Plans and conducts investigations of claims to analyze and confirm coverage and to determine liability, compensability and damages.
Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim.
Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
Liberty Mutual strives to create a workplace where everyone feels valued and supported. They build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions.
Investigate complex Homeowners/Commercial claims to confirm facts and cause of loss.
Compare investigation facts against policy to determine coverage of claim.
Assess and determine extent of damages, document with photos, measurements, repair estimate.
Mercury has been helping people reduce risk and overcome unexpected events for over 60 years. They are a team that encourages growth, fun, and collaboration, embracing diverse perspectives and offering competitive compensation and benefits.
Thoroughly verifies and explains coverage to Policyholders.
Sets reserves for anticipated losses and arranges required inspections.
Coordinates with other departments and researches customer inquiries.
Mercury Insurance has been helping people reduce risk and overcome unexpected events for over 60 years. They value their team members and offer diverse perspectives to serve customers from all walks of life.
Retaining and supervising outside counsel in the defense of our insureds in an effort to effectively resolve claims.
Verus Specialty Insurance, a member of W.R. Berkley Corporation (NYSE: WRB), is a leading Excess and Surplus Lines provider delivering comprehensive solutions across the United States. They blend the best of both worlds to foster innovation with a dynamic culture.
Accountable for the full handling and control of all claim matters assigned from inception to resolution.
Consistently evaluate potential exposure present as to all claims assigned and adapt to changing circumstances as claims develop.
Provide superior customer service to all co-employees, agents, policyholders and others encountered during the claims handling process.
Crum & Forster (C&F) provides specialty and standard commercial lines insurance products through their admitted and surplus lines insurance companies. C&F has more than 2000 employees in locations throughout the United States and is part of Fairfax Financial Holdings, a global, billion dollar organization.
Manages mid-level general liability claims by gathering information to determine liability exposure.
Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
Manages subrogation of claims and negotiates settlements.
Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides solutions for the rapidly changing and complex risk landscape.
Investigate, evaluate, and adjust multi-line general liability claims.
Establish and recommend reserves within defined authority levels.
Negotiate settlements in compliance with state laws and client expectations.
CCMSI partners with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology and collaborative problem-solving. As the largest privately-owned Third Party Administrator (TPA), they deliver customized claim solutions and are a certified Great Place to Work®.
Investigate and resolve Homeowners claims of moderate complexity in a timely and efficient manner.
Perform field inspections, traveling to customers’ homes to conduct on-site inspections and prepare detailed estimates.
Handle virtual claims using imagery and advanced video technology to collaborate with onsite vendors and insureds.
Mercury Insurance has been helping people reduce risk and overcome unexpected events for more than 60 years. They are one team that embraces diverse perspectives to serve customers from all walks of life.
Manage a complex portfolio of workers' compensation claims.
Conduct investigations and guide claim strategy.
Ensure fair and timely claim resolutions.
CCMSI partners with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology and collaborative problem-solving. As the largest privately owned Third Party Administrator (TPA), CCMSI is a certified Great Place to Work® where employee-owners are empowered to grow and make meaningful contributions.
Researches requests for review of resolvable claims from providers.
Compiles information related to member appeals that request an Executive Review.
Provides copies of necessary documents and submits information to the Appeals and Policy Manager for review.
PEHP Health & Benefits is a division of the Utah Retirement Systems that serves Utah’s public employees through competitively priced medical, dental, life, and long-term disability insurance plans on a self-funded basis. They embrace both a public mission and a commitment to creating customer value.
Design, develop, and maintain comprehensive training programs for new hire onboarding and process changes.
Deliver engaging training sessions to claims adjusters at all experience levels, including leadership.
Conduct training needs assessments using performance data analysis and surveys to identify skill gaps.
Openly is rebuilding insurance from the ground up, re-envisioning and enhancing every aspect of the customer experience. They are a rapidly growing team of exceptional, curious, empathetic people with a wide range of skill sets.
Be responsible for department quality audit process related to service standards, adherence to procedural, regulatory and financial requirements.
Review the referral of, submit, monitor and track all subrogation referrals receive by the Claim department and forwarded to external vendors.
Handle overpayment, check void and refunds, including maintenance of the overpayment log.
Berkley Accident and Health is a risk management company that designs innovative solutions to address the unique challenges of each client. With its entrepreneurial culture and a strong emphasis on analytics, they can help employers better manage their risk.
Performs routine and complex audits on phone calls and claims adjudication.
Researches claim processing problems and errors to determine their origin and appropriate resolution.
Provides prompt customer service to members, providers, billing departments, and other insurance companies regarding claims.
University of Utah Health is an integrated academic healthcare system with five hospitals, community health centers, and a health plan. It is nationally ranked and recognized for academic research, quality standards and overall patient experience with over 1,600 providers.
Managing multiple claims units/teams; Requires general knowledge of workers’ compensation statutes, regulations and compliance within the jurisdictions.
Provide strategic direction for the appropriate analysis of claims ensuring they are resolved in an equitable and timely.
Ensure the early recognition of exposures and setting of appropriate case reserves to ensure that future claim costs are accurately estimated.
Crum & Forster (C&F) provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F has more than 2000 employees and they are winning recognition as a great place to work, earning several workplace and wellness awards.
Investigates and analyzes Motor Vehicle Accident accounts.
Identifies and coordinates insurance benefits, resolving outstanding balances.
Acts as a liaison between clients, attorneys, and insurance companies.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage expertise and a unified intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers nationwide.
Contacts insurance companies for status on outstanding claims.
Processes and follows up on appeals to insurance companies.
Works outstanding accounts receivable from assigned work queues.
US Anesthesia Partners is dedicated to providing high-quality anesthesia services. They offer equal employment opportunities to all employees and applicants.
Resolve participant claim issues by responding to questions and resolving tickets in our ticketing system.
Process client claims and service provider invoices in case management system accurately and ensures contractual and legislative requirements are met.
Provide quality assurance for claims/invoices processed by other Claims Specialists.
They partner with governments and local agencies across Canada to create sustainable employment opportunities for people, businesses and communities. They understand that work gives hope, strengthens relationships and drives economic growth.
Adjudicate 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
Verify claims coverage through in-depth knowledge of policy Terms & Conditions
Fetch is dedicated to helping pets live their healthiest and happiest lives through comprehensive insurance coverage. They are a high-growth Warburg Pincus portfolio company with an expanding team of over 350 pet-loving employees working together to shape the future of pet health and wellness.
Manage, process, and monitor Off Campus Authorization (OCA) requests through the online OCA system.
Coordinate with various departments and outside entities to produce or request required Certificates of Insurance.
Support initial investigation into risk management issues and identify and address customer needs related to potential and actual claims.
Oregon Health & Science University aims to provide a comprehensive risk management program contributing to health, safety, and protection of patients, employees, faculty, students, and visitors, while also protecting the University's resources. They manage over 30 lines of insurance and a captive insurance company, with claims managed internally.
Leads creation of in-depth test plans and conducts User Acceptance Testing to ensure that systems meet business requirements.
Participates in the design of technology solutions based upon business needs.
Runs data queries and conducts data analysis to identify and solve business problems.
Mercury is committed to helping people reduce risk and overcome unexpected events. Guided by a diverse perspective, Mercury embraces the strengths and values of each team member to serve customers from all walks of life.