Medical Claims Adjuster

FMNE Insurance is seeking a Home Office Claims Adjuster to join our team in the Home Office Claims Department. This role is ideal for a motivated, detail-oriented professional who excels at investigating claims, makes sound decisions, and delivers fair, high-quality service to policyholders and agents. Join a stable, values-driven company with deep Midwest roots and a strong team-focused culture. This position is not eligible for visa sponsorship. Applicants must be authorized to work in the United States on a full-time basis. Please submit a resume and cover letter for consideration. We offer a competitive salary and a comprehensive benefits package, including health coverage, a generous 401(k), pension plan, wellness programs and a hybrid work model for eligible employees. Role Overview This position is responsible for, but not limited to, working toward fulfillment of the Company’s goal to provide prompt, fair, quality claims service. This role also investigates and manages the settlement of assigned claims, performing all duties with the use of independent judgment and subject to regular review. Responsibilities Demonstrates the Company’s mission, while successfully performing its core values related to integrity, service, excellence, stability, strength, respect, and teamwork. Conduct thorough investigations and efficiently settle assigned claims through telephone communication and written correspondence, ensuring timely resolution. Adhere strictly to the terms and conditions of the insurance contract, focusing on fair and accurate claim payments while maintaining strong customer service and positive relationships with policyholders and agents. Prepare and maintain comprehensive and accurate documentation to support all recommendations for claim payments or denials, ensuring compliance with company policies and regulatory requirements. Proactively communicate with the agent of record throughout the claim handling process, especially if any challenges or complications arise, to facilitate transparency and collaborative problem-solving. Regular and timely attendance in the office is an essential function of the position. Qualifications High school diploma or equivalent required; four-year college degree preferred. Excellent oral and written communication skills. Proficient in computer applications and software. Strong organizational skills with effective time management and sound decision-making abilities. Ability to multi-task, meet deadlines consistently, and perform well under pressure. Demonstrated ability to manage and maintain confidential information with professionalism and discretion is required. A comprehensive and strong knowledge of policy language, insurance principles, and coverage details is essential. Willingness and ability to work beyond standard business hours when required to meet business needs. FMNE Insurance Company recognizes that an individual with a disability may require accommodation to enable them to successfully perform a job function. Should you require such accommodation, please indicate the job function and suggested accommodation during the interview process. FMNE will attempt to make reasonable accommodation. #J-18808-Ljbffr