RemoteHunter is your dedicated AI job search assistant, turning the job hunt from a slow, individual effort into a quicker, smarter, and guided experience by streamlining each step of the process and speeding up your path to the right career opportunities.

Industry: Software Development
Company Size: 11-50 employees

RemoteHunter

Savvy Admin PROD

1. About Our Client:The organization operates in the risk management sector, providing solutions for workers’ compensation, auto, health, and disability management. Established in 1987 and publicly traded since 1991, the company addresses challenges related to managing risks and claims efficiently. With over 4,000 employees nationwide, the organization emphasizes a culture of accountability, commitment, excellence, integrity, and teamwork. It focuses on delivering integrated solutions through continual investment in technology and human capital.

2. About the Opportunity:The WC Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority under the supervision of a senior claims professional. This role supports the claims department’s objectives by ensuring claims are handled accurately and efficiently, contributing to optimal outcomes for customers and clients. The position is remote and plays a key role in upholding client and carrier guidelines while assisting with more complex claims as needed.

3. Responsibilities:• Receive workers’ compensation claims and confirm policy coverage

• Determine validity and compensability of claims

• Establish reserves and authorize payments within limits

• Manage non-complex lost-time claims under close supervision

• Communicate claim status to customers, claimants, and clients

• Adhere to client and carrier guidelines and participate in claims reviews

• Assist with complex or problematic claims as necessary

• Perform additional projects and duties as assigned

4. Requirements:• Bachelor’s degree or equivalent combination of education and experience

• Minimum of 1 year of industry experience and claims management preferred

• Current Workers’ Compensation license or certification maintained throughout employment

• Excellent written and verbal communication skills

• Ability to learn quickly and develop claims knowledge

• Strong problem-solving skills

• Proficient in Microsoft Office, including Excel

• Strong interpersonal, time management, and organizational skills

• Ability to meet performance competencies

• Capable of working independently and in a team environment

5. Pay Range and Compensation Package:• Pay range: $52,999 – $85,473

• Salary varies based on location, experience, skills, qualifications, and market conditions

• Level placement during hiring may adjust salary within this range

6. Benefits & Perks:• Medical (HDHP) with pharmacy

• Dental and vision coverage

• Long-term disability insurance

• Health Savings Account and Flexible Spending Account options

• Life, accident, and critical illness insurance

• Pre-paid legal insurance

• Parking and transit FSA accounts

• 401K and ROTH 401K retirement plans

• Paid time off

Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.

Note:RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.

WC Claims Specialist

Aisle & Abroad is a modern wedding, event, and destination experience studio specializing in beautifully curated celebrations and meaningful journeys. We help clients plan weddings, local events, honeymoons, anniversary trips, and personalized destination experiences with intention, creativity, and care.

Our focus is on crafting seamless, memorable moments—whether it’s walking down the aisle, celebrating a milestone, or exploring a new destination. By blending thoughtful planning, tailored recommendations, and elevated service, we create experiences that reflect each client’s vision and story.

At Aisle & Abroad, we believe life’s most important moments deserve exceptional settings and stress-free planning. Our team is committed to providing professional support, organized coordination, and a warm, personalized approach for every celebration and journey.

From the aisle to abroad, we’re here to bring your most meaningful moments to life.

Industry: Hospitality
Company Size: 11-50 employees

Aisle and Abroad

**Location: **Full Time / 100% Remote (United States)

**Salary: **$40,000 - $52,000 per year

**Job Description**

We are hiring Claims Specialists to review, process, and resolve customer claims submissions. This role involves handling sensitive personal and financial documentation. A background check and credit screening are required before employment.

**Responsibilities**

- Review incoming claims for completeness, accuracy, and eligibility

- Enter claim details and assign case numbers in the claims management system

- Verify claimant identity and supporting documentation

- Track and update claim status at each stage of processing

- Communicate decisions and updates to claimants via email and phone

- Escalate complex or disputed claims to senior review staff

**Requirements**

- High school diploma or GED required

- Strong attention to detail and case management skills

- Comfortable handling sensitive personal and financial documentation

- Must pass a pre-employment background check and credit screening

- No prior claims experience required — full training provided

- Must be authorized to work in the United States

~~To apply, submit your resume and complete our short online application form.~~

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Claims Specialist

EVERTEC, Inc. (NYSE: EVTC) is a leading full-service transaction processing business in Latin America, providing a broad range of merchant acquiring, payment processing and business solutions services.

The Company manages a system of electronic payment networks that process more than 2.1 billion transactions annually, and offers a comprehensive suite of services for core bank processing, cash processing and technology outsourcing. In addition, EVERTEC owns and operates the ATH® network, one of the leading personal identification number (“PIN”) debit networks in Latin America. 

Based in Puerto Rico, the Company operates in 19 Latin American countries and serves a diversified customer base of leading financial institutions, merchants, corporations and government agencies with “mission-critical” technology solutions.

Industry: IT Services and IT Consulting
Company Size: 5,001-10,000 employees

Evertec

**Business Solutions & Merchant Acquiring**

**Merchant Disputes**

**Puerto Rico**

**General Responsibilities**

The Claims Specialist is responsible for providing excellent customer care with a client service mindset with the ability to use collaborative and non-adversarial approaches in achieving diverse goals.

-  Responsible for evaluating disputed credit card transactions.

-  Investigates the disputes cases and determine if the chargeback if appropriate.

-  Debit Commercial accounts for chargebacks resolved against merchants.

-  Performs account reconciliations as part of the dispute resolution effort.

-  Provides merchants with the documentation that supports the debit to their commercial accounts.

-  Assists with training and developing new team members as assigned by management.

-  Performs special projects and other duties as may be assigned from time to time by management.

Performs duties through methods and actions that are consistently ethical and in total compliance with the laws, applicable regulations, Code of Ethics, corporate policies and guidelines and rules of conduct. Completes corporate trainings and certifications intended for the detection and prevention of money laundering related activities and fraud, insider training and conflict of interest policies and procedures, as applicable.

**Education And Experience Required**

-  Associate or Bachelor degree in Business Administration, Management, Accounting, or Finance preferred.

-  Experience in dispute resolution processes is preferred.

-  At least one (1) year of customer contact experience in a sale or call center environment via telephone and e-mail.

**Knowledge And Skills Required**

-  Knowledge of Windows operating system environment and Microsoft Office tools.

-  Bilingual in English and Spanish, preferred.

-  Must have excellent communication skills, both verbal and written, with the ability to effectively interface with customers and internal personnel.

-  Good analytical and problem-solving skills.

-  Ability to multi-task multiple priorities in a manner that is both timely and efficient within appropriate deadlines.

-  Capable of adapting to a rapidly changing environment while embracing new technologies/tools

**Additional Information**

**Lunes a Viernes de 8:00 a 5:00**

Available to work extended hours, weekends and/or holidays as needed and the availability to travel as required supporting projects in the region.

**The employee must meet the following requirements in order to participate in the recruitment process:**

Minimum of twelve (12) months as a regular employee of the Company in his or her current function. Obtain a rating of Meets Expectations or Above Expectations in the performance appraisal of the last two years. No disciplinary actions in the last year of employment. Compliance with the Company’s Code of Ethics and Standards of Conduct.

“Evertec Group, LLC is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, pregnancy, marriage, sexual orientation, gender identity, national origin, age, genetic information or condition, political affiliation, religious ideology, being a victim or perceived victim of domestic violence, sexual assault, or harassment, serving or having served in the Armed Forces of the United States, disability status, or any other protected category by Puerto Rico or US Federal law. EEO is the Law Poster. If you are an individual with a disability, a disabled veteran, or a wounded warrior and you are unable or limited in your ability to access or use this site as a result of your disability, please contact the People & Culture Department in advance at (787) 759-9999 or send an email to talentacquisition@evertecinc.com in order to accommodate your special needs. Evertec is an employer with E-Verify to verify the eligibility for employment of all the new employees. Participation Poster. Drug-free company. Equal Employment Opportunity/ Affirmative Action for Women/Veterans/People with Disabilities.”

**1. About Our Client **: The organization operates within the mortgage servicing industry, providing integrated, full-lifecycle loan servicing to borrowers and investors. It addresses the challenges borrowers face in managing their homeownership experience by delivering customer care and supportive programs. The company is involved in transforming residential real estate through its services.

**2. About the Opportunit**

y: The**Remote Default MI Claims Specialist, **I is responsible for preparing, filing, and following up on FHA, VA, USDA, PMI, and investor claims accurately and on time, ensuring compliance with insurer and investor guidelines as well as applicable laws. This role is vital for maintaining the accuracy and timeliness of claims processes, supporting the organization''s financial and operational integrity

**.3. Responsibiliti**

e

- s:

Prepare and file FHA, VA, PMI, and investor claims according to guidelines and requiremen

- ts.Review and follow up on foreclosure tracking steps related to claims and post-foreclosure activities dai

- ly.Update systems with completion dates when actions occ

- ur.Obtain approvals and reschedule steps when tasks cannot be completed on ti

- me.Perform routine daily follow-u

- ps.Document all servicing actions, delays, and communications in system not

- es.Inform Team Lead and Supervisor about trends and issues, including claim denials and title proble

- ms.Ensure timely imaging of all claim documen

- ts.Continuously develop skills and job knowled

- ge.Maintain a moderate understanding of foreclosure and claims process

- es.Prioritize work to meet strict deadlin

**es.4. Requirem**

e

- nts:

High School Diploma or equivalent work experi

**ence.5. Pay Range and Compensation P**

a

- ckage:

The target pay range for this position is $19.50 to $21.50 pe

**r hour.6. Benefits &am**

p

- ; Perks:

Comprehensive healthcare plans for employees and their

- families.Discretionary 401(k) match of 50% on the first 4% of pay con

- tributed.Access to employee discounts on fitness, restaurants, retail,

- and more.Customized training programs for career adv

- ancement.Employee referral

-  bonuses.Educational reimb

- ursement.Community contributions through a charitable fo

**undation.7. Equal Opportunity**

Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or nation

al origin.

Note: RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career p

age or ATS.

Remote Default MI Claims Specialist, I

Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We are corporately based outside of Philadelphia and have more than 50 offices nationwide.  In business for over 50 years, PHLY is nationally recognized as a member of Ward's Top 50, one of the Best Places to Work in Insurance, and one of the Healthiest 100 Workplaces in America.

Industry: Insurance
Company Size: 1,001-5,000 employees

Philadelphia Insurance Companies

**Description**

Job Description

**Marketing Statement**

Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.

We a re looking for a Claims Specialist - Auto to join our team!

**Job Summary**

Investigate, evaluate and settle more complex first and third party commercial insurance auto claims.

**Job Responsibilities**

Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner.

Communicates with all relevant parties and documents communication as well as results of investigation.

Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts.

Travel is required to attend customer service calls, mediations, and other legal proceedings.

**Job Requirements**

High School Diploma; Bachelor's degree from a four-year college or university preferred.

10 plus years related experience and/or training; or equivalent combination of education and experience.

-  National Range $82,800.00 - $97,300.00

-  Ultimate salary offered will be based on factors such as applicant experience and geographic location.

**EEO Statement**

Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.

**Benefits**

We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.

Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at https //www.phly.com/Careers/default.aspx

Claims Specialist - Auto

Reality check: Most people don’t grow up dreaming about a job in insurance. We certainly didn’t, but then we got here and realized Progressive is different—in a good way. We strive to create a fun and flexible work environment for everyone where employees are encouraged to risk, learn, and grow. With our progressive culture, work-life balance, and one of the largest contemporary art collections in the country, there’s a reason we’ve been named one of the best places to work. 

For more than 80 years, Progressive has offered a wide range of insurance choices to customers, including Auto, Home, Renters, Commercial Auto, Small Business, Motorcycle, Boat policies, and more. Progressive is the third largest auto insurer in the country—a combined effort of every single Progressive person. We’re a diverse group of more than 50,000 talented employees—from all walks of life, all fields of business, and all 50 states. With hundreds of career paths including Claims, Customer Care, Sales, Marketing, Legal, IT, Data Analysis and with Level20, our new business incubator, there may be an opportunity for you. Everyone here plays a role in our success as we continue to find new and better ways to move the insurance industry forward and be there for our customers during every stage of their lives.

Industry: Insurance
Company Size: 10,001+ employees

Progressive Insurance

Progressive is dedicated to helping employees move forward and live fully in their careers. Your journey has already begun. Apply today and take the first step to Destination: Progress.

As a **claims specialist ** on our team, you’ll play a critical role in our ability to successfully and efficiently resolve large-loss injury claims valued over $60k. Investigating intricate and high-risk claims – which may have some litigation features – you’ll consult with police officers, medical professionals, claimants and others involved in the accident. The information gathered will then be used while determining coverage, liability and the total value of the claim.

This is a hybrid role. You’ll be expected to report to an office about four days per month for important meetings, training, and collaboration and will have the benefit of continued coaching from a supportive team. If you prefer an in-office environment, you’re welcome to work in the office more than four days per month.

**Must-have Qualifications**

- Six years of relevant work experience with three years in claims handling OR

- Three years in claims handling and a bachelor’s degree OR

- Five years of relevant work experience with three years in claims handling and an associate degree

**Preferred Skills**

- Ability to quickly build rapport and successfully effect settlements

- Strong negotiation and customer service skills

- Excellent organization and problem-solving skills along with ability to multi-task and prioritize

- Knowledge of the rules of civil procedures in terms of filing/answering suit, discovery deadlines, and venue

- Ability to direct the use of discovery tools such as interrogatories, depositions and production of document

- 3 years of Casualty and Litigation claims handling experience

**Compensation**

- Based on location and experience

- Fresno, Irvine, Riverside, San Diego, Modesto, Sacramento: You will be paid $39.18 - $51.92/hour

- Concord, Woodland Hills, Pasadena and Torrance: You will be paid $42.69 - $56.73/hour

- Gainshare annual cash incentive payment up to 24% of your eligible earnings based on company performance

**Benefits**

- 401(k) with dollar-for-dollar company match up to 6%

- Medical, dental & vision, including free preventative care

- Wellness & mental health programs

- Health care flexible spending accounts, health savings accounts, & life insurance

- Paid time off, including volunteer time off

- Paid & unpaid sick leave where applicable, as well as short & long-term disability

- Parental & family leave; military leave & pay

- Diverse, inclusive & welcoming culture with Employee Resource Groups

- Career development & tuition assistance

Energage recognizes Progressive as a 2025 Top Workplace for: Innovation, Purposes & Values, Work-Life Flexibility, Compensation & Benefits, and Leadership.

Equal Opportunity Employer

Applicants must be authorized to work for any employer in the U.S. without the need or potential need, of current or future sponsorship for employment. Progressive does not hire candidates with (e.g., F-1 CPT, OPT, or STEM OPT, H-1B, O-1, E-3, TN) statuses for this role.

For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/

Claims Specialist Lead

American International Group, Inc. (NYSE: AIG) is a leading global insurance organization. AIG provides insurance solutions that help businesses and individuals in approximately 190 countries and jurisdictions protect their assets and manage risks through AIG operations and network partners.

Additional information about AIG can be found at www.aig.com | https://www.youtube.com/aig | https://twitter.com/aiginsurance | https://www.linkedin.com/company/aig/ | https://www.facebook.com/AIGInsurance | http://www.instagram.com/aiginsurance/

AIG is the marketing name for the worldwide property-casualty and general insurance operations of American International Group, Inc. All products and services are written or provided by subsidiaries or affiliates of American International Group, Inc. Products or services may not be available in all countries and jurisdictions, and coverage is subject to underwriting requirements and actual policy language. Non-insurance products and services may be provided by independent third parties. Certain property-casualty coverages may be provided by a surplus lines insurer. Surplus lines insurers do not generally participate in state guaranty funds, and insureds are therefore not protected by such funds.

AIG Social Media Community Guidelines:
https://www.aig.com/home/about/social-media-guidelines

Industry: Insurance
Company Size: 10,001+ employees

At AIG, we are reimagining the way we help customers to manage risk. Join us as a **Claims Specialist - Aviation ** to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team.

**Make your mark in Claims**

Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.

**How You Will Create An Impact**

As Claims Specialist for Aviation Claims you will responsible for handling claims across all sub-classes of NA Aerospace, with a focus on general aviation aircraft damage and liability claims. The You will identify loss trends and risk management opportunities and will effectively provide feedback to internal stakeholders. You need to be an experienced claims adjuster with a demonstrated ability to work independently, efficiently, and consistently in support of the client centric NA Aerospace claim proposition.

- Proactive and efficient management and adjusting of Aerospace claims across all sub-classes with a concentration in general aviation claims, including aircraft damage claims.

- Identify, and report claim trends, lessons learned and risk management opportunities to internal stakeholders.

- Contribute to the teams’ technical aerospace proficiencies through team meetings and internal roundtables.

- Effectively manage vendors, including attorneys and experts to minimize the total cost of Aerospace claims.

**What You Will Need To Succeed**

- Strong technical Aviation claim capability to manage and adjust AIG’s NA Aerospace general aviation hull and liability claims.

- Expertise in managing/minimizing the total cost of Aerospace claims.

- Ability to establish strong relationships with internal stakeholders, clients, and brokers.

- Excellent interpersonal and written communication skills, including the ability to explain technical issues and problem solve.

- Developed computer proficiency with an aptitude for claims systems.

- Self-motivated, ability to manage time and prioritize.

Ready to make a bigger impact? We look forward to reviewing your application.

At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike.

At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike.

**Enjoy Benefits That Take Care Of What Matters**

At AIG, our people are our greatest asset. We know how important it is to protect and invest in what’s most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development—to bring peace of mind to you and your family.

**Reimagining insurance to make a bigger difference to the world**

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

**Welcome to a culture of inclusion**

We’re committed to creating a culture that truly respects and celebrates each other’s talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIG’s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

~~AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories.~~

AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to candidatecare@aig.com.

**Functional Area**

CL - Claims

AIG AEROSPACE ADJUSTMENT SERVICES INC

Claims Specialist - Aviation

Zurich North America is one of the largest providers of insurance solutions and services to businesses and individuals. Our customers represent industries ranging from agriculture to construction and include more than 90% of the Fortune 500. We’ve backed the building of some of the most recognizable structures in North America — from the Hoover Dam to Madison Square Garden to the Confederation Bridge. Our North American, LEED Platinum® headquarters is located in the Chicago area. We employ approximately 9,000 people in North America and have offices throughout the U.S. and Canada. Further information is available at www.zurichna.com.

Zurich North America is part of Zurich Insurance Group, a leading multi-line insurer that serves its customers in global and local markets. With approximately 55,000 employees, Zurich provides a wide range of property and casualty, and life insurance products and services in more than 215 countries and territories. Zurich’s customers include individuals, small businesses, and mid-sized and large companies, as well as multinational corporations. The Group is headquartered in Zurich, Switzerland, where it was founded in 1872. The holding company, Zurich Insurance Group Ltd (ZURN), is listed on the SIX Swiss Exchange and has a level I American Depositary Receipt (ZURVY) program, which is traded over-the-counter on OTCQX. Further information is available at www.zurich.com. 

Follow Zurich North America on Instagram: https://www.instagram.com

Please be respectful of all commenters on the site. Any comments that contain vulgar language, name calling, personal attacks or are off topic are not allowed and will be deleted. Also spam and/or advertisements will also be removed. We reserve the right to review and delete any posts or comments, or report users if they violate Zurich North America's Rules of Conduct or LinkedIn's Terms of Service.

Zurich North America's Rules of Conduct:  https://bit.ly/3Qb9OaW

Industry: Insurance
Company Size: 10,001+ employees

Zurich North America

Zurich is seeking an experienced Workman’s Compensation Claims Specialist to join our team! We are specifically seeking candidates who can work from the Northeast with jurisdictions of CT, MA and ME.

The Workers Compensation Claims Specialist will handle single and multi-party commercial line Workman’s Compensation claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.

In this role you will be responsible for:

- Document claims file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate exposure and complexity personal or commercial line claims.

- Exercise judgement to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.

- Exercise judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.

- Work to have a timely resolution to claims by developing case strategy; developing a case evaluation; escalating issues as appropriate.

- Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims.

- Assess damages by calculating applicable damages or range of damages allowed by law.

- Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.

- Meet quality standards by following best practices.

- Ensure customer service by proactively communicating information; responding to inquiries; following customer protocols and may participating in customer marketing efforts.

- Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors. Departs from approved vendors with manager approval, where in the best interests of the insured.

- Ensure legal compliance by following state and federal laws and regulations and internal control requirements.

- Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud.

- Contribute to profitable growth by providing risk insight, information and trends to Business Unit or customer as needed.

- Protect Zurich’s reputation by keeping claims information confidential.

- Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks. And participating in professional societies.

Basic Qualifications:

- Bachelor’s Degree and 3 or more years of experience in the Claims or Insurance area OR

- Zurich Certified Insurance Apprentice, including an associate degree and 3 or more years of experience in Claims or Insurance area OR

- Completion of Zurich Claims Training Program and 2 or more years of experience in the Claims or Insurance area OR

- High School Diploma or Equivalent and 5 or more years of experience in the Claims or Insurance area AND

- Must obtain and maintain required adjuster license(s)

- Knowledge of insurance regulations, markets and products

- Microsoft Office experience

Preferred Qualifications:

- Jurisdiction knowledge of Virginia, West Virginia, Pennsylvania, or New Jersey, Delaware or Washington DC.

- Effective verbal and written communication skills

- Strong analytical, critical thinking, and problem-solving skills

- Solid time management, prioritization, and multi-tasking skills

- Experience collaborating in a team environment and building cross functional working relationships

- Adept in identifying and explaining complex financial and/or actuarial concepts.

- Ability to determine the scope and exposure for moderately complex claims

- Demonstrates understanding of the reserving process for indemnity and expense in analyzing the potential exposure of moderately complex claims

- Ability to develop and execute a negotiation strategy and plan for resolution

- Ability to identify subtleties in customer/client and/or business partner interactions

- Ability to present information necessary to propose a claim resolution to stakeholders

Your pay at Zurich is based on your role, location, skills, and experience. We follow local laws to ensure fair compensation. You may also be eligible for bonuses and merit increases. If your expectations are above the listed range, we still encourage you to apply—your unique background matters to us. The pay range shown is a national average and may vary by location. The proposed Salary range for this position is $59,900.00 - $98,200.00, with short-term incentive bonus eligibility set at 10%.

We offer competitive pay and comprehensive benefits for employees and their families. [Learn more about Total Rewards here.]

**Why Zurich?**

At Zurich, we value your ideas and experience. We offer growth, inclusion, and a supportive environment—so you can help shape the future of insurance. Zurich North America is a leader in risk management, with over 150 years of expertise and coverage across 25+ industries, including 90% of the Fortune 500®.

Join us for a brighter future—for yourself and our customers.

Zurich in North America does not discriminate based on race, ethnicity, color, religion, national origin, sex, gender expression, gender identity, genetic information, age, disability, protected veteran status, marital status, sexual orientation, pregnancy or other characteristics protected by applicable law. Equal Opportunity Employer disability/vets.

Zurich complies with 18 U.S. Code

- 1033.

**Please note: ** Zurich does not accept unsolicited CVs from agencies. Preferred vendors should use our Recruiting Agency Portal.

Location(s): AM - Parsippany, AM - Boston, AM - Connecticut Virtual Office, AM - Delaware Virtual Office, AM - Maine Virtual Office, AM - Maryland Virtual Office, AM - Massachusetts Virt. Office, AM - New Hampshire Virt. Office, AM - New Jersey Virtual Office, AM - New York Virtual Office, AM - Pennsylvania Virtual Office, AM - Rhode Island Virtual Office, AM - Vermont Virtual Office, AM - Virginia Virtual Office, AM - Washington DC, AM - West Virginia Virt. Office

Remote Working: Hybrid

Schedule: Full Time

Employment Sponsorship Offered: No

Linkedin Recruiter Tag:

Workers Compensation Claims Specialist II

We are a digital transformation company. We make digital 𝐡𝐮𝐦𝐚𝐧™ by combining human-centered design with real-time Analytics, AI, Cognitive Technology & Automation to create exceptionally engineered Brand Experiences! 

Sutherland is an experience-led digital transformation company. Our mission is to deliver exceptionally engineered experiences for customers and employees today, that continue to delight tomorrow.   

For over 35 years, we have cared for our customers’ customers, delivering measurable results and accelerating growth. Our proprietary, AI-based products and platforms are built using robust IP and automation. 

We are a team of global professionals, operationally effective, culturally meshed, and committed to our clients and to one another. 

We call it One Sutherland. #MakeDigitalHuman

Industry: IT Services and IT Consulting
Company Size: 10,001+ employees

Sutherland

**Company Description**

This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator determines how much money will be paid after an insurance claim has been examined. This is not a customer service or customer facing position. This is a data entry position where you will be processing medical claims per the specific client requirements. Claims can vary and are highly customized depending on the service level. You will work independently with the assistance of knowledge base and support personnel. You will also be expected to meet all Key Performance Indicators and Quality goals throughout Training and beyond.

**Job Description**

What you will be doing as a Claims Examiner:

- Work independently, processing claims via data entry for 90% of your day.

- Be responsible for effectively adjudicating claims to meet production, quality, and other metrics in accordance with policy/procedures and regulatory guidelines

- Follow up on claims needing additional information

- Refer problem claims to a Lead and/or auditor for additional review

- Make sure that the integrity of the information is accurate and kept private according to HIPPA guidelines

- Work with specific software

- May be assigned special projects

**When you join us, you’ll enjoy:**

- Pay rate of $13.50/hour with the opportunity to bonus an additional $1500 a month.

- Medical, dental, and vision plans.

- Paid training and PTO (be sure to ask about our Global Flexible Vacation Policy).

- Company-provided equipment.

- Advancement opportunities – 80% of our frontline leaders have been promoted from within.

- Monthly rewards & recognition programs.

- Employee Discounts.

- EAP and Health and Wellness programs including a personal trainer dedicated to Sutherland.

- Weekday schedule, Monday – Friday 8:30 AM – 5:00 PM EST.

**Qualifications**

**Skills**

- Data entry

- Time management

- Attention to detail

- Analytical

**Required Qualifications**

- High School Diploma or equivalent

- Excellent Internet Connectivity:

- Internet access speed of 2 Mbps upload and 10 Mbps download – the faster the better.

-

- house network, and a hard-wired internet connection capable of continuously supporting outstanding call quality and high-speed response rates. (Wireless and/or satellite Internet Service Providers are not compatible with our systems)

- A quiet and distraction-free, secure place to work

- Effective verbal and written communication skills

- Strong typing and analytical abilities

- Multi-tasking skills with a strong attention to detail

- Computer knowledge

- Minimum 40 words per minute on typing test

- Must have and maintain a clean and paper free work environment to meet our company policies.

- Medical Billing and Coding degree/certification.

- Previous experience in a medical office type setting, including some knowledge of insurance, claims, billing or coding, with an understanding of the different types of insurance (Medicare/Medicaid and/or Child Plus).

- Knowledge of Medical terminology

**Additional Information**

All your information will be kept confidential according to EEO guidelines.

EEOC and Veteran Documentation

During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.

At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all

Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.

Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.

Health Claims Specialists

Transportation Insight is your trusted partner powering the economy forward through expert logistics solutions and innovative technology. With our roots firmly planted in optimizing transportation operations, we proudly serve medium to enterprise-level shippers across a multitude of industries.

All our services are backed by the Beon Digital Logistics Platform providing easy-to-use technology and business intelligence at your fingertips.
✅ Contract Negotiation
✅ Parcel Optimization & Consulting
✅ Freight Bill Audit and Payment
✅ Transportation Planning & Execution
✅ Parcel Spend Management
✅ LTL & TL Carrier Procurement
✅ Managed Drayage Solutions

Accolades:
🏆 #4 Largest Domestic Transportation Management Provider (Armstrong & Associates)
🏆 #11 Largest US Logistics Company (Transport Topics)
🏆 2024 Newsweek Best Workplaces in America (Beon parent company)
🏆 Bronze Sponsor of Truckers Against Trafficking
🏆 FedEx Certified Parcel Auditor

🌟 Join Our Team: If you're looking to make a real impact in the logistics industry, whether you're a recent college grad or a seasoned professional, check out our open positions on our website.

Industry: Truck Transportation
Company Size: 501-1,000 employees

Transportation Insight

**JOB PURPOSE **

As a **Claims Processor ** at Transportation Insight, your role is crucial in ensuring accurate and efficient processing of claims related to transportation services. You will be responsible for reviewing, investigating, and resolving transportation claims in accordance with company policies and procedures.

**ESSENTIAL DUTIES AND RESPONSIBILITIES **

- Demonstrate comprehensive knowledge of carrier services, including tracking, reporting, and billing methods.

- Utilize effective problem-solving skills to verify potential claims identified by our proprietary auditing systems.

- Communicate information to carriers clearly, concisely, and in an organized manner. • Meet or exceed company expectations for key performance indicators.

- Prioritize daily tasks of claims to be completed using time management skills.

- Provide accurate and timely updates of claims information and resolutions in our proprietary systems.

- Escalate issues to leadership as they arise.

**JOB REQUIREMENTS **

- Associate degree preferred.

- Minimum of 1-2 years of experience in claims processing or related field.

- Strong attention to detail and accuracy.

- Excellent communication skills, both verbal and written.

- Ability to work independently and prioritize tasks effectively.

- Proficiency in Microsoft Office suite and other relevant software applications.

**KNOWLEDGE, SKILLS AND ABILITIES **

- Attention to detail paired with speed and accuracy on the keyboard.

- Ability to focus on individual work and work independently.

- Ability to define problems, collect data, establish facts, and draw valid conclusions.

- Ability to understand and act upon verbal and written instructions.

- Ability to communicate clearly, both verbally and in writing.

**MAY PERFORM OTHER DUTIES AS ASSIGNED**

**WORK ENVIRONMENT **

Standard office environment, usually indoors away from the elements with moderate noise. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

**PHYSICAL ** **EFFORT **

Maintain a stationary position for extended periods; move about the office, operate computers and files, as needed; and frequently communicate with others. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is required to stand, walk, and reach with hands and arms. Occasionally, the employee is required to lift boxes up to 20 pounds.

**SCHEDULING **

**This is a part-time position with Sunday availability required. ** Employees in this position must also be available to work occasional evenings and additional weekend hours during peak periods.

**TRAVEL **

Local travel is required. Out of state travel is limited, but may be required for special training/conferences.

**DISCLAIMER **

**The above statements are intended to describe the general nature and level of work being performed. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required. **

**EEOC/ADA STATEMENT: **

We are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, gender, sexual orientation, age, religion, disability, veteran, or any other status prohibited by applicable national, federal, state or local law. In an effort to recruit, develop and retain top talent, we are committed to a policy of nondiscrimination in all personnel practices to ensure equal opportunity for employment, promotion, and training for a more inclusive workforce.

**RECRUITMENT SCAM NOTICE: **

~~Transportation Insight/Nolan Transportation Group is aware of scams involving fake job interviews and offers. Our hiring process includes a formal interview with a member of our recruitment team. We do not conduct interviews exclusively through text or instant messaging platforms. TI/NTG does not require candidates to pay for training, equipment, or any other fees as a condition of employment. Any request for payment is a scam. Official communication from our recruitment team about your application will only come from emails ending in ‘@ntgfreight.com’ or from ‘transportationinsight@myworkday.com.' ~~

Claims Processor (Part-Time)

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