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bodily injury adjuster - litigation & homeowner liability - national general Jobs in New York

claims specialist professional liability

Great American Insurance Group

<div><p><b>Be Here. Be Great. </b>Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a &quot;small company&quot; culture where your ideas will be heard with &quot;big company&quot; expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.</p><p></p><p>
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.</p><p></p><p>
Great American&rsquo;s Professional Liability Division offers both medical and non-medical service providers protection from claims alleging an act, error, or omission by the firm, its staff, or contractors working on its behalf. The Division recognizes that every industry has unique needs and develops customized coverage solutions for specific professional liability exposures.</p><p></p><p>
https://www.greatamericaninsurancegroup.com/about-us/businessoperations/division/professional-liability</p><p></p><p>
The Professional Liability Division is seeking a Financial Products Claims Specialist to handle a diverse portfolio of claims, including Miscellaneous Professional Liability, Lawyers Excess Professional Liability, Canadian Professional Liability, and Telehealth and Miscellaneous Medical Professional Liability matters. This position is fully remote.</p><p></p><p><b>
Essential Job Functions and Responsibilities</b></p><ul><li>
Manages a large inventory of complex primary and excess professional liability claims across the U.S. and Canada.</li><li>
Plans and conducts complex claims investigations to confirm coverage and to determine liability, compensability and damages.</li><li>
Retains and directs approved consultants and outside counsel. Responsible for maintaining cost controls and overseeing the work of outside counsel.</li><li>
Analyzes and negotiates appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials.</li><li>
Determines available avenues of recovery and/or risk transfer opportunities, and their cost-effectiveness.</li><li>
Conveys complex information regarding coverage and settlements to insureds, claimants, and external partners.</li><li>
Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner.</li><li>
Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements.</li><li>
May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports.</li><li>
As directed, may assist Underwriting, Marketing, Risk Management, and Loss Prevention with projects, including evaluating potential new business.</li><li>
Performs other duties as assigned.</li></ul><p><b>
Job Requirements</b></p><ul><li><b>
Education: </b>Bachelor&rsquo;s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience.</li><li><b>
Experience: </b>Generally, a minimum of 9 years of experience in property and casualty claims handling. Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC). May possess LLM (Master's of Law) or JD (Juris Doctorate) and current attorney license with 2 to 4 years of post-bar experience.</li><li><b>
Scope of Job/Qualifications: </b>Works within broad limits and authority on assignments of the highest technical complexity, requiring specialized knowledge. Demonstrates excellent analytical, negotiation, and problem-solving skills. Maintains strong knowledge of insurance policies, coverage, and claims handling procedures. Maintains knowledge of industry laws and regulations. Advanced ability to organize and prioritize caseloads, ensuring timely resolution of claims. Excellent interpersonal and communication skills with the ability to build relationships and lead negotiations. Proven ability to handle confidential information with discretion. Viewed as a senior resource within the Claims department and/or organization.</li></ul><p></p><p><b>
Business Unit:</b></p>
Professional Liability<p></p><p><b><br>
Salary Range:</b></p>
$92,000.00 -$125,000.00<p></p><p><b>
Benefits:</b></p><p>
We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.</p><p></p><p><br>
Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.</p><p></p><ul><li><br>
<b>Excludes seasonal employees and interns.</b></li></ul></div>

Claims Specialist - Professional Liability

National General Insurance

<div><p>National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers&rsquo; evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.</p><p></p><p><b>
Job Description</b></p>
Responsible for investigating and confirming the facts of loss for the most complex automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Mentors and provides direction to junior employees.<p></p><p><b>
We&rsquo;re looking for a skilled Bodily Injury Litigation Adjuster with Homeowner Liability or Commercial General Liability experience to join our team! In this role, you&rsquo;ll manage complex injury claims, including fractures, bilateral fractures, fatalities etc. We&rsquo;re open to candidates located in Eastern or Central time zones who are eager to make an impact and grow their career in both Bodily Injury Litigation and Homeowner Liability.
</b></p><p></p><h3 class="jobSectionHeader"><b>Key Responsibilities</b></h3><ul><li>Recognizes and identifies body parts of a vehicle or understanding other potential property damage</li><li>Identifies customer needs and works to meet those needs using appropriate customer service skills</li><li>Determines subrogation or fraud potential and how to handle for the most complex cases</li><li>Applies advanced understanding of insurance policies written by the company, the industry, and organizational relationships within the company and department</li><li>Recommends process improvements</li><li>Applies increased experience in the Sr Adjuster level or a rotation into a specialty position (Coverage, Investigation Specialist, Total Loss, Initial Handler, Extended Handler, Litigation, etc.)</li><li>For claims involving injuries (if handled), learns how to review, evaluate, and negotiate moderate to complex/Catastrophic injury claims</li><li>Handles investigation regarding all aspects of the most complex auto claims (coverage, liability and damages) with the exercise discretion and independence within increased level of authority</li></ul><p></p><h3 class="jobSectionHeader"><b>
Experience</b></h3><ul><li>3 or more years of experience (Preferred)</li></ul><p></p><h3 class="jobSectionHeader"><b>
Supervisory Responsibilities</b></h3><ul><li>This job does not have supervisory duties.</li></ul><p></p><h3 class="jobSectionHeader"><b>
#LI-KR1</b></h3><p></p><p><b><br>
Skills</b></p>
Auto Insurance Claims, Automobile Accidents, Case Management, Casualty Insurance, Claims Administration, Claims Litigation, Claims Resolution, Claims Review, Commercial General Liability Insurance, Commercial Liability, Complex Claims, Fractures, General Liability Claims, General Liability Insurance, Homeowners Claims, Homeowners Insurance, Homeowners Insurance Claims, Insurance Claim Handling, Insurance Policies, Liability Insurance, Litigation, Negotiation, Personal Injury Claims, Property Damage, Relationship Management<p></p><p><b><br>
Compensation</b></p><p>
Base compensation offered for this role is:</p><p></p><p>
Adjuster Cons II: $56,000 - $82,500</p><p>
Adjuster Sr Cons I: $68,500 - $104,100</p><p>
Adjuster Sr Cons II: $68,500 - $105,140</p><p></p><p>
And is based on experience and qualifications. Total compensation for this role is comprised of several factors, including the base compensation outlined above, plus incentive pay (i.e. commission, bonus, etc.) if applicable for the role.</p><p><b>
Joining our team isn&rsquo;t just a job &mdash; it&rsquo;s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger &ndash; a winning team making a meaningful impact.</b></p><p></p><p>
Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.</p><p></p><p>
For jobs in San Francisco, please click &ldquo;here&rdquo; for information regarding the San Francisco Fair Chance Ordinance.</p><p><br>
For jobs in Los Angeles, please click &ldquo;here&rdquo; for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance.</p><p></p><p>
To view the &ldquo;EEO Know Your Rights&rdquo; poster click &ldquo;here&rdquo;. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs.</p><p></p><p>
To view the FMLA poster, click &ldquo;here&rdquo;. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.</p><p></p><p>
It is the Company&rsquo;s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee&rsquo;s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.</p><p></p><p>
National General Holdings Corp., a member of the Allstate family of companies, is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A&ndash; (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.</p><p></p><p><b>
Companies &amp; Partners</b></p><p></p><p>
Direct General Auto &amp; Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.</p><p></p><p><b>
Benefits</b></p><p></p><p>
National General Holdings Corp. is an Equal Opportunity (EO) employer &ndash; Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas. In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at (336) 435-2000.</p></div>

Bodily Injury Adjuster - Litigation & Homeowner Liability - National General

Arch Capital

<div><div>With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.</div><div></div><div><b>
Position Summary</b></div><div>
Arch Insurance Group, AIGI, is looking for an experienced claims professional to join its Major Case Unit as a Complex Claims and Coverage Specialist. This position will focus primarily on claims from our Programs, National Accounts, Alternative Markets, and Construction Business Units. In this role you will deal with sophisticated litigation and complex coverage issues, including long-tail bodily injury exposures, claims arising under Coverage B of Primary/Excess CGL policies, as well as environmental and toxic tort claims. You will handle claims involving Multi-District Litigation, Class Action lawsuits, complex coverage matters, claims against the company and Insurance Department Complaints. The successful candidate will have significant coverage experience as well as GL (Bodily Injury and Property Damage) and Auto Liability complex/large exposure claim handling experience, a passion for achieving excellent claim results and for delivering exceptional customer service. Responsibilities include, actively managing large exposure and complex general/auto liability claims (primary, umbrella and excess) handled by Third-party Administrators (&ldquo;TPA&rsquo;s&rdquo;) and supporting Arch business stakeholders. The successful candidate will work closely with the Arch Legal Department on a variety of matters.</div><div></div><div><b>
Responsibilities</b></div><ul><li>
Deliver industry leading technical claim handling/management, claim outcomes, business support and customer service. Make claim services an Arch competitive advantage.</li><li>
Collaborate with TPA team members, Arch Claim Account Managers (&ldquo;CAM&rsquo;s&rdquo;) and other claim professionals to proactively develop and effectively execute on appropriate claim resolution strategies</li><li>
Work closely with underwriters, Legal, Operations, claim professionals, and other Arch functions, to ensure timely and effective communication consistent with Arch Claims&rsquo; Procedures; striving to achieve optimum claim outcomes.</li><li>
Effective and timely communication with insureds and brokers; making exceptional customer service a top priority</li><li>
Coverage analysis, investigation, liability and damage evaluation, timely and accurate indemnity and expense reserving (within specific granted authority), litigation management, vendor management, settlement negotiations, including use of structure settlements where appropriate, and claim resolution</li><li>
Effective claim file documentation, claim coding and diary management</li><li>
Retain and work closely with defense and coverage counsel to create and execute on litigation/coverage strategies and budgets. Analyze and pay legal bills, consistent with claims specific strategy/budget and Arch Claims Litigation Management Guidelines</li><li>
Effective and timely claim reporting (verbal and written) to other claim professionals/management and business stakeholders, per Arch Claims Procedures</li><li>
Attend mediations, trials, other proceedings and meetings</li><li>
Assist CAM&rsquo;s and others with TPA management and oversight to include:<ul><li>
TPA claim staff training relating to Arch processes, procedures, expectations, reporting, technical claim handling, litigation/vendor management, legal/regulatory developments, customer service and other topics that may arise</li><li>
Sharing of claim handling/customer service best practices</li><li>
Assistance with claim file reviews and claim audits</li><li>
Regular meetings with TPA claims staff</li></ul></li><li>
Maintain all required state adjustor licenses</li></ul><div></div><div><b>
Qualifications</b></div><ul><li>
Minimum of 10 years&rsquo; commercial general/auto liability claim handling experience, including responsibility for complex and large exposure claims or insurance defense/coverage practicing attorney with similar law firm experience</li><li>
Significant experience handling claims involving contractual risk transfer, including making and responding to contractual indemnity and Additional Insured tenders</li><li>
TPA management/oversight experience is a plus</li><li>
Excellent customer service skills and service minded</li><li>
Strong analytical and problem-solving skills</li><li>
Strong negotiation skills</li><li>
Exceptional communication (written and verbal), collaboration, influencing, listening, and interpersonal skills to effectively develop productive working relationships both within and outside Arch</li><li>
Demonstrated ability to process large amounts of complex information, distill it down to key issues and decision points and concisely communicate the information verbally and in writing</li><li>
Demonstrated ability to effectively lead strategic discussions and leverage technical knowledge to make sound, cost-effective decisions and recommendations</li><li>
Demonstrated ability to work well independently and in a highly collaborative team environment</li><li>
Adaptable and able to succeed in a rapidly changing environment</li><li>
Strong Microsoft Excel, PowerPoint and Word skills</li><li>
Willing and able to travel up to approximately 10-15% of time</li><li>
This will be a hybrid role in office 3 days a week</li></ul><div></div><div><b>
Education</b></div><ul><li>
Juris Doctorate required</li></ul><div></div><div>
#LI-SW1</div><div>
#LI-HYBRID</div><div></div><div>
For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.</div><div></div><div>
$145,700 - $175,000/year</div><ul><li><div>
Total individual compensation (base salary, short &amp; long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope &amp; responsibilities of the role, qualifications, talent availability &amp; specialization as well as business needs. The above pay range may be modified in the future.</div></li><li><div>
Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&amp;D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click <div>here</div> to learn more on available benefits.</div></li></ul><div></div><div><br>
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn&rsquo;t the right fit but you&rsquo;re interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our <div>talent community</div> to share your preferences directly with Arch&rsquo;s Talent Acquisition team.</div><div></div>
14400 Arch Insurance Group Inc.</div>

Complex Claims and Coverage Specialist

USAA

<div><b>Location</b> New York, New York
<div><div><div><b>Job ID</b></div><div>
R0116375</div></div>
<div><div><b>Date posted</b></div><div>
03/27/2026</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><div><p>
As a dedicated Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory requirements. You will recognize and empathize with members&rsquo; life events, as appropriate.</p><p></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></p><p>
This is a <b>field-based role in the New York City area</b>. Candidates who are willing and able to work in this area are encouraged to apply.</p></div><p></p><p><b>
What you'll do:</b></p><div><div><div><div><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><p></p><p><b>
What you have:</b></p><ul><li><p>
High School Diploma or General Equivalency Diploma.</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><li><p>
Successful completion of a job-related assessment may be required.</p></li></ul><p></p><p><b>
What sets you apart:</b></p><ul><li><p>
Hands-on experience in the field handling high-severity and complex property claims such as fire, water damage, vandalism, malicious mischief, foreclosures, earth movement, collapse, and liability.</p></li><li><p>
Residential property field adjusting experience with dwelling, structure and additional living expenses.</p></li><li><p>
Experience working directly for a standard insurance carrier handling claims from start to finish (first notice of loss, reviewing policy, making coverage decisions)</p></li><li><p>
Proficient in using estimating platforms and virtual inspection tools like Xactimate, ClaimXperience and XactAnalysis</p></li><li><p>
Insurance industry designations such as AINS (Associate in General Insurance), CPCU (Chartered Property Casualty Underwriter), AIC (Associate in Claims), or SCLA (Senior Claims Law Associate) or actively pursuing</p></li><li><p>
Active Property &amp; Casualty adjuster license</p></li><li><p>
Currently reside in the New York City area, enabling quicker response times for local claims and a better understanding of regional risks</p></li><li><p>
US military experience through military service or a military spouse/domestic partner</p></li></ul><p></p><p><b>
Physical Demand Requirements:</b></p><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: $85,050 - $130,410.</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></div></div></div></div><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

MetroPlusHealth

<div><p><b>Job Ref: </b>133786<br>
<b>Category: </b>Claims<br>
<b>Department: </b>CLAIMS<br>
<b>Location: </b>50 Water Street, 7th Floor, New York, NY 10004
<br>
<b>Job Type: </b>Regular<br>
<b>Employment Type: </b>Full-Time<br>
<b>Salary Range: </b>$48,791.00 - $50,593.00<br>
</p><p></p><div><h2 class="jobSectionHeader"><b>Empower. Unite. Care.</b></h2><p><b>
MetroPlusHealth</b> is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.</p><div><div><div><h2 class="jobSectionHeader"><b>
About NYC Health + Hospitals</b></h2><div><div><p>
MetroPlus<b>Health</b> provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus<b>Health</b>'s network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlus<b>Health</b> has been committed to building strong relationships with its members and providers.</p><p><b>
Position Overview</b></p><p>
As a Claims Adjustment Specialist I, this individual will be responsible for analyzing standard to complex post-paid healthcare claims that require in depth research to determine accuracy and mitigate payment errors. The Claims Adjustment Specialist I will also be responsible for adjusting medical claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position will be responsible for responding to inquiries from providers whose claims may be paid incorrectly and performing accurate data entry and maintenance accurate records and files.</p></div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Work Shifts</b></h2><div><div><p><b>
7:00 A.M &ndash; 3:30 P.M</b><br>
<b>8:00 A.M &ndash; 4:00 P.M</b><br>
<b>8:30 A.M &ndash; 4:30 P.M</b><br>
<b>9:00 A.M &ndash; 5:00 P.M</b><br>
<b>10:00 A.M &ndash; 6:00 P.M</b></p></div></div></div></div><div><div><h2 class="jobSectionHeader"><b><br>
Duties &amp; Responsibilities</b></h2><div><div><ul><li>
Research and analyze medical claims adjustment requests along with related documentation to determine payment accuracy and adjust/adjudicate as needed using multiple systems and platforms.</li><li>
Ensure that the proper payment guidelines are applied to each claim by using the appropriate tools, processes, and procedures (e.g., claims processing P&amp;P&rsquo;s, grievance procedures, state mandates, CMS/Medicare/Medicaid guidelines, benefit plans, etc.)</li><li>
Research claims that may have paid incorrectly and communicate findings for adjustment; Adjust claims based on findings (i.e., correct coding, rates of reimbursement, authorizations, contracted amounts etc.) ensuring that all relevant information is considered.</li><li>
Advise business partners of findings outcome if their input is needed to help fix the issue.</li><li>
Communicate through correspondence with providers regarding claim payment or additional required information in a clear and concise manner.</li><li>
Process the adjustment of claims in a timely manner, according to established timelines.</li><li>
Remain current with changes/updates in claims processing, as well as updates to coding systems.</li><li>
Maintain accurate records of all claims processed, including notes on actions taken.</li><li>
Generate reports on claim activity as requested.</li><li>
Respond to audits of claims processed.</li><li>
Able to work independently and exercise good judgment<br>
</li></ul></div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Minimum Qualifications</b></h2><div><div><ul><li>
High School Degree or evidence of having passed a High School Equivalency Program required. Associate degree preferred.</li><li>
Minimum 2 years of claims operations experience in a healthcare field, with knowledge of integrated claims processing required.</li><li>
Experience using a PC and claim adjudication system(s)</li><li>
Experience using Customer Relationship Management (CRM) software; Salesforce is a plus.</li><li>
Experience working with large data and spreadsheets.</li><li>
Knowledge of medical terminology, CPT, ICD-10, and Revenue Codes</li><li>
Processing of Medical Claim Forms (HCFA, UB04)</li><li>
Knowledge of Medical Terminology</li><li>
Knowledge of HIPPA Guidelines regarding Protected Health Information</li><li>
Data Entry of Provider Claim/Billing information</li><li>
Experience handling or familiarity with Medical Claim inquiries from provider sites personnel including physicians, clinical staff, and site administrators.</li></ul><p><b>
Professional Competencies</b></p><ul><li>
Integrity and Trust</li><li>
Customer Focus</li><li>
Functional/Technical skills</li><li>
Written/Oral Communication</li><li>
Strong Analytical Skills</li><li>
Knowledgeable in MS Word and Excel</li></ul><p>
#LI-Hybrid</p><p>
#MHP50</p></div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Benefits</b></h2><div><div><p>
NYC Health and Hospitals offers a competitive benefits package that includes:</p><ul><li>
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week</li><li>
Retirement Savings and Pension Plans</li><li>
Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts</li><li>
Loan Forgiveness Programs for eligible employees</li><li>
College tuition discounts and professional development opportunities</li><li>
College Savings Program</li><li>
Union Benefits for eligible titles</li><li>
Multiple employee discounts programs</li><li>
Commuter Benefits Programs</li></ul></div></div></div></div></div></div></div><p></p>

Claims Adjustment Specialist I

Transatlantic Reinsurance

<p></p><div><p><b>About Us</b></p><div><div><div><div><p>
Since 1977 we have delivered first class solutions to insurers worldwide, by combining global reach with local decision making. We have built customer &amp; broker relationships on years of trust, experience and execution. Through our people, our products and our partnerships, we deliver the capacity and expertise necessary to contribute to the sustainable growth of prosperous communities worldwide. To do so, our colleagues work with:
</p><p></p><p><b>Integrity</b> Work honestly, to enhance TransRe&rsquo;s reputation</p><p><b>
Respect</b> Value all colleagues. Collaborate actively.</p><p><b>
Performance</b> We reward excellence. Be accountable, manage risk and deliver TransRe&rsquo;s strengths</p><p><b>
Entrepreneurship</b> Seize opportunities. Innovate for and with customers.</p><p><b>
Customer Focus</b> Anticipate their priorities. Exceed their expectations.</p></div></div></div></div><p></p><p>
We have the following job opportunity in our <b>New York City</b> office:</p><p><b><br>
Description</b></p><p></p><p>
We are seeking an experienced reinsurance claims examiner to manage a portfolio of Directors &amp; Officers (D&amp;O) and Errors &amp; Omissions (E&amp;O) claims in our New York City office. This position is a great opportunity for experienced claims examiner to assume responsibility for a significant book of business. Responsibilities will include, but not be limited to:</p><ul><li>
Analyzing and determining coverage for complex D&amp;O, E&amp;O, and professional liability reinsurance claims, including interpreting treaties and facultative certificates and evaluating allocation, limits, exclusions, and extra-contractual exposures.</li><li>
Reviewing underlying policies, pleadings, and claim documentation to assess coverage triggers and overall claim exposure.</li><li>
Managing the full lifecycle of claims, including establishing and maintaining reserves and overseeing financial transactions in accordance with contract terms and internal guidelines.</li><li>
Reviewing and processing cedant reporting (e.g., bordereaux, advices, cash calls), ensuring accuracy, completeness, and proper application of reinsurance agreements.</li><li>
Monitoring claim developments and adjusting strategies and reserves as appropriate.</li><li>
Preparing clear and concise claim summaries, large loss reports, and management updates to support internal and external stakeholders.</li><li>
Conducting cedant audits and portfolio reviews, identifying trends, emerging risks, and reserving issues, and providing actionable insights to underwriting and claims leadership.</li><li>
Partnering with cedants, brokers, underwriters, actuaries, and finance teams to resolve complex claim issues and deliver insights that inform underwriting strategy and portfolio management.</li><li>
Supporting broader portfolio initiatives and monitoring industry trends and regulatory developments.</li></ul><p></p><p><b>
Requirements</b></p><ul><li>
5+ years of (re)insurance D&amp;O and E&amp;O claims handling experience, treaty and facultative</li><li>
JD degree is strongly preferred</li><li>
Strong analytical and writing skills</li><li>
Ability to work well independently and within a team</li><li>
Ability to travel as needed for claims audits and industry events</li></ul><p><b><br>
Work Schedule</b></p><p>
TransRe is supportive of an agile work schedule, which may differ based on individual roles, your local office&rsquo;s practices and preferences marketplace trends, and TransRe&rsquo;s business objectives. This position is located in our New York City office and is eligible for a hybrid work schedule with 3 days in the office per week, and 2 days remote.</p><p></p><p><b>
Compensation</b></p><p>
In addition to base salary, for this position, TransRe offers a comprehensive benefits package, paid time off, and incentive pay opportunity. The anticipated annual base salary range in New York for this position, exclusive of benefits, paid time off, and incentive pay opportunity is $120,000 &ndash; $200,000. This range is an estimate and the actual base salary offered for this position will be determined based on certain factors, including the applicant&rsquo;s specific skill set and level of experience.</p><p></p><p>
We are an Equal Opportunity Employer (EOE) and we support diversity in the workforce.</p></div>

D&O / E&O Complex Claims Examiner

Liberty Mutual Insurance

<div><b>Description
</b><div><p>In today's rapidly evolving cyber landscape, our insureds face increasingly complex threats from ransomware and business email compromise to large‑scale data breaches. As a <b>Cyber Claim Officer</b>, you will manage high‑exposure, often time‑sensitive matters, working closely with breach coaches, forensic investigators, underwriters, actuaries and cybersecurity experts. You will play a critical role in helping organizations respond to emergent cyber incidents and privacy, media and technology errors &amp; omissions litigation, ensuring a confident and coordinated response, and shaping best practices in our cyber claims strategy. This is a high‑impact opportunity for someone who thrives on novel issues, technical complexity, fast‑moving incidents, and collaborative problem‑solving.</p><p></p><p><b><br>
Responsibilities</b></p><ul><li>
Analyzes, investigates, and evaluates cyber, media and technology‑related losses to determine coverage, exposure, and appropriate claim disposition.</li><li>
Utilizes CMS to document claims, track activity, and maintain accurate diary follow‑ups.</li><li>
Establishes and monitors indemnity and expense reserves within assigned authority, ensuring accuracy and adequacy throughout the claim lifecycle.</li><li>
Makes recommendations for reserves on claims outside of authority level.</li><li>
Prepares clear and comprehensive reports for management, underwriting, and other stakeholders.</li><li>
Identifies and communicates emerging cyber‑specific claim trends, threat vectors, and policy issues to management and underwriting.</li><li>
Manages litigation involving cyber, media, privacy, and technology‑related matters through strategic oversight of counsel.</li><li>
Adheres to line‑of‑business litigation guidelines, including budgeting, bill review, and payment processing.</li><li>
Proactively manages the full claim lifecycle from first notice through resolution, ensuring timely, strategic progression.</li><li>
Actively participates in mediations, arbitrations, and settlement negotiations within assigned settlement authority.</li><li>
Participates in internal and external claims audit processes.</li><li>
Provides claims‑focused marketing support by meeting with brokers, risk managers, and reinsurers.</li><li>
Maintains required adjuster licenses across jurisdictions.</li></ul><p><b>
Additional Cyber‑Specific Responsibilities Added:</b></p><ul><li>
Coordinates incident response activities with breach coaches, forensic firms, crisis‑communications teams, and cybersecurity vendors during active cyber events.</li><li>
Evaluates forensic findings (e.g., Digital Forensics and Incident Response (DFIR), Forensic Accounting) and integrates conclusions into coverage and liability decisions.</li><li>
Advises insureds on recovery strategies, including business interruption documentation, data restoration processes, and post‑incident cyber‑hygiene improvements.</li><li>
Engages in thought leadership such as panel presentations, white papers, conference attendance, etc.</li></ul><p></p><p><b><br>
You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Westborough, MA; Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Chandler, AZ; Las Vegas, NV; Plano, TX; or Suwanee, GA. Please note this policy is subject to change</b></p></div><b>
Qualifications</b><div><ul><li>
Bachelors' and/or advanced degree</li><li>
10 + years claims experience, with at least 5 years within a technical specialty</li><li>
Highly advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge</li><li>
Functional knowledge of law and insurance regulations in various jurisdictions</li><li>
Demonstrated superior verbal and written communications skills</li><li>
Highest level of advanced analytical, decision making and negotiation skills</li></ul></div><b>
About Us</b><p><b>
Pay Philosophy:</b> The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.<br>
<br>
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.<br>
<br>
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://LMI.co/Benefits<br>
<br>
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.<br>
<br>
<b>Fair Chance Notices</b></p><ul><li>
California</li><li>
Los Angeles Incorporated</li><li>
Los Angeles Unincorporated</li><li>
Philadelphia</li><li>
San Francisco</li></ul></div>

Cyber Claims Officer

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