claims adjuster supervisor

Fortegra

<div><p>The Senior Claims Adjuster, TPA Oversight will provide technical expertise and handle a wide variety of severity/complex claims as well as coverage litigation within Commercial Auto, Cargo, and Crane &amp; Rigging lines of business. Additionally, they will complement the existing Specialty Claims team that supports the Underwriting unit and will provide oversight of third parties and delegated authority referrals.</p>
<p><b>
Minimum Qualifications:</b></p>
<ul>
<li>A Bachelor&rsquo;s degree or the equivalent education and/or experience.</li>
<li>5-10 years of relevant and progressive experience handling Commercial Auto and General Liability claims.</li>
<li>Adjuster licenses, as mandated by specific states, are required.</li>
</ul>
<p><b>Primary Job Functions:</b></p>
<ul>
<li>Handle claims originating out of the Specialty Claims unit and provide technical oversight of Third Party Administrators (TPAs).</li>
<li>Direct oversight of commercial auto and specialty transport claims and coverage disputes.</li>
<li>Provide coverage, liability, and damages analysis with prompt identification of potential large loss claims.</li>
<li>Responsible for ensuring adequate reserving and accuracy of claims payments through appropriate supervision and authority levels.</li>
<li>Work in partnership with the TPA Claims Manager to ensure that claims are proactively managed and that all claim workflows and SLAs are adhered to.</li>
<li>Ensure timely disposition of all claims in accordance with regulatory and statutory requirements.</li>
<li>Ability to proactively identify exposures and claim trends which may affect the portfolio and provide written assessments to the Specialty business unit.</li>
<li>Resolve problems and respond to coverage questions from underwriting team and senior management.</li>
<li>Build and maintain key relationships with internal and external stakeholders (e.g. Reinsurers, Underwriters, Actuarial, Brokers, Attorneys, Vendors, etc.).</li>
<li>Effectively represent the Company&rsquo;s interests at mediations and settlement conferences.</li>
<li>Other duties as required by management.</li>
<li>Participate in Claim Reviews and claim audits periodically.</li>
<li>Attend depositions, settlement conferences and trials when necessary periodically.</li>
<li>Performs other duties or special projects as required or as assigned by a supervisor periodically.</li>
</ul>
<p><i>The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.</i></p>
<p><b>
Skills &amp; Competencies Required:</b></p>
<ul>
<li>Excellent written and verbal communication skills.</li>
<li>Strong analytical skills.</li>
<li>Strong negotiation skills.</li>
<li>In-depth knowledge of claims, litigation, and trial process.</li>
<li>Strong commitment to providing superior client service.</li>
<li>Excellent organizational and time management skills.</li>
<li>Proficiency in MS Office (Word, Excel, Outlook).</li>
<li>Ability to work independently with limited supervision.</li>
<li>Ability to successfully obtain the required state adjusters&rsquo; licenses.</li>
</ul>
<p><b>Additional Information:</b></p>
<ul>
<li>Full benefit package including medical, dental, life, vision, company paid short/long term disability, 401(k), tuition assistance and more.</li>
<li>The anticipated salary for this position is $100,000 - $130,000 per year, based on qualifications and experience.</li>
<li>Internal Notice: As part of our commitment to talent development, this position is open for internal promotion applications at the time of public posting.</li>
<li>Fortegra is not accepting unsolicited resumes from search firms for this position.</li>
<li>Please be aware of job fraud(s) &ndash; all correspondence emails regarding your candidacy will come from our Fortegra.com email address. Thank you.</li>
</ul>
<p>Equal Opportunity Employer<br>
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.</p></div>

Senior Claims Adjuster, TPA Oversight

Gallagher

<div><b>Introduction</b><br>
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div><br>
<b>Overview</b><div><b><br>
Role specifics:</b></div><div></div><ul><li><b><br>
Claims Background:</b><b> General Liability</b></li><li><b>
Jurisdictional Experience:</b><b> Any</b></li><li><b>
Active Adjusters' licenses</b><b>: Any</b></li><li><b>
Location: </b><b>This role is eligible for fully remote work</b></li></ul>
<br>
<b>How you'll make an impact</b><ul><li><br>
Apply claims management experience to execute decision-making to analyze claims exposure and litigation, plan the proper course of action, and appropriately resolve claims.</li><li>Interact extensively with various parties involved in the claim process to ensure effective communication and resolution.</li><li>Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process</li><li>Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements.</li><li>Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file.</li></ul><br>
<br>
<b>About You</b><div><b><br>
As a key member of our Claims Adjuster team, you will:</b></div><div></div><ul><li><br>
Investigate, evaluate, and resolve complex General Liability claims, applying your claims experience and analytical skills to make informed decisions and bring claims to resolution.</li><li>Work in partnership with our clients to deliver innovative solutions and enhance the claims management process</li><li>Think critically, solve problems, plan, and prioritize activities to optimally serve clients</li></ul><p></p><div><b><br>
R</b><b>equired Qualifications</b><b>:</b></div><div><ul><li><br>
High School Diploma.</li><li>Minimum of 5 years related claims experience.</li><li> Appropriate licensing and/or certification in all states in which claims are being handled.</li><li>Knowledge of accepted industry standards and practices.</li><li>Computer experience with related claims and business software.</li></ul></div><div></div><div><b><br>
D</b><b>esired Qualifications</b><b>:</b></div><div></div><ul><li><br>
Bachelor's Degree.</li></ul><div></div><div><br>
#LI-DF1 #LI-REMOTE</div><br>
<br>
<b>Compensation and benefits</b><p><br>
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.
</p><p>Below are the <b>minimum core benefits</b> you&rsquo;ll get, depending on your job level these benefits may improve:
</p><ul><li>Medical/dental/vision plans, which start from day one!</li><li>
Life and accident insurance</li><li>
401(K) and Roth options</li><li>
Tax-advantaged accounts (HSA, FSA)</li><li>
Educational expense reimbursement</li><li>
Paid parental leave</li></ul><div><b>
Other benefits include:</b></div><ul><li>
Digital mental health services (Talkspace)</li><li>
Flexible work hours (availability varies by office and job function)</li><li>
Training programs</li><li>
Gallagher Thrive program &ndash; elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing</li><li>
Charitable matching gift program</li><li>
And more...</li></ul><div><i>
**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.</i></div><div></div><div><b><br>
We value inclusion and diversity</b></div><p>
Click Here to review our U.S. Eligibility Requirements</p><p>
Inclusion and diversity (I&amp;D) is a core part of our business, and it&rsquo;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.
</p><p>Gallagher embraces our employees&rsquo; 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.</p><p>
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 &ldquo;protected characteristics&rdquo;) by applicable federal, state, or local laws.
</p><p>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.</p></div>

Senior Liability Claims Adjuster

<div><b>Introduction</b><br>
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div><br>
<b>Overview</b><div><b><br>
Role specifics:</b><br>
<ul><li><b>Jurisdictions: </b>US</li><li><b>Licenses: </b>Required</li><li><b>Location: </b>This role is eligible for fully remote work.</li></ul></div><br>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Apply claims management experience to execute decision-making to analyze claims exposure and litigation, plan the proper course of action, and appropriately resolve claims.</li><li>
Interact extensively with various parties involved in the claim process to ensure effective communication and resolution.</li><li>
Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process</li><li>
Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements.</li><li>
Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file.</li></ul>
<br>
<b>About You</b><p></p><div><b><br>
Potential candidates should have the following:</b><br>
<ul><li><b>Claims Background:</b> General Liability, Restaurant, Slip and Fall, Premises, Foodborne Illness.</li><li><b>Jurisdictional Experience: </b>US</li><li><b>Active Adjusters' licenses:</b> Required</li></ul><br>
As a key member of our Claims Adjuster team, you will:</div><ul><li>
Investigate, evaluate, and resolve complex General Liability claims, applying your claims experience and analytical skills to make informed decisions and bring claims to resolution.</li><li>
Work in partnership with our clients to deliver innovative solutions and enhance the claims management process</li><li>
Think critically, solve problems, plan, and prioritize activities to optimally serve clients</li></ul><div></div><div><b><br>
REQUIRED QUALIFICATIONS:</b><br>
<br>
<ul><li>High School Diploma.</li><li>Minimum of 5 years related claims experience.</li><li>Appropriate licensing and/or certification in all states in which claims are being handled.</li><li>Knowledge of accepted industry standards and practices.</li><li>Computer experience with related claims and business software.</li></ul></div><div><b><br>
DESIRED:</b><br>
<ul><li>Bachelor's Degree.</li></ul></div><div></div><div><br>
#LI-DR1</div><div>
#LI-Remote</div><br>
<div></div>
<br>
<b>Compensation and benefits</b><p><br>
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.
</p><p>Below are the <b>minimum core benefits</b> you&rsquo;ll get, depending on your job level these benefits may improve:
</p><ul><li>Medical/dental/vision plans, which start from day one!</li><li>
Life and accident insurance</li><li>
401(K) and Roth options</li><li>
Tax-advantaged accounts (HSA, FSA)</li><li>
Educational expense reimbursement</li><li>
Paid parental leave</li></ul><div><b>
Other benefits include:</b></div><ul><li>
Digital mental health services (Talkspace)</li><li>
Flexible work hours (availability varies by office and job function)</li><li>
Training programs</li><li>
Gallagher Thrive program &ndash; elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing</li><li>
Charitable matching gift program</li><li>
And more...</li></ul><div><i>
**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.</i></div><div></div><div><b><br>
We value inclusion and diversity</b></div><p>
Click Here to review our U.S. Eligibility Requirements</p><p>
Inclusion and diversity (I&amp;D) is a core part of our business, and it&rsquo;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.
</p><p>Gallagher embraces our employees&rsquo; 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.</p><p>
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 &ldquo;protected characteristics&rdquo;) by applicable federal, state, or local laws.
</p><p>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.</p></div>

Amrize

<div></div><div><div><div><div><div><div><div><h1 class="jobSectionHeader"><b>Warranty Claims Supervisor
</b></h1></div></div></div></div><div><div><div><div>Requisition ID: 16736
</div></div></div></div><div><div><div><div>Location:
Nashville, TN, US, 37214
</div></div></div></div><div><div><div><div>Pay Type: Salary
</div></div></div></div><div><div><div><div>Position type: Full-time / Salary
</div></div></div></div><div></div><div><div><p><b>COMPANY OVERVIEW</b>
<br>
Amrize is building North America. From bridges and railways to data centers, schools, offices and homes, our solutions are inside the buildings and infrastructure that connect people and advance how we live. And we invite you to come and build with us.</p>
<p>As the partner of choice for professional builders, we offer advanced branded solutions from foundation to rooftop. Wherever our customers are, whatever their job, we&rsquo;re ready to deliver. Our 19,000 colleagues work across 1,000 sites supported by an unparalleled distribution network. Infrastructure, commercial and residential, new build, repair and refurbishment: We&rsquo;re in every construction market.</p>
<p>Amrize listed on the New York Stock Exchange and the SIX Swiss Exchange on June 23, 2025, following our spinoff as an independent company. Join us and build <i>your</i> ambition.</p>
<p>Learn more at<b> </b>www.amrize.com/careers</p>
</div></div><div><div><div><div>Description:<br>
<p></p><p>Elevate is committed to providing the highest quality commercial roofing, wall and lining systems to solve our customers&rsquo; challenges, grounded by a 45-year legacy of proven experience. Our mission is to deliver solutions that save time, perform reliably and protect our communities. We are devoted to building partnerships rooted in trust in reflection of our Elevate promise that Nobody Covers You Better&trade;.</p><br>
<p></p><p>Elevate is part of the Amrize family of brands. Visit ElevateCommercialBP.com to learn more.</p><br>
<p></p><p>We&rsquo;re seeking a Warranty Claims Supervisor who&rsquo;s ready to be part of a people-first company offering best-in-class products, exceptional training, and deep industry pride&mdash;all built to help our partners and team succeed.</p><br>
<p></p><p><b>ABOUT THE ROLE</b></p><br>
<p></p><p>The Warranty Claims Supervisor is responsible for direct supervision of the team of Warranty Claims Investigators. The Supervisor oversees the dispatching of incoming Warranty Claims to the appropriate Investigator designated by assigned regions. The Warranty Claims Supervisor reports to the Warranty Claims Manager.</p><br>
<p></p><p><b>WHAT YOU&rsquo;LL ACCOMPLISH</b></p>
<ul><li>Directs and implements onboarding and training of Warranty Claims Investigators.</li>
<li>Manages moderate to high exposure claims directly throughout multiple regions as a floating Investigator as needed.</li>
<li>Oversees and maintain the active projects list of the department ensuring that Claims are updated regularly.</li>
<li>Acts as in house technical services resource for phone in questions by ﬁeld personnel as they arise.</li>
<li>Reviews monthly reports of overall activity and claims expenses to Warranty Claims Manager and Director of Warranty Services based on the project claim data, including pending and active claim expense reporting.</li>
<li>Review of work output of Claims Investigators including communications for grammar, clarity, tone, and company position regarding liability.</li>
<li>Manages a highly varied and busy work docket and balancing requirements and associated timing.</li>
<li>Work closely with the Warranty Services Leak response coordinators (WSC) in developing regional relationships with their adjacent Investigator to facilitate smooth communication and clarity of Holcim&rsquo;s position - Including training in knowledgeable review of contractor submitted repairs and photographs to determine proper liability.</li>
<li>Provides input for Performance Management of Investigators in gauging performance level for Review.</li>
<li>Develops reporting practices to track individual and team performance.</li>
<li>Interface with the law department in resolving escalated claims.</li>
<li>Interfacing with other departments including Technical Services, R&amp;D and Sales to streamline processes and ensure that the claims group is taking actions in the best interest of the company.</li>
<li>Manages moderate to highly escalated claims to mitigate expenses and meet budget goals.</li>
<li>Demonstrate a commitment to communicating, improving and adhering to health, safety and environmental policies in all work environments and areas.</li>
<li>Promote a culture of safety and exhibit these behaviors.</li><br>
</ul><p><br>
<b>WHAT WE'RE LOOKING FOR</b>
</p><ul><li>4 Year degree or 8+ years of experience in Roofing/Construction including claims resolutions and negotiations</li><br>
</ul><p></p><p><b>Additional Requirements:</b></p>
<ul><li>Successful candidates must adhere to all safety protocols and proper use of Amrize approved Personal Protection Equipment (&quot;PPE&quot;), including but not limited to respirators.</li>
<li>Employees that are required to wear respirators must be clean shaven where the respirator seal meets the face in order to pass the qualitative and quantitative fit test.</li><br>
</ul><p></p><p><b>WHAT WE OFFER</b></p>
<ul><li>Competitive salary</li>
<li>Retirement Savings: Choose from 401(k) pre-tax and/or Roth after-tax savings</li>
<li>Medical, Dental, Disability and Life Insurance</li>
<li>Holistic Health &amp; Well-being programs</li>
<li>Health Savings Accounts (HSAs) &amp; Flexible Spending Accounts (FSAs) for health and dependent care</li>
<li>Vision and other Voluntary benefits and discounts</li>
<li>Paid time off &amp; paid holidays</li>
<li>Paid Parental Leave (maternity &amp; paternity)</li>
<li>Educational Assistance Program</li>
</ul><p>#BuildingEnvelope</p>
<p>#LI-Hybrid</p>
<p>#LI-TV1</p><br>
<p></p><p><b>Amrize is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.</b></p>
<p><i>We thank all applicants for their interest; however, only those selected for an interview will be contacted.</i></p><br>
</div></div></div></div><p></p><div><div><p><b>BUILDING INCLUSIVE WORKSPACES</b>
<br>
At Amrize, there is endless opportunity for you to play your part. Whether you&rsquo;re in a technical, managerial, or frontline role, you can shape a career that works for you. We're seeking builders, creative thinkers and innovators. Come put your expertise to work while developing the knowledge and skills to drive your career forward. With us you&rsquo;ll have the chance to build your ambition!
</p><p>Amrize North America Inc. takes pride in our hiring processes and our commitment that all qualified applicants will receive consideration for employment without regard to age, race, color, ethnicity, religion, creed, national origin, ancestry, gender, gender identity, gender expression, sex, sexual orientation, marital status, pregnancy, parental status, genetic information, citizenship, physical or mental disability, past, current, or prospective service in the uniformed services, or any other characteristic protected by applicable federal, state or local law. Amrize North America Inc, and its respective subsidiaries are Equal Opportunity Employers, deciding all employment on the basis of qualification, merit and business need. Amrize Canada Inc. is committed to the principles of employment equity and encourages the applications from women, visible minorities, and persons with disabilities. Amrize North America Inc. participates in E-Verify and will provide the federal government with your I-9 information to confirm that you are authorized to work in the United States.</p>
<p>In compliance with the ADA Amendments Act (ADAAA), if you have a disability and would like to request accommodation in order to apply for a position with us, please email recruiting-accommodations@amrize.com. This email address should only be used for accommodations and not general inquiries or resume submittals. In Ontario, our organization/business is committed to fulfilling our requirements under the Accessibility for Ontarians with Disabilities Act. Under the Act, accommodations are available on request for candidates taking part in all aspects of the selection process.</p>
<p>While we sincerely appreciate all applications, only candidates selected for an interview will be contacted.</p>
</div></div><div><div><p><b>PROTECT YOURSELF FROM RECRUITMENT FRAUD</b>
<br>
The only way to apply for a position at Amrize is through our official Careers website. Be cautious of unsolicited offers or requests for information from other sources. Learn how to protect yourself from recruitment fraud here: Fraudulent Job Offers Policy</p><br>
</div></div><p><br>
<b>Nearest Major Market: </b>Nashville</p></div></div></div><div></div>

Warranty Claims Supervisor

WCF Insurance

<div><p>WCF Insurance, an &quot;A&quot; rated insurance carrier, continues to grow and is seeking a motivated professional to join our outstanding Claims team. At WCF, we take pride in our strong culture, comprehensive benefits, and collaborative environment.</p><p>
Our team is committed to delivering exceptional customer service to our policyholders and agents. We support our adjusters with caseloads well below industry standards, allowing the time and focus needed to manage claims effectively. In addition, our proprietary claims system-designed by claims professionals-prioritizes efficiency, usability, and strong claim outcomes.</p><p></p><p><b><br>
Position Overview</b></p><p>
The Claims Department has an immediate opening for a Worker's Compensation Disability Adjuster to manage claims in Utah and Nevada. This is a full time, exempt position that offers the opportunity for hybrid work (3 days per week in office, based on location.)</p><p>
This role may be filled at the Disability Adjuster or Senior Adjuster level, based on experience and qualifications.</p><p>
Candidates must reside within 50 miles of one of the following offices:</p><ul><li>
Sandy, Utah</li><li>
St. George, Utah</li><li>
Las Vegas, Nevada</li></ul><p>
All new hires are required to attend onboarding at our home office in Sandy, Utah for their first week of employment with WCF Insurance. Training will then continue in person at the designated office location.</p><p></p><p><b><br>
Key Responsibilities</b></p><ul><li>
The Worker's Compensation Disability Adjuster is responsible for managing claims from initial report through resolution, including:</li><li>
Investigating claims, documenting findings, and determining coverage and liability</li><li>
Managing industrial accident and occupational disease claims</li><li>
Reviewing and interpreting medical records and supporting documentation</li><li>
Coordinating the legal, medical, and disability components of each claim</li><li>
Collaborating with injured workers, policyholders and agents, medical providers and vendors, internal WCF departments, and Jurisdictional Divisions of Industrial Relations and other stakeholders.</li><li>
Ensuring compliance with all applicable statutory and regulatory requirements</li></ul><p></p><p><b><br>
Qualifications</b></p><p>
The ideal candidate will have:</p><ul><li>
Minimum of 2 years of workers' compensation disability adjusting experience</li><li>
Strong understanding of Nevada DIR rules and procedures and/or Utah statutes and regulations</li><li>
Working knowledge of medical terminology</li><li>
Excellent communication and interpersonal skills</li><li>
Strong investigative, organizational, and analytical abilities</li><li>
High attention to detail</li><li>
Multi-line claims experience (preferred)</li></ul><p><b>
Licensing Requirement:</b> Candidates residing outside Nevada must obtain a Nevada adjuster license within 45 days of hire, as required by state law.</p><p>
Internal applicants must have at least six months in their current role, maintain acceptable performance, and notify their current supervisor prior to applying.</p><p></p><p><b><br>
Benefits</b></p><p>
WCF Insurance offers an extensive compensation package. Benefits include Medical, Dental, and Vision insurance, company paid life insurance, 401K with a generous 6% employer match and additional benefits such as an Employee Assistance Program and time off to volunteer. All employees earn 4 weeks of vacation their first year.</p><p></p><p><b><br>
Compensation</b></p><ul><li>
Disability Adjuster: $69,400 - $95,300 annually.</li><li>
Senior Adjuster: $80,000 - $109,900 annually.</li></ul><p>
Compensation is based on location, experience, and education.</p><p></p><p><b><br>
OUR PEOPLE</b></p><p>
WCF strives to provide an excellent work experience and cultivate an inclusive environment where anyone who embodies our values will thrive</p><p></p><p><b><br>
WCF INSURANCE IS AN EQUAL OPPORTUNITY EMPLOYER</b></p><p>
WCF Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.</p></div><p></p>

Worker's Compensation Disability Adjuster

TEEMA

<div><p><b>Overview:</b><br>
Our client, the largest Third Party Administrator in North America is looking for an experienced Claims Adjuster to handle Workers Compensation Claims. At the direction of the Claims Supervisor and/or Claims Manager, the Claims Adjuster/Examiner II / III manages all aspects of workers&rsquo; compensation indemnity, medical-only, future medical, and litigated claims from inception through resolution, within established authority and company/client guidelines. This role requires frequent interaction with clients, claimants, medical providers, attorneys, vendors, nurse case managers, vocational case managers, and internal staff. The level of complexity, litigation exposure, settlement authority, and leadership responsibility will be commensurate with the examiner&rsquo;s experience and designation (Level II or Level III).<br>
<br>
<b>What you will be doing:</b><br>
Applies to Examiner II &amp; III</p><ul><li><p>
Manage a full caseload of workers&rsquo; compensation claims, including complex indemnity claims.</p></li><li><p>
Initiate, conduct, and document timely and thorough claim investigations.</p></li><li><p>
Determine compensability and administer benefits in accordance with state laws, rules, and company/client handling instructions.</p></li><li><p>
Manage medical treatment and medical billing; authorize services as appropriate.</p></li><li><p>
Communicate effectively with claimants, medical providers, vendors, and clients regarding claim issues.</p></li><li><p>
Compute and set reserves in accordance with Company and Client guidelines.</p></li><li><p>
Maintain an organized diary system and document claim files to reflect status, strategy, and action plans.</p></li><li><p>
Settle and/or finalize claims and obtain appropriate settlement authority.</p></li><li><p>
Conduct scheduled file reviews and respond to client inquiries.</p></li><li><p>
Identify injury trends, safety concerns, and other claim-related issues and communicate proactively to clients.</p></li><li><p>
Adhere to all company policies, procedures, and best practices.</p></li><li><p>
Utilize office systems and technology efficiently to manage caseload responsibilities.</p></li><li><p>
Perform other related duties as assigned.</p></li></ul><p>
Advanced / Senior Responsibilities (Primarily Examiner III)</p><ul><li><p>
Manage very complex, catastrophic, and litigated indemnity claims from inception to conclusion.</p></li><li><p>
Refer cases to outside defense counsel and actively participate in litigation strategy, hearings, mediations, and settlements.</p></li><li><p>
Identify and manage:</p><ul><li><p>
Subrogation opportunities</p></li><li><p>
Apportionment potential</p></li><li><p>
Excess reporting criteria and reimbursement</p></li></ul></li><li><p>
Prepare and assist with state audits, regulatory reporting, and client-specific reporting requirements.</p></li><li><p>
Develop and execute proactive claim strategies to drive timely and cost-effective resolution.</p></li><li><p>
Conduct detailed client file reviews and participate in client meetings as needed.</p></li><li><p>
Mentor and provide technical guidance to less experienced Claims Examiners.</p></li><li><p>
Handle multi-jurisdictional workers&rsquo; compensation claims as assigned.</p></li></ul><p><b><br>
What you will be doing:</b><br>
Education &amp; Experience<br>
Claims Examiner II:</p><ul><li><p>
Bachelor&rsquo;s degree in a related field (preferred)</p></li><li><p>
Minimum 3+ years of workers&rsquo; compensation claims experience, or equivalent combination of education and experience</p></li></ul><p>
Claims Examiner III:</p><ul><li><p>
Minimum 5+ years of progressive workers&rsquo; compensation claims experience</p></li><li><p>
Demonstrated experience handling complex and litigated indemnity claims</p></li></ul><p>
Knowledge, Skills &amp; Abilities</p><ul><li><p>
Strong technical knowledge of workers&rsquo; compensation statutes, regulations, and medical terminology</p></li><li><p>
Ability to independently analyze and manage complex claims</p></li><li><p>
Excellent written and verbal communication skills</p></li><li><p>
Ability to convey technical information to claimants, clients, and internal stakeholders</p></li><li><p>
Strong organizational, analytical, and time-management skills</p></li><li><p>
Ability to interact professionally with individuals at all levels of the business environment</p></li><li><p>
Proficiency in Microsoft Word and Excel (preferred)</p></li></ul><p>
Certifications / Licenses</p><ul><li><p>
Hawaii Workers Compensation Adjusters License</p></li></ul><br>
<p></p>
#Workwolf</div>

Workers Compensation Claims Examiner II/III - Hybrid

Pierce County Washington

<div><div><div><h2 class="jobSectionHeader"><b>Description</b></h2></div><br>
<p></p><br>
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<div><h2 class="jobSectionHeader"><b>Summary</b></h2></div>
<p></p><div><p><b>Why it's a great opportunity: </b>In this crucial role for Pierce County you will oversee and manage the small team that handles first and third-party liability claims and lawsuits both against and in support of Pierce County. These claims and lawsuits include property, right of way, personal injury, and other complicated claims. You will work with your team, various Departments, Pierce County lawyers, claimants, outside insurance companies, and Plaintiff attorneys representing their clients. The work your team does will be performed through Origami (the County&rsquo;s RMIS), Workday, Pierce County LYNX, and other programs, while providing data to Departments on liability knowledge, statistics, and outcomes.</p><p><b>
Why it's a great department: </b>The Finance &amp; Enterprise Services Department delivers enterprise-wide services that support every County department and many external partners, ensuring Pierce County operates effectively, efficiently, and with strong public stewardship. Finance &amp; Enterprise Services staff provide a broad portfolio of high-impact, countywide services, including budgeting and performance management, fiscal services, procurement and contracting, information technology, general services, fleet services, and risk management.</p><p>
Employees have the opportunity to work on strategic, enterprise-level initiatives, collaborate across departments, provide the operational and technical backbone which ensures the smooth delivery of services across the organization, and deliver critical analysis and decision support that informs leadership and shapes County priorities. The Finance &amp; Enterprise Services Department is focused on creating a culture where employees can help improve service delivery to make a meaningful impact on County operations and the community. The Department leads with safety, empowerment, and collaboration to create an environment where every person can contribute, challenge ideas, and continuously improve.</p><p>
Learn more about the Finance &amp; Enterprise Services Department here.</p><p><b>
How to be successful in the role: </b>Your success will depend on strong communication and interpersonal skills, a high level of attention to detail, adherence to rules and processes, direct and effective negotiation, and the ability to maintain strict confidentiality and discretion. You will also need to recognize the importance of customer service, showing compassion and understanding when working through stressful situations and challenging circumstances.</p><p><b>
Your future in this role: </b>You will have access to professional development through robust online learning and other training opportunities throughout your career to ensure your success. This position has multiple career growth and promotional opportunities in Pierce County to build on a great career while directly impacting the communities in Pierce County.</p><p><b>
Core daily responsibilities:</b></p><ul><li>
Supervise and coordinate the work of Risk Investigators, including establishing claims management procedures and workflow priorities; assigning, reviewing, and approving work; setting performance goals and expectations; conducting annual and midyear performance evaluations; and identifying and coordinating staff training and development needs.</li><li>
Act as Risk Investigator on complex claims and lawsuits filed against Pierce County, as directed by the Risk Manager. Provide input to the Risk Manager and Prosecuting Attorney&rsquo;s Office Civil Division in the negotiation and settlement of litigated cases.</li><li>
Utilize the County&rsquo;s Risk Management Information System (RMIS) to manage caseloads, monitor performance measures, and review claims and investigative activities of Risk Investigators.</li><li>
Prepare and analyze loss data and reports through the RMIS for audits, quarterly and financial reporting, actuarial studies, insurance renewals, and other operational and regulatory purposes.</li><li>
Provide claims trend analysis and reporting to support effective fiscal management of the County&rsquo;s Self Insurance Fund.</li><li>
Assist the Risk Manager with annual property and casualty insurance renewal submissions.</li><li>
Ensure consistent interpretation of laws, rules, policies, and procedures.</li><li>
Maintain effective communication and working relationships with internal departments, legal counsel, law enforcement agencies, insurance brokers and carriers, and claimants.</li><li>
Ensure timely and effective communication and information sharing among excess carriers, the Risk Management Division, and the Prosecuting Attorney&rsquo;s Civil Division.</li></ul><p>
A classification description with a more detailed list of essential functions can be found here.</p></div><p></p>
<div><h2 class="jobSectionHeader"><b>Minimum Qualifications</b></h2></div>
<p></p><div><ul><li>Postsecondary education in public safety, human resource management, public or business administration, or a closely related field may substitute for up to two (2) years of the required experience on a year-for-year basis.</li><li>
Four (4) years of progressively responsible professional experience in property and liability claims adjudication, accident investigations, settlement negotiations, report writing, safety or risk management audits, and insurance policy review and interpretation.</li><li>
A resume and cover letter are required for this position.</li></ul><p>
As a condition of employment, the applicant will need to authorize and complete a background check. Information received from the background check is reviewed case-by-case and will not necessarily remove an applicant from consideration.</p></div><p></p>
<div><h2 class="jobSectionHeader"><b>Supplemental Information</b></h2></div>
<p></p><div><p><b>To be considered for this opportunity please:</b></p><ul><li>
Complete and submit a detailed online Pierce County Employment Application by selecting &quot;APPLY&quot; above or go to: www.piercecountywa.org/jobs.</li><li>
If you have a question about this opportunity, please email the Recruitment Team at PCHRRecruit@piercecountywa.gov and specify the Job Number and Title.</li><li>
If you do not have internet access, you may visit your local public library or any WorkSource location and use their computers.</li><li>
Individuals needing accommodation in the application, testing process or need this job announcement in an alternative format may call Human Resources at (253) 798-7480, at least two days prior to the need.</li></ul><p>
This is a competitive selection process. Your application will be reviewed and evaluated for the quality and quantity of education/experience in the areas listed. Applicants whose qualifications most closely correspond to the County's needs will be eligible for further consideration. Notification of application status normally occurs 2 to 3 weeks after the closing date. Short notice may be given to applicants to participate in further selection processes which may include assessments, phone screen, and interviews.</p><p>
Pierce County is committed to fostering a Welcoming Workplace where employees are supported, respected, and able to thrive. We believe a strong public workforce is representative of the community it serves and that fair and just access to opportunity strengthens public service.</p><p>
Guided by the County Executive&rsquo;s Forward Together mission, Pierce County works to build communities that are safe, welcoming, and connected. This same commitment shapes how we recruit, develop, and retain our employees. County employees make a direct and visible impact in the lives of residents every day, and we invite you to join us in helping keep Pierce County a place people are proud to call home.</p></div><p></p>
</div><div></div><div><div><p>We are unable to sponsor or take over sponsorship of an employment visa at this time.</p></div></div></div>

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