256 complex claims and coverage technical specialist jobs found

Job Description: Step into a role where your client service expertise makes a meaningful impact. We are looking to add a Liability Claims Specialist to join our Creative Risk Solutions team. Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients.   Essential Responsibilities: Review coverage for commercial auto and general liability claims. Adjudicate claims, investigate bodily injury/liability claims, and negotiate settlements using "Best Practices for Claims." Maintain accurate loss information and establish/maintain reserves within authority. Research and respond to questions and complaints from insureds, claimants, agency partners, and carriers. Monitor...

Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic.   Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities.   Our field team members are located in every state in which we operate.   Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best. Essential Job Functions and Responsibilities Manages an inventory of claims to evaluate compensability/liability. Plans and conducts claim investigations to confirm coverage and to determine...

Job Description: Step into a role where your client service expertise makes a meaningful impact. We are looking to add a Liability Claims Specialist to join our Creative Risk Solutions team. Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients.   Essential Responsibilities: Review coverage for commercial auto and general liability claims. Adjudicate claims, investigate bodily injury/liability claims, and negotiate settlements using "Best Practices for Claims." Maintain accurate loss information and establish/maintain reserves within authority. Research and respond to questions and complaints from insureds, claimants, agency partners, and carriers. Monitor...

Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic.   Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities.   Our field team members are located in every state in which we operate.   Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best. Essential Job Functions and Responsibilities Manages an inventory of claims to evaluate compensability/liability. Plans and conducts claim investigations to confirm coverage and to determine...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   ***This is a hybrid work arrangement (time spent in office and remote). Depending on the employee's role and leadership's assessment, some employees will come into an ACG facility on a weekly basis, a monthly basis, or on an "as needed" basis for key meetings and collaborative activities. Most employees will be required to come into the office, at a minimum, for important departmental meetings or teambuilding events*** Florida Casualty Claim Specialist– The Auto Club Group Reports to: Claim Manager II What you will do: (Primary Duties & Responsibilities) The Auto Club Group is seeking prospective  Casualty Claim Specialists  who can work under less supervision with a high-level of authority to handle highly complex technical issues and the...

Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.   Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work ® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.   C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster,...

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This role is available for both remote and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall...

Company Farm Family Farm Family specializes in farm and ranch protection with a wide range of products including flexible farm packages, business owner policies, commercial package, workers compensation, commercial auto and select personal auto coverage. Farm Family is a leader in serving the Northeast and Mid-Atlantic markets and is pursuing growth across the U.S. The Farm Family entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Position Summary The Senior Litigation Specialist is responsible for the end-to-end management of complex, high-exposure claims, primarily involving bodily injury under General Liability, Commercial Auto, and Personal Auto claims. Experience with New York Labor Law is a plus. This role requires advanced technical claim handling, strategic litigation oversight, and close partnership with defense counsel to drive optimal outcomes. The ideal candidate must have strong negotiation skills, and the ability...

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.  CNA is the market leader in providing Lawyers liability coverage and provides best-in-class claim service. We are seeking a dynamic self-starter to join our Complex Claims team handling claims for law firms with less than 35 attorneys. At CNA, Claim Professionals use their specialized expertise to handle claims efficiently in a collaborative environment focused on continuous improvement. This position plays a critical role in managing and resolving legal malpractice claims by evaluating coverage, assessing liability and damages, setting timely reserves, negotiating and settling claims, and directing litigation. You will collaborate in a highly-experienced and rich team environment...

A highly experienced adjuster managing a caseload of complex claims, including litigation, to resolution. This position will report to a Sentry office under our hybrid work model. As a Claims Representative Specialist on one of Sentry’s Commercial Liability teams, this highly experienced claims adjuster will provide prompt claim investigation, evaluation, and settlement or denial of highly complex claims including those in litigation. The claims involve, but are not limited to, general liability and commercial auto losses. In addition, you will… What You’ll Do: Verify coverages and perform coverage investigations including issuing reservation of rights and/or disclaimers Investigate losses and negotiate claims settlements with claimants and their legal representative within assigned authority limits Manage investigative process by taking recorded statements, obtaining investigative reports, evaluating damages or eligibility for benefits, and determining legal...

The Indemnity Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s):  Litigation Management Support Specialist Employment Type:  Full-Time  FLSA Status:  Non-Exempt  Location:  In-Office    Summary:    We are looking for a highly capable Litigation Management Support Specialist to join our team and bring our overall litigation program to the next level to work from our Chicago, IL office.  Alternatively, this role can work from our offices in Albany, NY, Los Angeles, CA, New York City, NY, Omaha, NE, or Richmond, VA.  This position reports into the SVP of Global Claims Operations who is based in Georgia.   Employees in this role are required to accurately record all hours...

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, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte. What you will do You'll be responsible for adjusting auto bodily injury claims, in primarily Southern venues (including TX, GA, SC, and NC). You'll be communicating with all parties involved and completing investigations in a timely and thorough manner. This position will include contact with attorneys on serious claim matters, and you will consult with a supervisor on more complex coverage and technical matters. This position requires strong analytical skills, attention to detail, and the...

Sr Product Specialist - EM07JE We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.           At The Hartford, we do not just process applications—we push boundaries. We believe underwriting is not about saying “no,” it is about uncovering smart, data-driven “yeses” that serve both our customers and our business. And you? You are the visionary who will take us there. Ready to make waves in the AI-powered future of commercial insurance? Join us and lead the charge in shaping next-level underwriting solutions. Apply now and help us redefine what is possible. The Senior Product Specialist serves as a senior technical expert and product development leader responsible for the design, development, and maintenance of complex insurance products. This...

The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel.  This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established reserving authority limits Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of claims...

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a hybrid position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early...

The CA Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic claims as necessary Additional duties as assigned...

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Job Description Alternative Markets specialized in mono-line and/or multi-line primary programs on either a traditional guaranteed cost (Specialty Programs) or risk-sharing basis (Agency, Association or Group Captives). Alternative Markets focuses on niche programs....

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 exciting openings for Workers Compensation Senior Claims Specialists within the Central Region!   As a Senior 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.   Training is a critical component of your success, and that success starts with reliable attendance. Attendance...

About Integrated Specialty Coverages Integrated Specialty Coverages, LLC (ISC) is a growth stage technology and data-driven commercial MGA and insurance wholesaler leading innovation in the market.   Backed by one of the leading private equity firms, Onex Partners, and led by a forward-thinking management team, ISC is combining the worlds of insurance and technology to create an Insurtech powerhouse. As a leading online distributor of insurance products for a range of industries and “Main Street USA”, we are looking for the right people to help us in our mission of achieving exponential growth. We strive to be the number one place to go for brokers and agents to source insurance. To accomplish this, we’re building a digitally focused team that deeply understands the intersection between user experience, data, and AI/ML to optimize the way we engage with our customers and partners. Job Summary The Complex Loss Specialist position at Golden State Claims Services reports...