18 claims adjuster iii jobs found

Overview Works independently to manage Workers' Compensation cases, including complex and catastrophic claims.   Note commercial Workers' Compensation experience in California is required. Responsibilities DISTINGUISHING CHARACTERISTICS: Administers complex non-litigated and litigated workers’ compensation cases and integrates the delivery of benefits associated with sickness and long-term disability benefits.  Provides technical guidance, mentoring and support to claims assistants and clerical staff.     ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, the employee must be able to efficiently and effectively perform each of the following essential functions.  Reasonable accommodation may be made for individuals with disabilities.   The functions of this job include but are not limited to;            Set up claims and make timely three point contacts Ensure the privacy...

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 advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Every claim presents a new challenge. This role is ideal for someone who enjoys problem-solving, analyzing information, and making confident decisions while supporting customers and internal partners. Key Responsibilities • Applies increased experience in the Adjuster II level or a rotation into a specialty position (Coverage, Investigation Specialist, Total Loss, Initial Handler,...

The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary responsibility is evaluating claim handling quality, accuracy, and timeliness in categories including but not limited to: coverage analysis, investigation, valuation, reserving, compliance and accurate disposition of claims. This role has the ability to interpret results and trends in order to deliver operational reporting, and participate in the development and presentation of training.   This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Model ethical behavior and executes job responsibilities in accordance with CorVel’s core values, ethics, and information protection policies Serve as technical QA lead to assigned offices or departments Lead QA projects and serve as primary coordinator for senior leadership of assigned offices Support...

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 National General Insurance is currently hiring an experience Bodily Injury Telephone Adjuster. The ideal candidate will be based in one of the following Pacific time zone states: California, Nevada, Oregon, Arizona, and possess experience in handling homeowner, commercial, or auto liability claims. Candidates must be able to work 8am--5pm Pacific time zone hours. Litigation experience may be necessary for this role. The ideal candidate will possess strong analytical skills, excellent attention to detail, and the ability to effectively manage and negotiate claims. Responsible for investigating and...

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 advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Every claim presents a new challenge. This role is ideal for someone who enjoys problem-solving, analyzing information, and making confident decisions while supporting customers and internal partners. Key Responsibilities • Applies increased experience in the Adjuster II level or a rotation into a specialty position (Coverage, Investigation Specialist, Total Loss, Initial Handler,...

We are seeking a Sr. Claims Specialist for our Southern California Team. The Sr. Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel.  This position is remote. Candidates must hold a self-insured certificate. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives 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...

The 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...

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 The Claims Team Leader is responsible for providing our Agents exceptional claims and inquiry service through chat while managing and motivating ten to fifteen adjuster staff or vendors to achieve inspired levels of performance and expert execution of required claim processes. This individual supports the implementation of operational initiatives that enable the achievement of Claim, Discipline, Claims Service Area (CSA) and Company business objectives. This individual develops strategies to achieve employee performance levels and the expert execution of claim processes. The individual monitors staffing...

Overview Position Summary: If you’re passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury Insurance Property Claims team could be the place for you! Upon completion of the training program, ideal candidates will transition into a property claims field adjusting position traveling to loss sites that have been damaged by fire, water, weather, or other unexpected events. You may also handle some claims via virtual technology and/or collaborate with vendors.  The Property Claims Field Adjuster ll will learn apply knowledge of current Company policies, applicable regulatory standards, and procedures to investigate, evaluate and settle moderate Homeowner's property claims in a timely and efficient manner as to prevent unnecessary expense to the Company and policyholders, and provide exceptional service to our customers.   Geo-Salary Information...

The 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...

The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.   This is a remote position in CA. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and/or direct reporting manager   Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Utilize clinical and/or technical expertise to address the provision of medical care and identify inappropriate billing practices and errors, such as: duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time...

The 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...

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 The Bodily Injury Team Leader role will be managing a team of attorney-represented injury adjusters for our west coast claims team. Candidates must be able to work Pacific time zone hours. The Team Leader is responsible for providing our Agents exceptional claims and inquiry service through chat while managing and motivating ten to fifteen adjuster staff or vendors to achieve inspired levels of performance and expert execution of required claim processes. This individual supports the implementation of operational initiatives that enable the achievement of Claim, Discipline, Claims Service Area (CSA) and...

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 creating or auditing a comprehensive estimate of damages for 1st and 3rd party material damage claims in either the auto or specialty lines leading to the proper disposition. Responsible for training, mentoring, controlling quality and providing technical assistance on material damage claims. National General is hiring an experienced Auto Field Adjuster! Join our field estimating team covering Koreatown, Central LA, and South Central LA. Ideal candidates has experience in auto damage assessment, CCC One proficiency, strong negotiation and time management skills, and a customer-first...

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of...

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 Adjuster PRIMARY PURPOSE :   To handle losses and claims for property and casualty insurers. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Examines insurance policies and other records to determine insurance coverage. Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim. Consults police and hospital records and inspects property damage to determine extent of company's liability and varying methods of investigation according to type...

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 General Executive Adjuster (Remote in California with travel) As an adjuster at Sedgwick, you’ll have the opportunity to take on new challenges and help solve complex problems. Enjoy flexibility and autonomy in your daily work and your career path. Travel required. Must reside in California. Remote role with travel required. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service....

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 Sr. Executive General Adjuster (Remote in California) As an adjuster at Sedgwick, you’ll have the opportunity to take on new challenges and help solve complex problems. Enjoy flexibility and autonomy in your daily work and your career path. Travel required. Must reside in California. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.  Leverage Sedgwick’s broad, global network of experts...