Title: Claims Team Lead - Commercial Auto Excess Casualty Location: Remote (United States) Department: Reserv Claims Analysis, LLC Job Description: ROLE OVERVIEW The Claims Leader - Commercial Auto Excess Casualty oversees a team of specialists handling high-severity commercial auto liability claims that may exceed primary policy limits. This leader ensures technical excellence, operational efficiency, and consistent delivery of Reserv's modern, data-driven claims experience. The ideal candidate blends deep casualty expertise, strong leadership, and comfort with technology, guiding adjusters in a fast-moving environment where automation handles administrative tasks and humans focus on complex decision-making. KEY RESPONSIBILITIES Leadership & Team Development - Lead, mentor, and develop a team of Commercial Auto Excess Casualty Claim Specialists. - Foster a culture of technical excellence, continuous improvement, and data-driven decision-making. - Provide coaching on coverage analysis, litigation strategy, negotiation, and high-severity claim evaluation. - Conduct regular file reviews, performance assessments, and quality audits. Operational & Technical Oversight - Oversee the handling of complex excess casualty claims, ensuring accuracy, timeliness, and compliance. - Ensure consistent application of Reserv's structured-data workflows and modern claims platform. - Partner with Product and Engineering teams to refine automation tools, improve adjuster workflows, and enhance system capabilities. - Monitor key performance indicators (KPIs), including cycle time, accuracy, severity trends, and customer satisfaction. Strategic & Cross-Functional Collaboration - Serve as a subject-matter expert for MGAs, carriers, brokers, and internal stakeholders. - Collaborate with Underwriting and Actuarial partners to provide insights on claim trends, risk patterns, and emerging exposures. - Participate in client meetings, audits, and stewardship reviews, representing Reserv's claims philosophy and performance. - Support onboarding of new programs, ensuring alignment with Reserv's operational standards and client expectations. Litigation & Coverage Management - Guide adjusters on litigation strategy, counsel management, and complex coverage issues. - Review and approve high-value settlement recommendations, coverage positions, and strategic claim decisions. - Ensure adherence to multi-jurisdictional regulatory requirements and Reserv's internal best practices. REQUIRED QUALIFICATIONS - 10+ years of commercial auto liability or casualty claims experience, including high-severity or excess layers. - Prior leadership or team-lead experience within a carrier, TPA, or MGA environment. - Strong expertise in coverage analysis, litigation management, and catastrophic injury evaluation. - Excellent communication and relationship-building skills with internal teams and external partners. - Ability to thrive in a technology-driven, rapidly evolving environment. - Active insurance adjuster's license by way of a designated home state; home state license required if home state license is available - Willing to obtain all licenses within 60 days, including completing state required testing PREFERRED SKILLS & CERTIFICATIONS - Professional designations such as CPCU, SCLA, AIC, or equivalent. JD is also a big plus - Experience working with MGAs, E&S carriers, or tech-enabled TPAs. - Familiarity with structured-data workflows, AI-assisted claims tools, or modern claims platforms. WHY LEAD AT RESERV - Influence the future of claims handling in a company built on automation, transparency, and innovation. - Lead a team that focuses on meaningful, high-value work - not administrative burden. - Join a rapidly scaling organization backed by significant investment and committed to reinventing the claims experience. - Work in a culture that values expertise, experimentation, and continuous improvement. Benefits - Generous health-insurance package with nationwide coverage, vision, & dental - 401(k) retirement plan with employer matching - Competitive PTO policy – we want our employees fresh, healthy, happy, and energized! - Generous family leave policy after 8 months of continuous work - Work from anywhere to facilitate your work life balance - Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder! Additionally, we will - Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role - Work toward reducing and eliminating all the administrative work from an adjuster role - Foster a culture of empathy, transparency, and empowerment in a remote-first environment At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!

• Communicating with claimants, employers and various medical professionals through phone and e-mail to gather information regarding Short Term Disability Claims, Family Medical Leaves, and state benefits when applicable • Collaborating with fellow case managers, nurse case managers and consulting physicians to make appropriate and timely claim determinations • Reviewing complex medical records and effectively leveraging a variety of tools and resources to understand appropriate approval durations and future action planning • Completing accurate financial calculations consistent with company and state guidelines

Role Description We are looking for a highly analytical Senior Claims Researcher to join our Claims Excellence team. Reporting directly to the Director, Claim Payment Accuracy, you will be a key individual contributor responsible for executing the high-level technical audits and testing that ensure our claims are paid correctly the first time. You are not just a claims processor; you are a "claims detective" who enjoys digging into complex data to find the "why" behind payment variances. In this role, you will perform deep-dive research and quality audits across our adjudication ecosystem, focusing on the intersection of provider contracts, benefit design, and system configuration. As a Senior Claims Researcher, you will: - Technical Quality Auditing: Execute the monthly audit plan as designed by the Director, performing detailed reviews of claims to ensure they align with provider contracts, benefit rules, and pricing guidelines. - Root Cause Research: Go beyond identifying errors; perform deep-dive research into HealthEdge HRP and Source to determine if a variance was caused by configuration logic, manual intervention, or policy misinterpretation. - Data-Driven Reporting: Compile and present audit findings that highlight trends and "enterprise risk" areas, categorizing errors to provide the Director with actionable insights for executive-level reporting. - AI-Enabled Oversight: Support the implementation of AI and Machine Learning auditing tools by providing the "human-in-the-loop" feedback necessary to train and refine automated accuracy models. - BPaaS & Configuration Collaboration: Partner closely with our external BPaaS stakeholders and internal Configuration teams to communicate audit findings, utilizing JIRA to track the lifecycle of an error from identification to systemic resolution. - Strategic Testing: Act as the final safeguard for Clover’s adjudication accuracy, ensuring that the system's "real-world" output matches the contractual and benefit intent. Success in this role looks like: - By the end of your initial 90-day period: You will have mastered the nuances of Clover’s HealthEdge HRP and Source environments and will be actively executing the monthly audit cycle, performing both random and risk-based judgmental audits to ensure baseline payment accuracy. - By 6 months: You will be recognized as the "SME of Record" for identifying systemic payment trends across pricing and benefits. You will also be actively leveraging AI tools like Claude, Gemini, and ChatGPT to build out ongoing monitoring and oversight trends that identify high-impact risks to support judgmental sampling and targeted audits. - Continued success: You will be at the forefront of "Audit 2.0," utilizing AI-forward strategies to increase the scope and speed of your research. Your work will directly contribute to Clover’s commitment to achieving top-tier payment precision and the reduction of billing friction for our members and provider partners. Qualifications - 5+ years of experience in Medicare Advantage claims auditing, research, or complex adjudication. - Current coding certification is required (CPC, CCS, COC, or CIC). - Deep technical proficiency in HealthEdge HRP and Source. - A "researcher's mindset"—naturally curious, detail-oriented, and persistent in finding the root cause of a technical problem. - Extremely AI-forward and excited to use technology and LLMs (Claude, Gemini, ChatGPT) to move away from manual, spreadsheet-based auditing. - Strong communicator who can translate complex technical findings into clear, actionable reports for leadership. Benefits - Financial Well-Being: Competitive base salary and equity opportunities, performance-based bonus program, 401k matching, and regular compensation reviews. - Physical Well-Being: Comprehensive medical, dental, and vision coverage. - Mental Well-Being: Initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. - Professional Development: Learning programs, mentorship, professional development funding, and regular performance feedback and reviews. - Additional Perks: Employee Stock Purchase Plan (ESPP), reimbursement for office setup expenses, monthly cell phone & internet stipend, remote-first culture, paid parental leave for all new parents.

Role Description If you're looking for the stability of a profitable, growing company with the entrepreneurial spirit of a startup, we’re hiring. SageSure, a leader in catastrophe-exposed property insurance, is seeking a Senior Catastrophe Claims Adjuster. A qualified candidate will have strong estimating skills, can comfortably handle high severity losses, and distill complex information for customers. You’ll be able to effectively communicate and negotiate across multiple parties, including customers, contractors, and public adjusters. This is a desk-based adjusting position. If you're interested in joining our growing Claims team, we'd love to hear from you. - Investigate and document property claims, including policy review, recorded statements, assigning inspections, updating reserves, preparing or reviewing estimates, and negotiating settlements. - Communicate claim updates and decisions verbally and in writing. - Handle claims in compliance with all applicable regulations and internal processes. - Provide technical expertise and serve as an SME for Claims-related projects. - Act as a resource for less experienced staff. - Support catastrophe response as needed, to include potential overtime and deployment. - Lead high-profile and sensitive special investigations involving intricate and specialized fraud referrals. - Any other duties needed to help drive our purpose and fulfill our values. Qualifications - Bachelor's degree in a related field or equivalent relevant education. - 5+ years of property claims experience. - Estimating skills. - Excellent written and verbal communication skills. - Strong organizational abilities. - Empathetic interpersonal skills. - Adjuster licensed in home state or holds a non-resident license if license not required; meets requirements for licensing in additional states as needed. Requirements - Field claims experience (highly preferred). - Experience in catastrophe-focused environments (highly preferred). - Professional designations (highly preferred). Company Description Named among the Best Places to Work in Insurance by Business Insurance for four years in a row (2020-2023), SageSure is one of the largest managing general underwriters (MGU) focused on catastrophe-exposed property in the US. Since its founding in 2009, SageSure has experienced exceptional growth while generating underwriting profits for carrier partners through hurricanes, wildfires, and hail. Available in 16 states, SageSure offers more than 110 home, flood, and commercial products on behalf of its highly rated carrier partners. Today, SageSure manages more than $3.2 billion of inforce premium and helps protect more than 970,000 policyholders. - More than 1,000 employees in a distributed workforce environment across 12 offices. - Locations include: Fairfield, CA; Mountain View, CA; Cheshire, CT; Jacksonville, FL; Tallahassee, FL; Tampa, FL; Chicago, IL; Jersey City, NJ; Marlton, NJ; Cincinnati, OH; Houston, TX; Sheboygan, WI. - SageSure is a proud Equal Opportunity Employer committed to building a diverse workforce. - Our culture nurtures critical thinkers who run toward problems and engineer solutions.