Conduct on site inspections and assessments of property damages for both residential and commercial claims Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently May occasionally require interacting with parties who express strong emotions or concerns about ongoing inspections or claim resolutions

Evaluate and process referrals to ensure the appropriate distribution of workloads following established triage guidelines and practices. Assist in the detection of insurance fraud activity and improve fraud awareness. You will report to an SIU Manager. Position Compensation Range $23.00 $33.17 Pay Rate Type Hourly Compensation may vary based on the job level and your geog

Authorizes the appropriate payment or refers claims to investigators for further review Conducts data entry and claims processing/issues Handling issues within turnaround standards Ability to handle most claim types / cases / issues that are submitted to the team you are supporting Ability handle escalations as needed Ability to work multiple functions and applications in

Conduct independent coverage, liability and damages analysis in order to assess the extent of potential exposure to the Company. Draft correspondence that accurately and succinctly communicates Company's coverage position. Analyze, develop and determine appropriate case reserves on all assigned claim files and recommend changes where necessary to ensure actuarial accuracy

Complete field inspections, reviews and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company crop insurance policies Ensure compliant and cost effective application of crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory require

Claims Examiner Stop Loss Remote Job Locations US NJ EATONTOWN | US AZ Phoenix Job ID 2024 3873 Category Claims Type Regular Division A&H Crum & Forster Company Overview Crum & Forster (C&F) with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a finan

The Claims Senior Representative serves as a technical expert on claims adjusting and handles injury, material damage, real property damage, negligence, compensability, damage, and coverage issues. The role determines coverage and investigates, analyzes, negotiates, and settles claims not requiring outside investigation. The role delivers quality customer service in a hig

Manage the technical efforts associated with implementing complex Electronic Data Interchange (EDI) and Web Services trading partners. Provide HIPAA compliant guidance about MPI requirements and industry standard for EDI protocols. Conduct testing and in depth analysis. Implement process improvements.

include the following. Other duties may be assigned. Review coverage forms and claim records to determine insurance coverage for all claims, drafting timely coverage position letters when necessary. Interview client representatives and third parties; gather photos, statements, reports, medical records and other materials in order to analyze the extent of the insured's lia

CLA is a top 10 national professional services firm where our purpose is to create opportunities every day, for our clients, our people, and our communities through industry focused wealth advisory, digital, audit, tax, consulting, and outsourcing services. Even with more than 8,500 people, 130 U.S. locations, and a global reach, we promise to know you and help you. CLA i

Senior Claims Examiner Liability Requisition ID 2024 25399 Job Locations US NY Hauppauge Position Type Regular Full Time Category Claims Business Unit BUS_TPA US Excellence In Everything We Touch Position Summary Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate to d

Casualty Adjuster Requisition ID 2024 25498 Job Locations US KS Position Type Regular Full Time Category Claims Business Unit CUS_Loss Adjusting US Excellence In Everything We Touch Position Summary Resolves casualty claims of moderate to complex exposure by inveestigating losses and negotiating settlements. Responsibilities Examines claims forms, policies and endorsement

Under the direct supervision of a Claims Processing Supervisor and the general direction of the Manager, Claims Production, this position is primarily responsible for the accurate review, entry and processing of claims received for payment by Alameda Alliance for Health (AAH). Principal responsibilities include Research claims for completion and appropriateness. Review an

Job Description Summary At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best protecting and restoring their dreams when they need us most. We're leveraging our expertise, technology and new ways of working to actively reinvent one of America's larg

Thoroughly investigate claims and make compensability decisions. Communicate orally and in writing file directions and decisions with clients, injured workers and provider offices. Determine subrogation recovery opportunities and handle through conclusion. Adjudicate medical bills. Estimate and establish reserves on all claims for probable final payout. Manage medical car