analyst, healthcare medical coding - disputes, claims & investigations

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analyst, healthcare medical coding - disputes, claims & investigations Jobs in Atlanta

cdl class a driver – dedicated lanes il-tx Jobs in Atlanta

claims adjuster,tpa oversight Jobs in Atlanta

claims adjuster,tpa oversight

claims team lead apd

claims workforce management analyst Jobs in Atlanta

claims workforce management analyst

claims examiner

TRISTAR

<div>POSITION SUMMARY: Responsible for the prompt review of policy information including all relevant endorsements and schedules to determine coverage for loss and injury. Conduct an efficient claim examination and investigation leading to the final resolution of professional liability claims including matters in litigation. Frequent contact and interaction with involved parties including claimants and their legal representatives will be required. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client.
DUTIES AND RESPONSIBILITIES:<ul><li>
Review, process, and conclude assigned claims including investigation and evaluation of complex Auto and General Liability Casualty Claims.</li><li>
Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion.
</li><li>Maintain an ongoing diary.</li><li>
Continually assess exposure and evaluate accurate reserves and settlement recommendations.</li><li>
Prepare Loss Reports providing a thorough analysis of liability and damages.
</li><li>Where applicable, determine if subrogation and/or risk transfer exists and initiate recovery efforts at the direction of the client.</li><li>
Document all correspondence, reports, discussions, and decisions in the claim file record.</li><li>
Provide outstanding service to the client.</li><li>
Assist Supervisors and the Claim Department with requested tasks or special projects.</li><li>
Other duties as assigned</li></ul>
EQUIPMENT OPERATED/USED: Computer, 10-key, printer, copier, fax/scanner machine and other office equipment
SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire
QUALIFICATIONS REQUIRED:
Education/Experience: High School Diploma or GED required; bachelor&rsquo;s degree in a related field (preferred) and a minimum of five+ (5-10) years of commercial auto and general liability casualty-related experience; or equivalent combination of advanced education and experience.
Special Requirements:<ul><li>
At least 5-7 years of Commercial Automobile and General Liability claims experience required
</li><li>Knowledge of claims handling concepts, practices, and techniques, including but not limited to coverage issues and product line knowledge.
</li><li>Demonstrated verbal and written communication skills.
</li><li>Demonstrated advanced analytical, decision-making, and negotiation skills.
</li><li>Computer proficiency</li></ul>
Preferred Skills:<ul><li>
Ability to communicate effectively and clearly, both orally and in writing.</li><li>
Ability to manage relationships in a fast-paced environment, while demonstrating problem-solving and decision-making skills to work with customers.</li><li>
Good analytical abilities to review, exercise judgment, and evaluate claims in order to make sound decisions with a minimal amount of supervision.</li><li>
Excellent customer service skills.</li><li>
An understanding of the litigation process and case valuation in multiple jurisdictions.
</li><li>Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently, and exhibit good common sense.</li><li>
An ability to handle assigned claims following company guidelines and industry best practices with a minimal amount of supervision.</li><li>
Time management skills, organizational skills, and ability to prioritize issues and tasks.</li><li>
Ability to effectively operate computer equipment and applications.</li><li>
Independence, flexibility, and creativity.
</li></ul>Other Qualifications:
<ul><li>Multi-state adjuster licensure and/or the ability to obtain licenses through home-state reciprocity or through state adjuster examinations. AICPCU industry designations.</li><li><div>
FL, NY, GA or TX Adjuster license and others with full reciprocity and home state license (where an exam was required)</div></li></ul>
Mental and Physical Requirements:
<div><div>MENTAL AND PHYSICAL REQUIREMENTS</div><div><div> 
1. MENTAL EFFORT
a. Reasoning development:
Follow one- or two-step instructions; routine, repetitive task.
Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables.
Follow written, verbal, or diagrammatic instructions; several concrete variables.
Solve practical problems; variety of variables with limited standardization; interpret instructions.
X Logical or scientific thinking to solve problems; several abstract and concrete variables.
Wide range of intellectual and practical problems; comprehend most obscure concepts.</div></div><div><div> 
b. Mathematical development:
Simple additional and subtraction; copying figures, counting, and recording.
Add, subtract, multiply, and divide whole numbers.
X Arithmetic calculations involving fractions, decimals, and percentages.
Arithmetic, algebraic, and geometric calculations.
Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.
Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination; require theoretical application.</div></div><div><div> 
c. Language development:
Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.
Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.
Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.
Ability to compose original correspondence, follow technical manuals, and have increased contact with people.
X Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.</div></div><div><div> 
2. PHYSICAL EFFORT
a. Physical activity required to perform the job:
X Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
Light work:
a. Exerting up to 20 pounds of force occasionally
b. Exerting up to 10 pounds frequently
c. Exerting a negligible amount of force constantly to move objects
(If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most of the time, the job is rated for Light Work).
Medium work:
a. Exerting up to 50 pounds of force occasionally
b. Exerting up to 20 pounds of force frequently
c. Exerting up to 10 pounds of force constantly to move objects
Heavy work:
a. Exerting up to 100 pounds of force occasionally
b. Exerting up to 50 pounds of force frequently
c. Exerting up to 20 pounds of force constantly to move objects
Very heavy work:
a. Exerting in excess of 100 pounds of force occasionally
b. Exerting in excess of 50 pounds of force constantly to move objects
c. Exerting in excess of 20 pounds of force constantly to move objects 
</div></div> 
<div><div><ul><li>Visual requirements necessary to perform the job:</li></ul>
Far vision: clarity of vision at 20 feet or more
X Near vision: clarity of vision at 20 inches or less
X Mid-range vision: clarity of vision at distances of more than 20 inches and less than 20 feet
Depth perception: the ability to judge distance and space relationships, so as to see objects where and as they actually are
Color vision: ability to identify and distinguish colors
Field of vision: ability to observe an area up or down or to the right or left while eyes are fixed on a given point
</div></div> 
</div><div><div>2. PHYSICAL EFFORT (cont.) 
FREQUENCY</div><div><div> 
c. Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally):
Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms. Body agility is emphasized. This factor is important if the amount and kind of climbing required exceeds that required for ordinary locomotion.
Balancing: Maintaining body equilibrium to prevent falling when walking, standing, or crouching on narrow, slippery, or erratically moving surfaces. This factor is important if the amount and kind of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium.
Stooping: Bending body downward and forward by bending spine at the waist. This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.
Kneeling: Bending legs at knee to come to a rest on knee or knees.
Crouching: Bending the body downward and forward by bending legs and spine.
Crawling: Moving about on hands and knees or hands and feet.
Reaching: Extending hand(s) and arm(s) in any direction.
Standing: Particularly for sustained periods of time.
Walking: Moving about on foot to accomplish tasks, particularly for long distances.
Pushing: Using upper extremities top press against something with steady force in order to thrust forward, downward, or outward.
Pulling: Using the upper extremities to extend force in order to drag, haul, or tug objects in a sustained motion.
Foot
Motion: Using feet to push pedals.
Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position to position. This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.
X Fingering: Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.
X Grasping: Applying pressure to an object with the fingers and palm. 
</div><div>Frequently
Occasionally
</div></div> 
</div><div><div>2. PHYSICAL EFFORT (cont.) 
FREQUENCY</div><div><div> 
X Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
X Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication and to make fine discriminations in sound, such as when making find adjustments on machined parts.
Feeling: Perceiving attributes of objects, such as size, shape, temperature, or texture by touching with skin, particularly that of fingertips.
X Repetitive Substantial movements (motions) of the wrists, hands,
Motion: and/or fingers.</div><div> 
Frequently
Frequently
Frequently 
</div></div> 
<div><div>3. WORKING CONDITIONS
Disagreeable job conditions to which the employee may be exposed and the frequency (e.g., continually, frequently, or occasionally) of this exposure. 
</div></div> 
<div><div>WORKING CONDITION
ENVIRONMENTAL
FACTOR</div><div> 
NATURE/REASON
OF EXPOSURE</div><div> 
FREQUENCY</div></div><div> 
Dirt/Dust 
</div> 
<div>Noise 
</div> 
<div>Temperature extremes 
</div> 
<div>Dampness 
</div> 
<div>Vibrations 
</div> 
<div>Equipment movement hazard 
</div> 
<div>Chemicals/solvents 
</div> 
<div>Electrical shock 
</div> 
<div>Significant work pace/pressure 
</div> 
<div>Odors/Fumes 
</div> 
<div><div>Other (specify):</div></div></div></div>

Liability Claims Examiner III

Midway Insurance Management International

Midway Insurance Management International, Inc. provides Claims Management and Adjusting Services.We understand the insurance industry operates in a world where only the fittest will survive. It follows that our success is inherently linked to the success of our insurance partners. We understand that it takes creativity, resourcefulness and honest hard work to become a successful adjusting company.We provide the solutions to the ever increasing demands of the insured, agents and brokers:<ul><li>Casualty</li><li>Transportation</li><li>Auto</li><li>Litigation Management</li><li>Program Management</li><li>Individual Claims Assignments</li><li>Consulting Services</li><li>Administration</li></ul>Liability Adjuster Position:Job Summary:The Liability Claims Adjuster will be responsible for investigating, evaluating, and resolving liability claims related to commercial trucking incidents. This role requires strong analytical and negotiation skills, along with a deep understanding of insurance policies, claims handling procedures, and regulatory compliance. The ideal candidate will have experience in handling complex claims, working with insured parties, claimants, attorneys, and other stakeholders to ensure fair and efficient settlements.Key Responsibilities:<ul><li>Investigate and analyze liability claims, including reviewing accident reports, witness statements, and other relevant documentation.</li><li>Determine coverage, assess damages, and evaluate liability exposure.</li><li>Communicate with insureds, claimants, attorneys, and other involved parties to gather information and negotiate settlements.</li><li>Collaborate with internal teams, including underwriting and risk management, to assess claim impact.</li><li>Manage claims from initial report through resolution, ensuring timely and accurate processing.</li><li>Maintain detailed and organized claim files in compliance with company policies and industry regulations.</li><li>Work with external experts, such as investigators and medical professionals, when needed.</li><li>Prepare detailed reports and recommendations for claims resolution.</li><li>Stay up to date with industry trends, legal developments, and regulatory changes affecting liability claims.</li></ul>Job Type: Full-timePay: $55,000.00 - $75,000.00 per yearBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: Hybrid remote in Atlanta, GA 30326

Liability Claims Adjuster

Gallagher

<div>Introduction 
<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> 
Overview 
About the INVEST Program
Are you a recent college graduate looking for a long-term, stable, innovative and exciting career that helps make a meaningful difference and supports people through challenges? 
The Emerging Talent INVEST Program (ETIP) &ndash; Guardian Pathway is a 6-month paid, fully remote, entry-level immersive learning experience, designed for recent college graduates to gain real-world exposure, personalized coaching and mentorship and a clear, long-term career path in one of U.S. best industries. 
Program Highlights<ul><li>
6-months, paid, fully remote learning track</li><li>
Virtual classroom, peer shadowing, simulations, case studies, and hands-on experience</li><li>
Fully remote (candidates must physically reside in states specified although the role is remote)</li><li>
Interactive sessions, one-on-one mentorship, collaborative projects, exposure to wide variety of industries, clients, and knowledge material</li><li>
Fully paid licensing and advance education opportunities</li><li>
Career progression post-graduation into claims resolution manager roles and beyond</li></ul>
 
How you'll make an impact 
Over the course of this 6-month program you will be partnered with a team of peers and experienced Training Specialists that will create a supportive learning environment designed to position you for successful program completion. You will alternate between self-study modules, virtual classroom-style learning, guided training modules, and hands-on application of the knowledge gained. Over the course of the program, you will progressively increase your hands-on experience to immerse yourself into the world of claims management and client service excellence under the mentorship of the program mentors and training leaders. The program is designed to offer consistent and repeated opportunities to develop, grow and practice your knowledge, advance your education via licensing studies, and help you gain confidence in the unique and highly specialized field of commercial claims handling for world&rsquo;s largest employers and insurance carriers. 
What can you expect?<ul><li>
Participate in Structured Learning: Actively engage in the first phase of the INVEST Program, which includes instructor-led sessions, online modules, job shadowing, and mentorship focused on foundational insurance knowledge, claims operations, and state-specific workers&rsquo; compensation regulations.</li><li>
Shadow Claims Experts: Observe experienced claims professionals and learn best practices in managing lost time (indemnity) workers&rsquo; compensation claims.</li><li>
Practice in a Simulated Environment (&quot;Sandbox&quot;): Apply newly learned concepts in a controlled, simulated claims environment designed to mimic real-world scenarios. The sandbox allows colleagues to practice making decisions, inputting data, and managing mock claims without risk, helping build confidence before handling actual cases.</li><li>
Complete Program Milestones: Achieve key learning objectives and performance checkpoints as you build technical knowledge and professional skills essential for a successful claims career.</li><li>
Collaborate and Network: Engage with peers, mentors, and cross-functional teams to deepen understanding of the claims process and build professional relationships within the organization.</li><li>
Gradual Claim Ownership: Begin handling new workers&rsquo; compensation claims starting in Week 3 of the program. Claim assignments will begin at an incremental, supportive pace, with inventory gradually increasing as confidence and competency develop.</li><li>
Support Claims Management: Take ownership of an evolving portfolio of indemnity claims under close supervision. Begin applying program training to real-world scenarios, including benefit calculations, wage loss evaluations, and return-to-work considerations.</li><li>
Claims Analysis and Learning: Continue developing skills in analyzing medical documentation, regulatory guidelines, state-specific regulations, and supplemental case materials to determine claim strategy, financial exposure and potential next steps.</li><li>
Stakeholder Communication: Engage in professional communication and strategy development with clients; provide support and empathy to the injured employees; secure key details from medical providers and other key stakeholders to support collaborative, outcome-focused, and empathetic claims handling.</li><li>
Client Service Instructions &amp; Carrier Guidelines: 
Learn how to interpret and apply client service instructions and carrier guidelines to ensure claims are handled in compliance with expectations. This includes understanding unique requirements for documentation, communication, and jurisdictional standards across our diverse client base.</li></ul><div>
Reserving Acumen: 
Build core skills in setting and adjusting reserves by analyzing claim details, medical data, and potential outcomes. You&rsquo;ll learn how accurate reserving supports financial stewardship and impacts overall claim strategy.</div> 
 
About You<div> 
Education: Bachelor&rsquo;s degree or 4-year degree from an accredited institution preferred.</div><div>
Candidates possessing a Bachelor&rsquo;s degree will receive preferential treatment. Others with proven experience will be considered.</div><div></div><div> 
Attributes:</div><ul><li>
Active listening skills
</li><li>Problem-solving mindset</li><li>
Adaptable to changes in procedures and technology</li><li>
Computer literacy, including strong familiarity with M365 products (e.g. Outlook, Word, and basic Excel and PPT)</li><li>
Strong verbal and written communication skills</li><li>
Strong time management and ability to multi-task</li><li>
Detail-oriented</li><li>
Curious, learning-focused mindset</li></ul><div></div><div> 
#GBTopJob</div><div>
#remote</div><div>
#INVEST</div> 
 
Compensation and benefits 
We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.
Below are the minimum core benefits you&rsquo;ll get, depending on your job level these benefits may improve:
<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>
Other benefits include:</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>
**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.</div><div></div><div> 
We value inclusion and diversity</div>
Click Here to review our U.S. Eligibility Requirements
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.
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.
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.
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.</div>

Emerging Talent INVEST Program - Guardian Associate

<div>
 At AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Adjuster TTPO Claims to play your part in that transformation. It&rsquo;s an opportunity to grow your skills and experience as a valued member of the team.
 
 
 
 Make your mark in TPA 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
 
 
 
 
 <ul>
 <li>
 Analyze and process bodily injury and third-party property damage claims by investigating and gathering information to determine the exposure on the claim; ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans. Determine need for and direct independent adjusters to gather information to determine exposure on the claim and control their costs.
 </li>
 <li>
 Identify and evaluate coverage issues; prepare comprehensive coverage letters with supervisory review and analysis; retain and provide direction to coverage counsel when necessary.
 </li>
 <li>
 Assess liability and resolve claim within established evaluation. Maintain diaries and complete tasks within required timeframes as set forth by department guidelines; ensure claim files are timely and properly documented with clear and concise analysis on coverage, damages, reserves, and liability including an action plan for resolution. Process and pay invoices within a timely manner.
 </li>
 <li>
 Coordinate vendor referrals for additional investigation and/or litigation management. Calculate and assign timely and appropriate reserves; monitor reserve accuracy throughout the life of the claim.
 </li>
 <li>
 Refer case as appropriate to supervisor and management. Respond to requests or directions in a professional and timely manner.
 </li>
 <li>
 Attend arbitrations, mediations, settlement conference and trials.
 </li>
 <li>
 Successfully complete required State licensing examinations and continuing education requirement.
 </li>
 <li>
 Communicate with all internal business partners including underwriters to make sure underwriting is aware of large losses and industry trends.
 </li>
 <li>
 Partner with TPA Governance and Relationship Management to help TPA&rsquo;s and Insureds comply with claim handling and reporting guidelines.
 </li>
 <li>
 Work with TPA Claims Financial to check the accuracy of TPA financials ensuring alignment with TTPO financials.
 
 
 </li>
 </ul>
 
 What You&rsquo;ll Need To Succeed
 
 
 
 
 <ul>
 <li>
 4 plus years of General Liability/Auto claims experience.
 </li>
 <li>
 Experience with complex and high exposure General Liability Bodily Injury and Property damage claims
 </li>
 <li>
 Excellent communication skills (verbal/written) and strong negotiation skills
 </li>
 <li>
 Advanced experience and capabilities in litigation claims management, including ADR and mediation processes, involving auto/GL exposures.
 </li>
 <li>
 Strong technical expertise interpreting insurance contracts.
 </li>
 <li>
 In depth knowledge of claim handling procedures, claims performance strategies, and claim best practices.
 </li>
 <li>
 Advanced analytical and problem solving skills.
 </li>
 <li>
 Should also have a demonstrated ability to initiate and champion change initiatives that leverage technology and improve skills in benchmarking.
 </li>
 <li>
 Creativity in resolving challenging business problems, as well as ability to achieve business goals and objectives is essential.
 
 
 </li>
 </ul>
 Ready to take your career to the next level? We would love to hear from you.
 
 
 The position is eligible for a bonus in accordance with the terms of the applicable incentive plan. In addition, we&rsquo;re proud to offer a range of competitive benefits, a summary of which can be viewed here: US Benefits Overview.
 
 
 #TPA #Claims
 
 
 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&rsquo;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&mdash;as well as your professional development&mdash;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&rsquo;s most far-reaching property casualty networks. It is an exciting time to join us &mdash; 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&rsquo;re committed to creating a culture that truly respects and celebrates each other&rsquo;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&rsquo;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 Claims, Inc.
 
 
</div>

Claims Adjuster,TPA Oversight

Reserv

<div>About Reserv
Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.
We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can&rsquo;t wait to meet you. 
About the role
We are seeking a highly organized, detail-oriented, and customer-focused Non-Standard Claims Adjuster to support our deposit replacement and surety programs. In this role, you will manage first-party claims involving non-standard policy language and complex contractual agreements. Success requires strong analytical skills and the ability to interpret policy forms, lease agreements, financial ledgers, and supporting addenda with accuracy and confidence.
You will work directly with property managers, policyholders, and internal stakeholders to drive fair, thorough, and timely claim outcomes. This role requires clear communication, sound judgment, and the ability to navigate nuanced coverage positions while maintaining a high level of professionalism and empathy.
This position is ideal for an adjuster who thrives in a fast-paced, evolving environment and enjoys working within specialty programs. The right candidate is adaptable, solutions-oriented, and comfortable balancing high claim volume with exceptional service delivery and compliance standards. 
Who You Are:<ul><li>
Highly motivated and growth-oriented. You&rsquo;re excited about building a tech-driven claims organization.</li><li>
Passionate adjuster. You care deeply about the customer experience and delivering fair, timely resolutions.</li><li>
Empathetic. You exercise patience and understanding in every interaction.</li><li>
Urgent but balanced. You work with a sense of urgency but understand that doesn&rsquo;t mean working at all hours.</li><li>
Creative problem-solver. You find innovative ways to resolve claims efficiently while keeping the insured&rsquo;s best interests in mind.</li><li>
Comfortable with conflict. You see conflict as a conversation, not a confrontation&mdash;an opportunity to collaborate and resolve issues.</li><li>
Curious. You want to know the whole story to make informed decisions early and drive prompt resolutions.</li><li>
Anti-status quo. You don&rsquo;t just wish things were different&mdash;you take action to improve processes and outcomes.</li><li>
Communicative. You can break down complex topics, actively listen, and ensure clarity in every interaction. (What does this mean to you? We&rsquo;d love to know!)</li><li>
Sense of humor. Claims are challenging&mdash;you know how to keep things light when needed.</li></ul> 
What you'll do<ul><li>
Provide prompt, courteous, and high-quality customer service.</li><li>
Manage a high volume of low-complexity claims; set and adjust reserves appropriately.</li><li>
Gather necessary information and documentation to initiate the claims process, explain coverage, and outline the next steps.</li><li>
Analyze contracts, financial ledgers, lease agreements, and addenda to determine claim validity and obligations.</li><li>
Ensure compliance with state regulations, policy provisions, and internal procedures.</li><li>
Communicate with all involved parties and issue payments within the set authority.</li><li>
Contribute to the continuous improvement of claims guidelines, best practices, and workflows.</li><li>
Oversee and direct investigative service providers, working closely with clients, counsel, and other stakeholders.</li><li>
Stay informed on industry trends, legal decisions, and policy changes affecting claims handling.</li></ul> 
Qualifications<ul><li>
Bachelor&rsquo;s degree preferred (but if you meet the other qualifications, don&rsquo;t let that stop you from applying!).</li><li>
3 years of experience in general claims handling or related insurance roles.</li><li>
Ability to interpret non-standard policy language, contract terms, and lease agreements.</li><li>
Have active adjuster license(s) and be willing to obtain all required licenses within 60 days, including completing state-required testing</li></ul><ul><li>
Familiarity with state regulations, policy provisions, and claims procedures.</li><li>
Strong analytical skills&mdash;able to evaluate complex data and make sound decisions.</li><li>
Curious, proactive, and always looking for better ways to do things.</li><li>
The desire for continuous learning and professional growth.</li><li>
Willingness to travel for client and claim needs.</li><li>
Excellent verbal and written communication skills with strong attention to detail.</li><li>
Superior organizational skills&mdash;able to prioritize and manage workload efficiently.</li><li>
Comfortable with an Apple laptop, Google Docs, Sheets, and other relevant software.</li></ul>
Benefits<ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!</li></ul> 
Additionally, we will<ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul> 
At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!</div>

Specialty Risk/Non-Standard Claims Resolution Specialist

SageSure

<div>Overview:

If you're looking for the stability of a profitable, growing company with the entrepreneurial spirit of a startup, we're hiring. SageSure, a leader in catastrophe-exposed property insurance, is seeking a Senior Liability Claims Adjuster. A qualified candidate can comfortably and independently handle high severity and complex losses from start to finish. Losses usually involve litigation. You'll be able to effectively communicate and negotiate across multiple parties, including customers, claimants, attorneys and experts. This is a desk-based adjusting position. If you're interested in joining our growing Claims team, we'd love to hear from you.

What you'd be doing:
<ul>
<li>Investigate and document claims involving liability exposures and litigation proceedings,</li>
<li>Conduct detailed policy/coverage reviews, take recorded statements, assign inspections, actively manage reserves, prepare or review damages and injuries, hire coverage and defense council, and negotiate settlements on high severity or complex losses.</li>
<li>Communicate claim updates and decisions verbally and in writing</li>
<li>Handle claims in compliance with all applicable regulations and internal processes</li>
<li>Provide technical expertise and serve as an SME for Claims-related projects</li>
<li>Act as a resource for less experienced staff</li>
<li>Support catastrophe response as needed, to include potential overtime</li>
<li>Any other duties needed to help drive our purpose and fulfill our values</li>
</ul>
We're looking for someone who has:
<ul>
<li>7+ years of property and/or liability claims experience</li>
<li>3+ years of homeowners or commercial liability &amp; litigation claim handling experience</li>
<li>Excellent written and verbal communication skills</li>
<li>Strong organizational abilities</li>
<li>Empathetic interpersonal skills</li>
<li>Highly effective investigation skills</li>
<li>Complete understanding of Section II of a homeowner's policy</li>
<li>Adjuster licensed in home state or holds a non-resident license if license not required; meets requirements for licensing in additional states as needed</li>
</ul>
Highly preferred candidates also have:
<ul>
<li>10+ years of multi-line claim handling experience</li>
<li>5+ years of commercial &amp; personal lines liability experience</li>
<li>Professional designations
</li><li>Licensing in several of the states we do business</li>
</ul>
About the Claims team at SageSure:

On SageSure's Claims team, you'll be doing more than investigating and resolving losses. From the ground up, you'll be pioneering a best-in-class claims handling approach that leverages transformative technology to support our customers, agents and employees. As a part of this customer-focused, process-oriented team you will be the face of SageSure, helping our policyholders through some of their most trying times. Whether you hold a formal leadership role or are a key team player, you'll coach, mentor and engage with those around you in ways that bring out the best in people and effect change.
You can easily distill complex processes in ways those outside the industry can understand and know the importance of aligning communication tools to customer preferences. You thrive on setting and exceeding expectations, and know building relationships, not completing transactions, is the heart of the insurance business.
<div>
About SageSure: 
 
Named among the Best Places to Work in Insurance by Business Insurance for four years in a row (2020-2023), SageSure is one of the largest managing general underwriters (MGU) focused on catastrophe-exposed markets in the US. Since its founding in 2009, SageSure has experienced exceptional growth while generating underwriting profits for carrier partners through hurricanes, wildfires, and hail. Available in 16 states, SageSure offers more than 50 competitively priced home, flood, earthquake, and commercial products on behalf of its highly rated carrier partners. Today, SageSure manages more than $1.9 billion of inforce premium and helps protect 640,000 policyholders. 
 
SageSure has more than 1000 employees working remotely or in-office across nine offices: Cheshire, Connecticut; Chicago, Illinois; Cincinnati, Ohio; Houston, Texas; Jersey City, New Jersey; Mountain View, California; Marlton, New Jersey; Tallahassee, Florida; and Seattle, Washington. 
 
SageSure offers generous health benefits and perks, including tuition reimbursement, wellness allowance, paid volunteer time off, a matching 401K plan, and more. 
 
SageSure is a proud Equal Opportunity Employer committed to building a workforce that reflects the spectrum of perspectives, experiences, and abilities of the world we live in. We recognize that our differences make us strong, and we actively seek out diverse candidates through partnerships with organizations, institutions and communities that represent various backgrounds. We champion belonging and inclusion for all identities, including, but not limited to, race, ethnicity, religion, sexual orientation, age, veteran status, ability status, gender, and country of origin, striving to create a culture where all individuals feel valued, respected, and empowered to bring their authentic selves to work. 
 
Our nimble, highly responsive culture nurtures critical thinkers who run toward problems and engineer solutions. We relentlessly pursue better outcomes by investing in the technology, talent, and tools that position us to succeed in demanding markets. Come join our team! Visit sagesure.com/careers to find a position for you.</div></div>

Senior Liability Claims Adjuster, Complex

ForzaCare

<div>ABOUT US:
Founded in 2022, ForzaCare is a purpose-driven organization that helps injured individuals recover faster and return to work safely through coordinated, clinically appropriate care. Our name reflects our mission - Forza means &quot;strength,&quot; representing the power of our team, and Care reflects our compassion for those we serve.
ForzaCare is proud to be part of Ethos Risk Services, a leading national provider of investigative and risk mitigation solutions. Together, we're expanding our reach and strengthening our ability to deliver exceptional service across the workers' compensation industry. Learn more about ForzaCare and Ethos partnership here. 
JOB SUMMARY:
As a Telephonic Case Manager at ForzaCare, you'll play a vital role in coordinating care for injured workers, primarily through phone-based interactions. Their responsibilities encompass communication, documentation, collaboration, and support to facilitate recovery and a successful return to work.
This role is ideal for a Registered Nurse with a national accreditation such as CCM, CDMS, COHN, CRRN. While prior experience in workers' compensation is strongly preferred, a minimum of 2 years of case managment experience is required. 
KEY RESPONSIBILITIES:<ul><li>
Coordinate care between medical providers, employers, attorneys, insurance carriers, and injured workers via phone to discuss treatment plans, progress, and return-to-work strategies.</li><li>
Develop, document, and monitor individualized recovery goals and return-to-work plans.</li><li>
Provide consistent communication and detailed progress reports to clients and stakeholders.</li><li>
Ensure all case management work meets or exceeds customer and compliance requirements.</li><li>
Build and maintain strong relationships with clients, providers, and internal team members.</li></ul> 
QUALIFICATIONS:
Education &amp; Licensure:<ul><li>
Active Registered Nurse (RN) or Certified Rehabilitation Counselor (CRC) license with an associated college degree is required.</li><li>
Minimum of 2 years in medical/surgical nursing experience AND 2 years of case management experience in workers' compensation?</li><li>
Additional certifications such as CCM, CIRS, or other case management credentials are preferred.</li><li>
Must comply with all state-specific licensure and certification requirements.</li></ul> 
Skills &amp; Attributes:
At ForzaCare, we look for professionals who embody our values and thrive in a collaborative, purpose-driven environment:<ul><li>
Motivated &ndash;You take pride in exceeding goals and continuously improving.</li><li>
Organized &ndash; You can manage a fast-paced workload and multiple priorities with ease.</li><li>
Collaborative &ndash; You communicate clearly and work well with diverse teams and stakeholders.</li><li>
Committed &ndash; You uphold ForzaCare's mission to deliver high-quality, compassionate care and comply with all safety, ethical, and professional standards.</li></ul> 
ForzaCare is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic.</div>

Telephonic Case Manager – Workers’ Compensation

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