Claims Adjuster Jobs - Remote Work From Home & Flexible
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30+ days agoLooking for aClaims Adjusterto adjudicateclaimsin accordance with best practice guidelines and regulatory requirements from FNOL through to resolution. You will be an ambassador of our customer centeredclaimsjourney and will maintain clear lines...
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3 weeks agoCollaborate with CX to provide customer service, guidance, and education to policyholders through every step of theclaimsprocess. Review veterinary bills for accuracy and to determine whether coverage applies forclaimedcosts. Investigateclaimsto...
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30+ days agoClaims Adjusterlicense required and will be obtained during training. Investigate andadjust claimsaccording to applicable laws and policy provisions. Conductclaiminvestigations including but not limited to recorded statements, securing public...
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30+ days agoAs a First Party PropertyClaims Adjuster, you will review property damageclaiminformation from the OutsideAdjuster, complete the investigation, and resolve theclaim．最小的啊f 1 year of property or industry equivalent experience.
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New!Yesterday帮助客户解决汽车claimsinvolving up to two vehicles. This is not a field position. Primarily over the phone, you'll accurately documentclaimsdetails, interview those involved in an accident, make coverage and liability decisions, and...
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New!YesterdayManage a high volume ofclaimfiles from beginning to end. Resolve and document autoclaimsas quickly and accurately as possible. Interview all involved in an accident to determine coverage and liability decisions. Validate damage is consistent with...
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29 days agoCurrently seeking an experienced commercial Senior PropertyClaim Adjusterto provide quality, cost-efficient, and timely investigation of propertyclaims．Applicableadjusterlicense and 4 years of propertyclaims adjustingexperience. 100% remote work.
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New!4 days ago调查的起源和原因claimsby contacting the appropriate parties including insureds, landlords, property managers, claimants, agents, attorneys, contractors, experts, special investigation unit, otheradjusters, public personnel, etc.
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23 days agoAs an inside catastrophe (CAT)claims adjusteron our Home & Property team, you'll care for customers impacted by wildfires, hailstorms, tornadoes and other weather-related events. Primarily over the phone, you'll handle coverage and damage analysis...
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17 days agoInvestigate liabilityclaimsthoroughly by gathering relevant information, reviewing policy coverage, and conducting interviews with all parties involved. Analyze and evaluate liabilityclaimsto determine the extent of our company's responsibility...
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30+ days agoInvestigates and evaluates moderately complex auto and casualtyclaims．Documentsclaimactivities, reserve analysis, summaries of reports. Identifies, investigates, and pursues opportunities for recovery. Handles litigated files of low complexity.
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New!YesterdayManage a caseload of complex pollution accounts. Timelyclaimmanagement of new loss assignments and reassignments. Develop account strategies and manage both litigated and non-litigated pollutionclaims．Evaluate and resolve cases.
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New!YesterdayPlay a critical role in ensuring qualityclaimfile management, service level agreements are met, and regulatory requirements are satisfied while helping to create and provide an industry-leading customerclaimsexperience.
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New!YesterdayManage a caseload of General LiabilityClaims(premises and auto) in multiple states. Manage new loss assignments, reassignments and proper reserve setting. Be able to perform coverage analysis, responsibilities to defend, tasks to indemnity, and...
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2 weeks agoExamine and interpret homeowner policies, forms in force, and other records. Investigate relevant facts needed to evaluate and determine coverage, liability and damages on litigationclaimfiles involving complex property damage and coverage issues.
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New!YesterdayManage a caseload of Construction DefectClaimsin multiple states. Manage new loss assignments, reassignments, and proper reserve setting. Be able to perform coverage analysis, responsibilities to defend, tasks to indemnity, and choice of law. Remote.
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16 days agoWe are looking for a smart, motivated LicensedClaims Adjusterto create exceptional new practice questions and instructional content that will help test-takers succeed on theClaims AdjusterLicensing Exam. Outstanding candidates must be self-starters...
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New!TodayAnalyzing theclaimexposure to determine the proper course of action and to appropriately settle or close theclaimin accordance with state, company & client policy and procedure.Building and maintaining rapport with client contacts to ensure retention.
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29 days agoResponsible for investigating and confirming the facts of loss for the most complex Homeowner'sClaims．Determines coverage, damages and otherwiseadjustsand negotiatesclaimswithin limit of authority. Responsible for creating a comprehensive...
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New!2 days agoIdentifies possibly suspiciousclaimsand may work with the Special Investigations Unit to resolve and negotiate settlements. Responds to customers in a polite, professional and empathetic manner, matching their needs with services...
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New!TodayAs aClaimsSpecialist, you are experienced in working for a Third Party Administrator (TPA), or Insurance Carrier having dealt with the fullclaimlife cycle from open to close. You're familiar with managing, litigating, andadjusting claims．..
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24 days agoYour role would be to investigate andadjustworkers' compensationclaimswith the highest potential exposure. We take an extremely aggressive and pro-active approach inclaims adjustingand are looking for the person who not only knows their...
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29 days agoExhibits mastery estimating fundamentals in order to create estimates of damages on the most complex 1st party homeowner losses of all severities. Applies mastered content in interpretations of all policy types written by the company and assists leaders.
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30+ days ago调查中等复杂的房主claimsto confirm facts, origin & cause of loss.Address & handle exposures of theclaim, including Dwelling, Other Structures, Contents, Loss of Use. Investigations may include scene inspection. Maintainclaims．
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2 weeks agoApply broad knowledge of current company policy, applicable regulatory standards and procedural changes to investigate, evaluate and settle complex Homeowner's or Commercial propertyclaimsin a timely and efficient manner as to prevent unnecessary...
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3 weeks agoReviewsclaimsfor other possible coverage as provided by vehicle manufacturers or parts and labor warranties provided by previous repairer. Providesclaimpayment authorizations based on the correct parts and labor amounts using the available data...
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23 days agoReceives and adjudicates medicalclaims/bills for payment/denial. Researchclaims/bills for appropriate support documents &/or documentation. Analyzes andadjustsdata and benefits criteria for payment. Responds to and researches vendor and member...
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New!TodayCorresponds through verbal/written communication with policyholders, claimants, travel coordinators, etc. to gather important information to supportclaimdecision. Serve as a customer advocate in all interactions to provide an outstanding customer...
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30+ days agoAuditclaimsdaily statistically valid sampling method, using prescriber audit criteria. Performs simpleadjustmentsas necessary.Conduct in-depthclaimsaudits on performance groups, as well as focus audits for specifically identified situations.
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13 days agoRespond to concerns from the Department of Insurance (DOI), Better Business Bureau (BBB), and social media within regulatory guidelines. Minimum of 2-3 years prior Homeowners Property Insurance experience required. Propertyclaims adjusting．..
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29 days agoAll aspects of property and liability losses related to Personal Lines Homeowners with emphasis on litigated files. Makes prompt contact with customers to set expectations, develop an action plan, and perform an initial exposure assessment.
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9 days agoConsistently process entry level and intermediateclaimqueues with a 99% or greater accuracy rate. Adhere to approvedclaimworkflow requirements to maximize efficiency. Serve as backup toClaimAdministration team for entry-leveladjustments．..
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9 days agoPerform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. Ability to code government and state models. This includes code everything projects.
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New!4 days agoDemonstrates a thorough understanding of RiskAdjustment编码的所有风险adjustedproducts including hierarchical condition categories (HCCs) and CDPS model codes. Participates in quality coding initiatives as appropriate or assigned. Performs over...
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29 days agoThe Team Lead,Claimsis responsible for leading a team ofAdjustersand Specialists by monitoring their workloads, providing supervisory oversight for individualclaimactivities, and providing technical and jurisdictional direction onclaims．..
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22 days agoClaimhandling responsibilities will include the following: reviewing assignedclaims, contacting the insured and other affected parties, setting expectations for the remainder of theclaim, and initiating documentation in theclaimhandling system.
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29 days agoGuide our customers from the First Notice of Loss through the resolution of theirclaim．Confirm coverage and monitor repairs of low-complexityclaims．Maintain a general understanding ofclaimsresolution procedures and timeframes. Address customer...
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New!YesterdayExhibits mastery estimating fundamentals in order to create estimates of damages on the most complex 1st party homeowner losses of all severities.Applies mastered content in interpretations of all policy types written by the company & assists leaders.
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1 week agoProvide best-in-classclaims通过特殊的解决经验claimfiles. Investigate, manage and resolve assignedclaimswhile making decisions consistent with internal best practices. Operate independently, managing a high volume of...
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8 days agoResponsible for Hospitalclaimsbilling. Hospitalclaimsfollow-up. Hospitalclaimsdenials resolution. Responsible for reconciliation of the accounts receivable by working assigned reports and must be able to produce high volumes.
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29 days agoTheClaimsSpecialist will play a critical role in ensuring qualityclaimfile management, service level agreements are met, and regulatory requirements are satisfied all while helping to create and provide an industry leading customerclaims．..
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29 days agoTheClaimsSpecialist will play a critical role in ensuring qualityclaimfile management, service level agreements are met, and regulatory requirements are satisfied all while helping to create and provide an industry leading customerclaimsexperience.
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30+ days ago创建reports to assess quality and efficiency within theclaimsteam. Develop and present reports on Key Performance Indicators (KPIs). Leverage data to highlight areas needing improvement. Utilize data to prepare Cost/Benefit analysis for potential...
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29 days agoBe responsible for ensuringclaimsare handled in accordance with established guidelines and service instructions. Ensures timely completion of file reviews, calibration sessions and analysis reports. Identifyclaim-handling trends by applying...
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22 days agoManages a personal caseload ofclaims, which may include litigation, to ensure the proper adjudication or settlement of thoseclaims, and they are handled according to Company policies and procedures, within the Company's contractual and legal liability.
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30+ days agoProvide the best possibleclaimservice to both internal and external customers. Promote teamwork and proactively seek opportunities to assist fellow associates with common challenges, i.e. systems use, file quality, etc. Perform thorough investigation...
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FeaturedNew!3 days agoMakes timely and appropriate contacts, determines and completes appropriate level of investigation to make determination of coverage, assess liability and determine damages. Takes a recorded statement from all parties involved in theclaimwhen...
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New!TodayPromptly and effectively handle assignedclaimswith little to no direction and oversight, which may include complex and catastrophic casualty losses. Make decisions within delegated authority, recommend settlement values in the disposition of...
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25 days agoProvide strategic management oversight in designing, implementing, directing, and monitoring RiskAdjustmentDepartment functions. Direct the RiskAdjustmentDepartment, act as a subject matter expert, and provide executive-level advice and guidance...
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30+ days agoCollaborate with internal departments, including but not limited to, Data Science, Finance, Actuarial, Operations, Provider Network Management, Engineering, and external vendors on riskadjustmentactivities. Manage the end to end flow of data...
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