54 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....

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 Claim Adjuster - Liability Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?   Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected...

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...

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...

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 Sr Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:       Irving, TX : 2201 W. Royal Lane Suite 125 Irving, TX 75063   PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and...

Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and “bring it” every day, EPIC is always looking for people who have “the right stuff” – people who know what they want and aren’t afraid to make it happen. Headquartered in San Francisco and founded in 2007, our company has over 3,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees.  Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in your next career? Then consider joining our amazing...

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...

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 Account Manager manages the overall client relationship by providing strategic advice on coverage, risk management and business needs, ensuring that the client's insurance program aligns with long-term goals and growth plans.  The Account Manager remains knowledgeable of advances in the insurance business as well as stays abreast of the types of insurance products available.  A GLIMPSE INTO YOUR DAY Serves as the main point of contact for the clients, addressing...

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBLITIES: Project client claim data to develop budgets, calculate client rates, benefit costs, and IBNR reserves Review experience reporting for accuracy Collaborate with consultants and account teams to prepare and deliver client financial presentations Assess complex client risk, understanding the strategic implications of the competitive carrier/product marketplace, and make sound underwriting-based assumptions Manage and oversight of underwriting support team Renew and market carriers for assigned book of business Analyze / negotiate annual renewals and proposals from carriers for accuracy and financial...

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...

Who is Federated Insurance? At Federated Insurance, we do life-changing work, focused on our clients’ success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we’re looking for employees who want to make a difference in others’ lives, all while enhancing their own.   Federated’s culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect.  We strive to create a work environment that embodies our core principles and values.  We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities.  Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values. What Will You Do? Customer-focused, source of...

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...

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.  You have a clear vision for where your career can go – and at CNA, we’re committed to helping you get there. We foster a culture where people know they matter, feel connected to meaningful work, and are supported in using their talents 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...

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...