30 workers compensation complex claims adjuster jobs found

Overview Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett’s Berkshire Hathaway group – one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.   Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company’s success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!...

CorVel is hiring a No-Fault Adjuster (Claims Specialist) for our Client Site in Jamacia Queens, NY. The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic no-fault 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 an on-site position for our client site in Jamaica, Queens, NY. Once fully trained, the employee will be able to work from home one day per week. ESSENTIAL FUNCTIONS AND 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 no-fault claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and...

CorVel is hiring a No-Fault Adjuster (Claims Specialist) for our Client Site in Brooklyn, NY. The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic no-fault 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 an on-site position for our client site in Brooklyn, NY. Once fully trained, the employee will be able to work from home one day per week. ESSENTIAL FUNCTIONS AND 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 no-fault claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier...

We’re thrilled that you are interested in joining us here at the Amynta Group! As a member of Oryx Insurance Brokerage, Inc claims team, utilize knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex construction nature in order to achieve appropriate outcomes. In this position you will administer and resolve Workers Compensation claims in a timely manner in accordance with legal statues, policy provisions and carrier guidelines. Responsibilities: Promptly investigate all assigned claims with minimal supervision, including those of a more complex Construction nature. Determine coverage, compensability, potential for subrogation recovery, and other offsets  (when applicable). Alert Supervisor and carriers Special Investigations Unit to potentially suspect claims. Ensure timely denial or payment of benefits in accordance with jurisdictional requirements. Establish appropriate reserves with documented...

Manager Claims - CH07AE 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.              Are you ready to take on a pivotal leadership role within the Complex Claims Unit (CCU) – Latent Bodily Injury? CCU is a highly specialized home office claim unit responsible for managing the Company's legacy/long-tail bodily injury claims. Claims within CCU are often associated with more complex coverage issues that could potentially span multiple years of insurance coverage. These claims commonly involve litigation, require specific expertise to manage, and often entail significant exposures. As a Claim Manager, you will be responsible for delivering consistently high-quality work, outstanding customer service, driving innovation, and coaching a diverse...

The Northeast Workers’ Compensation Regulatory Specialist is responsible for managing jurisdictional reporting, regulatory filings and compliance-related processes across the Northeast region.  This role ensures timely, accurate and compliant submission of filings, responses and payments to mitigate organizational risk and potential penalty exposure. The Specialist oversees HP and C-8.1 activity from intake through resolution, supports FROI/SROI reporting and exception processes and assists with OSHA and Medicare validation initiatives.  This role partners closely with claim professionals and leadership to strengthen regulatory workflows, identify trends, reduce penalties and support broader regulatory projects as assigned.  This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Regulatory Filings & Compliance Oversight Manage HP and C-8.1 activity from intake through resolution, including review, rebuttal, corrective payment coordination and...

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):    Senior Technical New York Labor Law Claims Specialist   Employment Type:  Full-Time    FLSA Status:  Exempt    Location:  In-Office      ____________________________________________________________________________ Summary:      Due to continued growth, we are looking for a highly capable Senior Technical New York Labor Law Claims Specialist to join our team and work from our New York City office. We work together in the office five days a week   in order to   strengthen our culture, build team connections, and drive profitability. This role...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has a need for Clinical Review Nurse remote or in an office  location.     PRIMARY PURPOSE:   The Clinical Review nurse has the responsibility of reviewing the medical necessity, appropriateness, quality and efficiency of services in the appropriate setting for Workers’ Compensation claimants. This position assesses the medical appropriateness of proposed treatments and medications for our injured employees, and partners with the AmTrust Claims Adjuster team to expedite medically necessary treatment for each claim.  They also review pharmacy authorizations to determine appropriateness of pharmaceutical treatment.  Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization.   This position will be hybrid out of one of our AmTrust office locations!  Responsibilities...

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 provide 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 expertise will be...

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 Risk Advisor is responsible for new insurance account production and sales activities within assigned accounts. The individual in this position conducts research in the market and develops a base of business to educate, promote and sell insurance services, keeps current on business community activities to obtain leads for business development activities, and maintains and services a profitable book of insurance business for existing clients. The Risk Advisor projects a professional...

- Multi-state commercial insurance carrier is seeking a Senior SIU Investigator.  The SIU Senior Investigator reviews and investigates referrals to the SIU to identify suspicious indicators of potential fraud committed by claimants, insureds, agents, brokers, providers and attorneys and conducts investigations of varying complexity. This is a remote position and reports to the SIU Manager. The ideal candidate will have proficiency in investigating claims across multiple lines of business to include Workers Compensation, Commercial Auto (PIP / No Fault, etc.), and Commercial General Liability. The preferred candidate will be in the New York area. Key Accountabilities/Deliverables: Evaluate SIU referrals to establish if there are suspicious elements present that might warrant a SIU investigation and prepare concise investigative plans of action. Submit assignments to vendors for various investigative tasks when warranted and manage those assignments while controlling...

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 Join our team as a Field Auto Appraiser and make a real impact on the auto claims process! In this role, you’ll be on the front lines, writing estimates directly at customer homes, repair shops, or tow yards, and ensuring a smooth and efficient claims experience. You’ll engage in a variety of interactions – whether face-to-face, virtual, or written – as you assess damages and finalize estimates with both customers and repair shops. With a dynamic range of tasks including repairable estimates, total loss assessments, and virtual...

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. This is a hybrid position reporting to our New Hartford, NY location.  What you will do The Medical Only (MO) role is a workers' compensation claims representative position. You will be responsible for handling low complexity claims that are first party and classified as medical only. In this position, you will use skills in investigation, evaluation, and negotiation to resolve claims. Communication skills will also be applied to correspond in writing and over the phone with individuals...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description Responsible for investigating and confirming the facts of loss for the most complex automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Mentors and provides direction to junior employees. We’re looking for a skilled Bodily Injury Litigation Adjuster with Homeowner Liability or Commercial General Liability experience to join our team! In this role, you’ll manage complex injury claims, including fractures, bilateral fractures, fatalities etc., while applying your expertise to ensure accurate and fair outcomes. We’re open...

Overview A Commercial Property General Adjuster is responsible for investigating, evaluating, and resolving large and complex property claims involving commercial buildings, equipment, and inventory. The adjuster must have extensive knowledge of property insurance policies, coverages, and exclusions, as well as the ability to negotiate and communicate effectively with clients, brokers, and other parties. The adjuster must also be able to handle multiple tasks and prioritize workloads in a fast-paced environment. This position has potential to be remote depending on location. Responsibilities Review and analyze complex commercial property claims, including verifying coverage, determining liability, and assessing damages. Conduct thorough investigations, including interviewing witnesses, inspecting property damage, reviewing documents, and consulting experts. Prepare detailed and accurate reports, estimates, and reserves for...

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 an inside Property Adjuster, and what it takes to do the job!   As a Moderate Inside Property Adjuster, you will provide exceptional service to our policyholders. Working in this hybrid environment, your primary responsibility will involve virtually inspecting damages, investigating coverage, preparing estimates, and settling claims promptly and accurately. You will be interacting with customers, contractors, and vendors through various software platforms such as Xactimate and ClaimsX Video...

Argo Group International Holdings, Inc .  and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. (“BWS”), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions. Job Description Business Title(s):   Senior   Environmental   Technical Claims Specialist   Employment Type:   Full-Time   FLSA Status:   Exempt   Location:   In-Office     Summary:    We are looking for a highly capable Senior Environmental Technical Claims Specialist to join our team and work from any   one of   the our   offices in Albany, Chicago, Los Angeles, New York City, Omaha, Richmond (VA), Rockwood (PA), or Springfield...

Healthcare Risk Advisors is seeking a medical malpractice Claims Specialist to join our claims team. This is a hybrid opportunity based out of New York City. This position is responsible for performing investigations, evaluations, negotiations, and settlements to equitably resolve claims.  Position conducts business with policyholders and others in a manner that achieves economy and upholds the company’s reputation for quality service. This position has contacts with employees, vendors, lawyers, and policyholders.  This position works under immediate supervision. Qualifications:  Bachelor’s degree required. Minimum of 2-5 years as a claims adjuster, paralegal, attorney, or related experience. Adjusters license required, or JD in lieu of requirement. Excellent interpersonal and organizational skills. Strong knowledge of medical malpractice law. Strong listening skills. Strong negotiating skills. Strong Microsoft Office Suite skills....

Overview Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett’s Berkshire Hathaway group – one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.   Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company’s success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!...

At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.  Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers’ expectations while making a real impact for our company through our shared purpose.  When you join our company, we want you to feel valued, supported and proud to work here. That’s why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Experienced Auto Damage Adjuster- White Plains/New Rochelle, NY Salary: Starting pay rate varies based upon position and location. Ask your Recruiter for details! We are looking for talented Auto Damage Adjusters to join our team in White Plains/New Rochelle, NY. As an experienced Adjuster, you should have a minimum of 12 months of Auto Damage experience and demonstrated a track record of success...