claims specialist

Champion Wholesale Foods, LLC

<p>Responsible for researching store claims against the warehouse distribution operations. This involves using the computer and researching various transcations as well as extensive camera review. Office environment, but does involve some time on the floor in a refrigerated 34 degree warehouse while investigating specific slot locations in order to resolve the claim inquiry.</p><p>This job has a flexible schedule and offers a very good work/life balance. Office area is climate controlled and it is a professional, great work environment. Covid protocols are in place and we offer a safe and fun environment in which to work.</p><p>Job Type: Full-time</p><p>Pay: From $14.00 per hour</p><p>Benefits:</p><ul><li>Dental insurance</li><li>Flexible schedule</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Physical Setting:</p><ul><li>Office</li></ul><p>Work Location: In person</p>

Claims Specialist

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><br>
<div><b>
Salary:</b> Salary can be up to $120,000 per year, dependent upon experience</div><div><b>
Claims Background:</b> Professional Liability Claims, Paralegal experience, or related insurance support role<br>
<b>Jurisdictional Experience:</b> Open to any<br>
<b>Active Adjuster Licenses:</b> Must be willing to obtain all licenses as required by the manager within a specified timeframe</div><div>
</div><div>
The Claims Specialist within GB Specialty is responsible for managing moderately complex <b>Healthcare Professional Liability</b> claims. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements.</div>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Analyzes coverage and settles moderately complex claims in Healthcare Professional Liability.</li><li>
Generally, incumbent does not work on workers&rsquo; compensation claims.</li><li>
Able to manage the full-life cycle of all assigned claims files.</li><li>
Analyzes coverage and determines defense obligations.</li><li>
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.</li><li>
Creates reservation of rights and coverage denial letters.</li><li>
Negotiates settlements with clients, client attorneys, and Public Adjusters.</li><li>
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.</li><li>
Prepares reserve and settlement authority requests for client and carrier approval.</li><li>
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.</li><li>
Has a solid understanding of claims processing and the insurance brokerage business.</li><li>
Has a basic understanding of the terminology and case law associated with correctional medicine professional liability claims.</li><li>
Handles claims consistent with clients&rsquo; and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements.</li><li>
Incumbents at this level should be able to work at full caseload capacity.</li></ul>
<br>
<b>About You</b><br>
<div><b>
Claims Background:</b> Paralegal experience, junior professional liability claims experience, or insurance claims support background, preferably within healthcare or medical professional liability</div><div><b>
Jurisdictional Experience:</b> Open to any<br>
<b>Active Adjusters&rsquo; Licenses:</b> Not required initially; must be willing to obtain licenses as directed</div><div></div><div><b><br>
Required:</b></div><br>
<div></div><ul><li>
Bachelor's Degree Required</li><li>
Minimum 2 years of experience in claims, insurance, paralegal, legal support, or a related environment.</li><li>
Strong insurance fundamentals and understanding of claims processes.</li><li>
Ability to analyze documentation, summarize facts, and support coverage and liability determinations.</li><li>
Computer proficiency with claims systems and standard business software.</li><li>
Must be able to obtain required adjuster licenses within designated timeframes.</li></ul><div><b><br>
Preferred:</b></div><ul><li>
Prior experience within healthcare (medical malpractice) claims is a plus</li></ul><div><b>
Behaviors:</b><ul><li>
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, and communicate effectively in writing and verbally.</li><li>
Strong analytical skills to support claims decisions and issue resolution.</li><li>
Ability to interpret policies, records, and related documentation.</li></ul><div>
#LI-TJ1</div><div>
#GBSpecialtyCareers</div></div></div><div></div>

Claim Specialist - Healthcare Professional Liability

<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>
Salary: </b>Salary for this position could go up to $119,000 per year, dependent upon experience.</div><div><div><b>
Jurisdictions:</b> Open to any</div><div><b>
Licenses:</b> Must be willing to obtain all licenses as required by the manager within a specified timeframe</div><div><b>
Location:</b> This role is eligible for fully remote work</div><div></div><div><br>
The Claims Specialist within GB Specialty is responsible for managing moderately complex <b>Healthcare Professional Liability</b> claims, with a primary focus on <b>Correctional Medicine</b>. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements.</div></div>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Analyzes coverage and settles moderately complex claims in Correctional Medicine Professional Liability.</li><li>
Generally, incumbent does not work on workers&rsquo; compensation claims.</li><li>
Able to manage the full-life cycle of all assigned claims files.</li><li>
Analyzes coverage and determines defense obligations.</li><li>
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.</li><li>
Creates reservation of rights and coverage denial letters.</li><li>
Negotiates settlements with clients, client attorneys, and Public Adjusters.</li><li>
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.</li><li>
Prepares reserve and settlement authority requests for client and carrier approval.</li><li>
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.</li><li>
Has a solid understanding of claims processing and the insurance brokerage business.</li><li>
Has a basic understanding of the terminology and case law associated with correctional medicine professional liability claims.</li><li>
Handles claims consistent with clients&rsquo; and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements.</li><li>
Incumbents at this level should be able to work at full caseload capacity.</li></ul>
<br>
<b>About You</b><div><b><br>
Required:</b></div><ul><li><div>
Bachelor&rsquo;s degree required</div></li><li><div>
Minimum 2+ years of experience in handling professional liability claims</div></li><li><div>
Strong insurance fundamentals and understanding of claims processes.</div></li><li><div>
Ability to analyze documentation, summarize facts, and support coverage and liability determinations.</div></li><li><div>
Computer proficiency with claims systems and standard business software.</div></li><li><div>
Must be able to obtain required adjuster licenses within designated timeframes.</div></li></ul><div><b>
Preferred:
</b></div><ul><li>Prior experience within healthcare, medical malpractice, or correctional medicine claims a plus.</li><li>
Strong insurance background (carrier, TPA, brokerage, or claims support experience).</li><li>
JD preferred but not required</li></ul><div><b>
Behaviors:</b></div><div><ul><li>
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, and communicate effectively in writing and verbally.</li><li>
Strong analytical skills to support claims decisions and issue resolution.</li><li>
Ability to interpret policies, records, and related documentation.</li></ul><div>
#LI-TJ1</div><div>
#GBSpecialtyCareers</div></div></div>

Claim Specialist - Correctional Medicine

USAA

<div><b>Location</b> Houston, Texas
<div><div><div><b>Job ID</b></div><div>
R0116857</div></div>
<div><div><b>Date posted</b></div><div>
04/14/2026</div></div>
</div><div><p><b>Why USAA?</b></p><p>
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 #1 choice for the military community and their families.</p><p></p><p>
Embrace a fulfilling career at USAA, where our core values &ndash; honesty, integrity, loyalty and service &ndash; define how we treat each other and our members. Be part of what truly makes us special and impactful.</p><p></p><p><b>
The Opportunity</b></p><p>
As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements in compliance with all state regulatory requirements.</p><p>
Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses within your locally assigned territory. Field Adjusters may travel outside of their local territory to respond to claims in other regions when needed. This is an hourly, non-exempt position with paid overtime available.</p><p>
This is a <b>field-based </b>role for <b>The Woodlands, TX</b><b>.</b> Candidates currently living in this location or willing to self-relocate are encouraged to apply.</p><h2 class="jobSectionHeader"><b>
What you'll do:</b></h2><ul><li><p>
Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability.</p></li><li><p>
Partners with vendors and internal business partners to facilitate complex claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance.</p></li><li><p>
Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics.</p></li><li><p>
Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies.</p></li><li><p>
Determines and negotiates complex claims settlement within authority limits. Develops recommendations and collaborates with management for determining settlement amounts outside of authority limits and accurately manages claims outcomes.</p></li><li><p>
Maintains accurate, thorough, and current claim file documentation throughout the claims process.</p></li><li><p>
Advance knowledge of estimating technology platforms and virtual inspection tools. Utilizes platforms and tools to prepare claims estimates to manage complex property insurance claims.</p></li><li><p>
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.</p></li><li><p>
May be assigned CAT deployment travel with minimal notice during designated CATs.</p></li><li><p>
Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.</p></li><li><p>
Works independently solving complex problems with minimal guidance; acts as a resource for colleagues with less experience.</p></li><li><p>
Adjusts complex claims with attorney involvement.</p></li><li><p>
Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations.</p></li><li><p>
May require travel to resolve claims, attend training, and conduct in-person inspections.</p></li><li><p>
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.</p></li></ul><h2 class="jobSectionHeader"><b>
What you have:</b></h2><ul><li><p>
High School Diploma or General Equivalency Diploma required.</p></li><li><p>
2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.</p></li><li><p>
Advanced knowledge of estimating losses using Xactimate or similar tools and platforms.</p></li><li><p>
Proficient knowledge of residential construction.</p></li><li><p>
Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations.</p></li><li><p>
Proficient negotiation, investigation, communication, and conflict resolution skills.</p></li><li><p>
Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills.</p></li><li><p>
Ability to travel 50-75% of the year (local &amp; non-local) and/or work catastrophe duty when needed.</p></li><li><p>
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.</p></li></ul><h2 class="jobSectionHeader"><b>
What sets you apart:</b></h2><ul><li><p>
US military experience through military service or a military spouse/domestic partner</p></li><li><p>
5 years of prior field experience handling higher severity/complex losses (i.e. vandalism, malicious mischief, foreclosures, earth movement, collapse, liability, etc.)</p></li><li><p>
Prior experience adjusting property claims using virtual technologies</p></li><li><p>
Prior property field adjuster experience handling DWG, APS and ALE adjustments</p></li><li><p>
Industry designations such as AINS, CPCU, AIC, SCLA (or actively pursuing)</p></li><li><p>
Xactimate Level 1 and/or Level 2 certification</p></li><li><p>
Prior deployments in support of catastrophes</p></li><li><p>
Currently hold an active Adjuster License</p></li><li><p>
Currently reside within or have the ability to self-relocate to <b>The Woodlands, TX</b></p></li></ul><h2 class="jobSectionHeader"><b>
Physical Demand Requirements:</b></h2><ul><li><p>
May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces.</p></li><li><p>
May need to meet all USAA safe driving requirements including verification of driving record through MVR &amp; possession of valid driver&rsquo;s license.</p></li><li><p>
May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car.</p></li><li><p>
May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics.</p></li></ul><p></p><p><b>
Compensation range: </b>The salary range for this position is: $69,920.00 - $133,620.00.</p><p></p><p><b>
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.).</b></p><p><b>
Compensation:</b> 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.
</p><p></p><p>Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.</p><p></p><p>
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.</p><p></p><p><b>
Benefits:</b> 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.</p><p></p><p>
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com</p><p></p><p><i>
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.
</i></p><p></p><p><i>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.</i></p></div></div>

Property Adjuster Specialist - Field

Metropolitan Transit Authority of Harris County, Texas

<b>Requisition Number:</b><br>
7886
<br><br>
<b>Pay Rate:</b><br>
PGR11
<br><br>
<b>Location:</b><br>
Houston, TX, US
<br><br>
<b>Category:</b><br>
Public Safety
<br><br>
<b>Description:</b><br>
Basic Function
<br>Responsible for investigating and administering assigned Liability claims and when warranted pursue litigation and subrogation against third parties. Performs duties in a safe, efficient manner and in compliance with applicable rules and safety procedures. Responsibilities and Specific Duties
<br><br>
Investigates and administers liability claims of varying complexity including, bodily injury, first party auto, third party auto, first party property, and general liability.
<br><br>
Sets appropriate financial reserves and maintains adequate funding.
<br><br>
Sets appropriate diary date schedule according to claim milestones.
<br><br>
Takes recorded statements from involved parties and explains the Texas Tort Claims Act and procedures as needed.
<br><br>
Requests indexing of all injured parties through Insurance Services Office (ISO) and confirms eligibility for benefits through Centers for Medicaid & Medicare Services (CMS).
<br><br>
Requests damage appraisals, police reports, medical bills, medical reports and wage information.
<br><br>
Reviews facts, establishes liability, evaluates damages and negotiates appropriate settlements within the authority granted based upon all known facts.
<br><br>
Reports suspected fraudulent claim activities to the appropriate law enforcement agency, NICB or counsel for METRO.
<br><br>
Maintains contact with all parties regarding claims (i.e., repair vendors, appraisal vendors, doctors, claimants, and attorneys).
<br><br>
Coordinates investigation with Workers’ Compensation adjusters to avoid duplication of processes and subrogation pursuit.
<br><br>
May be required to represent METRO at mediations, depositions, pretrial hearings and other legal proceedings as deemed appropriate.
<br><br>
Provides any additional information requested by supervisors or lawyers relating to claims.
<br><br>
Reviews claim files on a daily diary basis and pursues subrogation.
<br><br>
Provides excellent customer service to METRO internal and external customers.
<br><br>
Applies Safety Management System (SMS) methods and principles in daily routine and supports all aspects of the agency’s Public Transportation Agency Safety Plan (PTASP).
<br><br>
Promotes safety awareness and follows safety procedures to reduce or eliminate accidents.
<br><br>
Performs other job-related duties as assigned.
<br><br>
<b>Pay Range:</b> $70,700 - $92,800 Education Requirement
<br>High school diploma or GED is required. Bachelor’s degree in Risk Management, Finance or Business Administration is preferred. Years & Experience Required
<br>Minimum five (5) years of progressively responsible liability claims and litigation claims management experience. Knowledge & Skills Required
<br>Excellent analytical skills in researching and reviewing negligence laws, traffic codes, accident reports, statements or interrogatories, medical bills, indexes and medical narratives. Good communications (written and verbal) skills. Must have an understanding of legal insurance defense, medical terminology, and functional knowledge of Texas Tort Claims Act and/or Texas Workers’ Compensation Act. Texas Insurance Adjusters license in one of these types: Texas Property and Casualty or a Texas All Lines license is required. Bilingual preferred. Additional Information
<br>The Metropolitan Transit Authority of Harris County, Texas has a zero-tolerance drug and alcohol policy for all employees. All internal and external applicants will be required to undergo drug testing before employment and will be subject to further drug and/or alcohol testing throughout their employment.
<br><br>
Further, employees who perform safety-sensitive functions will submit to drug and/or alcohol testing in accordance to the Department of Transportation (DOT) and the Federal Transit Administration (FTA) regulatory requirements.
<br><br>
We provide equal opportunity to all qualified individuals regardless of race, color, religion, age, sex, national origin, veteran status, genetic information or disability.
<br><br>
<b>Nearest Major Market:</b> Houston

Senior Claims Adjuster (Liability)

CCMSI

<div><h2 class="jobSectionHeader"><b>Overview
</b></h2><div><div><div><div><b>Claim Representative, Medical Only</b></div><div><b>
Location:</b> Houston, Texas</div><div><b>
Schedule: </b>8:00 am - 4:30pm (CST) - Hybrid Schedule after initial training period (2 days in- office per week)</div><div><b>
Salary Range: </b>$20-24/hour</div><p></p><div><b>
Build Your Career With Purpose at CCMSI</b></div><div></div><div><br>
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.</div><div></div><div><br>
We don&rsquo;t just process claims&mdash;we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified <i>Great Place to Work&reg;</i>, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.</div><div></div><div><b><br>
Job Summary</b></div><div></div><div><br>
Manages designated medical-only claims and supports claims staff, with opportunity for development and promotion to Medical Only Claim Representative II or Claim Associate I. Accountable for delivering quality claim services that meet CCMSI corporate standards and client expectations.</div><br>
<div></div>
</div></div></div><h2 class="jobSectionHeader"><b>Responsibilities
</b></h2><div><div><div><ul><li>Set up and manage medical files only in accordance with corporate claim standards and law.</li><li>
Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision.</li><li>
Review and approve related medical and miscellaneous invoices on designated claims. Negotiate any disputed bills/invoices for resolution under direct supervision.</li><li>
Request and monitor medical treatment of designated claims in accordance with corporate claim standards.</li><li>
Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim.</li><li>
Close claim files when appropriate.</li><li>
Retrieve closed claim files and re-file in storage, as requested.</li><li>
Provide support to claim staff on client service teams.</li><li>
Compliance with Corporate Claim Standards and special client handling instructions as established.</li><li>
Performs other duties as assigned.</li></ul>
</div></div></div><h2 class="jobSectionHeader"><b>Qualifications
</b></h2><div><div><div><div><b>Required:</b></div><ul><li>
Associate degree OR two (2) years of related business experience</li><li>
Ability to manage medical‑only claims cradle‑to‑grave</li><li><b>
Active Texas Adjuster License</b></li><li>
Strong attention to detail and organization skills</li><li>
Ability to follow established procedures and meet deadlines</li><li>
Proficiency with Microsoft Office (Word, Excel, Outlook)</li><li>
Strong written and verbal communication skills</li><li>
Reliable, predictable attendance during scheduled hours</li><li>
Ability to work in a fast‑paced, in‑office environment</li></ul><div><b>
Nice to Have:</b></div><ul><li>
Prior medical‑only or workers&rsquo; compensation claims experience</li><li>
Knowledge of medical terminology</li><li>
Experience working with multiple clients or industries</li><li>
Prior experience in a TPA environment</li><li><b>
Bilingual (Spanish)</b> Proficiency- Highly valued for communicating with claimant, employers, or vendors. Not required.</li></ul><h2 class="jobSectionHeader"><b>
Why You&rsquo;ll Love Working Here</b></h2><ul><li>4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year</li><li>Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance</li><li>Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)</li><li>Career growth: Internal training and advancement opportunities</li><li>Culture: A supportive, team‑based work environment</li></ul><h2 class="jobSectionHeader"><b>
How We Measure Success</b></h2><div>
At CCMSI, medical‑only claim professionals succeed through accuracy and consistency. Success in this role is measured by:</div><div><ul><li><br>
<b>Queue management</b> &ndash; timely handling of assigned medical‑only claims</li><li><b>Audit performance</b> &ndash; compliance with corporate standards and NM regulations</li><li><b>Accuracy &amp; documentation</b> &ndash; clear, complete, and timely claim notes</li><li><b>File progression</b> &ndash; appropriate reserve activity and timely claim closure</li><li><b>Team support &amp; reliability</b> &ndash; responsiveness and dependable in‑office attendance</li><li><b>Cultural alignment</b> &ndash; recognizing that every claim represents a real person</li></ul></div><div></div><div><b><br>
This is where we shine, and we hire claim professionals who want to shine with us.</b></div><div></div><div><b><i><br>
Compensation &amp; Compliance</i></b></div><div></div><div><i><br>
The posted salary reflects CCMSI&rsquo;s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.</i></div><div><i>
CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.</i></div><div></div><div><i><br>
CCMSI posts internal career opportunities in compliance with applicable state and local promotion transparency laws.</i></div><div></div><div><b><i><br>
Visa Sponsorship:</i></b><i> CCMSI does not provide visa sponsorship for this position.</i></div><div><b><i>
ADA Accommodations:</i></b><i> CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.</i></div><div><b><i>
Equal Opportunity Employer:</i></b><i> CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.</i></div><div></div><div><i><br>
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.</i></div><div></div><div><b><br>
Our Core Values</b></div><div>
At CCMSI, we believe in doing what&rsquo;s right&mdash;for our clients, our coworkers, and ourselves. We look for team members who:</div><div><b><br>
Lead with transparency</b> &ndash; We build trust by being open and listening intently in every interaction.<br>
<b>Perform with integrity</b> &ndash; We choose the right path, even when it is hard.<br>
<b>Chase excellence</b> &ndash; We set the bar high and measure our success. What gets measured gets done.<br>
<b>Own the outcome</b> &ndash; Every employee is an owner, treating every claim and decision as our own.<br>
<b>Win together</b> &ndash; Our greatest victories come when our clients succeed.</div><div></div><div><b><br>
We don&rsquo;t just work together&mdash;we grow together. If that sounds like your kind of workplace, we&rsquo;d love to meet you.</b></div><div></div><div><br>
#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA#MedicalOnlyClaims #WCClaims #ClaimsRepresentative #InsuranceJobs #WorkersCompensation #EntryLevelClaims #ClaimsCareers #TPACareers #HoustonJobs #TexasJobs #HealthcareClaims #HiringNow #IND123 #LI-Hybrid</div></div></div></div></div>

Claim Representative, Medical Only

<div>
 <strong>
  Why USAA?
  <br/>
  <br/>
 </strong>
 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 #1 choice for the military community and their families.
 <br/>
 <br/>
 Embrace a fulfilling career at USAA, where our core values &ndash; honesty, integrity, loyalty and service &ndash; define how we treat each other and our members. Be part of what truly makes us special and impactful.
 <br/>
 <br/>
 <strong>
  The Opportunity
  <br/>
  <br/>
 </strong>
 As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements in compliance with all state regulatory requirements.
 <br/>
 <br/>
 Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses within your locally assigned territory. Field Adjusters may travel outside of their local territory to respond to claims in other regions when needed. This is an hourly, non-exempt position with paid overtime available.
 <br/>
 <br/>
 This is a
 <strong>
  field-based
 </strong>
 role for
 <strong>
  The Woodlands, TX.
 </strong>
 Candidates currently living in this location or willing to self-relocate are encouraged to apply.
 <br/>
 <br/>
 <strong>
  What You'll Do
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability.
  </li>
  <li>
   Partners with vendors and internal business partners to facilitate complex claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance.
  </li>
  <li>
   Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics.
  </li>
  <li>
   Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies.
  </li>
  <li>
   Determines and negotiates complex claims settlement within authority limits. Develops recommendations and collaborates with management for determining settlement amounts outside of authority limits and accurately manages claims outcomes.
  </li>
  <li>
   Maintains accurate, thorough, and current claim file documentation throughout the claims process.
  </li>
  <li>
   Advance knowledge of estimating technology platforms and virtual inspection tools. Utilizes platforms and tools to prepare claims estimates to manage complex property insurance claims.
  </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>
   Works independently solving complex problems with minimal guidance; acts as a resource for colleagues with less experience.
  </li>
  <li>
   Adjusts complex claims with attorney involvement.
  </li>
  <li>
   Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations.
  </li>
  <li>
   May require travel to resolve claims, attend training, and conduct in-person inspections.
  </li>
  <li>
   Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What You Have
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   High School Diploma or General Equivalency Diploma required.
  </li>
  <li>
   2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
  </li>
  <li>
   Advanced knowledge of estimating losses using Xactimate or similar tools and platforms.
  </li>
  <li>
   Proficient knowledge of residential construction.
  </li>
  <li>
   Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations.
  </li>
  <li>
   Proficient negotiation, investigation, communication, and conflict resolution skills.
  </li>
  <li>
   Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills.
  </li>
  <li>
   Ability to travel 50-75% of the year (local &amp; non-local) and/or work catastrophe duty when needed.
  </li>
  <li>
   Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What Sets You Apart
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   US military experience through military service or a military spouse/domestic partner
  </li>
  <li>
   5 years of prior field experience handling higher severity/complex losses (i.e. vandalism, malicious mischief, foreclosures, earth movement, collapse, liability, etc.)
  </li>
  <li>
   Prior experience adjusting property claims using virtual technologies
  </li>
  <li>
   Prior property field adjuster experience handling DWG, APS and ALE adjustments
  </li>
  <li>
   Industry designations such as AINS, CPCU, AIC, SCLA (or actively pursuing)
  </li>
  <li>
   Xactimate Level 1 and/or Level 2 certification
  </li>
  <li>
   Prior deployments in support of catastrophes
  </li>
  <li>
   Currently hold an active Adjuster License
  </li>
  <li>
   Currently reside within or have the ability to self-relocate to The Woodlands, TX
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Physical Demand Requirements
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces.
  </li>
  <li>
   May need to meet all USAA safe driving requirements including verification of driving record through MVR &amp; possession of valid driver&rsquo;s license.
  </li>
  <li>
   May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car.
  </li>
  <li>
   May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Compensation range:
 </strong>
 The salary range for this position is: $69,920.00 - $133,620.00.
 <br/>
 <br/>
 <strong>
  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.).
  <br/>
  <br/>
 </strong>
 <strong>
  Compensation:
 </strong>
 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.
 <br/>
 <br/>
 Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
 <br/>
 <br/>
 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.
 <br/>
 <br/>
 <strong>
  Benefits:
 </strong>
 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.
 <br/>
 <br/>
 For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
 <br/>
 <br/>
 <em>
  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.
  <br/>
  <br/>
 </em>
 <em>
  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.
 </em>
</div>


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