claims examiner

Sunrise Systems, Inc.

<div>
 
 
 Job Title: Claims Examiner - 3
 
 
 
 
 Location: Jersey City, NJ 07302
 
 
 
 
 Duration: 6 Weeks with potential to extend
 
 
 
 
 Position Type: Hourly contract Position (W2 only)
 
 
 
 
 
 
 &bull; Hybrid work model: 4 days in-office, 1 day remote.
 
 
 &bull; Standard hours: 9:00 AM &ndash; 5:00 PM, with a 30-minute lunch break.
 
 
 
 
 
 
 Position Summary
 
 
 
 The Claims Examiner is responsible for managing a portfolio of complex casualty claims, including those involving intricate coverage issues and Long Tail Exposure (LTE) claims that span multiple policy periods or involve class action litigation. This role requires expertise in handling claims such as concussion/head injury, abuse and molestation, chemical/toxic/environmental exposures, and claims potentially triggering Personal and Advertising Injury coverage under Commercial General Liability, Umbrella, and Excess policies.
 
 
 The position demands a high level of technical competence, litigation management skills, and the ability to navigate sensitive and high-exposure claims while maintaining professionalism and compliance with company standards.
 
 
 
 
 
 
 Key Responsibilities
 
 
 <ul>
 <li>
 Claims Management:
 </li>
 <li>
 Investigate, evaluate, and resolve complex casualty claims with potential long-term exposure.
 </li>
 <li>
 Draft and issue coverage position letters and maintain accurate documentation in claim files.
 </li>
 <li>
 Respond promptly and professionally to inquiries from policyholders, brokers, and internal business partners.
 </li>
 <li>
 Litigation Oversight:
 </li>
 <li>
 Manage coverage litigation and arbitration related to assigned claims.
 </li>
 <li>
 Direct and oversee outside counsel in coverage disputes, ensuring alignment with company strategy.
 </li>
 <li>
 Develop litigation and resolution strategies, manage discovery requests, and participate in depositions, mediations, and trials as necessary.
 </li>
 <li>
 Collaboration &amp; Communication:
 </li>
 <li>
 Work closely with internal stakeholders to provide updates and recommendations on claim status and litigation progress.
 </li>
 <li>
 Maintain strong relationships with clients and business partners, delivering exceptional customer service.
 </li>
 </ul>
 
 
 
 
 
 Required Skills &amp; Competencies
 
 
 <ul>
 <li>
 Strong organizational skills with the ability to manage multiple complex claims simultaneously.
 </li>
 <li>
 Excellent written and verbal communication skills, including drafting legal and coverage-related documents.
 </li>
 <li>
 Effective negotiation and interpersonal skills for managing sensitive claims and litigation.
 </li>
 <li>
 Ability to work independently in a complex operating environment, demonstrating sound judgment and issue-spotting capabilities.
 </li>
 <li>
 Comfort and willingness to handle claims involving abuse, sexual molestation, and other sensitive exposures.
 </li>
 </ul>
 
 
 
 
 
 Education &amp; Experience
 
 
 <ul>
 <li>
 Minimum 5 years of experience as a licensed claims professional with specialized expertise in:
 </li>
 <li>
 Litigation management
 </li>
 <li>
 Complex coverage issues
 </li>
 <li>
 High-exposure and/or long-term exposure claims
 </li>
 <li>
 Coverage litigation
 </li>
 <li>
 Law degree preferred, but not required.
 </li>
 </ul>
</div>

Claims Examiner

USAA

Why USAA?At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the choice for the military community and their families.Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.The OpportunityAs a dedicated Injury Examiner, you will be responsible to adjust complex bodily injury claims, UM/UIM, and small business claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy.This role is remote eligible in the continental U.S. with occasional business travel. However, individuals residing within a 60-mile radius of a USAA office will be expected to work on-site three days per week.What you'll do:<ul><li>Adjusts complex auto bodily injury claims with significant injuries (e.g. traumatic brain injury, disfigurement, fatality) and UM/UIM, and small business claims, as well as some auto physical damage associated with those claims. Identifies, confirms, and makes coverage decisions on complex claims.</li><li>Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes.</li><li>Prioritizes and manages assigned claims workload to keep members and other involved parties informed and provides timely claims status updates.</li><li>Collaborates and supports team members to resolve issues and identifies appropriate matters for escalation.</li><li>Partners and/or directs vendors and internal business partners to facilitate timely claims resolution.</li><li>Serves as a resource for team members on complex claims.</li><li>Delivers a best-in-class member service experience by setting appropriate expectations and providing proactive communication.</li><li>Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.</li><li>May be assigned CAT deployment travel with minimal notice during designated CATs.</li><li>Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.</li><li>Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.</li></ul>What you have:<ul><li>High School Diploma or General Equivalency Diploma.</li><li>4 years auto claims and injury adjusting experience.</li><li>Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations.</li><li>Advanced negotiation, investigation, communication, and conflict resolution skills.</li><li>Demonstrated strong time-management and decision-making skills.</li><li>Proven investigatory, prioritizing, multi-tasking, and problem-solving skills.</li><li>Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims.</li><li>Ability to exercise sound financial judgment and discretion in handling insurance claims.</li><li>Advanced knowledge of coverage evaluation, loss assessment, and loss reserving.</li><li>Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.</li></ul>What sets you apart:<ul><li>2 or more years of catastrophic injury experience (e.g. traumatic brain injury, disfigurement, fatality)</li><li>Experience handling UM/UIM injury claims</li><li>College Degree (Bachelor's or higher).</li><li>Insurance Designation.</li></ul>Compensation range: The salary range for this position is: $85,040 - $162,550.USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.). Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Injury Examiner

The Graduate Recruitment Specialist Ltd. Web

Everyone has a voice and the chance to make a difference. Their training ensures everyone has the opportunity to gain funded professional qualifications and continuous personal development. Teamwork is a fundamental part of how they work and as a collective unit we focus on achieving their goals together. Having fun, working hard and sharing in the company's success ensures they keep true to their ethos.NATURE OF BUSINESS:Our client offers a fresh approach to a traditionally overlooked sector. They are passionate about putting their customers first above all things. They are a true leader within their sector with a team that has more than a century of combined experience. This makes them the go-to experts for their client's third-party damage claims, no matter how bizarre or quirky. Employing their own team of specialist site operatives, allowing them to handle everything from claims to repairs in one smooth process.Company Accreditations:The Client is passionate about training within their organisation. Their employees can progress their professional qualifications and continually develop their skills within the industry.With roots firmly in repair and construction, dealing with unusual and sometimes unconventional projects, they have set out to become a repair and construction company with a real difference.They are members of the Charted Institute of Building (CIOB) and undertake professional qualifications within the membership to expand knowledge and experience in the industry. Their staff members also undertake examinations and progression through the Charted Institute of Insurance (CII) and other professional bodies dependent on the role.They are members of the Charted Institute of Building (CIOB) and undertake professional qualifications within the membership to expand knowledge and experience in the industry. Their staff members also undertake examinations and progression through the Charted Institute of Insurance (CII) and other professional bodies dependent on the role.Our client has split their intervention team in two due to business growth - SME (Subject Matter Experts) and normal intervention. For the SME side of the team, they are looking to bring someone into the business able to investigate circumstances around a claim. This would be for high value claims.Our client is looking to recruit a high calibre professional with excellent communication and investigative skills. You will be someone who is comfortable talking to people from all backgrounds and levels and be able to adapt accordingly. You will be looking to establish a permanent career within the team and be part of the exciting future of this organisation.As a member of this team, you will be allocated cases to investigate, dealing with a range of different clients. You will be required to investigate each case and ensure you have all the data correct, this will involve communication with the client, being able to listen and ask the right questions.If you are looking for a challenging business focused role that requires excellent attention to detail and offers variety, progression routes and training with a dynamic environment this is a role to be considered. Skills Required <ul><li>Proven client/customer focused experience in an office environment</li><li>Experience in the insurance sector</li><li>Ability to investigate and actively listen</li><li>The ability to work when required in a fast -paced environment</li><li>Emotionally intelligent</li><li>Experience dealing with customers over the telephone</li><li>Ability to work to deadlines</li><li>Personable and approachable</li><li>Ability to communicate effectively on all levels</li><li>Excellent attention to detail</li><li>IT literate and able to pick up new systems</li><li>Ability to work on own initiative and manage own workload as well as add real value to the team</li><li>Excellent progression.</li><li>Company pension which increases with time served</li><li>An industry leading maternity policy</li><li>£500 wellbeing payment at annual review</li><li>Loyalty bonus at milestone years</li><li>Support to continue training and paid for professional qualifications</li><li>Access to a Rising Stars programme and equal support for mental and physical wellbeing.</li></ul>HOURS OF WORK: 8.45 - 5.00pm Monday to Friday with a break for lunchHOLIDAY: 25 days plus bank holidays, an extra 16 hours of time off in lieu taken at no more than two-hour slots which equates to the total of 27 days plus bank holidays. An additional day is also given for your Birthday if it falls on a weekday.Please complete the below web submission form and a consultant will be in touch soon.

Subject Matter Expert - Claims

Adams & Martin Group

<div>
 
 Adams &amp; Martin Group is seeking a Workers' Compensation Paralegal to join a law firm in Minneapolis. This is a direct hire, onsite position.
 
 
 
 Key Responsibilities:
 
 
 <ul>
 <li>
 Support attorneys with legal tasks, including drafting and filing documents.
 </li>
 <li>
 Calendar management.
 </li>
 <li>
 Manage client files and maintain electronic records.
 </li>
 <li>
 Coordinate schedules, meetings, and deadlines.
 </li>
 <li>
 Prepare discovery requests and assist in trial preparation.
 </li>
 <li>
 Communicate with clients, opposing counsel, and medical providers.
 
 
 </li>
 </ul>
 Requirements:
 
 
 <ul>
 <li>
 2+ years of paralegal experience in workers' compensation.
 </li>
 <li>
 Strong organizational and time management skills.
 </li>
 <li>
 Excellent written and verbal communication.
 </li>
 <li>
 Proficiency in Microsoft Office and legal software.
 </li>
 <li>
 Ability to work independently and collaboratively.
 </li>
 <li>
 Bachelor's degree or paralegal certification preferred.
 
 </li>
 </ul>
 
 
 
 
 All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated
 
 
 Los Angeles county
 
 
 , to the extent our customers
 
 
 require
 
 
 a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.
 
 
 
 
 
 
</div>

Workers' Compensation Paralegal

Morgan & Morgan

<div><div>At Morgan &amp; Morgan, the work we do matters. For millions of Americans, we're their last line of defense against insurance companies, large corporations or defective goods. From attorneys in all 50 states, to client support staff, creative marketing to operations teams, every member of our firm has a key role to play in the winning fight for consumer rights. Our over 6,000 employees are all united by one mission: For the People.</div>
Summary

We are seeking an experienced Workers' Compensation Paralegal to join our team. As a Workers' Compensation Paralegal you will work closely with our talented attorneys providing support before, during and after trials.

Responsibilities
<ul>
<li>Prepare legal documents including pleadings, motions, affidavits, complaints, legal memoranda</li>
<li>E-file all court documents in state and federal court</li>
<li>Communications with clients, court, counsel, and others</li>
<li>Conduct legal research and factual investigation</li>
<li>Prepare discovery documents, interrogatories, and responses</li>
<li>Draft and server summons</li>
<li>Coordinate and summarize depositions</li>
<li>Prepare trial binders and exhibits</li>
<li>Drafting pleadings, motions and appellate documents and filing them with the court</li>
<li>Performing administrative duties (calendar hearings and deadlines, organize case files, manage logistics)</li>
<li>Maintain pleadings and discovery indexes</li>
<li>Organize exhibits, documents, evidence, briefs, and appendices</li>
<li>Aid attorney with interrogatories and other discovery requests</li>
<li>Gather relevant information from a variety of sources</li>
<li>Liaise between trial teams and internal/external third parties</li>
<li>Witness preparation</li>
<li>Assisting with case settlements</li>
<li>Other tasks as requested by the attorney</li>
</ul>
Qualification
<ul>
<li>Associate degree, certificate, or equivalent work experience (preferred)</li>
<li>2+ years of litigation experience (preferred)</li>
<li>Completion of a nationally accredited paralegal program (preferred)</li>
<li>Experience in Personal Injury, Workers' Compensation, Premises, or other injury related practice areas (preferred)</li>
<li>Must possess the ability to multi-task, prioritize, and manage workload with a positive attitude and minimal supervision</li>
<li>Excellent written and verbal communication skills, proficient in calendaring depositions, mediations, and hearings</li>
<li>Applicable knowledge of motions, discovery, evidence, litigation documentation, court rules, and procedures, practices, etc.</li>
<li>Highly organized with the ability to juggle multiple deadlines in a fast-paced environment</li>
<li>Extensive computer and database expertise; Microsoft Word, Excel, Outlook, and type no less than 35 wpm</li>
<li>Remote and/or hybrid not eligible</li>
</ul>
#LI-KL1<div>
Benefits

Morgan &amp; Morgan is a leading personal injury law firm dedicated to protecting the people, not the powerful. This success starts with our staff. For full-time employees, we offer an excellent benefits package including medical and dental insurance, 401(k) plan, paid time off and paid holidays.

Equal Opportunity Statement

Morgan &amp; Morgan provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

E-Verify

This employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the I-9 Form.
Privacy Policy

Here is a link to Morgan &amp; Morgan's privacy policy.</div></div>

Goldberg Segalla LLP

THE POSITION 
 
Goldberg Segalla LLP, a national law firm with more than 23 offices in 11 states, has an immediate opportunity for associates to join our Workers&rsquo; Compensation group in Georgia. This position will be completely remote. 
 
THE QUALIFICATIONS 
 
Qualified candidates will have at least 1 year of Workers' Compensation experience and be admitted in Georgia. 
 
THE BENEFITS 
 
This position also offers a competitive salary, bonuses and a full benefits package. Our benefits package includes, but is not limited to, health insurance, dental insurance, life insurance, a 401(k) plan, flexible spending, and more. 
 
THE FIRM 
 
The Goldberg Segalla approach to teamwork and mentoring fosters career satisfaction and growth. Associates receive both the resources and the opportunities necessary to thrive and succeed, from engaging in various stages of the litigation process, to working with key client teams, to delivering results for both our clients and our firm. 
 
Goldberg Segalla isn&rsquo;t merely a business&mdash;we&rsquo;re a community. We value the diversity of our team and strive to create a collaborative and enjoyable culture for everyone, where leadership is rewarded, and efficiency, mutual respect, and working together for the common good are traits we all embody. 
 
 Goldberg Segalla is a national civil litigation firm with offices spanning major metro markets across the U.S., providing strategic coverage wherever our clients do business. As a firm of experienced litigators and trial attorneys, Goldberg Segalla's capabilities span business and commercial disputes, employment and labor, insurance coverage, product liability, and more. Today, our more than 500 attorneys are trusted counselors to public and private clients in key sectors and industries including construction and energy, transportation, manufacturing, retail and hospitality, and insurance.

Attorney-Workers Compensation Associate

Search 1584+ Claims examiner jobs near you this January. New roles added regularly across leading industries. Apply today.

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Subject Matter Expert - Claims

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