Claims Specialist
$69.6k - $92.4kSummit
Company SCI Summit Consulting, LLC Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic. Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities. Our field team members are located in every state in which we operate. Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best. Essential Job Functions And Responsibilities Manages an inventory of claims to evaluate compensability/liability. Plans and conducts claim investigations to confirm coverage and to determine liability, compensability and damages. Determines and negotiates appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials. Conveys moderately complex information regarding coverage and settlements to insureds, claimants, and external partners. Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner. Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements. Performs other duties as assigned. Great American’s culture is built on connection, shared learning, and strong relationships. To support this, employees in this role are expected to be on-site four days a week, with the flexibility to work one day remotely. Core in-office days are Tuesday–Thursday, with the fourth day determined by business needs. The person hired for this position will work out of the Gainesville, GA office which offers a hybrid work environment (4 days in office, 1 day remote) or will work remotely in the following states: Georgia, Illinois, Indiana, Kentucky, North Carolina, South Carolina, Tennessee. Job Requirements Education: Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience. Experience: Generally, a minimum of 5 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). Scope of Job/Qualifications: Works within significant limits and authority on assignments of higher technical complexity and coordination. Demonstrates strong analytical, negotiation, and problem-solving skills. Demonstrates knowledge of insurance policies, coverage, and claims handling procedures. Maintains knowledge of industry laws and regulations. Demonstrates 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. This job is non-exempt in California and Washington. Salary Range $69,600.00 -$92,400.00 Benefits 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. 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 Excludes seasonal employees and interns. #J-18808-Ljbffr
- ...Review and process Wellness, Accident, and Vision insurance claims Determine the nature and validity of claims by reviewing policy status and supporting documents Provide prompt customer service to policy holders and providers regarding claims Document phone calls and...SuggestedWork experience placementWork at office
$56.27k - $69.9k
...Pay Plan Title: Claims Specialist III Working Title: Claims Specialist III FLSA Status: Exempt Posting Salary Range: $56,270 - $69,898 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact Trillium Health Resources is a Tailored Plan and Managed...SuggestedWork at officeLocal areaImmediate startRemote workWork from homeFlexible hours- ...insurance solutions that address your business’s unique risks. Summary/Job Purpose This position is responsible to adjust assigned claims within delegated limits of authority, conduct timely and thorough investigations, handle subrogation claims, and complete fair and...SuggestedLocal area
$132.8k - $219.1k
...Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range... ...bench strength. Field Severity Support: Some Complex Claim Specialists may be responsible for all or some of the following: Collaborate...SuggestedLocal area- ...Bodily Injury Claims RepresentativeA career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.We offer a merit-based work-from-home program based...SuggestedWork at officeLocal areaWork from home
- EnableComp is seeking a Revenue Specialist for Third-Party Claims to investigate and analyze Motor Vehicle Accident accounts. This role acts as a liaison between clients, patient attorneys, and insurance companies while maintaining confidentiality of sensitive health information...
- ...Buick GMC Cadillac in Raleigh seeks a detail-oriented Warranty Administrator to join our Service Department. You will process warranty claims, ensure proper documentation, and collaborate with Service Advisors, Technicians, Parts, and management to keep claims accurate and...
- A managed care organization serving North Carolina is seeking a Claims Relations Coordinator to handle claims issues and support the provider community. The ideal candidate will manage claims inquiries and ensure timely resolutions. Qualifications include a high school...Remote workWork from homeFlexible hours
$60.6k - $95.7k
...Management Liability Claims Specialist IAT Insurance Group has an immediate opening for a Management Liability Claims Specialist that can be located in any of our IAT locations. This role works a hybrid schedule from an IAT Office. The hybrid schedule reflects our...Work at officeImmediate startRemote workVisa sponsorship- ...CRC Group is seeking an experienced Claims Professional to lead and adjudicate complex property and casualty claims in North Carolina. You will analyze coverage, assess liability, and collaborate with brokers, legal counsel, and underwriters to determine fair outcomes...
$100k
...National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist, Professional Liability | Medical Malpractice | Long Term Care PRIMARY PURPOSE OF THE ROLE: To analyze complex or...Full timeLocal areaFlexible hours$60.6k - $95.7k
...Management Liability Claims SpecialistIAT Insurance Group has an immediate opening for a Management Liability Claims Specialist that can be located in any of our IAT locations.This role works a hybrid schedule from an IAT Office. The hybrid schedule reflects our values...Work at officeImmediate startRemote workVisa sponsorship- EnableComp is seeking a Revenue Specialist, Medicaid who ensures proper submission and adjudication of Medicaid claims, handling PHI with strict privacy. You will verify eligibility, analyze payments, and gather records to secure prompt reimbursements. The role requires...
- MSIG USA is seeking a seasoned Claims Adjuster to handle assigned claims across a range of complexities. You will investigate, adjust reserves, and settle claims in accordance with company guidelines and regulatory requirements. The role requires 5+ years of claims experience...
- Forhyre in the United States seeks a Claims Business Analyst to bridge IT capacity with business goals by supporting analytics, building, testing, and deployment of our software product’s features. This role collaborates with the Director of Claims to deliver timely claims...
- Auto-Owners Insurance in Raleigh, NC is seeking an experienced Casualty Claims professional. After initial in-person training, you may have the flexibility of work-from-home time as defined by leadership. Travel for onsite investigations and meetings is required. You will...Remote jobWork from home
- Jobtailor in North Carolina seeks a claims processor to review and process Wellness, Accident, and Vision insurance claims, determine claim validity by examining policy status and documents, and provide prompt service to policyholders and providers. You will document calls...Work at office
$63.08k - $82.79k
...departments, financial institutions, and external agencies. Position Summary Mecklenburg County is excited to welcome a Senior Claims Specialist to our Finance Department. This role serves as the Claims Specialist Lead within the revenue cycle function, serving as the...Work at office- First American is seeking a Default Claims Associate to service mortgage accounts, file GNMA claims and support loss mitigation activities in compliance with investor and agency guidelines. The role involves interacting with mortgagors, attorneys, and investors to manage...Remote job
- Cornerstone Building Brands is seeking a Claims Representative to manage warranty claims from intake through final resolution with a focus on customer experience. The role is hybrid, based out of Welcome, NC, requiring two in-office days per week. The position emphasizes...Work at office2 days per week
- TEKsystems is seeking a Remote Customer Service Representative to support the Group Life & Disability Claims team. The role thrives in a fast-paced call center, handling disability, life, and leave claims with accuracy and empathy. We welcome candidates with 2-3+ years...Remote jobContract work
- Job Description As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and...Work experience placement
- EnableComp is seeking a Revenue Specialist - Veterans Administration to act as the liaison between client contacts and the VA. This role handles PHI with strict privacy and security, analyzes VA claim payments, and ensures proper documentation is used for reimbursement...
- ...a detail-oriented Warranty Administrator to join our Service Department in Raleigh, NC. The role focuses on processing GM warranty claims, verifying coverage, and ensuring proper documentation with Service Advisors and Technicians. The ideal candidate has dealership warranty...
- Old Republic Commercial Risk in Raleigh, NC seeks a seasoned claims professional to independently investigate, evaluate, and resolve high-risk workers' compensation claims. You will administer and resolve complex claims in line with statutes, policy provisions, and company...
- SCI Summit Consulting, LLC is hiring for a property and casualty claims role focusing on workers’ compensation. You will manage claim inventories, conduct investigations, and negotiate settlements within authority limits while maintaining meticulous files. The position...
- TruCapital Partners is seeking a Claims Technical Specialist in the United States (North Carolina) to manage moderate to complex general liability claims and oversee litigated matters. The role provides technical guidance to claims examiners on investigation quality, reserving...
- ...MBP is seeking a Construction Claims Analyst/Lead Construction Claims Analyst to support complex delay, productivity, and cost-impacts analyses across multiple MBP offices, including Tampa, Raleigh, and DC areas. The ideal candidate has strong experience in scheduling...
- ...Overview Claims Administrator position in Raleigh, NC at Construction Partners, Inc. (CPI). CPI is a vertically integrated civil infrastructure company operating across eight southeastern states, supported by hot-mix asphalt plants, aggregate facilities and liquid asphalt...For contractorsWork at officeLocal area
- ...A leading insurance firm is seeking a Trucking Underwriting Specialist to manage a portfolio of logging and forestry trucking risks. Responsibilities include underwriting new and renewal submissions, evaluating risks, and collaborating with agency partners. Candidates...
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