36 experienced claims adjuster jobs found

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)     The Medical Only Claims Specialist I is an entry level claims role. The incumbent is expected to be proficient with the Claims unit, policies, processes, procedures, and terminology.      The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision.     Primarily responsible for the investigation and management of workers’ compensation claims. Conducts a 1 to 3-point contact on the managed claims, which is dependent on either the facts of the case or the claim type; determines compensability of claims, manages the medical treatment program, and assists in the return-to-work process. This includes calling and discussing potential claim activity and work-related injuries with policyholders, claimants, providers, attorneys, agents, and state agencies....

Job Title: Multi-line Claims Adjuster - Water Districts Program Location: Remote / Hybrid (dependent upon on proximity of office location) Reports To: Charlie Stevens Employment Type: Full-Time Job Requisition ID: 2026-204 Requisition Begin Date: 03/10/2026 Requisition End Date 05/10/2026 (Posting may close earlier if filled or business needs change.) Help us insure it Tokio Marine HCC - Public Risk Group,  a member of the Tokio Marine group of companies, is a market leader in providing specialized insurance products for municipal entities. We cover counties, cities, townships, villages, police departments, prisons, fire departments and more. We serve the growing insurance and risk management needs of medium and large governmental entities and provide property and casualty insurance coverages in multiple states. Role Overview Do you have what it takes to match wits with attorneys? Can you analyze medical records, contracts, and repair estimates...

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:   Hourly Job Description:   Attendance is mandatory during the initial 90-day training and probationary period for this position. New hires are expected to be present for all scheduled training sessions. Absences, tardiness, or early departures during this period may impact continued employment. Candidates should ensure they are able to meet these attendance expectations before applying for consideration. Eligible candidates must also live within 50 miles of Dearborn, Michigan for consideration. Michigan Claim Customer Service Representative – AAA The Auto Club Group Reports To: Claim Manager as appropriate What you will do: Claim Customer Service Representatives will be responsible for taking first notice of loss, handling claim inquiries, initiating claim services, and handling...

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)   This is an entry-level position. This position leads to a Medical Only Claims Specialist I and is expected to last up to 12 months. Upon completion of the training plan the incumbent is expected to be proficient with the Medical Only Claims policies, processes, procedures, and terminology related to the job. In addition, the incumbent will be proficient in the job responsibilities and tasks of the Medical Only Claims Specialist I position description. The incumbent will be evaluated on their progress and successful completion of the training plan each quarter. Upon satisfactory completion, the incumbent will be eligible for the Medical Only Claims Specialist I position.  Medical Only Claims Associate will work with all members of the team and may receive direction, support, and instruction from the Manager or Medical Only Claims Specialists depending on the assignment....

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

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:   Sr. Claim Specialist - Michigan PIP & Litigation – The Auto Club Group ****$5,000 Sign-On Bonus for qualified candidates. This Michigan-based position requires residency within the State of Michigan due to in-person court appearances. What you will do: The Auto Club Group is seeking prospective  Senior   Claim Specialist who can work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims.  In this position, you will have the opportunity to: Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete coverage analysis on the most complex...

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:   Claim Specialist - Michigan PIP – The Auto Club Group Reports to : Claim Manager as appropriate What you will do: The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed....

Responsibilities Investigate, analyze, strategize, adjust loss/expense reserves and effectively manage claims and litigation involving bodily injury, property damage, professional liability, and D&O to achieve the best possible outcome Provide counsel and take action on coverage issues, factual developments, liability exposure, loss/expense reserves, and settlement opportunities Provide outstanding customer service to our policy holders, business partners, claimants, and teammates throughout the organization Attend mediation hearings and settlement conferences, when appropriate Review insurance policies, and prepare reservation of rights and/or declination letters, as necessary Support highly successful and growing claims team Additional duties may be assigned Qualifications Minimum 3-4 years of insurance defense experience and/or insurance coverage experience...

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:   Eligible candidates for this role should reside within the metro Detroit Michigan area. Preferred candidates should reside in Canton, MI, Ypsilanti, MI, or west Oakland County. Metro Detroit Field Property Claim Specialist -AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create additional sub-claims if...

Know your rights Inform yourself of your rights and responsibilities by reviewing the content provided in the list below. Employment Eligibility (e-Verify):  English & Spanish Right to work:  English  /  Spanish It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Position Overview :  The primary duties of a field adjuster are to inspect the loss and prepare documents detailing the claim. Essential Job Functions Communicate with desk examiners, insureds, attorneys, and other experts to gather information on claims Negotiate settlements with the insured and/or their representatives Prepare reports based on the policy language and submit payment recommendations to the desk examiners Prepare detailed estimates of the damage Manage workload and submit closing documents in a timely fashion Regular and reliable attendance Marginal Job...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. Follow claims handling...

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)   This is an entry-level position. This position leads to a Medical Only Claims Specialist I and is expected to last up to 12 months. Upon completion of the training plan the incumbent is expected to be proficient with the Medical Only Claims policies, processes, procedures, and terminology related to the job. In addition, the incumbent will be proficient in the job responsibilities and tasks of the Medical Only Claims Specialist I position description. The incumbent will be evaluated on their progress and successful completion of the training plan each quarter. Upon satisfactory completion, the incumbent will be eligible for the Medical Only Claims Specialist I position.  Medical Only Claims Associate will work with all members of the team and may receive direction, support, and instruction from the Manager or Medical Only Claims Specialists depending on the assignment....

SUMMARY Medical Bill Review Specialist I Primarily responsible for analyzing bills for multi-state Workers Compensation medical claims to determine appropriateness of services billed. Responsible for analyzing simple billings by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes. Responsible for making bill review processing determinations according to rules, regulations, and/or third-party partners. Medical Bill Review Specialist II Primarily responsible for performing technical review of more complex medical bills, including modifiers, anesthesia, & psychiatric. Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes and excessive charges. Also responsible for analyzing assigned medical bills to determine compliance with business rules, client specific requirements and multiple state rules, regulations and...

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:   Claim Specialist – Michigan PIP – The Auto Club Group Reports to: Claim Manager as appropriate What you will do : The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed....

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description A day in the life of a Field Property Adjuster, and what it takes to do the job! As a Field Property Adjuster, you will be dedicated to providing exceptional service to our policyholders. Your primary responsibility will involve traveling to our customers' homes to conduct on-site inspections, investigate coverage, prepare estimates, and settle claims promptly and efficiently. Additionally, you will handle virtual claims countrywide, leveraging various platforms and software such as Xactimate and ClaimsX Video Collaboration. Your...

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:   Claim Specialist – Michigan PIP – The Auto Club Group Reports to: Claim Manager as appropriate What you will do : The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed....

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:   Eligible candidates must reside within the metro Detroit Michigan area for consideration and have a valid state driver's license. Preferred candidates should reside in Oakland, Macomb, or Wayne County. Metro Detroit Field Property Claim Specialist -AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create...

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:   Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager I What you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss. Ensure all possible policyholder benefits are identified,...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated claims trainee to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company’s claims training program for the assigned line of insurance and requires the person to: Investigate,...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, this specific role could have the flexibility to work from home up to 3 days per week. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated claims trainee to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company’s claims training program for the assigned line of insurance and requires the person to: Investigate,...