Claims Adjusters, Examiners, and Investigators

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**

As the **Claims Supervisor** you will be supervising claims processors 12+ and will oversee daily quality and inventory of claims for efficiency and accuracy to meet compliance. Claims that are being processed are claims that a member did not use their benefits for at pharmacy. You will also be tracking inventory, monitor active inventory to confirm claims are moving through the process that should be on average 5 claims per hour and will be assigned claims depending on the type of claim that are worked will be about 5 per hour. Any errors you will research to determine the error and work the claims processor to make correct to resubmit.

Claims Supervisor in this function will oversee daily claims inventory to ensure Medicare Part D timeliness compliance is maintained as well as appropriate turnaround time of claims processing for performance guarantees. The supervisor will provide expertise or general claims support to team in reviewing, researching, investigating processing claims. They will support short and long term operational/strategic business activities – by enhancing and maintaining operation information and models. They also develop and implement effective business solutions through research and analysis of data and claims/business processes.

This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime.

We offer 4-6 weeks of on-the-job training. The hours of the training will be aligned with your schedule. **Training will be conducted virtually from your home.**

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

**Primary Responsibilities:**

+ Conducts analysis, identifies trends, and provides direction to overall team.

+ Daily oversight of Claims inventory

+ Ensures that proper benefits are applied to every claim.

+ Applies appropriate processes and procedures to process claims (e.g., claims processing policies and procedures, state mandates, CMS/Medicare guidelines, benefit plan directives).

+ Manage audits, including training of team members.

+ Manages claim(s) escalations. Resolve or address new or unusual claims errors/issues as they arise, applying appropriate knowledge or prior experience.

+ Identifies/develops/implements new claims processes procedures/solutions as needed, and documents appropriately for future use (e.g., non-standard situations, special handling requirements).

+ Identify training opportunities among staff members and implement training and operational synergies.

+ Collaborate with internal or external business partners to resolve claims errors/issues along with operational partners to help improve claims processing workflows and efficiencies.

+ Participates on strategic initiatives related to manual claim processing to knowledge share, test new processes, and ensures staff is trained to support.

+ Conduct Team 1:1’s and annual performance review

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

**Required Qualifications:**

+ High School Diploma / GED OR equivalent years of work experience

+ Must be 18 years of age OR older

+ 1+ years of leadership and or subject matter expert

+ 3+ years of PBM OR Healthplan experience

+ Experience proficiency using Microsoft Word (create and / OR edit docs, sending correspondence), Excel (updating reports, spreadsheets, ability to create and / OR edit, basic formulas, sorting, filtering), PowerPoint (create and / OR edit presentations), Outlook (email, scheduling meetings)

+ Ability to work full time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime.

**Preferred Qualifications:**

+ Managing daily task of others (training, coaching, mentoring)

+ Retail pharmacy experience.

+ RxClaim system experience

**Telecommuting Requirements:**

+ Ability to keep all company sensitive documents secure (if applicable)

+ Required to have a dedicated work area established that is separated from other living areas and provides information privacy.

+ Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

**Soft Skills:**

+ Excellent customer service

+ Ability to influence and negotiate through use of verbal, written, and interpersonal means with a diverse group of people/disciplines at all levels of an organization.

+ Problem solving, propose, and implement solutions.

+ Time management skills and ability to multi-task and prioritize work.

+ Written and verbal communication skills

+ Ability to work in a complex fast-paced environment, flexible and adaptable to changing situations, and a strong commitment to teamwork.

+ Ability to remain calm in stressful situations and to always display professional conduct.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $48,700 - $87,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

**_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._

_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission._

_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._

_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

\#RPO

Property Claims Adjuster I - CL09CN

We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.

Sustaining The Hartford’s unique workplace culture is vital to delivering on our purpose – underwriting human achievement – and continuously producing outstanding results. Our enterprise work model, which reflects a mix of in-office, hybrid and fully remote roles, helps us attract, retain and develop the talent we need to achieve the company’s strategic goals. This role can be performed in either a hybrid or remote work arrangement.

At The Hartford, we respect our employees for their unique perspectives, ideas and solutions. We empower individuals and teams to invent faster, smarter ways of meeting customers’ needs while improving our performance. Character and customer value are just as vital to our reputation as financial performance which leads to behaviors that put the customer at the center of everything we do.

Class Start Date: 9/22/25

Training Period (no time off): 9/22/25 to 12/19/25

In person training week of 12/8/25

This position will be accountable for successfully investigating, reserving, assigning and settling first party property losses while delivering superior customer service.

The ideal candidate will operate in the full file model and handle all claims by selecting the proper estimating resource to adjudicate the claim.

This position will ensure quality standards are met with vendors utilized to adjudicate the claim.

Claim File Management

+ Handle claim files in a manner consistent with Claim quality standards and goals.

+ Negotiate skillfully in challenging situations with internal and external groups.

+ Make independent business decisions to move claims forward as needed.

+ Consistently provide high-quality customer service

+ Meet or exceed expectations and requirements of internal and external customers.

+ Properly assess the exposure of assigned claims.

+ Utilize organization and communication skills to effectively resolve assignments, manage claim deadlines, and appropriately manage vendors.

+ Develop technical and jurisdictional expertise, including knowledge of independent adjusters, contractors, vendors, etc.

+ Set appropriate and timely file reserves.

+ Identify and properly manage subrogation, salvage and other recovery opportunities.

+ Identify fraud indicators and initiate investigation.

+ Always demonstrate professionalism and establish credibility when interacting with customers; personally enhance The Hartford’s reputation in the marketplace.

Business Acumen and Technical Expertise

+ Demonstrate knowledge of LOB specific competencies to ensure effective management of claims.

+ Utilize verbal and numerical critical thinking skills to gather information and data; make sound decisions based upon the mixture of analysis, wisdom, experience and judgment.

+ Ability to communicate in a clear succinct manner (written and verbal).

Teamwork and Team Building

+ Support and help create a team environment that achieves diversity and inclusion behaviors.

+ Build appropriate rapport and constructive and effective relationships with people inside and outside the organization.

+ Represent The Hartford as a credible, trustworthy, flexible and dependable resource.

+ Demonstrate courtesy, honesty, integrity, respect and competence when interacting with others.

+ Consistently act with the highest level of integrity and adhere to general principles of business ethics.

Qualifications:

+ College Degree or Equivalent work experience (insurance, construction, military) preferred.

+ Minimum of 1 year of customer service experience, applicable insurance knowledge is a plus.

+ Ability to handle complex and difficult negotiations with urgency.

+ Ability to handle competing priorities while positively impacting the quality and service we are committed to delivering.

+ Superior desk management skills required.

+ Critical thinking skills inclusive of investigation, decision making and conflict resolution.

+ Ability to contribute and promote an inclusive culture of continuous learning that is built on teamwork, collaboration, transparency, and accountability to one another.

+ Passionate desire to help both internal and external customers.

+ Ability to embrace change and flourish with industry-changing technology and trends.

+ Ability to create and maintain loyal customers by creating a service experience that differentiates us within the industry.

+ Ability to listen attentively to our customer’s needs and exhibit empathy during difficult situations.

+ Ability to produce clear and grammatically accurate correspondence.

ADDITIONAL INFORMATION:

+ You will be required to successfully complete a multi-week New Hire Training Course.

+ Required to pass an Adjuster's State Licensing test within 30 days of post training lab

+ Must be available for the multi-week training from September 22, 2025 - December 19th, 2025.

+ Training will likely include 1 week of travel to the Chicago area (Naperville, IL) for an in-person learning lab the week of December 8th, 2025.

+ This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Scottsdale, AZ, a Naperville, IL) will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise.

Compensation

The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford’s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:

$51,440 - $77,160

Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

About Us (https://www.thehartford.com/about-us) | Our Culture (https://www.thehartford.com/about-us/corporate-culture) | What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees) | Perks & Benefits (https://www.thehartford.com/careers/benefits)

Every day, a day to do right.

Showing up for people isn’t just what we do. It’s who we are – and have been for more than 200 years. We’re devoted to finding innovative ways to serve our customers, communities and employees—continually asking ourselves what more we can do.

Is our policy language as simple and inclusive as it can be? Can we better help businesses navigate our ever-changing world? What else can we do to destigmatize mental health in the workplace? Can we make our communities more equitable?

That we can rise to the challenge of these questions is due in no small part to our company values that our employees have shaped and defined.

And while how we contribute looks different for each of us, it’s these values that drive all of us to do more and to do better every day.

About Us (https://www.thehartford.com/about-us)

Our Culture

What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees)

Perks & Benefits (https://www.thehartford.com/careers/benefits)

Legal Notice (https://www.thehartford.com/legal-notice)

Accessibility StatementProducer Compensation (https://www.thehartford.com/producer-compensation)

EEO

Privacy Policy (https://www.thehartford.com/online-privacy-policy)

California Privacy Policy

Your California Privacy Choices (https://www.thehartford.com/data-privacy-opt-out-form)

International Privacy Policy

Canadian Privacy Policy (https://www.thehartford.com/canadian-privacy-policy)

Unincorporated Areas of LA County, CA (Applicant Information)

MA Applicant Notice (https://www.thehartford.com/ma-lie-detector)

Specialist Claims - CH07DE

We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.

This dynamic Claim Specialist role will be part of a team of professionals who support the Harford Global Specialty (HGS) Claims Division. Our ideal candidate will have expertise in: primary and excess claims (including general liability, excess auto liability, products liability, and pollution liability) on integrated general liability/pollution liability policies, contractor pollution liability and site-specific pollution liability policies. We are seeking a motivated, self-starter who would enjoy a fast-paced collaborative work environment! The Claim Specialist will handle a caseload of complex, high-exposure claims on Excess General Liability and Environmental policies from inception to final resolution. This team works closely with our underwriting, actuarial and legal partners to ensure the best possible result for our customers. The claim caseload will involve both primary and excess coverages with complex fact patterns requiring some knowledge of environmental regulations and response actions as well as analysis of contracts between parties to determine liability for risk transfer opportunities.

Key responsibilities of this position include:

+ Conduct complex investigations and extensive claim file reviews on assigned cases

+ Determine coverage, draft position letters and communicate the coverage position(s) to insureds, business partners and legal counsel

+ Operate within prescribed authority levels to set appropriate expense and indemnity reserves

+ Regularly monitor indemnity reserves for any required adjustment

+ Present cases above authority level to leadership for expense/indemnity reserve and settlement authority

+ Develop and implement resolution strategies to achieve high quality outcomes

+ Pro-actively manage environmental consultants and/or litigation and counsel throughout the case lifecycle

+ Directly oversee the litigation planning, execution, budget and bill review

+ Attend trials and mediations as necessary

+ Positively contribute to our claim and enterprise goals by participating in ad hoc audits, projects and product development initiatives

+ Prepare comprehensive reports and deliver presentations to senior claim leadership on: case developments, policy issues, industry trends, etc.

+ Collaborate with valued business partners to review and address claim trends

+ Address inquiries from agents and policyholders with a focus on providing superior customer service

Qualifications:

+ Bachelor’s Degree is required

+ Candidates with a JD license and specialization within environmental or construction case experience are preferred.

+ Minimum of 7 years of claims experience with strong preference for candidates who have handled general liability, pollution liability, site pollution, construction or product liability claims or environmental policies.

+ Prior experience handling both primary and excess policy coverages/claims

+ Working knowledge of environmental, coverage and tort laws

+ Strong coverage acumen with the ability to readily apply the terms and conditions found in manuscript policies to the facts of the claim

+ Familiarity with state specific environmental and insurance regulatory requirements

+ High level of discipline, results-orientation and ability to drive bottom line results

+ Superior analytical ability and organizational skills

+ Effective interpersonal communication skills in both verbal and written formats

+ Proven strategic reasoning and execution skills

+ Excellent negotiation and advanced technical claim handling skills

+ Full command of issues and medicals relative to high value bodily injury claims

+ Strong ability to analyze coverage and liability issues, manage time limit demands and assess extra contractual exposures and other issues of complexity

+ Ability to effectively communicate in a highly-matrixed environment

+ Readily able to influence and drive successful, collaborative claim outcomes

This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Phoenix, AZ, Naperville, IL) will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise.

Compensation

The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford’s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:

$106,400 - $159,600

Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

About Us (https://www.thehartford.com/about-us) | Our Culture (https://www.thehartford.com/about-us/corporate-culture) | What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees) | Perks & Benefits (https://www.thehartford.com/careers/benefits)

Every day, a day to do right.

Showing up for people isn’t just what we do. It’s who we are – and have been for more than 200 years. We’re devoted to finding innovative ways to serve our customers, communities and employees—continually asking ourselves what more we can do.

Is our policy language as simple and inclusive as it can be? Can we better help businesses navigate our ever-changing world? What else can we do to destigmatize mental health in the workplace? Can we make our communities more equitable?

That we can rise to the challenge of these questions is due in no small part to our company values that our employees have shaped and defined.

And while how we contribute looks different for each of us, it’s these values that drive all of us to do more and to do better every day.

About Us (https://www.thehartford.com/about-us)

Our Culture

What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees)

Perks & Benefits (https://www.thehartford.com/careers/benefits)

Legal Notice (https://www.thehartford.com/legal-notice)

Accessibility StatementProducer Compensation (https://www.thehartford.com/producer-compensation)

EEO

Privacy Policy (https://www.thehartford.com/online-privacy-policy)

California Privacy Policy

Your California Privacy Choices (https://www.thehartford.com/data-privacy-opt-out-form)

International Privacy Policy

Canadian Privacy Policy (https://www.thehartford.com/canadian-privacy-policy)

Unincorporated Areas of LA County, CA (Applicant Information)

MA Applicant Notice (https://www.thehartford.com/ma-lie-detector)

Location(s)

Phoenix, Arizona

**Details**

Kemper is one of the nation’s leading specialized insurers. Our success is a direct reflection of the talented and diverse people who make a positive difference in the lives of our customers every day. We believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be highly motivating and productive. Kemper’s products and services are making a real difference to our customers, who have unique and evolving needs. By joining our team, you are helping to provide an experience to our stakeholders that delivers on our promises.

**Position Summary** :

Looking for that next opportunity to use your advanced negotiation skills? Kemper is looking for experienced Represented Bodily Injury Claims Adjusters for our growing teams! This specialized position focuses solely on the analysis & negotiation of bodily injury claims that are ordinarily assigned after the initial coverage determination, property damage handling, and investigation are completed. Claim inventories primarily involve attorney-represented files with varying degrees of complexity.

**Position Responsibilities** :

+ Initiate thorough coverage and liability investigations

+ Draft coverage letters as appropriate

+ Evaluate and resolve moderate to severe, including fatal, bodily injury claims with prompt review and respond to all demands, including time limit demands

+ Obtain and thoroughly analyze complex medical records and data

+ Research and apply applicable laws in multiple states

+ Submit timely large loss reports and referrals to home office when appropriate

+ Prepare for and deliver quality presentations of high exposure cases to upper claims management

+ Timely reserve losses and continue to monitor reserve adequacy

+ Skillfully and professionally negotiate settlements with claimants and attorneys

+ Adjust insurance policies for UM/UIM claims

**Position Qualifications** :

+ High School Diploma or GED required

+ 3 plus years of claims adjusting experience handling complexand severe first party and bodily injury claims with high exposures

+ Must be detail oriented and show a high level of accuracy

+ Excellent verbal and written communication skills

+ Exercise decisiveness and execution within authority

+ Ability to work independently and as a team

+ Strong problem-solving skills

+ Strong time management and organizational ability

+ Must have the ability to deal with conflict in an effective manner

+ Proficient in MS Office

+ Experience with Guidewire claims system is a plus

+ This position is a remote role and must be located in the state of Arizona.

The range for this position is $59,900.00 to $99,700.00. When determining candidate offers, we consider experience, skills, education, certifications, and geographic location among other factors. This job is also eligible for our Kemper benefits package (Medical, Dental, Vision, PTO, 401k, etc.)

Kemper is proud to be an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, disability status or any other status protected by the laws or regulations in the locations where we operate. We are committed to supporting diversity and equality across our organization and we work diligently to maintain a workplace free from discrimination.

Kemper does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Kemper and Kemper will not be obligated to pay a placement fee.

Kemper will never request personal information, such as your social security number or banking information, via text or email. Additionally, Kemper does not use external messaging applications like WireApp or Skype to communicate with candidates. If you receive such a message, delete it.

**Kemper at a Glance**

The Kemper family of companies is one of the nation’s leading specialized insurers. With approximately $13 billion in assets, Kemper is improving the world of insurance by providing affordable and easy-to-use personalized solutions to individuals, families and businesses through its Kemper Auto and Kemper Life brands. Kemper serves over 4.8 million policies, is represented by approximately 22,200 agents and brokers, and has approximately 7,500 associates dedicated to meeting the ever-changing needs of its customers. Learn more at Kemper.com .

*Alliance United Insurance Company is not rated.

_We value diversity and strive to be an employer of choice. An Equal Opportunity Employer, M/F/D/V_

**Our employees enjoy great benefits:**

• Qualify for your choice of health and dental plans within your first month.

• Save for your future with robust 401(k) match, Health Spending Accounts and various retirement plans.

• Learn and Grow with our Tuition Assistance Program, paid certifications and continuing education programs.

• Contribute to your community through United Way and volunteer programs.

• Balance your life with generous paid time off and business casual dress.

• Get employee discounts for shopping, dining and travel through Kemper Perks.

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Specialist Sr - Commercial Coverage Specialist

**PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

+ Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.

+ Negotiates claim settlement up to designated authority level.

+ Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.

+ Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.

+ Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.

+ Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.

+ Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.

+ Represents Company in depositions, mediations, and trial monitoring as needed.

+ Communicates claim activity and processing with the client; maintains professional client relationships.

+ Ensures claim files are properly documented and claims coding is correct.

+ Refers cases as appropriate to supervisor and management.

+ Delegates work and mentors assigned staff.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

**QUALIFICATIONS**

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred.

**Experience**

Six (6) years of claims management experience or equivalent combination of education and experience required.

**Skills & Knowledge**

+ In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business

+ Excellent oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Analytical and interpretive skills

+ Strong organizational skills

+ Excellent negotiation skills

+ Good interpersonal skills

+ Ability to work in a team environment

+ Ability to meet or exceed Performance Competencies

**WORK ENVIRONMENT**

When applicable and appropriate, consideration will be given to reasonable accommodations.

**Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

**Physical** **:** Computer keyboarding, travel as required

**Auditory/Visual** **:** Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is_ **_($74,228 - $103,000_** **_)_** _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

**About the Role**

Uber is a technology company that is changing the way the world thinks about transportation. Whether it's heading home from work, getting a meal delivered from a favorite restaurant, or a way to earn extra income, Uber is becoming part of the fabric of daily life. We're making cities safer, smarter, and more connected.

As a Claims Senior Manager, you and your team will provide strategic guidance to external insurance partners, align on best-in-class claims management processes, and leverage data-driven insights to drive impactful results. If you thrive in a fast-paced environment, enjoy solving complex claims issues, and want to influence industry-leading claims operations, this role offers the perfect opportunity to make a meaningful impact.

Uber embraces a hybrid work model. This approach promotes a balanced and productive work environment that accommodates both individual preferences and organizational needs.

What You'll Do

+ **Consulting and Advisory** : You and your team will provide expert consultation to external insurance partners on the best practices for commercial auto claims handling, primarily bodily injury, underinsured and uninsured motorist claims.

+ **Process Implementation:** You and your team will develop and implement preferred processes for claims management, ensuring alignment with industry standards and Uber needs.

+ **Strategic Planning:** You will work closely with Uber's Chief Claims Officer and lead your team to design and execute strategic plans to enhance claims operations. You will utilize data-driven insights and claims management behavioral expertise to create industry leading approaches to design best in class TNC/DNC best claim practices in partnership with our business partners and stakeholders.

+ **Complex Issue Resolution:** Lead and develop your team to advise on the resolution of complex coverage issues and litigation management, helping external and internal business partners navigate and mitigate risks.

+ **Data Analysis and Recommendations:** Use data analytics to identify trends, inform recommendations and implement solutions that improve claim outcomes while providing guidance to internal stakeholders such as Risk Management, Legal, Safety and Product lines.

+ **Documentation and Training:** Lead your team to use optimal framework to document processes and collaborate with both internal and external Learning and Development to design and provide training ensuring successful adoption and adherence to new procedures and technology.

+ **Contract Review, Budgeting and Staffing:** Experienced in contractual review and managing compliance, adherence to expense management budgets and proven application of varying staffing models to ensure desired internal team and external business partner results.

+ **Stakeholder Engagement:** Develop relationships with internal and external stakeholders and business partners to understand Uber needs while tailoring solutions aligned with contractual requirements and market needs as well as maintain retention of talent through satisfaction with consulting services as well as improved results.

Basic Qualifications

+ Minimum of 5 years experience in commercial auto or general liability claims handling with experience handling bodily injury claims.

+ Proven experience in managing litigation related to commercial auto or general liability claims.

+ A minimum of 3 years of frontline claims leadership experience.

Preferred Qualifications

+ Demonstrated ability in the successful design and implementation of actionable insights using data and claims management behavioral expertise.

+ Experience handling high policy limits and complex coverage issues

+ Exceptional ability to adopt presentations and messaging to different levels of audience from individual contributors to senior executive leaders.

+ Experience managing relationships with TPAs, insurance carriers and suppliers.

+ High degree of adaptability to meet changing business needs

+ Ability to serve as an insurance and claims subject matter expert

+ Insurance designation(s) (AIC, ARM, SCLA, CPCU)

+ Extraordinary attention to detail

For Chicago, IL-based roles: The base salary range for this role is USD$162,000 per year - USD$180,000 per year. For Phoenix, AZ-based roles: The base salary range for this role is USD$144,000 per year - USD$160,000 per year. For all US locations, you will be eligible to participate in Uber's bonus program, and may be offered an equity award & other types of comp. You will also be eligible for various benefits. More details can be found at the following link https://www.uber.com/careers/benefits.

Uber is proud to be an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. If you have a disability or special need that requires accommodation, please let us know by completing this form- https://docs.google.com/forms/d/e/1FAIpQLSdb_Y9Bv8-lWDMbpidF2GKXsxzNh11wUUVS7fM1znOfEJsVeA/viewform

Marine Claims Senior Claims Specialist

125273

Zurich North America is hiring a Marine Claims Senior Claims Specialist Role (With Hull and Liability experience preferred) to join our team! We are open to remote work for the right candidate located within the U.S..

In this role you will be responsible for:

+ Ability to handle dedicated accounts.

+ Frequent interaction with Assureds, Brokers and Underwriters.

+ Some travel may be required but this is not very frequent.

Basic Qualifications:

+ Bachelor’s Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Zurich Certified Insurance Apprentice, including an associate degree with 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.AND

+ Must obtain and maintain required adjuster license(s)

+ Microsoft Office experience

+ Knowledge of insurance regulations, markets, and products

Preferred Qualifications:

+ Extensive Marine claims experience preferred.

+ Emphasis on Marine Liability, Hull, Blue water and brown water claims, Jones Act, General Average and Ocean Cargo Claims experience preferred.

+ Licensed in all states as needed preferred.

+ Effective verbal and written communication skills

+ Strong analytical, critical thinking and problem-solving skills

+ Strong multi-tasking and prioritization skills

+ Experience collaborating in a team environment and building cross functional working relationships

+ Proactively shares and promotes sharing of insights

+ Ability to gather unique perspectives from other teams/functions to optimize outcomes.

+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims

+ Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims

+ Ability to determine the scope and exposure for complex claims

+ Ability to leverage trend and relationships to provide high-quality customer service

+ Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts.

+ Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims

+ Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies

At Zurich, compensation for roles is influenced by a variety of factors, including but not limited to the specific office location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a fair and reasonable compensation range for each role. For more information about our Total Rewards, please clickhere (https://www.zurichna.com/careers/benefits) . Additional rewards may encompass short-term incentive bonuses and merit increases. We encourage candidates with salary expectations beyond the provided range to apply as they will be considered based on their experience, skills, and education.The compensation indicated represents a nationwide market range and has not been adjusted for geographic differentials pertaining to the location where the position may be filled. The proposed salary range for this position is $74,300.00 - $121,700.00, with short-term incentive bonus eligibility set at 15%.

As an insurance company, Zurich is subject to 18 U.S. Code § 1033.

A future with Zurich. What can go right when you apply at Zurich?

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please clickhere (https://www.zurichna.com/careers) to learn more.

Zurich in North America is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.

Location(s): AM - New York Virtual Office, AM - Remote Work (US)

Remote Working: Hybrid

Schedule: Full Time

Employment Sponsorship Offered: No

Linkedin Recruiter Tag: #LI-LC1 #LI-ASSOCIATE #LI-REMOTE

EOE Disability / Veterans

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Representative - Workers Comp (CA experience preferred)

**PRIMARY PURPOSE** : To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

+ Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.

+ Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.

+ Administers subrogation of claims and negotiates settlements.

+ Communicates claim action with claimant and client.

+ Ensures claim files are properly documented and claims coding is correct.

+ May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

+ Maintains professional client relationships.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

+ Travels as required.

**QUALIFICATIONS**

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred.

**Experience**

Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.

**Skills & Knowledge**

+ Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business

+ Excellent oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Analytical and interpretive skills

+ Strong organizational skills

+ Good interpersonal skills

+ Ability to work in a team environment

+ Ability to meet or exceed Service Expectations

**WORK ENVIRONMENT**

When applicable and appropriate, consideration will be given to reasonable accommodations.

**Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

**Physical:** Computer keyboarding, travel as required

**Auditory/Visual:** Hearing, vision and talking

**NOTE** : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is_ **_($43,929 - $60,000_** **_)_** _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

(REMOTE) Claims Adjuster - Auto Liability / Bodily Injury

**PRIMARY PURPOSE** **:** To analyze mid- and higher-level general auto claims to determine scope of damages; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Manages mid-level and higher-level auto commercial and personal lines claims by gathering information to determine exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.

+ Assesses liability and resolves claims within evaluation.

+ Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

+ Manages subrogation of claims and negotiates settlements.

+ Communicates claim action with claimant and client.

+ Ensures claim files are properly documented and claims coding is correct.

+ Maintains professional client relationships.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Travels as required.

**QUALIFICATIONS**

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.

+ Current adjusters license highly preferred.

**Experience**

Four (4) years of claims management experience or equivalent combination of education and experience required.

**Skills & Knowledge**

+ Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles as applicable to line-of-business.

+ Excellent oral and written communication skills, including presentation skills

+ PC literate, including Microsoft Office products

+ Analytical and interpretive skills

+ Strong organizational skills

+ Excellent interpersonal skills

+ Excellent negotiating skills

+ Ability to create and complete comprehensive, accurate and constructive written reports

+ Ability to work in a team environment

+ Ability to meet or exceed Performance Competencies

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (47,011.00 - 65,816.00 - 84,620.00) USD annual salary. Commission eligible role. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #LIremote #claimsexaminer #claims

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Supervisor

**PRIMARY PURPOSE:** To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.

+ Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.

+ Provides technical/jurisdictional direction to examiner reports on claims adjudication.

+ Compiles reviews and analyzes management reports and takes appropriate action.

+ Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.

+ Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.

+ Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.

+ Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.

+ Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.

+ Assures that direct reports are properly licensed in the jurisdictions serviced.

+ Ensures claims files are coded correctly and adequate documentation is made by claims examiners.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

**SUPERVISORY RESPONSIBILITIES**

+ Administers company personnel policies in all areas and follows company staffing standards and training recommendations.

+ Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.

+ Provides support, guidance, leadership and motivation to promote maximum performance.

**QUALIFICATIONS**

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.

**Experience**

Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.

**Skills & Knowledge**

+ Thorough knowledge of claims management processes and procedures for multiple product lines

+ Excellent oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Leadership/management/motivational skills

+ Analytical and interpretive skills

+ Strong organizational skills

+ Excellent interpersonal skills

+ Excellent negotiation skills

+ Ability to work in a team environment

+ Ability to meet or exceed Performance Competencies

**WORK ENVIRONMENT**

When applicable and appropriate, consideration will be given to reasonable accommodations.

**Mental** : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

**Physical:** Computer keyboarding, travel as required

**Auditory/Visual:** Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is_ **_($68,000 - $95,000_** **_)_** _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**