This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a detail-oriented and customer-focused professional to join our team as a Life Claims Analyst. In this role, you will ensure the accurate, timely, and comprehensive assessment of claims by carefully analyzing documentation, verifying information, and determining appropriate next steps. - Evaluates and adjudicates complex claims by reviewing medical records, contract language, and supporting documentation to determine accurate and timely payment or denial decisions. - Processes claim transactions and inquiries by analyzing documentation, keying data accurately, drafting determination letters, and communicating outcomes clearly to internal and external customers. - Delivers exceptional customer service across multiple channels, resolves escalations, applies service recovery techniques, and builds customer loyalty through clear, compliant communication. - Ensures compliance and quality standards by adhering to company policies, industry regulations, productivity benchmarks, and making appropriate referrals (e.g., legal, underwriting, investigations) when necessary. - Contributes to team and process excellence by supporting training and peer development, participating in process improvements, maintaining strong working relationships, and continuously expanding knowledge and skills. Qualifications - Demonstrates accountability and urgency, consistently delivering accurate results while meeting deadlines in a fast-paced environment. - Adapts quickly to change, shows flexibility, learns new skills readily, and effectively manages multiple tasks and priorities. - Works independently and collaboratively, building positive relationships while remaining approachable and team-oriented. - Exhibits strong analytical, organizational, and decision-making skills, with attention to detail and the ability to operate within structured, compliant guidelines. - Communicates effectively and maintains customer focus, utilizing strong technical skills, handling escalations professionally, and meeting attendance and flexibility requirements. - Promotes a culture of diversity and inclusion, values different ideas and opinions, and listens courageously, remaining curious in all that you do. - Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico. Requirements - College degree or work equivalent. - Insurance product knowledge of Business area. - Experience with the application of policies, practices and procedures in a business environment. - Knowledge of medical terminology. - Presentation skills. Benefits - Hourly Wage: Minimum: $22.25, plus annual bonus opportunity. - 401(k) plan with a 2% company contribution and 6% company match. - Work-life balance with vacation, personal time and paid holidays.

• Investigating and confirming facts of loss for advanced automobile accidents • Determines coverage, liability, damages and adjusts claims • Negotiates claims within limit of authority

• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim • Manages claims through well-developed action plans to an appropriate and timely resolution • Assesses liability and resolves claims within evaluation • Negotiates settlement of claims within designated authority • Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim • Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level • Prepares necessary state filings within statutory limits • Manages the litigation process; ensures timely and cost-effective claims resolution • Coordinates vendor referrals for additional investigation and/or litigation management • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients • Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets • Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner • Communicates claim activity and processing with the claimant and the client; maintains professional client relationships • Ensures claim files are properly documented and claims coding is correct

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description JWF Specialty is a division of EPIC. JWF is a best-in-class Third Party Administrator (TPA) and the TPA of choice for EPIC. They're a successful and rapidly growing division with a strong reputation for innovation and customer satisfaction. The Claims Specialist handles a caseload of approximately 130 auto and general liability claims for primarily public-sector clients. The position requires: - Establishing facts of loss - Coverage analysis - Investigation - Liability/negligence determination - Damage assessment - Settlement negotiations - Identifying potential fraud - Appropriate use of authorized vendors - Completing timely and appropriate reserve analysis All file handling must be within state statutes, client claims handling guidelines and JWF Best Practices. Qualifications - At least 5+ years of experience handling auto property and/or general liability claims - Professional communication skills – both written and verbal - High attention to detail - Strong relationship-building skills - Positive and outgoing disposition Requirements - 5+ years auto property damage claim experience preferred - Excellent interpersonal, communication, organizational and presentation skills - Computer proficiency, working knowledge of Microsoft Office products - Advanced level of interpersonal skills to handle sensitive and confidential situations - Advanced ability to negotiate claims - Advanced ability to work independently - Advanced level of organization and time management skills - Must possess advanced level written and verbal communication skills - Must be able to explain and appropriately respond to auditors, clients, and potential clients during in-person presentations - Must be able to pass all training courses within 12 months with a score of 80% or above - High School Diploma or GED required; Bachelor's degree from an accredited college or university preferred - Must possess required jurisdictional licensing (or be willing to obtain one within 30 days of start date) Benefits - Generous Paid Time off - Managed PTO for salaried/exempt employees; 22 PTO days starting out for hourly/non-exempt employees; 12 company-observed paid holidays; 4 early-close days - Generous leave time options: Paid parental leave, pregnancy disability and bonding leave, and organ donor/bone marrow donor leave - Generous employee referral bonus program of $1,500 per hired referral - Employee recognition programs for demonstrating EPIC’s values - Employee Resource Groups: Women’s Coalition, EPIC Veterans Group - Professional growth & development: Mentorship Program, Tuition Reimbursement Program, Leadership Development - Unique benefits such as Pet Insurance, Identity Theft & Fraud Protection Coverage, Legal Planning, Family Planning, and Menopause & Midlife Support - Additional benefits include 401(k) matching, medical insurance, dental insurance, vision insurance, and wellness & employee assistance programs - 50/50 Work Culture supporting collaboration, teamwork, and an inclusive work environment - EPIC Gives Back – charitable efforts include Donation Connection, Employee Assistance Fund, and People First Foundation