About This Career Path
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
Financial Services
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures.
Financial Services Industry
Are you interested in training?
Contact an Advisor for more information on this career!Claims Adjusters, Examiners, and Investigators
Average
$59,030
ANNUAL
$28.38
HOURLY
Entry Level
$37,760
ANNUAL
$18.16
HOURLY
Mid Level
$55,350
ANNUAL
$26.61
HOURLY
Expert Level
$80,370
ANNUAL
$38.64
HOURLY
Claims Adjusters, Examiners, and Investigators
Claims Adjusters, Examiners, and Investigators
Job Titles
Entry Level
JOB TITLE
Entry-level Adjuster
Mid Level
JOB TITLE
Mid-level Adjuster
Expert Level
JOB TITLE
Senior Adjuster, or Partner
Supporting Programs
Claims Adjusters, Examiners, and Investigators
Claims Adjusters, Examiners, and Investigators
01
Examine claims forms and other records to determine insurance coverage.
02
Analyze information gathered by investigation and report findings and recommendations.
03
Pay and process claims within designated authority level.
04
Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
05
Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
06
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
07
Investigate and assess damage to property and create or review property damage estimates.
08
Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
09
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
10
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Claims Adjusters, Examiners, and Investigators
Common knowledge, skills & abilities needed to get a foot in the door.
KNOWLEDGE
Customer and Personal Service
KNOWLEDGE
English Language
KNOWLEDGE
Administrative
KNOWLEDGE
Mathematics
KNOWLEDGE
Computers and Electronics
SKILL
Reading Comprehension
SKILL
Active Listening
SKILL
Critical Thinking
SKILL
Speaking
SKILL
Judgment and Decision Making
ABILITY
Written Comprehension
ABILITY
Oral Comprehension
ABILITY
Oral Expression
ABILITY
Deductive Reasoning
ABILITY
Inductive Reasoning
Claims Adjusters, Examiners, and Investigators
**Optum** is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.**
This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am – 5:00 pm. It may be necessary, given the business need, to work occasional overtime.
We offer 3-4 weeks of paid training. The hours during training will be 8:00 am to 5:00 pm, Monday - Friday. Training will be conducted virtually from your home.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities:**
+ Applies knowledge/skills to activities that often vary from day to day.
+ Demonstrates a moderate level of knowledge and skills in own function.
+ Requires little assistance with standard and non-standard requests.
+ Solves routine problems on own.
+ Works with supervisor to solve more complex problems.
+ Prioritizes and organizes own work to meet agreed upon deadlines.
+ Works with others as part of a team.
+ Claims Processing Systems/Resources
+ Use appropriate systems/platforms/applications to process claims .
+ Navigate systems tools and screens efficiently and effectively (e.g., keyboard skills, macros, shortcuts)
+ Use appropriate documentation, reference materials and/or websites to ensure that claims are processed accurately and efficiently. (e.g., policy/procedure manuals, knowledge libraries, bulletins, training materials, databases, SharePoint sites, data warehouses)
+ Learn and use new systems/applications/resources as needed.
+ Claims Processes and procedures:
+ Apply appropriate processes and procedures to process claims (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
+ Leverage training resources to help apply claims processes/procedures appropriately (e.g., UI-earn courses, coaches/mentors)
+ Apply knowledge of applicable laws, regulations and compliance requirements to ensure that claims are processed properly (e.g., HIPAA, PPACA/Health Care Reform, state-specific regulations/grievance procedures, TAT
+ Demonstrate Knowledge Of Products and Services
+ Demonstrate knowledge of applicable product/service offerings, and the value they provide to members and providers.
+ Keep current on new product/service offerings and the value they provide.
+ Demonstrate knowledge of benefit plan provisions (e.g., plan language, coverages, limitations, exclusions) and keep current on changes as they occur.
+ Apply knowledge of products and services to process claims appropriately
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ High School diploma / GED OR equivalent years of work experience
+ Must be 18 years or older
+ Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
+ Microsoft Office Suite experience (Microsoft Outlook, Microsoft Excel, Microsoft Word)
+ Ability to work full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am – 5:00 pm. It may be necessary, given the business need, to work occasional overtime.
**Preferred Qualifications:**
+ Experience processing medical, dental, prescription or mental health claims
**Telecommuting Requirements:**
+ Ability to keep all company sensitive documents secure (if applicable)
+ Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
+ Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The hourly range for this role is $16.00 to $28.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
**_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission._
_Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
\#RPO
Full Time
Sr Claims Analyst (Debit Fraud Claims)
Phoenix, Arizona
**Job Description:**
**Class Start Date: 05/05/2025**
**Work Schedule: Monday - Friday (8:00 AM to 5:00 PM)**
At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. We do this by driving Responsible Growth and delivering for our clients, teammates, communities and shareholders every day.
Being a Great Place to Work is core to how we drive Responsible Growth. This includes our commitment to being a diverse and inclusive workplace, attracting and developing exceptional talent, supporting our teammates’ physical, emotional, and financial wellness, recognizing and rewarding performance, and how we make an impact in the communities we serve.
At Bank of America, you can build a successful career with opportunities to learn, grow, and make an impact. Join us!
**Job Description:**
This job is responsible for resolving the day-to-day complex claims and escalations including in-depth analysis for fraud and non-fraud claims, handling complex decisions based on analytical research, established policies and procedures, and judgment. Key responsibilities include following all applicable regulatory guidelines and establishing procedures while utilizing multiple systems and tools. Job expectations include interacting with multiple business partners and clients in order to educate, set appropriate expectations, or deny the claim.
**Responsibilities:**
+ Interacts with multiple business partners to appropriately investigate and decision claim
+ Follows up with clients either verbally or through written communication
+ Educates and communicates claim decisions to clients
+ Records data captured during client interactions accurately
**Required Skills: "Must" have these skills to be minimally qualified.**
+ Experience in a Customer Service or Client Facing Environment
+ Must display excellent customer service skills with the ability to diffuse difficult customer interactions
+ Must possess excellent problem solving and analytical skills
+ Customer-centric approach to problem resolution
+ Must work well in a team environment, as well as independently
+ Strong personal ownership and follow through skills
+ Must have a strong and positive work ethic and display Bank of America's Values
+ Must be flexible and adapt quickly to change
+ Ability to multi-task and meet defined performance goals
+ Must be a meets in performance results
+ Proficient PC skills in a Windows based environment
+ Excellent written and oral communication skills
**Desired Skills:**
+ Prior experience in a Fraud or Non-Fraud Claims back office investigations or Call Center role
+ Experience in claiminvestigations/systems
**Skills:**
+ Attention to Detail
+ Decision Making
+ Due Diligence
+ Research
+ Active Listening
+ Adaptability
+ Issue Management
+ Problem Solving
+ Business Acumen
+ Collaboration
+ Oral Communications
+ Written Communications
**LOB Specific Information:**
This role will be supporting the _Research_ function within Debit Fraud Claims.
**Shift:**
1st shift (United States of America)
**Hours Per Week:**
40
Bank of America and its affiliates consider for employment and hire qualified candidates without regard to race, religious creed, religion, color, sex, sexual orientation, genetic information, gender, gender identity, gender expression, age, national origin, ancestry, citizenship, protected veteran or disability status or any factor prohibited by law, and as such affirms in policy and practice to support and promote the concept of equal employment opportunity and affirmative action, in accordance with all applicable federal, state, provincial and municipal laws. The company also prohibits discrimination on other bases such as medical condition, marital status or any other factor that is irrelevant to the performance of our teammates.
To view the "Know your Rights" poster, CLICK HERE (https://u.go/0As7EN) .
View the LA County Fair Chance Ordinance (https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf) .
Bank of America aims to create a workplace free from the dangers and resulting consequences of illegal and illicit drug use and alcohol abuse. Our Drug-Free Workplace and Alcohol Policy (“Policy”) establishes requirements to prevent the presence or use of illegal or illicit drugs or unauthorized alcohol on Bank of America premises and to provide a safe work environment.
To view Bank of America’s Drug-free Workplace and Alcohol Policy, CLICK HERE .
This communication provides information about certain Bank of America benefits. Receipt of this document does not automatically entitle you to benefits offered by Bank of America. Every effort has been made to ensure the accuracy of this communication. However, if there are discrepancies between this communication and the official plan documents, the plan documents will always govern. Bank of America retains the discretion to interpret the terms or language used in any of its communications according to the provisions contained in the plan documents. Bank of America also reserves the right to amend or terminate any benefit plan in its sole discretion at any time for any reason.
Full Time
**About this role:**
Wells Fargo is seeking a Senior Business Execution Consultant on the Workforce Management team within Consumer and Small Business Banking Operations (CSBBO). This execution consultant will develop analysis and models to optimize workforce staff in large telephony and back-office operations organizations. To be successful in this role, the individual will possess a strong understanding of back-office workforce management, capacity planning/forecast modeling for operations, contact center and business utility functions. The workforce management team works to support staffing strategies to include tactical forecasting and scheduling, real-time capacity monitoring, capacity planning, and back-office workload support for CSBBO contact centers and delivery teams. Learn more about our career areas and lines of business at wellsfargojobs.com.
**In this role, you will:**
+ Review and research moderately complex business, operational, and technical challenges that require an in-depth evaluation of variable factors.
+ Manage all activities related to their staffing models including what-if and trend analysis, requirement gathering, cost/benefit analysis, process analysis and mapping/improvement projects. Will also serve as the subject matter expert for their assigned area of responsibility.
+ Perform solution-based strategic thinking to enable the business to operate as leanly as possible without sacrificing quality or risking metric results.
+ Monitor and publish results to plan, identify gaps and lead remediation strategy with operations leadership.
+ Be responsible for the development and ongoing administration of the long-term capacity planning models (which forecast volume, productivity, shrinkage and headcount needs to meet required business objectives)
+ Partner with various departments to ensure a thorough understanding of operational strategies while ensuring that the Capacity Plans accurately reflect those strategies.
+ Identify strategic recommendations on how to optimize our workforce.
+ Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures
+ Communicate and coordinate with various departments including Operations, Finance, Workforce Management Support, and other partners.
+ Work both independently and in partnership with global leadership developing strong relationships with remote partners through the creation and communication of polished analysis and PowerPoint presentations built to inform and recommend strategies to Sr. Leadership
+ Manage or participate in large cross group projects and mentor less experienced staff.
**As a successful candidate, you will have:**
+ The ability to think creatively to build out advanced Excel spreadsheets from scratch.
+ Excellent capabilities with Microsoft Excel Pivot Tables/Data Analysis/Database knowledge
+ The ability to analyze, review, forecast, and trend complex data – creating “what if” models, identifying viable options to enable data-driven decisions that supports business objectives.
+ Strategic planning, problem solving, analytical skills and the ability to balance multiple tasks simultaneously.
+ The ability to plan, prioritize, organize, and complete work to meet established objectives.
+ Strong written and verbal communication skills that convey the ability to synthesize complex concepts into easy to digest formats for senior leaders.
+ The ability to maintain composure in critical situations and communicate effectively.
+ A high level of professionalism, integrity, and maturity
+ Excellent interpersonal and collaboration skills with a global team
+ Strong technical skills including Microsoft Office Suite and Teams
**Required Qualifications:**
+ 4+ years of Analytics experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education.
**Desired Qualifications:**
+ 4+ years' workforce management and/or workforce optimization experience
+ 4+ years of performing telephony and/or back-office forecasting to assess volume and FTE need.
+ Ability to gather and analyze data and synthesize models to optimize workforce staffing.
+ Experience with call center workforce management tools (Aspect, Verint, IEX, Nice, etc)
+ 3+ years of experience using advanced level of proficiency in MS Excel working with large data sets, including ability to utilize VLOOKUPs, create pivot tables and graphs, and incorporate standard formulas and functions.
+ Ability to influence across all organizational levels, particularly senior management.
+ Ability to quickly establish credibility to build and maintain effective working relationships.
+ Ability to effectively communicate, verbally and written, with executive level presence with the ability to translate complex analysis and insights into relevant business discussions with diverse groups of leaders and organizations.
**Job Expectations:**
+ Ability to travel up to 10% of the time
+ This position is not eligible for Visa sponsorship.
**Posting End Date:**
10 Mar 2025
**_*Job posting may come down early due to volume of applicants._**
**We Value Diversity**
At Wells Fargo, we believe in diversity, equity and inclusion in the workplace; accordingly, we welcome applications for employment from all qualified candidates, regardless of race, color, gender, national origin, religion, age, sexual orientation, gender identity, gender expression, genetic information, individuals with disabilities, pregnancy, marital status, status as a protected veteran or any other status protected by applicable law.
Employees support our focus on building strong customer relationships balanced with a strong risk mitigating and compliance-driven culture which firmly establishes those disciplines as critical to the success of our customers and company. They are accountable for execution of all applicable risk programs (Credit, Market, Financial Crimes, Operational, Regulatory Compliance), which includes effectively following and adhering to applicable Wells Fargo policies and procedures, appropriately fulfilling risk and compliance obligations, timely and effective escalation and remediation of issues, and making sound risk decisions. There is emphasis on proactive monitoring, governance, risk identification and escalation, as well as making sound risk decisions commensurate with the business unit’s risk appetite and all risk and compliance program requirements.
Candidates applying to job openings posted in US: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected characteristic.
Candidates applying to job openings posted in Canada: Applications for employment are encouraged from all qualified candidates, including women, persons with disabilities, aboriginal peoples and visible minorities. Accommodation for applicants with disabilities is available upon request in connection with the recruitment process.
**Applicants with Disabilities**
To request a medical accommodation during the application or interview process, visit Disability Inclusion at Wells Fargo (https://www.wellsfargojobs.com/en/diversity/disability-inclusion/) .
**Drug and Alcohol Policy**
Wells Fargo maintains a drug free workplace. Please see our Drug and Alcohol Policy (https://www.wellsfargojobs.com/en/wells-fargo-drug-and-alcohol-policy) to learn more.
**Wells Fargo Recruitment and Hiring Requirements:**
a. Third-Party recordings are prohibited unless authorized by Wells Fargo.
b. Wells Fargo requires you to directly represent your own experiences during the recruiting and hiring process.
**Req Number:** R-440024
Full Time
**About this role:**
Wells Fargo is seeking a Senior Business Execution Consultant on the Workforce Management team within Consumer and Small Business Banking Operations (CSBBO). This execution consultant will develop analysis and models to optimize workforce staff in large telephony and back-office operations organizations. To be successful in this role, the individual will possess a strong understanding of back-office workforce management, capacity planning/forecast modeling for operations, contact center and business utility functions. The workforce management team works to support staffing strategies to include tactical forecasting and scheduling, real-time capacity monitoring, capacity planning, and back-office workload support for CSBBO contact centers and delivery teams. Learn more about our career areas and lines of business at wellsfargojobs.com.
**In this role, you will:**
+ Review and research moderately complex business, operational, and technical challenges that require an in-depth evaluation of variable factors.
+ Manage all activities related to their staffing models including what-if and trend analysis, requirement gathering, cost/benefit analysis, process analysis and mapping/improvement projects. Will also serve as the subject matter expert for their assigned area of responsibility.
+ Perform solution-based strategic thinking to enable the business to operate as leanly as possible without sacrificing quality or risking metric results.
+ Monitor and publish results to plan, identify gaps and lead remediation strategy with operations leadership.
+ Be responsible for the development and ongoing administration of the long-term capacity planning models (which forecast volume, productivity, shrinkage and headcount needs to meet required business objectives)
+ Partner with various departments to ensure a thorough understanding of operational strategies while ensuring that the Capacity Plans accurately reflect those strategies.
+ Identify strategic recommendations on how to optimize our workforce.
+ Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures
+ Communicate and coordinate with various departments including Operations, Finance, Workforce Management Support, and other partners.
+ Work both independently and in partnership with global leadership developing strong relationships with remote partners through the creation and communication of polished analysis and PowerPoint presentations built to inform and recommend strategies to Sr. Leadership
+ Manage or participate in large cross group projects and mentor less experienced staff.
**As a successful candidate, you will have:**
+ The ability to think creatively to build out advanced Excel spreadsheets from scratch.
+ Excellent capabilities with Microsoft Excel Pivot Tables/Data Analysis/Database knowledge
+ The ability to analyze, review, forecast, and trend complex data – creating “what if” models, identifying viable options to enable data-driven decisions that supports business objectives.
+ Strategic planning, problem solving, analytical skills and the ability to balance multiple tasks simultaneously.
+ The ability to plan, prioritize, organize, and complete work to meet established objectives.
+ Strong written and verbal communication skills that convey the ability to synthesize complex concepts into easy to digest formats for senior leaders.
+ The ability to maintain composure in critical situations and communicate effectively.
+ A high level of professionalism, integrity, and maturity
+ Excellent interpersonal and collaboration skills with a global team
+ Strong technical skills including Microsoft Office Suite and Teams
**Required Qualifications:**
+ 4+ years of Analytics experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education.
**Desired Qualifications:**
+ 4+ years' workforce management and/or workforce optimization experience
+ 4+ years of performing telephony and/or back-office forecasting to assess volume and FTE need.
+ Ability to gather and analyze data and synthesize models to optimize workforce staffing.
+ Experience with call center workforce management tools (Aspect, Verint, IEX, Nice, etc)
+ 3+ years of experience using advanced level of proficiency in MS Excel working with large data sets, including ability to utilize VLOOKUPs, create pivot tables and graphs, and incorporate standard formulas and functions.
+ Ability to influence across all organizational levels, particularly senior management.
+ Ability to quickly establish credibility to build and maintain effective working relationships.
+ Ability to effectively communicate, verbally and written, with executive level presence with the ability to translate complex analysis and insights into relevant business discussions with diverse groups of leaders and organizations.
**Job Expectations:**
+ Ability to travel up to 10% of the time
+ This position is not eligible for Visa sponsorship.
**Posting End Date:**
10 Mar 2025
**_*Job posting may come down early due to volume of applicants._**
**We Value Diversity**
At Wells Fargo, we believe in diversity, equity and inclusion in the workplace; accordingly, we welcome applications for employment from all qualified candidates, regardless of race, color, gender, national origin, religion, age, sexual orientation, gender identity, gender expression, genetic information, individuals with disabilities, pregnancy, marital status, status as a protected veteran or any other status protected by applicable law.
Employees support our focus on building strong customer relationships balanced with a strong risk mitigating and compliance-driven culture which firmly establishes those disciplines as critical to the success of our customers and company. They are accountable for execution of all applicable risk programs (Credit, Market, Financial Crimes, Operational, Regulatory Compliance), which includes effectively following and adhering to applicable Wells Fargo policies and procedures, appropriately fulfilling risk and compliance obligations, timely and effective escalation and remediation of issues, and making sound risk decisions. There is emphasis on proactive monitoring, governance, risk identification and escalation, as well as making sound risk decisions commensurate with the business unit’s risk appetite and all risk and compliance program requirements.
Candidates applying to job openings posted in US: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected characteristic.
Candidates applying to job openings posted in Canada: Applications for employment are encouraged from all qualified candidates, including women, persons with disabilities, aboriginal peoples and visible minorities. Accommodation for applicants with disabilities is available upon request in connection with the recruitment process.
**Applicants with Disabilities**
To request a medical accommodation during the application or interview process, visit Disability Inclusion at Wells Fargo (https://www.wellsfargojobs.com/en/diversity/disability-inclusion/) .
**Drug and Alcohol Policy**
Wells Fargo maintains a drug free workplace. Please see our Drug and Alcohol Policy (https://www.wellsfargojobs.com/en/wells-fargo-drug-and-alcohol-policy) to learn more.
**Wells Fargo Recruitment and Hiring Requirements:**
a. Third-Party recordings are prohibited unless authorized by Wells Fargo.
b. Wells Fargo requires you to directly represent your own experiences during the recruiting and hiring process.
**Req Number:** R-440024
Full Time
**Who Are We?**
Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$48,700.00 - $80,400.00
**Target Openings**
1
**What Is the Opportunity?**
This position services Insureds/Agents in and around Tucson, AZ. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.
This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
**What Will You Do?**
+ Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel.
+ The on the job training includes practice and execution of the following core assignments:
+ Handles 1st party property claims of moderate severity and complexity as assigned.
+ Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates.
+ Broad scale use of innovative technologies.
+ Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate.
+ Establishes timely and accurate claim and expense reserves.
+ Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
+ Negotiates and conveys claim settlements within authority limits.
+ Writes denial letters, Reservation of Rights and other complex correspondence.
+ Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
+ Meets all quality standards and expectations in accordance with the Knowledge Guides.
+ Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
+ Manages file inventory to ensure timely resolution of cases.
+ Handles files in compliance with state regulations, where applicable.
+ Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
+ Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
+ Identifies and refers claims with Major Case Unit exposure to the manager.
+ Performs administrative functions such as expense accounts, time off reporting, etc. as required.
+ Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
+ May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
+ Must secure and maintain company credit card required.
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards.
+ This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor’s Degree preferred or a minimum of two years of work OR customer service related experience preferred.
+ Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic
+ Verbal and written communication skills –Intermediate
+ Attention to detail ensuring accuracy - Basic
+ Ability to work in a high volume, fast paced environment managing multiple priorities - Basic
+ Analytical Thinking – Basic
+ Judgment/ Decision Making – Basic
+ Valid passport preferred.
**What is a Must Have?**
+ High School Diploma or GED and one year of customer service experience OR Bachelor’s Degree required.
+ Valid driver's license - required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. We are committed to recruiting, retaining and developing the diverse talent of all of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email ([email protected]) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/ .
Full Time
Sr Claims Analyst (Consumer ACH)
Phoenix, Arizona
**Job Description:**
This job is responsible for resolving the day-to-day complex claims and escalations including in-depth analysis for fraud and non-fraud claims, handling complex decisions based on analytical research, established policies and procedures, and judgment. Key responsibilities include following all applicable regulatory guidelines and establishing procedures while utilizing multiple systems and tools. Job expectations include interacting with multiple business partners and clients in order to educate, set appropriate expectations, or deny the claim.
At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. We do this by driving Responsible Growth and delivering for our clients, teammates, communities and shareholders every day.
Being a Great Place to Work is core to how we drive Responsible Growth. This includes our commitment to being a diverse and inclusive workplace, attracting and developing exceptional talent, supporting our teammates’ physical, emotional, and financial wellness, recognizing and rewarding performance, and how we make an impact in the communities we serve.
At Bank of America, you can build a successful career with opportunities to learn, grow, and make an impact. Join us!
**Job Description:**
This job is responsible for resolving the day-to-day complex claims and escalations including in-depth analysis for fraud and non-fraud claims, handling complex decisions based on analytical research, established policies and procedures, and judgment. Key responsibilities include following all applicable regulatory guidelines and establishing procedures while utilizing multiple systems and tools. Job expectations include interacting with multiple business partners and clients in order to educate, set appropriate expectations, or deny the claim.
**Responsibilities:**
+ Interacts with multiple business partners to appropriately investigate and decision claim
+ Follows up with clients either verbally or through written communication
+ Educates and communicates claim decisions to clients
+ Records data captured during client interactions accurately
**Monday - Friday 7am-4:30pm (May vary summer/winter)**
**Phoenix AZ, Catalina BLDG.**
**Required Qualifications:**
• 1 year experience in a Customer Service or Client Facing Environment
• Must display excellent customer service skills with the ability to diffuse difficult customer interactions
• Must possess excellent problem solving and analytical skills
• Customer-centric approach to problem resolution
• Must work well in a team environment, as well as independently
• Strong personal ownership and follow through skills
• Must have a strong and positive work ethic and display Bank of America's Values
• Must be flexible and adapt quickly to change
• Ability to multi-task and meet defined performance goals
• Must be a meets in performance results
• Proficient PC skills in a Windows based environment
• Excellent written and oral communication skills
**Desired Qualifications:**
• Prior experience in a Fraud or Non-Fraud Claims back office investigations or Call Center role
• Experience in claim investigations/systems
**Skills:**
+ Attention to Detail
+ Decision Making
+ Due Diligence
+ Research
+ Active Listening
+ Adaptability
+ Issue Management
+ Problem Solving
+ Business Acumen
+ Collaboration
+ Oral Communications
+ Written Communications
**Minimum Education Requirement:** High School Diploma / GED / Secondary School or equivalent
**Shift:**
1st shift (United States of America)
**Hours Per Week:**
40
Bank of America and its affiliates consider for employment and hire qualified candidates without regard to race, religious creed, religion, color, sex, sexual orientation, genetic information, gender, gender identity, gender expression, age, national origin, ancestry, citizenship, protected veteran or disability status or any factor prohibited by law, and as such affirms in policy and practice to support and promote the concept of equal employment opportunity and affirmative action, in accordance with all applicable federal, state, provincial and municipal laws. The company also prohibits discrimination on other bases such as medical condition, marital status or any other factor that is irrelevant to the performance of our teammates.
To view the "Know your Rights" poster, CLICK HERE (https://u.go/0As7EN) .
View the LA County Fair Chance Ordinance (https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf) .
Bank of America aims to create a workplace free from the dangers and resulting consequences of illegal and illicit drug use and alcohol abuse. Our Drug-Free Workplace and Alcohol Policy (“Policy”) establishes requirements to prevent the presence or use of illegal or illicit drugs or unauthorized alcohol on Bank of America premises and to provide a safe work environment.
To view Bank of America’s Drug-free Workplace and Alcohol Policy, CLICK HERE .
This communication provides information about certain Bank of America benefits. Receipt of this document does not automatically entitle you to benefits offered by Bank of America. Every effort has been made to ensure the accuracy of this communication. However, if there are discrepancies between this communication and the official plan documents, the plan documents will always govern. Bank of America retains the discretion to interpret the terms or language used in any of its communications according to the provisions contained in the plan documents. Bank of America also reserves the right to amend or terminate any benefit plan in its sole discretion at any time for any reason.
Full Time
Complex Liability Claims Specialist
121370
Zurich is currently looking for an experienced claims adjuster to join our Complex Liability Claims team.
If you are ready for a career move, consider working for a company with a global footprint that offers an excellent work/life balance, terrific benefits including an incentive plan, 401K match and a second 401K company contribution, flexible work options, summer hours and a great culture.
This position is a fully remote position that can be filled anywhere in the US. It requires management of complex primary high exposure auto and general liability claims and litigation involving bodily injury, property damage, personal injury and advertising injury. The Claims Specialist is responsible for proactively managing claims and litigation effectively in accordance with our Best Practices while delivering outstanding customer service. The position requires regular communication with customers, brokers, our Business Units and senior Claims management.
The ideal candidate will have experience managing and resolving high severity injury claims and litigation in multiple jurisdictions, proven skills in time management and caseload management, and must be able to document claim files by accurately capturing and updating claims data/information in compliance with best practices.
Basic Qualifications:
+ Bachelors Degree and 6 or more years of experience managing general liability and/or auto claims and litigation including some experience with high severity claimsOR
+ Juris Doctor and 2 or more years of experience managing general liability and/or auto claims and litigation including some experience with high severity claimsOR
+ Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience managing general liability and/or auto claims and litigation including some experience with high severity claimsOR
+ Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.OR
+ High School Diploma or Equivalent and 8 or more years of experience managing general liability and/or auto claims and litigation including some experience with high severity claimsAND
+ Must obtain and retain required adjuster licenses
+ Microsoft Office experience
+ Knowledge of insurance regulations, markets, and products
Preferred Qualifications:
+ JD, SCLA, AIC or CPCU
+ Experience working in a collaborative team environment and across work groups
+ Excellent verbal and written communication skills
+ Expertise resolving severe bodily injury and property damage claims and litigation in multiple jurisdictions
+ Strong skills in coverage, claim evaluation and negotiation
+ Proven organization and time management skills
+ Ability to work independently
Compensation for roles at Zurich varies depending on a wide array of factors including but not limited to the specific office location, role, skill set, and level of experience. As required by local law, Zurich provides in good faith a reasonable range of compensation for roles. For additional information about our Total Rewards, click here . Other rewards may include short term incentive bonuses and merit increases. **Candidates with salary expectations outside of the range are encouraged to apply, and will be considered based on experience, skill, and education.** The salary provided is a nationwide market range and has not been adjusted for the applicable geographic differential associated with the location where the position may be filled. The starting salary range for this position is $75,000.00 - $130,000.00,with short-term incentive bonus eligibility set at 15%.
As an insurance company, Zurich is subject to 18 U.S. Code § 1033.
As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time ( https://www.zurichna.com/careers/faq ).
A future with Zurich. What can go right when you apply at Zurich?
Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please clickhere (https://www.zurichna.com/careers) to learn more.
As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet
Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.
Location(s): AM - Remote Work (US), AM - Alabama Virtual Office, AM - Alaska Virtual Office, AM - Arizona Virtual Office, AM - Arkansas Virtual Office, AM - California Virtual Office, AM - Colorado Virtual Office, AM - Connecticut Virtual Office, AM - Delaware Virtual Office, AM - Florida Virtual Office, AM - Georgia Virtual Office, AM - Hawaii Virtual Office, AM - Idaho Virtual Office, AM - Illinois Virtual Office, AM - Indiana Virtual Office, AM - Iowa Virtual Office, AM - Kansas Virtual Office, AM - Kentucky Virtual Office, AM - Louisiana Virtual Office, AM - Maine Virtual Office, AM - Maryland Virtual Office, AM - Massachusetts Virt. Office, AM - Michigan Virtual Office, AM - Minnesota Virtual Office, AM - Mississippi Virtual Office, AM - Missouri Virtual Office, AM - Montana Virtual Office, AM - Nebraska Virtual Office, AM - Nevada Virtual Office, AM - New Hampshire Virt. Office, AM - New Jersey Virtual Office, AM - New Mexico Virtual Office, AM - New York Virtual Office, AM - North Carolina Virt. Office, AM - North Dakota Virtual Office, AM - Ohio Virtual Office, AM - Oklahoma Virtual Office, AM - Oregon Virtual Office, AM - Pennsylvania Virtual Office, AM - Rhode Island Virtual Office, AM - South Carolina Virt. Office, AM - South Dakota Virtual Office, AM - Tennessee Virtual Office, AM - Texas Virtual Office, AM - Utah Virtual Office, AM - Vermont Virtual Office, AM - Virginia Virtual Office, AM - Washington St Virt. Office, AM - West Virginia Virt. Office, AM - Wisconsin Virtual Office, AM - Wyoming Virtual Office
Remote Working: Yes
Schedule: Full Time
Employment Sponsorship Offered: No
Linkedin Recruiter Tag: #LI-KO1 #LI-ASSOCIATE #LI-REMOTE
Full Time
Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
**Job Posting Title**
Customer Care Specialist
**Job Description**
This position is a front-line service position providing assistance to members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operationsproduction and quality standards.
**Responsibilities**
+ Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.
+ Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
+ Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
+ Assists efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
+ Assists in the mentoring and training of new staff.
+ Assumes full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).
+ Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
+ Demonstrates flexibility in areas such as job duties and schedule in order to aid in better serving members and help organization achieve its business and operational goals.
+ Educates providers on how to submit claims and when/where to submit a treatment plan.
+ Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved.
+ Informs providers and members on appeal process.
+ Leads or participates in activities as requested that help improve Care Center performance, excellence and culture.
+ Links or makes routine referrals and triage decisions not requiring clinical judgment.
+ Performs necessary follow-up tasks to ensure member or provider needs are completely met.
+ Provides information regarding in-network and out-of-network reimbursement rates and states multiple networks to providers.
+ Refers callers requesting provider information to Provider Services regarding professional provider selection criteria and application process.
+ Refers patients/EAP clients to the Care Management team for a provider, EAP affiliate, or Facility.
+ Responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
+ Support team members and participate in team activities to help build a high-performance team.
+ Thoroughly documents customers' comments/information and forwards required information to the appropriate staff.
**Education & Experience**
+ Education Level, GED or High School diploma
+ Preferred Associates or Bachelor's
+ Experience Level, Less than 2 years
+ Required Field Experience, Customer Service
Must be eligible to work in the United States without the need for work visa or residency sponsorship.
**Additional Qualifications**
+ Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.
+ Responsible for meeting call handling requirements and daily telephone standards as set forth by management.
+ Must agree to observing service for the purpose of training and quality control.
+ Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
+ Must be able to maneuver through various computer platforms while verifying information on all calls.
+ Must be able to talk and type simultaneously.
**Preferred Qualifications**
**Physical Demands**
+ Must be able to remain in a stationary position 50% of the time. Must be able to "move or traverse"
+ Must be able to constantly operate a computer and/or other office productivity equipment
+ Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information
+ Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Potential pay for this position ranges from $17.85 - $25.48 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.
_Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. _
_We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._
_Prime Therapeutics LLC is a Tobacco-Free Workplace employer._
Positions will be posted for a minimum of five consecutive workdays.
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].
Full Time
Summary of Position
The claims adjuster is a motivated self-starter that is responsible for the management of all aspects of an assigned book of claims. The candidate should be familiar with insurance policy languages and able to apply claims adjusting principals to determine applicable coverage.
Position Functions
This position is responsible for:
+ Management of assigned claims book including intake, processing, adjustment, and settlement of the claims through:
+ Understanding and interpreting the policy to determine applicable coverage and the cause and extent of loss within effective policy periods.
+ Setting accurate reserves within specific authority limits or make recommendations for adjusting reserves as necessary and appropriate.
+ Determine and utilize third party resources for needed claims investigations.
+ Maintain organized and detailed claims files within internal database systems.
+ Ensure accuracy of documentation and information relative to each claim
+ Understands and applies salvage and subrogation processes to assist internal and external legal department with the recovery process.
+ Any other assigned projects
Knowledge, Skills, & Abilities
The candidate should be customer service orientated, demonstrate a positive attitude and the ability to share knowledge and work effectively in a team environment with all levels of company staff; posses strong professional verbal and written communication skills, strong mathematical skills, strong time management and organizational skills; and analytical and problem-solving skills with the ability to manage and prioritize multiple projects independently in a fast-paced office environment. Hand-on training is provided.
Other Requirements
Minimum of year of prior claims adjusting experience. Knowledge of the marine cargo and/or logistics fields is a plus.
A working knowledge of Microsoft Office products, Adobe, spreadsheet software, and general computer skills are required.
Adjusters License in any of the U.S. states; if no license, candidate will be required to obtain applicable license within 6 months of hire.
Physical Requirements
Must be able to sit and operate a computer; answer and communicate effectively on a telephone.
Supervisory Responsibilities
None
Equipment Used
Computer, various programs to include Microsoft Office, telephone, fax machine, copy machine, postage meter, scanner
Hours of Operation and Working Conditions
We are looking for candidates in the following states: Arizona and Rhode Island
This position's work hours are Monday through Friday 9am to 5pm, in a business-casual office environment. We currently operate in a hybrid capacity with 3 days in the office, Wednesday and Thursday are required and 2 days at home. This position requires occasional flexibility for working additional hours to accomplish project objectives. Occasional business travel may be required.
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Full Time
At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities to put customers at the center of what we do best – protecting and restoring their dreams when they need us most. We're using our expertise, technology and new ways of working to reinvent one of America's largest industries—creating positive impact that empowers our customers, communities, and company to succeed. We are problem solvers who ask important questions and handle challenges big and small. Together, we change what's expected of insurance.
You will investigate and maintain property claims, secure information, review coverages, complete field inspections, and settle claims. You will handle moderately complex homeowner property field claims, typically within 1-2 hours of Phoenix, AZ (you must be located in this market). You will also occasionally handle desk claims.
This is a fully remote/work from home role where you will spend 80% of your time in the field. On occasion you may be asked to travel to an office location for in person engagement activities such as team meetings, training and culture events.
You will report to the Property Claim Manager. A company fleet vehicle is provided with the position and there's an option to use the vehicle for personal use.
Position Compensation Range:
$56,000.00 - $92,000.00
Pay Rate Type:
Salary
_Compensation may vary based on the job level and your geographic work location._ _Relocation support is offered for eligible candidates._
**Responsibilities**
+ Investigates origin and cause of claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, and public personnel.
+ Identify complex issues. Handle claims on a good faith basis.
+ Handle 1st party claims under multiple policy types and numerous endorsements.
+ Conduct on-site inspections when needed, evaluates damages, and handles claim negotiations with insureds, claimants, attorneys, and public adjusters.
+ Respond to customer inquiries, makes appropriate decisions and closes files.
+ Interpret and determine policies, leases, by-laws, declarations, articles and contract coverages and applies to all parties for assigned losses.
+ Provide all parties with claim process and status; answers questions or redirect to other areas.
**Requirements**
+ You will have familiarity with Xactimate or 2+ years of prior property field claims experience (alternatively, you may have construction, restoration, or mitigation experience).
+ Demonstrated experience providing customer-focused solutions or service.
+ Demonstrated experience handling 1st party moderately complex claims, or other equivalent experience.
+ Understanding of policies and endorsements related to property coverages and experience with each phase of the claim handling process.
**Licenses**
+ Valid driver's license required plus an acceptable driving record.
+ Obtain state specific property casualty claims licensing.
**Travel Requirements**
+ Up to 20%.
+ Catastrophe duty up to 20% as applicable.
**Physical Requirements**
+ Ascend or descend ladders, stairs, scaffolding, ramps, poles and the like. We may ask you for employees to visit areas that have a higher hazard than a typical office such as customer homes or other locations.
+ Move self in different positions to accomplish tasks in different environments including tight and confined spaces.
+ Adjust or move objects up to 50 pounds in all directions.
+ Your offer will be made contingent on the results of applicable background checks and signing a non-disclosure agreement for proprietary information, trade secrets, and inventions
+ Our policy restricts consideration of applicants needing employment sponsorship (visa) to specialty occupations. Sponsorship will not be considered for this position
\#LI-Remote
The candidate(s) selected for this role will be employed by AFICS, Inc. (American Family Insurance Claims Services, Inc.), an affiliate of American Family Mutual Insurance Company, S.I.
We encourage you to apply even if you do not meet all of the requirements listed above. Skills can be used in many different ways, and your life and professional experience may be relevant beyond what a list of requirements will capture. We encourage those who are passionate about what we do to apply!
We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits.
We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.
\#LI-DB1
Full Time
Financial Services
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