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Gallagher logo
Gallagher

Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on protected characteristics by applicable federal, state, or local laws.

Claims Adjuster Senior Workers Compensation

Claims SpecialistClaims SpecialistOtherRemoteSeniorTeam 5,001-10,000

Location

United States

Posted

93 days ago

Salary

0

Seniority

Senior

No structured requirement data.

Job Description

Claims Adjuster Senior Workers Compensation

Gallagher

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. How you'll make an impact Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim. Interacts extensively with various parties involved in the claim process. Able to clearly communicate concise action plans, and present plans for moving the case to conclusion. Will demonstrate complete knowledge of the claim file process through presentation of actions and responses to client questions. Processes claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements. Demonstrated ability to comply with carrier reporting and threshold requirements. Able to recognize and pursue excess insurance recoveries. Incumbents will have the ability to handle a full case load, with proven ability to handle cases of increased severity. About You Required: High school diploma and 5 years related claims experience required. Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements. Extensive knowledge of accepted industry standards and practices. Computer experience with related claims and business software. Preferred: Bachelor's degree preferred. Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses. Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation. Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

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At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. Job Description As an Obvious Total Loss Adjuster, you will play a critical role in our claims handling process, focusing on determining the repairability or total loss of vehicles. Working remotely, you will spend the majority of your time managing total loss claims. Your responsibilities will involve reviewing claim details, preparing total loss valuations, assessing vehicle conditions, determining salvage valuations, and engaging in negotiation and settlement processes with our valued customers and/or claimants. Preferred Qualifications - 12 months or more of Auto Collision estimating in CCC One, Audatex, or Mitchell preferred - Previous experience in total loss adjustment or a related field is highly desirable. - Proficiency in using estimating software and valuation tools for virtual assessments. - Strong analytical skills to evaluate moderate to complex vehicle damages effectively. - Excellent negotiation and communication skills to interact with customers and stakeholders remotely. - Ability to work independently and manage time efficiently in a virtual work environment. - Detail-oriented and organized, with a commitment to delivering accurate and timely results. Work Location: This position is a remote home-based role. Your home office does not need to be near an Allstate office, but it does need to be in the United States. This Position is not available for Washington, California, Alaska, and Hawaii residents. When you work from home full time, you’ll need: - A dedicated workspace in your residence that is private and free from distractions. - A minimum internet bandwidth of 50 MB download speed and 5 MB upload speed. - Appropriate work surface and seating. Work schedule: Candidates are considered based on the time zone they live in. If you selected for this position you need to be willing to work one of the following schedules to be determined by business needs. Standard business hours 8:00 am - 4:30 pm local time “Please note, you will be required to attend 2-week of in person training.” What Allstate will provide: - A technology bundle that includes all equipment needed to perform your work from home (laptop, monitor, headset, keyboard, and mouse.) - Connectivity reimbursement of $80 per month to offset some of the cost of internet. Notice of Licensing Requirement: As a condition of employment, your office/area may require you to obtain an adjuster and/or an appraiser license which includes passing an additional background check with the Department of Labor. If applicable, you will be required to secure license(s) within 60 days of hire. If required, the Hiring Manager will work with you along with the Centralized Licensing team to ensure that you are properly licensed. Sign on Bonus: You may be eligible for a $1000 Licensing Sign on Bonus if you have the applicable active licenses needed for this role. This could include Home Resident Property & Casualty License, Designated Home State (DHS) Florida or Texas License, and/or applicable Appraiser License. **Candidates who work for or have previously worked for and are seeking to be rehired at Allstate and its family of companies are not eligible for this sign-on bonus. Allstate Benefits: Allstate cares about you and your wellbeing. We offer a comprehensive total rewards package that includes pay, benefits, and programs to help you balance work with the rest of your life. You can choose whatever benefits are most important you. Here are some of our offerings: - Competitive salary based on experience and qualifications. - Medical, dental, and vision coverage. - Allstate pension plan and 401(k) savings plan. - Ayco financial coaching. - Spring Health mental and emotional wellbeing resources. - Paid parental leave. - Adoption reimbursement. - Paid time off. - Tuition reimbursement. - Wellness incentives. Notes: The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. 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This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company’s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee’s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. 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United States
Job Closed
Highmark Health logo

Appeals Analyst

Highmark Health

Creating remarkable health experiences, freeing people to be their best.

OtherRemoteTeam 10,001+Since 1852H1B Sponsor

Company : Highmark Inc.Job Description : JOB SUMMARY This job reviews inquiries to determine if they meet the definition of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals; initiates a case file for each grievance and appeal; ensures compliance with organizational and regulatory requirements for member or provider issues; independently coordinates the resolution with internal/external parties as required; and documents and summarizes to all parties involved in the case the investigation results. ESSENTIAL RESPONSIBILITIES - Review inquiries to determine if they meet definition of appeal/grievance. - Request and review all related relevant documentation and assemble case file. - Coordinate resolution results and relay investigative results with all involved parties. - Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross functional teams to reduce trends. - May support the Quality Assurance, Appeal and other quality committees. - Other duties as assigned or requested. EDUCATION Required - High School Diploma or GED Substitutions - None Preferred - None EXPERIENCE Required - 3-5 years of relevant, progressive experience in the area of specialization. Exempted experience requirements effective August 2016. Preferred - Experience in Customer Service or a related field LICENSES or CERTIFICATIONS Required - None Preferred - None SKILLS - Knowledge of multiple processing systems and workflows - Knowledge of claims processing methodologies - Ability to interpret all government regulations - Knowledge of company products - Excellent organizational skills - Strong verbal and written communication skills Languages (Other than English) None Travel Requirement 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Occasionally Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $21.53 Pay Range Maximum: $32.95 Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org California Consumer Privacy Act Employees, Contractors, and Applicants Notice

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Adjuster

Sedgwick

Sedgwick, headquartered in Memphis, Tennessee, provides a global clientele with technology-enabled risk and benefits solutions. Distinguished as an Employer of

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Adjuster PRIMARY PURPOSE: Handles losses and claims valued up to $15,000 for property and casualty insurers through the thorough examination of documents, records, loss reports, and other relevant documentation. Efficiently manages a case load using technology for efficient claim processing. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Evaluates insurance policies, claims forms, policies, endorsements, carrier instructions, and other records to determine insurance coverage. - Conducts thorough investigations, gathers official reports as needed, consults police and hospital records and inspects physical damage or written estimates for damages based on a conducted inspection to determine extent of company's liability and varying methods of investigation, according to type of insurance. - Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim. - Estimates cost of repair, replacement, or compensation. - Prepares report of findings and negotiates claim settlements by adhering to carrier instructions and obtaining necessary information. Issues settlement checks, files regulatory documents, and handles salvage and subrogation as applicable. - Recommends litigation by legal department when settlement cannot be negotiated. - Attends litigation hearings and participates in depositions as necessary. - Revises case reserves in assigned claims files to cover probable costs. - Maintains an expected caseload efficiently. - Utilizes technology and automation tools for efficient claim handling. - Sends claims exceeding $15,000 gross loss amount to leadership for authority approval. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Must obtain IIA-AIC designation within 12 to 18 months in the role. Appropriate state adjuster license is required. Experience Three (3) year of related experience or equivalent combination of education and experience required. Prior experience handling property and casualty claims a plus but not required. Skills & Knowledge - Empathetic claims handling demeanor - Strong communication, analytical, organizational, and interpersonal skills - PC literate, including Microsoft Office products - Analytical and interpretive skills - Negotiating skills - Ability to create and complete comprehensive, accurate and constructive written reports - Ability to work in a team environment - Ability to meet or exceed Performance Competencies WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

United States
Job Closed
OtherRemoteTeam 10,001+Since 1922H1B Sponsor

Overview Being good neighbors – helping people, investing in our communities, and making the world a better place – is who we are at State Farm. It is at the core of how we operate and the reason for our success. Come join a #1 team and do some good! Grow Your Skills, Grow Your Potential Responsibilities Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-related claims for homeowners, commercial properties, and large losses. We are looking for an experienced and highly skilled professional to contribute to our dynamic team. You will be the first point of contact to meet with our insureds, explain coverage, estimate damages, and help them through the claims process while providing Remarkable service. Key Responsibilities: - 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 - Provide exceptional customer service throughout the claims process, addressing inquiries and concerns promptly and professionally - Gather necessary evidence, document findings, and prepare detailed reports to support the claims handling process - Investigate and adjust both personal and commercial property claims with exposures up to $500,000 - Evaluate coverage and policy terms to determine the validity of claims and ensure compliance with local regulations - Negotiate and settle claims within the authorized limits, considering policy provisions, industry standards, and company guidelines Where you'll work: This position is located in Swedesboro, NJ. Competitive candidates should reside within one of the listed zip codes and will service this same territory: 08001 08014 08020 08027 08028 08032 08038 08039 08051 08056 08061 08062 08066 08067 08069 08070 08071 08072 08079 08080 08085 08090 08094 08097 08098 08310 08312 08318 08322 08326 08328 08341 08343 08344 08360. This is a Remote-Field position in which you will work from home and utilize a mobile office/vehicle for in-person appointments. Although the primary work location is in the field, with a commutable distance from home, there will be opportunities for virtual work to be completed at home. Additionally, there may be occasions where you will be required to travel outside your assigned area to assist in other territories. Hours of operation are continually evaluated and may change based on business need. Successful candidates are able and willing to work flexible schedules and may be asked to work overtime and/or irregular hours. Qualifications Competitive candidates must demonstrate: - Experience as a Property Field Inspection Claim Specialist in the insurance industry, specifically in property claims - Strong knowledge of property insurance policies, coverage and claim handling practices - Knowledge of both residential and commercial building construction - Familiarity with local regulations and compliance requirements in your assigned territory - Excellent communication and interpersonal skills to effectively interact with clients, agents, and other stakeholders - Proven effective communication skills to handle difficult/emotional conversations with a customer-minded focus - Proven ability to assess damages, estimate repair costs, and negotiate settlements - Detail-oriented with strong organizational and analytical skills - Proficient in using claims management software and other relevant tools - Physical agility to allow for: frequent lifting, carrying and climbing a ladder; ability to navigate roofs at various heights for inspection of both residential and commercial structures; ability to crawl in tight spaces - May be required to complete Rope and Harness Safety Training. - A valid driver's license is required Preferred: - Bachelor's Degree in a related field or equivalent work experience - Experience in handling complex or high-value claims - Construction background - Water mitigation inspection experience - Xactimate, XactContents Additional Details: - Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s). - State Farm recently implemented new pre-employment assessments. Candidates that have previously taken an assessment may be asked to participate in additional testing Our Benefits Because work-life balance is a priority at State Farm, compensation is based on our standard 38:45-hour work week! - Potential starting salary range: $64,965.62 - $99,000.00 annually - Starting salary will be based on skills, background, and experience - High end of the range limited to applicants with significant relevant experience - Potential yearly incentive pay up to 15% of base salary At State Farm, we offer more than just a paycheck. Check out our suite of benefits designed to give you the flexibility you need to take care of you and your family! - Get Paid! On top of our competitive pay, you are eligible for an annual raise and bonus. - Stay Well! Focus on you and your family’s health with our robust health and wellbeing programs. State Farm pays most of your healthcare premium, and we offer multiple healthcare plan options, including a high deductible plan. All medical plans provide 100% coverage for in-network preventative care, AND you and your family have access to vision, dental, telemedicine, 24/7 mental health professionals, and much more! - Develop and Grow! Take advantage of educational benefits like industry leading training programs, top-notch tuition assistance programs, employee resource groups, and mentoring. - Plan Ahead! Plan for those big moments in life with benefits like fertility/IVF/adoption assistance, college coaching, national discount programs, interactive monthly financial workshops, free financial coaching, and more. You can also start a savings account or consider financing through our State Farm Federal Credit Union! - Take a Little “You” Time! You will have access to our generous time off policies designed so you can plan around holidays, family events, volunteering, or just to take a relaxing day off. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! - Give Back! We offer several ways to give back through our Matching Gift Program, Good Neighbor Grant Program, and the Employee Assistance Fund. - Finish Strong! Plan for retirement using free financial advisors and a 401(k) plan with company contributions of up to 7% of your salary. Visit our State Farm Careers page for more information on our benefits, locations, and the hiring process of joining the State Farm team!

United States