24 claim representative ii jobs found

Claim Representative II:  This is the intermediate level of the claim handler career path. Handles moderate difficult claims. Exercises progressively more 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. Facilitate 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....

SUMMARY:     Claim Representative I:  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.    Claim Representative II:  This is the intermediate level of the claim handler career path.  Handles moderate to difficult claims.  Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves.  Negotiates and settles claims within given authority.    Claim Representative III:  This is the advanced level of the claim handler career path.  Investigates claims and exercises significant discretion in the determination of compensability of claims.  May handle large, more complex customers requiring high touch, labor intensive claim service.  Considers many factors...

SUMMARY:       Claim Representative II:  This is the intermediate level of the claim handler career path.  Handles moderate to difficult claims.  Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves.  Negotiates and settles claims within given authority. Works remotely with occasional travel to on-site visits with insured municipalities.  Is a resident in the State of Michigan     RESPONSIBILITIES/TASKS: Verifies coverage of claimed property and casualty damage.   Determines liability for covered claims by thorough investigation of the claim and applicable exclusions.   Analyzes liability for claims pursuant to Michigan municipal liability statutes and caselaw. 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...

SUMMARY This is the intermediate level of the claims handling career path responsible for managing a caseload of Michigan No-Fault Personal Injury Protection (PIP) claims of moderate to high complexity. The Claim Representative II investigates and administers both litigated and non-litigated PIP claims, exercising independent judgment in coverage analysis, compensability determinations, exposure evaluation, and claim resolution. The position requires thorough knowledge of Michigan No-Fault law, including order of priority investigations, coverage verification, injury causation analysis, and litigation management. The Claim Representative II collaborates regularly with insureds, claimants, healthcare providers, attorneys, and internal business partners to ensure timely, accurate, and compliant claim handling. This fully remote opportunity is available for candidates residing in Michigan.   RESPONSIBILITIES/TASKS:   Determines compensability under Michigan Assigned...

SUMMARY     This is the advanced level of the claim handler career path. Investigates claims and exercises significant discretion in the determination of compensability of claims. May handle large, more complex customers requiring high touch, labor intensive claim service. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Mentors lower-level claim handlers. Coordinates special projects and provides guidance to others. Must have California experience.   ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned. 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...

A Workers' Compensation Nurse Case Manager coordinates and manages the medical care of injured employees throughout the workers' compensation claim process. Responsibilities include evaluating medical needs, assessing treatment progress, identifying barriers to recovery, educating stakeholders, and ensuring care is delivered in accordance with workers' compensation regulations and best practices. The official NJM job title is Medical Management Coordinator II/Telephonic Nurse Case Manager. The position requires the nurse to work and communicate with other members of the Medical Management team in addition to the Workers' Compensation (WC) Claims team, WC Claims Supervisors, and other team members. Essential Duties and Responsibilities: Demonstrate knowledge, skills, and competency in the application of case management standards of practice. Develop and provide ongoing support of the rehabilitation plan through comprehensive assessment, planning, implementation, and...

Overview The Property 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 an Amtrust Office  Responsibilities Investigates the property 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 strategy,...

NJM’s WC Claims Department is seeking an experienced Claims Specialist, Sr. who lives in Western or Central PA to provide on-site service to our policyholders and agents in that area.   This is a 100% remote position which includes virtual claims handling for customers in any area of PA and possibly MD, DE or CT as needed.   At NJM, our WC Claims Department empowers our employees to focus on delivering guidance and empathy to our customers.  As a department driven by service and customer advocacy, we are committed to providing transparent, empathetic support and collaborative engagement during the life of a claim. The WC Claims Department takes pride in being a key component in the growth and success of our policyholders’ business operations. To meet these expectations, WC Claims Specialists are supported by a dedicated call center who can field calls for them and other specialized units who are responsible for setting reserves, making permanency payments, and following...

The Commercial Claims department is seeking a Commercial Claims Specialist II . A Claims Specialist handles all lines of Commercial business including coverage issues and litigation exposures. The Commercial Claims Specialist II is a disciplined self-starter with outstanding communication & customer service skills. Has developed coverage skills, negotiation experience, and is a creative & analytic proactive problem solver. Also, can prioritize work assignments, is an independent worker but can work as a member of the team. Individuals should be decisive, "own" the decisions they make, and the work produced, responsible, dependable and developing presentation skills. This position can be based in our Hammonton or West Trenton, NJ Offices. Once the full time training in the office is complete , the schedule will be Hybrid; 3 days in the office and 2 days at home. There is no option for fully remote. Schedule: Monday-Friday, specific hours are subject 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...

Job Title: Claims Adjuster II - Casualty FLSA Status: Exempt Job Family: Claims Department: Casualty Claims Location: Corporate Office (Fort Wayne, IN) JOB SUMMARY Responsible for effectively analyzing and resolving assigned claims consistent with Claims Department standards and company objectives. POSITION ESSENTIAL FUNCTIONS AND RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Resolve all assigned claims (including the occasional serious/complex claim, which could include but not be limited to unusual damage or coverage issues, or that need the involvement of expert analysis or require early recognition of policyholder concerns) within established settlement authority in a prompt, fair and equitable manner. Identify and investigate coverage, damage, and reserve...

As one of the leading writers of Federal Crop Insurance, AgriSompo North America combines industry experience, resources, capital and talent to deliver both traditional and innovative crop insurance and productivity tools to farmers, ranchers, insurers and agribusinesses in the United States. Our organization operates within a culture rooted in ethics, integrity and a belief that accountability, collaboration and agility are crucial to long-term success.  AgriSompo North America is a part of AgriSompo, Sompo International’s global agriculture platform. This platform is an integrated underwriting, technology and distribution platform delivering innovate insurance and reinsurance solutions to agriculture partners worldwide.  Sompo International, AgriSompo’s parent company, is a global organization driven by its core values, a carrier that holds promise, trust and the commitment to protect.  Through operating subsidiaries, Sompo International writes agriculture, casualty and...

   SUMMARY:   Primarily responsible for receiving and inventory areas, coordinating, storing, stocking, and distributing a wide variety of mail, materials and supplies throughout the building, including mail room, print center, IT, etc.  Unloads shipments from receiving dock and sorts items for delivery.  Responsible for the maintenance of archival file storage and prepares files for storage or destruction off site. Contacts include buyers, delivery personnel, and employees throughout the company. When the incumbent qualifies and is able to perform all responsibilities independently, they will progress to a level II.  ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.  •    Maintains company stock & inventory and assists with purchase requests.  •    Fulfills, ships, and delivers stock materials and special orders to departments.  •    Maintains a supply of marketing materials and processes marketing and claim...

Description Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers an exciting opening for a Workers Compensation Claims Specialist within the West Region!   As a Workers Compensation Claims Specialist, you will work within a Claims Team, using the latest technology to review, analyze, and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements, and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. You may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads.   Depending on your overall skills and experience, you may be considered as a Claims Specialist II,...

Description Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers an exciting opening for a Senior Workers Compensation Claims Specialist within the West Region!   The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads.   Depending on your overall skills and experience, you may be considered as a Senior Claims...

The Company    At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $2.0B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, our Home Office is based in Central New York, with Regional Office locations in NYC, Dallas and Charlotte. This is a hybrid role reporting to our New Hartford, NY location. What you will do The Claims Business Analyst acts as a liaison between the business/customers and IT/vendor development teams for business needs requiring technology and process based solutions including identifying and analyzing business needs, conducting requirements gathering, and defining scope and objectives. This role is accountable for the ongoing administration of applications within the Claims Department and user...

Our General Claims department in Hammonton, NJ is looking for a Property Damage Representative candidate who has excellent communication skills as well as strong organizational and time management skills.  We are looking for talent with and without prior experience in the insurance industry. Hours: Monday through Friday, 8:45 a.m. to 5:00 p.m. with work from home opportunities after training is complete. Salary: The level and salary is commensurate with direct experience and credentials.  Level I - $51,120.55 - $67,542.80 annually based on experience  Level II - $58,737.25 - $89,324.95 annually based on experience  Sr. Level - $77,698.40 - $102,805.30 annually based on experience Responsibilities Appropriately handle, settle and close property damage (automobile) claims by bringing a prompt and amicable resolution Verify coverage, open claims, contact parties involved Verify and investigate information presented by first and third party claimants...

SUMMARY:   Primarily responsible for providing customer service and underwriting technical support to agencies and policyholders related to underwriting rules, procedures and regulations, policy, and audit information.   Reviews & approves/declines endorsement requests and responds to bureau criticisms to maintain policies and stay in compliance with Accident Fund’s and bureau rules and regulations. Verifies coverage for current policy and/or additional named insureds/DBA’s/locations.   Completion of experience rating promulgations or Loss Pricing & Projection Model.   Mentors PPRs & CBR’s with basic questions and policy information.   Contacts include state rating bureaus, Service Center staff, Business Development Consultants, Business Development Managers, Corporate Underwriting, Finance Department, Claims Department, agents, and policyholders.   ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned. Respond to...

Title :  Senior General Liability Claims Adjuster II Location : Austin, TX / Dallas, TX (Hybrid)   Reporting to : Director, TPA Claims Start Date: December 14, 2026   About Hippo:   Hippo was built on a promise: make homeownership effortless. Nearly a decade later, that mission still drives us. We use technology and data to help our customers stay ahead of problems and protect what matters most.     Today, that same tech-native approach powers our work beyond homeowners. Hippo operates as a diversified carrier platform, partnering with MGAs to deliver tailored program solutions that help them grow and deliver better customer experiences. Behind that work is a team that values ownership, curiosity, collaboration, and continuous improvement.    If you're energized by building what's next, we'd love to meet you.  About The Job: We are seeking an Experienced General Liability Claims Adjuster who is licensed in multiple states to...

Description   The Site Pollution Environmental Executive Underwriter works independently and autonomously on all but the most complex site pollution environmental accounts and cases, subject to required process oversight. Underwrites site pollution policies within established underwriting authority, evaluating risks associated with current and historical operations, hazardous materials, regulated substances, waste management, storage and disposal practices, environmental permits, remediation activities, and potential pre-existing or gradual pollution conditions. Makes analytical, data-driven decisions on whether to accept business based on information provided, including environmental reports, Phase I and Phase II assessments, regulatory records, loss history, site inspections, engineering reports, financial information, contract details, and broker submissions. Evaluates coverage needs, policy terms, exclusions, retentions, limits, and conditions, and...