144 claims adjuster iii jobs found

Overview Assigned to our Worker's Compensation Line of Business, the Adjuster III is responsible for prompt and independent review of insurance claims through effective research, evaluation, investigation, negotiation and interaction with insureds or claimants.  The Adjuster III is often assigned to mid-size or mid complexity claims in the Line of Business. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust and Claims organization.  Experience handling Worker's Compensation Claims is required for this position. 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 workers, witnesses and producers. Analyzes coverage that may or may not be applicable to the claim by policy or statutes. Reviews coverage...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Claims Adjuster II - WC. The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker’s compensation insurance claims through effective research, negotiation and interaction with insures, and claimants, ensuring that company resources are utilized in a cost-effective manner in the process. The adjuster reports to a WC Supervisor. Responsibilities Thoroughly investigating workers’ compensation claims by contacting injured workers, medical providers, and employer representatives. Determining if claims are valid under applicable workers’ comp statutes. Communicating with medical providers to develop and authorize appropriate treatment plans. Reviewing and analyzing medical bills to confirm charges and treatment are workers’ comp injury-related and in accordance...

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Adjuster III – Auto and General Liability to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency. How you will create an impact The Casualty Claims Specialist III is responsible for investigating, evaluating, and negotiating general and auto liability claims  while maintaining a high standard of customer service.  This includes prompt contact with insureds and follow up...

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...

Overview Workers Compensation Claims Adjuster III, CA is responsible for prompt efficient review and disposition of insurance claims through effective research, evaluation, investigation, negotiation and interaction with insureds or claimants. The Adjuster III is often, though not always, assigned to larger claims with a larger exposure or severity in the Line of Business.  Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust and Claims organization.   The salary range for this role is $33.64 an hour - $47.12 an hour. This range is only applicable for jobs to be performed in California. Base pay offered may vary depending on, but not limited to education, experience, skills, geographic location, travel requirements, sales or revenue-based metrics. This range may be modified in the future Responsibilities Investigates the claim or coverage by making timely and...

Overview Amtrust Financial Services, a fast-growing commercial insurance company, is seeking a Subrogation Claims Adjuster with Workers' Compensation experience. The successful candidate will directly handle subrogation related claims. This adjuster role is responsible for prompt and independent investigations and review of subrogation claims through effective coverage analysis and liability investigation. In this role, the adjuster is responsible for negotiations and interactions with insureds, claimants, adverse parties, and counsel. The successful candidate will evaluate risk transfer opportunities as well as ensuring appropriate investigation of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, and proper negotiation strategy is employed. This position reports to a line of business supervisor or manager.   This position will require hybrid...

Overview The Commercial Property Subrogation Adjuster III 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 position will require hybrid attendance in an AmTrust office 3 days per week. 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 strategy, action plan, and...

Pay Philosophy The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. Description Personal Lines Casualty Complex is currently hiring for a Senior Claims Resolution Specialist to handle our Northeast Region for auto and homeowner’s casualty claims.  This role is responsible for the investigation, evaluation and disposition of cases on assignment, which may include an established portion of the...

The Claims Quality Assurance serves as the claim technical expert for the Claims Operations by auditing compliance with established CorVel, Industry and Carrier claim handling standards. The primary responsibility will be to evaluate claim handling quality, accuracy and timeliness in categories including but not limited to: Coverage analysis, investigation, valuation, reserving, compliance and accurate disposition of claims. The successful candidate will have the ability to interpret results and trends in order to deliver operational reporting, participate in the development and presentation of training.    This is a hybrid position. ESSENTIAL FUNCTIONS AND 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 various departments within assigned offices as needed. Lead QA projects and serve as...

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:   Position Description : The Auto Club Group is seeking a prospective Homeowners Claims Representative II who will 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. 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, and initiating documentation in the claim handling system.   Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported...

The 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 work from home position, reporting to our Franklin, TN office.   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 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...

Make your mark in AL/GL Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency. How you will create an impact The Casualty Claims Specialist I is responsible for investigating, evaluating, and negotiating general and auto liability claims while maintaining a high standard of customer service.  This includes prompt contact with insureds and follow up to complete timely and accurate reserves and claim resolution.  Analyzing coverage Evaluating liability and damages Establishing accurate reserves throughout the life of the file Maintaining and managing a diary system to efficiently manage and resolve cases...

The 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 work from home position, reporting to our Atlanta, GA office.   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 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...

The Medical Allocator creates a cost projection of a patient’s medical treatment needs by reviewing medical records and identifying a pattern of care. The medical cost projection, also knowns as a Medicare Set-Aside (MSA) report, is part of a workers’ compensation or liability claim settlement.  The Medical Allocator will rely on their medical knowledge and guidelines provided by the Centers for Medicare and Medicaid Services (CMS) to evaluate the patient’s treatment plan for future medical treatment needs.  Work from home possible.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Collaboration with the claim adjuster Review medical records to prepare a Medicare Set-Aside allocation (MSA) report Perform evidenced based medical research Utilize medical knowledge to outline the patient’s medical treatment. Assign pricing to medical treatment allocations Assign pricing to medication allocations Prepare submission of MSA report to CMS for review and approval...

Overview This position is a remote opportunity for those 50 miles or more from an AmTrust office. Those located within a 50 mile radius are expected to abide by our hybrid schedule of 3 days on-site and 2 days work from home. The Resolution Adjuster is responsible for prompt and independent review of insurance claims, through effective research, evaluation, investigation, negotiation and interaction with insureds, claimants, and counsel.  The Adjuster is assigned to mid-sized and / or mid-complexity claims in the line of business. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust Claims organization.   The salary range for this role is $92,000 - $102,000/year. This range is only applicable for jobs to be performed in New York. Base pay offered may vary depending on, but not limited to education, experience, skills, geographic location, travel requirements, sales or revenue-based metrics. This...

The Telephonic Case Manager coordinates resources and creates flexible, cost-effective options for ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return-to-work if appropriate. The Telephonic Case Manager will rely on their medical knowledge to evaluate the patient’s current treatment plan for medical appropriateness based on their physical and medical status. The Telephonic Case Manager must be able to discuss the patient’s medical and physical conditions with the treating physicians, along with discussing/ recommending alternate treatment plans for the patient. The Telephonic Case Manager must have the ability to explain medical conditions and treatment plans to the patient, family members and adjuster; supporting the goals of the Case Management department, and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Provides medical case management to individuals through...

The Vocational Case Manager provides vocational rehabilitation services and medical case management to physically disabled individuals through coordination with clients, referral source, physician, employer, attorney and others with the ultimate goal being the client’s timely return to gainful employment. The Vocational Case Manager interviews and evaluates the client to determine the degree of disability, eligibility and feasibility of vocational rehabilitation services. This position determines suitable job goals consistent with the client’s interests, aptitudes, and physical limitations, supporting the goals of the Case Management department and CorVel. The job will require regular, sometimes daily, travel to the Eastern Shore of Maryland, Delaware, and Eastern PA. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Schedule and carry out appointments with client, family, adjuster, medical providers, employer, attorney, vendors as necessary Communicate via telephone...

The Telephonic Case Manager coordinates resources and creates flexible, cost-effective options for ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return-to-work if appropriate. The Telephonic Case Manager will rely on their medical knowledge to evaluate the patient’s current treatment plan for medical appropriateness based on their physical and medical status. The Telephonic Case Manager must be able to discuss the patient’s medical and physical conditions with the treating physicians, along with discussing/ recommending alternate treatment plans for the patient. The Telephonic Case Manager must have the ability to explain medical conditions and treatment plans to the patient, family members and adjuster; supporting the goals of the Case Management department, and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Provides medical case management to individuals through...

The Qualified Rehabilitation Consultant (QRC)/Vocational Case Manager provides vocational rehabilitation services and medical case management to individuals following a work place injury through coordination with client, insurer, physician, employer, attorney and others with the ultimate goal being the client’s timely return to gainful employment. The Vocational Case Manager interviews and evaluates the client to determine the degree of disability, eligibility and feasibility of vocational rehabilitation services. This position determines suitable job goals consistent with the clients’ interests, aptitudes and physical limitations; supporting the goals of the Case Management department, and of CorVel. Candidates with case management experience or vocational rehabilitation background encouraged to apply This is a Minnesota Field Case Management position. Only MN candidates will be considered. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Schedule and carry out...

The Telephonic Case Manager coordinates resources and creates flexible, cost-effective options for ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return-to-work if appropriate. The Telephonic Case Manager will rely on their medical knowledge to evaluate the patient’s current treatment plan for medical appropriateness based on their physical and medical status. The Telephonic Case Manager must be able to discuss the patient’s medical and physical conditions with the treating physicians, along with discussing/ recommending alternate treatment plans for the patient. The Telephonic Case Manager must have the ability to explain medical conditions and treatment plans to the patient, family members and adjuster; supporting the goals of the Case Management department, and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Provides medical case management to individuals through...