilize applicable tools and resources to complete setup Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Medicare, Medicaid, and commercial insurance guidelines Strong attention to...

Overview The Workers Compensation Subrogation Adjuster is responsible for prompt and independent review of subrogation claims through effective coverage analysis, investigation, evaluation, negotiation and interaction with insureds, claimants, adverse parties and counsel. This adjuster  is often assigned to mid-size or mid complexity claims in the Line of Business across multiple jurisdictions.  Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust and Claims organization   This role will require a hybrid work schedule (4 days in office, Fridays from home) in our Dallas, TX office.  Responsibilities Investigates the claim or coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimant or injured party, witnesses, producers and adverse parties. Documents...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Care Team Representative Entry-level, Care Team Representative Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you’ll need to live near one of our dynamic Centers of Excellence📍 Irving, TX : 2201 W. Royal Lane, Suite 125, Irving TX 75063 ✨ What we offer: A stable, consistent work environment —both in-office and virtual A comprehensive training program to help you support employees and...

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: Analyzes and processes claims by gathering information and drawing conclusions. Manages and evaluates General Liability claims affecting primary and excess policies in a fast-paced E&S Claim environment. ESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below....

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: The incumbent is responsible for investigating, evaluating, negotiating, and resolving personal lines property claims. Responsible for adjusting major and complex losses in their entirety, but may also adjust standard losses. ESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not...

You have a clear vision of where your career can go. And we have the leadership to help you get there.  At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.  This individual contributor role operates under moderate direction and within defined authority limits to manage commercial claims of low to moderate complexity and exposure within the General Liability line of business. The position is responsible for investigating, evaluating, and resolving claims in accordance with company protocols, while meeting quality, timeliness, and customer service standards. The role requires regular communication with customers and insureds and may support designated accounts. This position offers a flexible, hybrid work schedule, requiring 2 days in a CNA office per week. JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination...

Salary range is: $70,138.85 - $85,000.00 This position is bonus and/or commission eligible. CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy , creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com .   The Role Total compensation will be heavily weighted toward variable pay that directly reflects your individual and team contributions. This is a field-based role...

Description We are seeking an experienced Middle Market Senior Underwriter to underwrite commercial property & casualty risks in the middle market segment. As an individual contributor, you will make analytical, data-driven underwriting decisions within delegated authority, with limited guidance from leadership. You will evaluate and price moderately complex to complex accounts, manage broker and client relationships, and help shape product and portfolio strategy for your book of business. To be considered for this role, candidates must reside within the specified geographic location. This position requires regular in-person visits with local brokers and agents, so remote hires outside the designated territory cannot be accommodated. Key Responsibilities Underwrite middle market commercial accounts within assigned authority by assessing submissions, reviewing coverage terms, exposures, loss history, financials, and supporting information to...

Description     At Liberty Mutual, we’re committed to delivering exceptional legal services to our customers around the world, working to uphold and protect our policyholders’ rights and positively impacting our business. As an Attorney at Liberty Mutual, you’ll join a diverse team that values a healthy work/life balance and enjoy benefits that include eligible performance bonuses, 20 days of flexible time off each year, personal holidays, and a 401(k) plan with matching contributions. If you’re looking for a place to build a long-term career while making a positive difference, consider joining our legal team where you’ll represent Liberty Mutual and our policyholders in moderately complex civil litigation matters involving claims for monetary damages or compensation for personal injuries or property damage of moderate value.   Liberty Mutual is seeking a skilled and proactive Attorney to independently manage moderately complex civil litigation matters....

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: An Actuarial Services Senior Professional (ACAS or exam progressed candidate) will support pricing and predictive modeling initiatives across our specialty programs division. This role requires deep expertise in actuarial modeling, data analytics, and insurance pricing, along with the ability to independently execute advanced statistical analyses and influence business decisions. The ideal candidate...

WHO WE ARE Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.   WHAT WE’RE LOOKING FOR The Client Service Specialist executes all administrative tasks related to account management and policy servicing. These duties include processing policy endorsements, renewals, cancellations, and maintaining accurate account records.  The Client Service Specialist ensures timely and accurate handling of client requests, policy updates, and back-end service work to support the overall client experience and meet internal compliance standards.   A GLIMPSE INTO YOUR DAY Orders...

MSIG USA continues to grow!  Company Overview: MSIG USA is the US-based subsidiary of  MS&AD Insurance Group Holdings, Inc. , one of the world’s top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business’s unique risks. Summary/Job Purpose: Underwrites profitable property business on a nationwide basis in accordance with Corporate goals. Essential Functions: Selects and underwrites complex property risks within delegated underwriting authority. Reviews applications and requirements to determine acceptability of risk in accordance with Company guidelines and standards. Perform all aspects of the underwriting process and due diligence including review and analysis of financial documents and individual risk factors....

WHO WE ARE Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.   WHAT WE’RE LOOKING FOR The Client Service Specialist executes all administrative tasks related to account management and policy servicing. These duties include processing policy endorsements, renewals, cancellations, and maintaining accurate account records.  The Client Service Specialist ensures timely and accurate handling of client requests, policy updates, and back-end service work to support the overall client experience and meet internal compliance standards.   A GLIMPSE INTO YOUR DAY Orders...