1,732 Claims Adjuster jobs in the United States

The Company

Ingles Markets began in 1963 as a single supermarket and has since grown into a regional grocery store chain with just under 200 retail locations operating in 6 southeastern states, a 1.6-million-square foot distribution center, two truck fleets, and a milk processing plant. Ingles Markets’ headquarters and distribution center are located just 15 minutes outside of Asheville, NC in the town of Black Mountain.

The Team

We are a lean team that services 27,000 employees across 6 states. We work hard as a collective team to ensure everything is accomplished, even if it is not in our job description. While we do take things seriously, we like to have fun while we are doing it, so we can create the most impact and difference that we can.

The Position

The Claims Adjuster is responsible for handling claims involving store customers and employees. They will provide quality customer service by expediting the handling of general liability, workers compensation and property damage claims through investigations, evaluations, and negotiations.

Key Responsibilities:

• Coordinate, review, and authorize medical treatments and referrals.
• Investigate claims for compensability utilizing all tools necessary.
• Negotiate settlements while placing business decisions first and foremost.
• Pay lost wages and any ratings, as appropriate.
• Maintain communication with the Safety Department on OSHA-required reporting.
• Ensure claimants return to work smoothly and quickly while complying with any work restrictions.
• Attend legal mediations, hearings, and informal conferences.
• Frequently work closely with claimant attorneys and defense counsel.
• Adequately reserve claims to closure.
• Perform data entry into the appropriate systems.
• Ensure compliance with state filings and deadlines in self-insured states.
• Respond to all correspondence in a timely manner.
• Perform all other duties as assigned.

The Ideal Candidate:

• High School Diploma or equivalent required. Bachelor's Degree in a business-related field and 2+ years of claim handling experience preferred. General Liability experience a plus.
• North Carolina state-issued adjusters license, preferred. If not licensed, new hire must obtain NC license within 6 months of start date, company paid.
• Working understanding of Claim Management Systems.
• Excellent skills with Microsoft Office applications.
• Able to operate various types of office equipment.
• Excellent interpersonal and communication skills, both written and verbal.
• Able to adapt quickly in a dynamic work environment.
• Moderate-to-high stress tolerance.

The Company

Ingles Markets began in 1963 as a single supermarket and has since grown into a regional grocery store chain with just under 200 retail locations operating in 6 southeastern states, a 1.6-million-square foot distribution center, two truck fleets, and a milk processing plant. Ingles Markets' headquarters and distribution center are located just 15 minutes outside of Asheville, NC in the town of Black Mountain.

The Team

We are a lean team that services 27,000 employees across 6 states. We work hard as a collective team to ensure everything is accomplished, even if it is not in our job description. While we do take things seriously, we like to have fun while we are doing it, so we can create the most impact and difference that we can.

The Position

The Claims Adjuster is responsible for handling claims involving store customers and employees. They will provide quality customer service by expediting the handling of general liability, workers compensation and property damage claims through investigations, evaluations, and negotiations.

Key Responsibilities:

• Coordinate, review, and authorize medical treatments and referrals.
• Investigate claims for compensability utilizing all tools necessary.
• Negotiate settlements while placing business decisions first and foremost.
• Pay lost wages and any ratings, as appropriate.
• Maintain communication with the Safety Department on OSHA-required reporting.
• Ensure claimants return to work smoothly and quickly while complying with any work restrictions.
• Attend legal mediations, hearings, and informal conferences.
• Frequently work closely with claimant attorneys and defense counsel.
• Adequately reserve claims to closure.
• Perform data entry into the appropriate systems.
• Ensure compliance with state filings and deadlines in self-insured states.
• Respond to all correspondence in a timely manner.
• Perform all other duties as assigned.

The Ideal Candidate:

• High School Diploma or equivalent required. Bachelor's Degree in a business-related field and 2+ years of claim handling experience preferred. General Liability experience a plus.
• North Carolina state-issued adjusters license, preferred. If not licensed, new hire must obtain NC license within 6 months of start date, company paid.
• Working understanding of Claim Management Systems.
• Excellent skills with Microsoft Office applications.
• Able to operate various types of office equipment.
• Excellent interpersonal and communication skills, both written and verbal.
• Able to adapt quickly in a dynamic work environment.
• Moderate-to-high stress tolerance.

Are you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Are you a Spanish speaker looking to apply those skills in a professional environment? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers' Compensation Claims Adjuster.

Upon successful completion of the Claims Training program, the Claims Adjuster Trainee will be responsible for management of a caseload of workers compensation claims from inception to resolution. Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations. This individual will continue to build on claims knowledge and claims will increase in number and complexity.

• Successfully completes classroom training introducing workers compensation claims handling strategies, medical terminology, statutory requirements, and investigative skills.
• Conducts initial investigation of reported claims to determine coverage, compensability, severity, and gather all other relevant information via three-point contact telephone calls.
• Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.
• Develops and updates a Plan of Action for the successful resolution of each claim.
• Makes prompt, sound decisions on issues that arise based on the best information available, ensuring that work is performed in accordance with Company guidelines and applicable statutory requirements. Timely escalates issues/red flags to Supervisor.
• Ensures benefits due injured worker are calculated and issued appropriately in accordance with legal requirements including the issuance of appropriate notices and filings.
• Fosters a positive and close working relationship with internal and external partners, including Call Center, Medical Management, Special Investigations, and Indemnity Adjusting Staff.

• Minimum of High School Diploma or equivalent certificate required; Bachelor's degree from four-year college or university is preferred.
• Ability to communicate effectively verbally and in writing; Spanish fluency ability a plus.
• Solid interpersonal and customer service skills.
• Ability to manage and prioritize multiple assignments in a fast-paced environment.
• Strong organization skills to ensure tasks are completed within hard deadlines.
• Knowledge of Microsoft Office/365 suite of applications and ability to master proprietary and vendor software.

• Full Training Program
• Growth and advancement opportunities
• Work-Life Balance
• Manageable Caseloads
• Modernized Historical Setting in East Sacramento
• Free Lot Parking

• Paid Time Off
• Paid Holidays
• Retirements Savings Match
• Group Health Insurance (Medical, Dental, and Vision)
• Life and AD&D Insurance
• Long Term Disability Insurance
• Accident and Critical Illness Insurance
• Flexible Savings Accounts
• Paid Community Volunteer Day
• Employee Assistance Program
• Tuition Reimbursement Program
• Employee Referral Program
• Diversity, Equity and Inclusion Program

In accordance with the California Equal Pay Act, the starting hourly wage for this job is $ . This hourly wage is what the employer reasonably expects to pay for the position based on potential employee qualifications, operational needs and other considerations consistent with applicable law. The pay scale applies only to this position and only if it is filled in California. The pay scale may be different for other positions or in other locations.

With more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts.

At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplacesomething we truly value. We've created an approachable and collaborative atmosphere. Here you'll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.

Job Title: Risk Management Coordinator - Insurance (Part-Time)

Duration: 7+ Months

Location: Sparks, NV

Work Schedule: 30 hours/week (Part-Time)

Max Pay Rate: $30.34/hour

About the Role

Are you looking to build a career in Risk Management within a dynamic and fast-paced environment? We're seeking a Risk Management Coordinator to join our team on a part-time basis. This role offers a unique opportunity to gain hands-on experience in insurance operations and risk mitigation strategies.

As a key member of the Risk Management team, you will provide administrative and operational support across various insurance-related functions. This includes assisting with data management, documentation, and coordination of insurance compliance activities.

Responsibilities

• Support the Risk Management team with day-to-day administrative tasks.
• Execute shipping requests and maintain data in the Risk Management Information System (RMIS).
• Assist with business insurance projects including:
• Facility lease insurance requirements
• Certificate of insurance requests
• Renewal data collection and documentation
• Responding to internal inquiries related to insurance coverage
• Ensure timely and accurate tracking of insurance documentation and compliance.
• Collaborate with internal stakeholders to support contract review and claims management processes.

Minimum Qualifications

• High school diploma or equivalent.
• 2+ years of relevant experience in insurance or risk management.
• Higher education may substitute for relevant experience.

Preferred Qualifications

• Strong customer service and communication skills.
• Ability to manage multiple tasks and meet deadlines effectively.
• Familiarity with risk management processes including coverage placement, insurance recovery, and asset protection.
• Proficiency in Microsoft Excel and Smartsheet.

Additional Information

• This is a part-time role (30 hours/week) and will not transition to full-time.
• Candidates with a strong background in insurance are highly preferred.

Join to apply for the Claims Adjuster role at Aspire General Insurance

Join to apply for the Claims Adjuster role at Aspire General Insurance

Description

Aspire General Insurance Company and its affiliated general agent, Aspire General Insurance Services, are on a mission to deliver affordable specialty auto coverage to drivers without compromising outstanding service.

Description

Aspire General Insurance Company and its affiliated general agent, Aspire General Insurance Services, are on a mission to deliver affordable specialty auto coverage to drivers without compromising outstanding service.

Our company values can best be described with ABLE : to always do the right thing, be yourself, learn and evolve, and execute. Join our team where every individual takes pride in driving their role for shared success.

What You'll Do

Under the close supervision of the Training Supervisor, the Claims Adjuster Trainee performs essential functions to develop the skills and knowledge required to investigate, evaluate, and resolve automobile claims. This entry-level position involves comprehensive training in a classroom setting and practical, on-the-job experience to ensure proficiency in all aspects of claims adjudication.

Responsibilities

• Successfully complete all assigned claims training programs in a classroom setting
• Engage actively in learning sessions, demonstrating a clear understanding of the material covered.
• Investigate automobile claims thoroughly to gather relevant information;
• Evaluate claims to determine their validity and potential payout based on policy terms and conditions.
• Resolve automobile claims efficiently and in a timely manner, ensuring customer satisfaction
• Ensure ongoing adjudication of claims within company standards, industry best practices and all state and federal regulations;
• Stay updated on changes in regulations and company policies
• Document all investigations, evaluations, recommendations, and action plans accurately
• Maintain detailed and organized records in the claims management system
• Produce grammatically correct and clearly written correspondence including letters, memos, reports and claim file documentation;
• Communicate effectively with claimants, policyholders, and other stakeholders through written and verbal means
• Regular and predictable punctuality and attendance;
• Perform other duties as necessary to support the claims department and organizational goals
  
  

• A 4 year college degree or at least 1 year industry experience;
• Must have strong communication skills;
• Must have strong written communication skills;
• Must be able to multi-task;
• Must be able to pass a background check;
• Must have a disciplined approach to all job-related activities;
• Must have a solid foundation of personal organization, sound decision making and analytical skills, strong interpersonal and customer service skills;
• Ability to work in a fast paced environment while managing multiple priorities simultaneously;
• Ability to achieve targeted performance goals.
• Ability to develop excellent working relationships with staff, clients, Partners and outside agencies;
• Ability to communicate with others in an effective and friendly manner, one that is conducive to being a conscientious team member, fostering a spirit of good will, indicative of a professional environment and atmosphere;
• Ability to be a team player and work cohesively with other Company Partners and Companies staff to achieve company goals;
• Able to represent the company in a professional manner and contribute to the corporate image;
• Able to consistently provide excellent client service.
  
  

• This is a non-exempt position which complies with alternative work schedule when applicable;
• This position may require mandatory overtime as deemed appropriate by management;
• The office is that of a highly technical company supporting a paperless environment;
• Travel may be required;
• This work environment is fast-paced and accuracy is essential to successful task completion;
• Travel may be required;
• Requires extended periods of computer use and sitting
  
  

• dependent on plan(s) selected

• Seniority level Internship

• Employment type Full-time

• Job function Finance and Sales
• Industries Insurance

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You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Claims Adjuster responsible for reviewing and adjudicating various types of claims. The role involves meeting production and quality goals, ensuring all necessary criteria are applied to validate claims, and effectively managing pending claims and correspondence.

Key Responsibilities

• Review and adjudicate production claims while meeting production and quality goals.
• Investigate claims and apply necessary criteria to determine their validity.
• Understand and apply Anthem JAA workflow and processing procedures to adjudicate claims.
• Apply benefit plan rules and guidelines to pay, pend, or deny claims.
• Track pending claims and correspondence, including reviewing patient claim history.
• Generate accurate claim EOB messages and correspondence.
• Determine eligibility and coverage for specific group/plan.
• Resolve claim problems by taking necessary actions.
• Utilize training and documentation to stay updated on processing guidelines and regulations.
• Update claims system with relevant notes.
• Conduct investigations for COB, No-fault, Pre-existing, and other claims.
• Contact employers, providers, and participants as needed.
• Identify correct providers, PPOs, and ensure proper pricing is obtained.
• Perform claim adjustments and handle customer service referrals as needed.
• Troubleshoot utilization review and medical necessity issues using vendor information.
• Use Claim Workflow system for assignments, routing, and follow-up.
• Manage additional claim-related duties, projects, and assignments.

• One to two years of college or equivalent experience.
• Medical billing and/or AMA coding experience preferred.
• Data Entry experience or equivalent type work using keyboard/PC.
• Requires NYS Accident & Health Adjuster License

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Position Overview

Fetch Pet Insurance, a tech-enabled pet wellness company, has consistently been an innovative leader in the pet insurance industry, offering the most extensive and all-inclusive pet insurance and health advice.

Put simply, Fetch makes vet bills affordable. We offer a comprehensive product that does not have any restrictions based on breed, age, or size. We are believers in helping pets get through their bad days but also focus on extending the good days. How do we do that? – through a wide portfolio of products + offerings, which include Fetch Health Forecast, our pet health and lifestyle blog, The Dig, and our partnerships with Project Street Vet and animal no-kill shelters across North America.

Our business is growing and we are looking for compassionate professionals that want to join a team that works hard and celebrates success!  You will have an opportunity to hone your skills and develop new skills as you learn the ins-and-outs of Fetch pet insurance and support our pet parents. Your success is our success!

RESPONSIBILITIES.

• Adjudicate assigned claims in accordance with the Terms & Conditions of the individual pet’s policy
• Review medical records, lab results, invoices, and claims forms for complete and thorough assessment
• Process claims determinations to include assessment and payment for submitted claims
• Verify claims coverage through in-depth knowledge of policy Terms & Conditions
• Consult with treating veterinary practices regarding medical records evaluation and necessary documentation
• Maintain an average quality assurance score above department minimums
• Complete assigned tasks within compliance deadlines
• Maintain an average productivity rate above department minimums
• Provide feedback on process opportunities to further strengthen SOPs

REQUIRED SKILLS.

• Comprehensive understanding of disease processes and veterinary medical terminology
• Ability to read and interpret veterinary medical records and invoices
• Ability to identify chronic and acute medical conditions
• Adapt quickly in a fast-paced, ever-changing environment and operate multiple computer systems simultaneously
• Work independently in a remote capacity, while also fostering teamwork and collaborating with others
• Superior communication skills for collaboration with team members and support from managers
• Demonstrated problem solving skills and ability to work through complex medical/vet-related scenarios affecting a pet’s diagnosis and/or treatment plan

QUALIFICATIONS.

• Minimum of five years experience as a veterinary technician
• Bachelor's degree in veterinary science OR CVT or equivalent preferred
• Property and Casualty Adjuster license in good standing preferred
• Complete and pass state adjuster licensing
• Be reliable with good attendance
• Able to work a minimum of 42 hours per week, with occasional weekends and extra hours as needed

WORK-FROM-HOME SET-UP.

• Subscription to reliable high-speed internet connection (minimum of 100 Mbps download and 30 Mbps upload speed)
• A quiet, dedicated place to work in your home that is not easily disrupted by background noises or distractions
• Office workspace must be large enough to accommodate two 19” dual monitors, laptop, mouse, keyboard, and headset
• Ability to set up and connect (with instructions and remote IT team assistance) equipment that is shipped to your home

—ABOUT FETCH—

Fetch is a high-growth, Warburg-Pincus portfolio company. We are a passionate group of 200+ employees and partners across the U.S. and Canada dedicated to helping pets live their best lives. We have two offices (New York City, NY, and Winnipeg, Canada), and we currently provide security to over 360,000 pet parents.

We don’t just accept differences — we celebrate it, we support it, and we thrive on it for the benefit of our employees, our products, and our community. We are proud to be an equal opportunity employer. We recruit, hire, pay, grow and promote no matter of gender, race, color, sexual orientation, religion, age, protected veteran status, physical and mental abilities, or any other identities protected by law.

1. Interpret the insurance policy and determine if coverage is afforded.
2. Interpret the traffic laws according to the state, city where accident took place and determine if insured contributed to the accident.
3. Offer customer service to both our internal and external customer.
4. Explore, analyze and evaluate information
5. Guide customer through the claims process.
6. Handle conflict resolution
7. Review estimates/damages being claimed
8. Identify potential fraud indicators
9. Secure statements, identify exposures, and reserve accordingly.

1. Meet state licensing requirements
2. Be able to work flexible hours
3. Have the ability to work independently

• Must be able to read and understand contracts and be proficient in handling complex coverage and liability claims
• Must be able to adapt to change and handle a fast-paced environment while maintaining a current pending with desk management skills
• Must have excellent communication skills, both written and oral, to discuss coverage, liability and bodily injury settlements with attorneys and others
• Three to five years of Casualty and Bodily Injury claims adjusting experience required
• Litigation experience preferred but not required
• Customer Service experience required
• College Degree preferred but not required if experience meets requirements
• Proficient in Microsoft Office applications (Word, Excel, PowerPoint, Access, and Outlook) preferred
• Texas Adjuster's license required.

FM is a leading property insurer of the world's largest businesses, providing more than one-third of FORTUNE 1000-size companies with engineering-based risk management and property insurance solutions. FM helps clients maintain continuity in their business operations by drawing upon state-of-the-art loss-prevention engineering and research; risk management skills and support services; tailored risk transfer capabilities; and superior financial strength. To do so, we rely on a dynamic, culturally diverse group of employees, working in more than 100 countries, in a variety of challenging roles.

FM has an exciting opportunity for a Claims Adjuster position to work in the Atlanta Claims office in Alpharetta. 

• Depending on the experience level, the incumbent is assigned losses, including Property Damage and Business Interruption losses, up to $1,500,000 without a supervisor and as the first adjuster on losses up to $0,000,000 within the Operations geographical area, or as otherwise directed by the Operations Claims Manager.
• Consults with the insureds and offers FM  assistance in loss mitigation, salvage, restoration of production and claims preparation. In addition to seeking assistance within FM, in consultation with a supervisor, the incumbent is authorized to engage recognized independent adjusters, forensic accountants, consultants, engineers or salvage experts. They are also responsible for identifying legal needs, and with the approval of the Operations Claims Manager also recommends engagement of attorneys where subrogation is involved.
• Negotiates with the insured to reconcile differences of opinion about the extent of loss and/or coverage to reach an equitable and fair settlement as promptly as possible.
• When a loss is settled, forwards the claim with their recommendations for payment to the Operations office where the account is written for final review and approval.
• Adheres to Fair Claims Handling requirements relating to claim investigations and payments as outlined in the state/provincial manuals and FM Claims operating requirements.
• The incumbent keeps the insured and FM claims offices advised of progress of losses being handled via timely letters and memos. Disagreements relating to coverage and measurement disputes shall be brought to the attention of the Operations Claims Manager Written for review and action.
• Jurisdictional licensing may be necessary in some cases.
• The position is office based with required field work. The candidate must be willing to travel, sometimes with short notice, and work out of town as needed to effectively manage assigned losses.

Education

Bachelor’s degree in Engineering or other applicable discipline, or equivalent experience.

Experience

2 or more years of commercial property field experience.

Skills and competencies

• An understanding of claims procedures.
• Interpersonal skills including negotiating and consulting.
• Excellent written and oral communication skills.
• Must be organized and possess ability to make quick and sound recommendations.
• A high-level business understanding of FM is required as is a working knowledge of company-based technology.

The hiring range is $90 720 - 130,400. These ranges are representative of the hiring salary for the role. The final salary offer will vary based on geographic location, individual education, skills, and experience. The position is eligible to participate in FM’s comprehensive Total Rewards program that includes an incentive plan, generous health and well-being programs, a 401(k) and pension plan, career development opportunities, tuition reimbursement, flexible work, time off allowances and much more.