Claims Specialist
Claim Specialist Job In Oak Brook, IL
We are seeking a detail-oriented and customer-focused Claims Specialist to join our team. The Claims Specialist will be responsible for managing, evaluating, and processing insurance claims efficiently while ensuring compliance with company policies and industry regulations. This position is 100% onsite
Claims Specialist Responsibilities:
Assisting with claims for property damage on vehicles
Assisting with bodily injury claims that are filed by individuals injured in accidents
Contacting customers, attorneys, doctors and hospitals
Claims Specialist Requirements:
Must have 3-5 years of claims experience
License preferred, but not required
Strong analytical and problem-solving skills.
Excellent verbal and written communication skills
Ability to handle sensitive information with confidentiality and professionalism
Strong attention to detail and organizational skills
If you are interested in this opportunity and meet the qualifications, please apply today!
Thank you,
Jessica McCourt
Senior Project Manager
LaSalle Network
LaSalle Network is an Equal Opportunity Employer m/f/d/v.
LaSalle Network is the leading provider of direct hire and temporary staffing services. For over two decades, LaSalle has helped organizations hire faster and connect top talent with opportunities, from entry-level positions to the C-suite. With units specializing in Accounting and Finance, Administrative, Marketing, Technology, Supply chain, Healthcare Revenue Cycle, Call Center, Human Resources and Executive Search. LaSalle offers staffing and recruiting solutions to companies of all sizes and across all industries. LaSalle Network is the premier staffing and recruiting firm, earning over 100 culture, revenue and industry-based awards from major publications and having its company experts regularly contribute insights on retention strategies, hiring trends and hiring challenges, and more to national news outlets.
Complex General Liability Claims Specialist
Claim Specialist Job In Chicago, IL
About the Role: As a Claim Specialist for Maxum Primary and Excess Liability Claims in the Liability Major Case Unit, you will be responsible for handling a caseload of bodily injury and non-bodily injury claims. The claims often involve complex fact patterns requiring analysis of contracts between parties to determine indemnity and contribution obligations and risk transfer opportunities. As these claims are often in litigation, experience handling litigated matters and managing defense counsel is required, as is prior experience handling primary and excess policy coverages and claims.
Responsibilities
Conducting investigations and analyzing and evaluating the information learned;
Making coverage determinations and communicating written position(s) to insureds and other required parties;
Within prescribed authority levels, setting appropriate expense and indemnity reserves and monitoring on a regular basis for any needed adjustment;
Presenting cases to management for expense or indemnity reserve authority above established authority levels;
Developing and implementing resolution strategies to achieve high quality outcomes;
Proactively managing litigation and counsel, inclusive of litigation planning and execution, budgeting and bill review;
Attending trials and mediations as necessary;
Qualifications:
Bachelor's degree required; law degree a plus.
Minimum of five plus years handling complex litigated coverage and commercial general liability matters.
Candidate should be disciplined, results-oriented and able to focus on bottom line results.
Superior analytical ability and organizational skills.
Excellent oral and written communication skills.
Excellent strategic thinking ability and execution skills.
Excellent negotiation and advanced technical claim handling skills, including knowledge of coverage and tort laws.
Pay range and compensation package: $106K to $159K
Professional Liability Claims Manager
Claim Specialist Job In Chicago, IL
Our client, a well-established insurance provider, is seeking a Professional Liability Claims Specialist to join their growing team in Chicago. This role involves proactively managing professional liability claims, including Errors & Omissions (E&O) and Cyber liability, while ensuring fair, timely, and cost-effective resolutions.
Key Responsibilities
Manage a portfolio of professional liability claims, ensuring efficient and fair resolutions.
Assess coverage issues, conduct risk analyses, and issue appropriate documentation.
Investigate claims thoroughly and establish appropriate reserves.
Pursue risk transfer opportunities, including contractual indemnity and additional insured issues.
Ensure all claims handling aligns with best practices and legal compliance.
Represent the company at mediations, settlement conferences, and trials when required
Qualifications & Experience
Bachelor's degree in Business Administration, Insurance, or a related field.
5+ years of experience in professional liability claims handling or litigation as an attorney.
Key Skills & Competencies
Strong expertise in professional liability claims, with a solid understanding of relevant case law and regulations.
Proactive approach to investigation, risk transfer, and claims resolution.
Exceptional communication and negotiation skills to liaise effectively with insureds, claimants, underwriters, and senior management.
Automotive Claims Adjuster
Claim Specialist Job In Oak Brook, IL
We are First Chicago Insurance Company! We currently have offices in Bedford Park, IL, (about one mile south of Chicago Midway Airport), as well as Richardson, Texas (Dallas area). Due to our significant growth, we are pleased to announce that we have a new Claims office in Oak Brook, IL!
If you are an experienced Non-Standard Auto CLAIMS PROFFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFFESSIONAL!!
We are seeking experienced Non-Standard Auto Liability Claims Specialist to join our new office in Oak Brook!
This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First- and Third-Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims.
DUTIES & RESPONSIBILITIES:
Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss
Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim
Honor/decline/negotiate first and third-party liability claims upon completion of coverage/policy investigation and analysis of damages and liability
Work directly with internal and external customers to develop evidence and establish facts on assigned claims
Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims
Prepare and present claim evaluations for the appropriate settlement authority
Notify the Underwriting Department of any adverse information uncovered in the course of the investigation
Familiarity with unfair claim practices in states where we do business
Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service
Provide customer service both to internal and external customers
Handle other duties as assigned
QUALIFICATIONS REQUIRED:
Minimum 2-3 years previous auto insurance or other auto related experience A MUST!
Non-Standard Auto claims handling experience a plus!
Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills
General working knowledge of policies, file procedures, state rules and regulations
Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster
Preferred:
Prior claims experience
Ability to use on-line claims system
Bi-lingual a plus!
First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive:
Competitive Salaries
Flexible Work Schedules
Remote and Hybrid
Commitment to your Training & Development
Medical and Dental
Telemedicine Benefit
401k with a generous company match
Paid Time Off and Paid Holidays
Tuition Reimbursement Training Programs
Wellness Program
Fun company sponsored events
And so much more!
Casualty Claims Specialist
Claim Specialist Job In Chicago, IL
Everest is a leading global reinsurance and insurance provider, operating for nearly 50 years through subsidiaries in the Europe, Bermuda, Canada, Singapore, US, and other territories. Our strengths include extensive product and distribution capabilities, a strong balance sheet, and an innovative culture. Throughout our history, Everest has maintained its discipline and focuses on creating long-term value through underwriting excellence and strong risk and capital management. But the most critical asset in this organization is our people.
Everest is a growth company offering Property, Casualty, and specialty products among others, through its various operating subsidiaries located in key markets around the world. Everest has been a global leader in reinsurance with a broad footprint, deep client relationships, underwriting excellence, responsive service, and customized solutions. Our insurance arm draws upon impressive global resources and financial strength to tailor each policy to meet the individual needs of our customers.
Everest has an opportunity for an experienced claims professional or attorney to join our Casualty Claims team. This individual will handle mainstream and moderately complex auto, general liability and excess liability and umbrella claims of all varieties.
Responsibilities include but not limited to:
* Reviewing and analyzing complex coverage issues and preparation of coverage position letters.
* Investigating, analyzing and evaluating liability and damages.
* Managing and directing outside counsel.
* Preparing case summary reports related to matters of significant reserve and trial activity.
* Setting timely and appropriate case reserves.
* Developing and executing claim strategies as well as resolution strategies.
* Negotiating and resolving cases.
* Attending trials, mediations and settlement conferences.
* Working with underwriters to support policy construction and drafting, reporting claim trends, data analysis, and risk assessments.
* Extensive communication with insureds, brokers, reinsurers, actuaries, and underwriters.
* Attending client meetings and industry functions to support retention and development of client relationships and business.
* Performing similar work-related duties as assigned.
Qualifications, Education & Experience:
* Strong analytical and organizational skills.
* Excellent verbal and written communication skills.
* Strong negotiation and investigation skills.
* Ability to think strategically.
* Ability to influence others and resolve complex, disputed claims.
* In-depth knowledge of the litigation, arbitration, and trial process.
* Currently holds or readily can obtain all required adjuster licenses.
* Ability to identify and use relevant data and metrics to best manage claims.
* Collaborative mind-set and willingness to work with people outside immediate reporting hierarchy to improve processes and generate optimal departmental efficiency.
* Ability and willingness to present to senior management and to others in other group settings.
* Knowledge of the insurance industry, claims process and legal and regulatory environment.
* 3-5 years of claims handling experience or legal experience.
* B.A. or B.S. required; JD helpful but not required.
Our Culture
At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture.
* Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Diversity, Equity and Inclusion.
* Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together.
All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve.
For NY & CA only: The base salary range for this position is $90,000-$130,000 annually. The offered rate of compensation will be based on individual education, experience, qualifications and work location.
#LI-Hybrid
#LI-VP1
Type:
Regular
Time Type:
Full time
Primary Location:
Warren, NJ
Additional Locations:
Boston, MA, Chicago, IL - South Riverside, Hartford, CT, Houston, TX, Los Angeles, CA, New York, NY, San Francisco, CA
Everest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy), sexual orientation, gender identity or expression, national origin or ancestry, citizenship, genetics, physical or mental disability, age, marital status, civil union status, family or parental status, veteran status, or any other characteristic protected by law. As part of this commitment, Everest will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Everest Benefits at *********************************.
Everest U.S. Privacy Notice | Everest (everestglobal.com)
Claims Specialist, Lawyers Professional Liability
Claim Specialist Job In Chicago, IL
Do you have experience handling Lawyers Professional Liability or other Professional Liability claims? Are you motivated by working in a collaborative environment? If so, this role may be for you! We are looking for a strategic thinker with leadership skills to join our U.S. Lawyers Claims team.
About the Role
This role has responsibility for handling Lawyers Professional Liability claims while also supporting internal and external customers. You will manage a caseload of claims from receipt to final resolution. Our team works closely with the U.S. Agents Claims team, and you may have the opportunity to handle Agents Claims, as well.
Additional key responsibilities include:
* Maintain strong client focus by aggressively and proactively analyzing issues, providing support, and assuring client satisfaction in a timely fashion.
* Complying with legal and regulatory requirements, investigate, evaluate, and settle claims, applying technical knowledge and people skills to reach fair and prompt claim resolution.
* Complete detailed reviews of claim related issues, including coverage, liability, and damage assessments, and document the claim file appropriately.
* Set and maintain appropriate and timely indemnity and expense reserves.
* Formulate and execute negotiation and resolution strategies.
* Evaluate claims data to assist with identifying claim trends.
* Support Underwriting in connection with Claims information and consultation on coverages.
In this role, you will be working with other Claims Handlers dedicated to working on Lawyers Professional Liability Claims. Our team also handles other types of claims, including U.S. Agents claims, and has a strong emphasis on quality and customer service.
About You
Focused, self-motivated, and a confident professional with a hardworking sales mindset to develop insights, propose solutions, and build growth opportunities for clients and Swiss Re. You are a proactive and well-organized decisionmaker who works well both independently and as part of a team. You also have the following:
* Bachelor's degree or equivalent industry experience.
* 3+ years' Claims handling experience or equivalent industry experience.
* Possess solid coverage, liability, damage investigation, evaluation, and claims resolution skills.
* Excellent negotiation skills.
* Excellent customer service skills and experience collaborating with underwriters, clients, brokers, and internal and external business partners.
* Strong data analytic skills.
* Experience with handling claims in a paperless environment.
* Interest in developing leadership and management skills.
* Possess, or willing to obtain, adjuster licenses as needed for various jurisdictions.
* Ability to successfully deliver the Swiss Re Claims Commitment.
Some travel may be required.
The estimated base salary range for this position is $84,000 to $150,000. The specific salary offered for this or any given role will take into account a number of factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget. At Swiss Re, we take a "total compensation approach" when making compensation decisions. This means that we consider all components of compensation in their totality (such as base pay, short-and long-term incentives, and benefits offered), in setting individual compensation.
About Swiss Re Corporate Solutions
Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer. We anticipate and manage risks, from natural catastrophes and climate change to cybercrime.
Swiss Re Corporate Solutions is the commercial insurance arm of the Swiss Re Group. We offer innovative insurance solutions to large and midsized multinational corporations from our approximately 50 locations worldwide. We help clients mitigate their risk exposure, whilst our industry-leading claims service provides them with additional peace of mind.
Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. Swiss Re Corporate Solutions embraces a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability.
If you are an experienced professional returning to the workforce after a career break, we encourage you to apply for open positions that match your skills and experience.
Swiss Re is an equal opportunity employer. It is our practice to recruit, hire and promote without regard to race, religion, color, national origin, sex, disability, age, pregnancy, sexual orientations, marital status, military status, or any other characteristic protected by law. Decisions on employment are solely based on an individual's qualifications for the position being filled.
During the recruitment process, reasonable accommodations for disabilities are available upon request. If contacted for an interview, please inform the Recruiter/HR Professional of the accommodation needed.
Keywords:
Reference Code: 132685
Nearest Major Market: Chicago
Job Segment: Liability, Claims, HR, Underwriter, Law, Insurance, Human Resources, Legal
Claims Specialist
Claim Specialist Job In Hoffman Estates, IL
Pay Philosophy 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.
Description
The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim's management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.
You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Suwanee, GA; Boston, MA; Plano, TX; or Hoffman Estates, IL. Please note this policy is subject to change.
Responsibilities:
* Manages an inventory of claims to evaluate compensability/liability.
* Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
* Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
* Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
* Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
* Performs other duties as assigned.
Qualifications
* BS/BA degree or equivalent work experience.
* Minimum of 2 years experience in claims adjustment, general insurance or formal claims training.
* Required to obtain and maintain all applicable licenses.
* Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU).
* Knowledge of claims investigation techniques, medical terminology and legal aspects of claims.
About Us
As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally.
At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow.
We are proud to support a diverse, equitable and inclusive workplace, where all employees feel a sense of community, belonging and can do their best work. Our seven Employee Resource Groups (ERGs) offer a centralized, open space to bring employees and allies together to connect, learn and engage.
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: ***********************
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.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
Claims Specialist
Claim Specialist Job In Oak Brook, IL
JOB SUMMARY: This position reports to the Manager, Claims and is responsible for handling and resolving third party liability claims to include property damage and bodily injury claims.
ESSENTIAL JOB FUNCTIONS:
Evaluate and resolve third party claims across all of Hub Group's transportation and logistics solutions.
Proactively and aggressively monitor and manage property damage and bodily injury claims.
Establish and maintain claim files in Hub Group's claims management program.
Identify, gather, and preserve relevant evidence following incidents involving Hub Group assets.
Assist outside defense counsel with discovery requests in litigated cases.
Develop and maintain strong relationships with internal and external stakeholders to ensure superior customer service.
Negotiate and determine settlements and claim resolutions, process payment requests and final case paperwork following discussion of valid claims with customers, carriers, and appropriate Hub personnel.
Duties, responsibilities, and activities may be assigned or changed from time to time.
Coordinate and lead investigations with Safety and Operations.
Investigate and gather information necessary evaluate third party claims.
MINIMUM QUALIFICATIONS:
High school diploma and claims processing experience.
One to three years of experience handling property damage and/or bodily injury claims.
Ability to learn, understand and apply knowledge of DOT and other federal regulations applicable to the transportation industry.
Excellent written and oral communication skills necessary to prepare reports and to interpret and communicate complex material, statistical data, and results to management.
Creative ability to find innovative improvement opportunities while balancing accountabilities, specifically with external customers.
Proficient with Microsoft Office products, including Excel, and with web-based applications, claims database software and the ability to determine trend analysis and produce reports to support findings.
Ability to manage multiple priorities as well as flexibility to adapt to change with new systems and methods while working in a team environment.
Claims Specialist
Claim Specialist Job In Oak Brook, IL
JOB SUMMARY: This position reports to the Manager, Claims and is responsible for handling and resolving third party liability claims to include property damage and bodily injury claims. ESSENTIAL JOB FUNCTIONS: * Evaluate and resolve third party claims across all of Hub Group's transportation and logistics solutions.
* Proactively and aggressively monitor and manage property damage and bodily injury claims.
* Establish and maintain claim files in Hub Group's claims management program.
* Identify, gather, and preserve relevant evidence following incidents involving Hub Group assets.
* Assist outside defense counsel with discovery requests in litigated cases.
* Develop and maintain strong relationships with internal and external stakeholders to ensure superior customer service.
* Negotiate and determine settlements and claim resolutions, process payment requests and final case paperwork following discussion of valid claims with customers, carriers, and appropriate Hub personnel.
* Duties, responsibilities, and activities may be assigned or changed from time to time.
* Coordinate and lead investigations with Safety and Operations.
* Investigate and gather information necessary evaluate third party claims.
MINIMUM QUALIFICATIONS:
* High school diploma and claims processing experience.
* One to three years of experience handling property damage and/or bodily injury claims.
* Ability to learn, understand and apply knowledge of DOT and other federal regulations applicable to the transportation industry.
* Excellent written and oral communication skills necessary to prepare reports and to interpret and communicate complex material, statistical data, and results to management.
* Creative ability to find innovative improvement opportunities while balancing accountabilities, specifically with external customers.
* Proficient with Microsoft Office products, including Excel, and with web-based applications, claims database software and the ability to determine trend analysis and produce reports to support findings.
* Ability to manage multiple priorities as well as flexibility to adapt to change with new systems and methods while working in a team environment.
Claims Status Specialist (GF)
Claim Specialist Job In Oak Brook, IL
General Description TVG-Medulla, LLC provides support and services to two comprehensive chiropractic care companies, Chiro One Wellness Centers and MyoCore Personalized Pain Care, both industry leaders in evidence-based, patient outcomes-centered care.
The Claims Status Specialist will maximize insurance collections by investigating claim status on assigned accounts and performing appropriate follow up actions to ensure payment of claims.
Essential Functions and Responsibilities
Investigate status of insurance claims on assigned accounts by reviewing mail/EOBs, insurance websites, calling insurance companies, etc.
Facilitate collections of balances due by performing the appropriate follow up actions once claim status is determined.
Review claims submissions for errors and update/correct erroneous claims.
Maintain patient ledgers on assigned accounts to reflect accurate balances due.
Communicate with clinical teams regarding information requests and claim status updates and maintain follow up as needed.
Maintain claim status log with detail of status and actions taken on assigned accounts.
Ensure all communication is clear, professional, and branded.
Notify management of any strange scenarios, possible compliance concerns or recurring issues.
Minimum Qualifications
Proficient computer and data entry skills
Excellent written and verbal communication
Basic knowledge of insurance benefits
Familiarity in Microsoft Office (primarily Outlook, Excel, and Word)
Preferred Qualifications
Two or more years of insurance, billing, or related experience
Job Competencies
Ability to remain calm and professional during difficult situations
Excellent written and verbal communication skills
Ability to multi-task and prioritize
Solution-oriented approach to problem-solving
Disclaimer
All team members agree to consistently support compliance and TVG-Medulla, LLC policies and Standards of Excellence with regard to maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, adhering to applicable federal, state, and local laws and regulations, accreditation, and licenser requirements (if applicable), and Medulla procedures and protocols. Must perform other related duties and assist with project completion as needed. Team member may be required to provide necessary information to complete a DMV (or equivalent agency) background check.
Claims Specialist, Motor Truck Cargo
Claim Specialist Job In Chicago, IL
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
This individual contributor position works under moderate direction, and within defined authority limits, to manage primarily motor truck cargo claims with moderate to high complexity and exposure. There may also be opportunity to handle ocean marine claims. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
JOB DESCRIPTION:
Essential Duties & Responsibilities:
Performs a combination of duties in accordance with departmental guidelines:
Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.
Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
May serve as a mentor/coach to less experienced claim professionals
May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
Solid working knowledge of motor truck cargo claims handling, liability analysis, policy coverage and claim practices.
Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
Demonstrated ability to develop collaborative business relationships with internal and external work partners.
Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
Demonstrated investigative experience with an analytical mindset and critical thinking skills.
Strong work ethic, with demonstrated time management and organizational skills.
Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
Developing ability to negotiate low to moderately complex settlements.
Adaptable to a changing environment.
Knowledge of Microsoft Office Suite and ability to learn business-related software.
Demonstrated ability to value diverse opinions and ideas
Education & Experience:
Bachelor's Degree or equivalent experience.
Typically a minimum four years of relevant experience, preferably in claim handling.
Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
Professional designations are a plus (e.g. CPCU)
#LI-CP1
#LI-Hybrid
In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut,
Illinois
,
Maryland,
Massachusetts
,
New York and Washington,
the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
Workers Compensation RTW Claim Representative
Claim Specialist Job In Downers Grove, IL
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$65,300.00 - $107,600.00
**Target Openings**
1
**What Is the Opportunity?**
Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery The injured worker is working modified duty and receiving ongoing medical treatment. The injured worker as returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and there has been a change in the current position. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered.
**What Will You Do?**
+ Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability
+ Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions.
+ Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment.in collaboration with internal nurse resources where appropriate.
+ Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome.
+ Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits.
+ Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment.
+ Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations.
+ Negotiate settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction.
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ 2 years Workers Compensation claim handling experience preferred.
+ Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making.
+ Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. Ability to effectively present file resolution to internal and/or external stakeholders.
+ Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise.
+ General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract.
+ Principles of Investigation: Intermediate investigative skills including the ability to take statements. Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss.
+ Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves.
+ Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package.
+ Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
+ Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed.
+ WC Technical:
+ Intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state.
+ Intermediate knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
+ Customer Service:
+ Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes
+ Teamwork:
+ Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result
+ Planning & Organizing:
+ Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals
+ Maintain Continuing Education requirements as required or as mandated by state regulations
**What is a Must Have?**
+ High School Diploma or GED required.
+ Minimum of 1 year Workers Compensation claim handling experience or successful completion of the WC trainee program required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Claim Readiness Specialist
Claim Specialist Job In Westchester, IL
Full-time Description
We offer competitive pay as well as PTO, Holiday pay, and a comprehensive benefits package!
Benefits:
Health insurance
Dental insurance
Vision insurance
Life Insurance
Pet Insurance
Health savings account
Paid sick time
Paid time off
Paid holidays
Profit sharing
Retirement plan
Free parking
GENERAL SUMMARY
The Claim Readiness Specialist is responsible for entering and importing charges and ensuring the appropriate billing codes on used for all charges. The Claim Readiness Specialist will ensure charges are entered accurately, efficiently, and timely into the practice management system. The Claim Readiness Specialist is also responsible for resolving all assigned claim edits and submission of claims to third party payers within the clearinghouse/practice management system in a timely and efficient manner. They work with Coding and Revenue Integrity Supervisor to escalate charge entry and bill submission issues to prevent incorrect billing. This role reports to the Revenue Integrity Supervisor.
Requirements
ESSENTIAL JOB FUNCTION/COMPETENCIES
Responsibilities include but are not limited to:
Enters and import charges daily for all professionals ensuring accurate coding.
Determines correct CPT codes for professional surgical procedures along with Evaluation and Management (E&M) clinical encounters. Also determines appropriate all ICD-10 diagnosis codes.
Ensures all prior day's charges and edits have been accurately resolved and claim is ready to bill insurance in a timely manner.
Identifies root cause issues causing charge edits and communicates these issues to leadership for upstream education.
Communicates with Coders, Business Office staff and Providers when necessary to resolve errors and clarify issues.
Stays accountable to quality and productivity standards, and monitor compliance with policies and procedures.
Identifies process opportunity trends and recommend ways to improve efficiencies.
Ensures adherence to third party and governmental regulations relating to coding, billing, documentation, compliance, and reimbursement.
Participates in special projects, personal development training, and cross training as instructed.
Informs Supervisor, Coding and Revenue Integrity of trends, inconsistencies, discrepancies for immediate resolution.
Works in conjunction with peers and functional areas of the Coding and Revenue Integrity department for the betterment of completing tasks and the company overall.
Job may require other duties as assigned.
Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and/or violations to a supervisor and/or the Compliance Department; and the timely completion the Annual Compliance Training.
CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS
Certified Professional Coder (CPC) preferred.
KNOWLEDGE | SKILLS | ABILITIES
Demonstrates and uses a strong working knowledge of CPT coding and ICD10 coding as it relates to urology services.
Understands the utilization of modifiers and other billing and coding rules to include the AMA and other billing and coding organizations.
Knowledge of medical terminology and consistent application of medical documentation requirements.
Excellent verbal and written communication skills.
Excellent organizational skills and attention to detail.
Strong analytical and problem-solving skills.
Skill in using computer programs and applications including Microsoft Office.
Ability to work independently and manage deadlines.
Ability to follow policies and procedures for compliance, medical billing, and coding.
Ability to type and enter data with proficiency and accuracy.
Proven ability to manage multiple projects at a time while paying strict attention to detail.
Ability to successfully meet established timelines.
Ability to operate essential office equipment, including multi-line phone, computer, fax machine, scanner, and photocopy machine.
Complies with HIPAA regulations for patient confidentiality.
Complies with all health and safety policies of the organization.
EDUCATION REQUIREMENTS
High School Diploma or equivalent required.
EXPERIENCE REQUIREMENTS
Minimum of three years revenue cycle experience within a physician practice.
Experience in Urology or physician practice environment preferred.
Minimum 2 years hands on coding and/or billing experience within a physician's office and/or successful completion of secondary education in medical coding/billing or medical administration, or urology experience.
REQUIRED TRAVEL
N/A
PHYSICAL DEMANDS
Carrying Weight Frequency
1-25 lbs. Frequent from 34% to 66%
26-50 lbs. Occasionally from 2% to 33%
Pushing/Pulling Frequency
1-25 lbs. Seldom, up to 2%
100 + lbs. Seldom, up to 2%
Lifting - Height, Weight Frequency
Floor to Chest, 1 -25 lbs. Occasional: from 2% to 33%
Floor to Chest, 26-50 lbs. Seldom: up to 2%
Floor to Waist, 1-25 lbs. Occasional: from 2% to 33%
Floor to Waist, 26-50 lbs. Seldom: up to 2%
Salary Description 24.65
Collision Desk Adjuster - Fleet Management
Claim Specialist Job In Rolling Meadows, IL
Join Innovation Group's commitment to #GoingBeyond
Innovation Group provides comprehensive operational support and a range of expert services to the world's leading insurers, brokers, fleet managers and automotive manufacturers. Our 3,300 employees across ten countries deliver exceptional standards on a large scale for over 1,200 clients, saving our global clients tens of millions of dollars annually. Innovation Group helps put their lives back on track. It takes empathy, it takes going above and beyond, it takes building the right relationships and it takes people who want a career. We look to do things differently and we're always searching for people who are up for making an impact.
Innovation Group is seeking a Auto/Collision Desk Adjuster to join our Fleet Management quality and compliance team in Rolling Meadows, Illinois.
You will have the opportunity to:
Complete reviews of adjuster estimates against carrier guidelines and make appropriate suggestions for changes.
Build solid and long lasting relationships with Vendors and Independent Contractors.
Ensure that all services within the Innovation auto division are provided with high quality statistical auditing services highly focused on quality assurance of estimates.
Provide statistical auditing for claims by client and individuals in order to analyze, operational improvements and adherence to client specific estimating guidelines.
Handle all escalation issues related to the quality of the work provided.
What we're looking for:
5 -7 years Auto or Collision experience required.
3 - 5 years Customer Service experience
Collision Industry experience
Previous estimating experience
Account Management experience
Estimating software experience required
Negotiating Skills
Excellent Verbal and Written Communication Skills
At Innovation Group, we value the contributions of our employees. We provide a robust benefits package that includes:
Medical, dental, and vision insurance
Life insurance
Short-term and long-term disability insurance
Flexible spending account options
Health and dependent care saving accounts
17 days of paid time-off per year
Paid sick leave
8 paid holidays
401(k) investment options
Employee assistance programs
Claims Supervisor
Claim Specialist Job In Chicago, IL
The Casualty Claims Supervisor will be responsible for the direct supervision of the Casualty Claims unit. Scope of the position includes ensuring compliance with State mandated claims handling guidelines and assuring proper investigation and conclusions of claims. Monitor production, staff development and the quality of files assigned to the Unit.
Seeking local candidates to work in the Bedford Park location, approximately one mile south of Chicago Midway Airport. Hybrid Opportunities Available.
DUTIES & RESPONSIBILITIES:
Lead, motivate, and provide direction to the Casualty Unit
Conduct file and diary reviews for the purpose of monitoring adjuster's work and to assure appropriate documentation is available, fair claim settlement practices are followed, and company quality standards are maintained.
Place appropriate authority level on claim files based upon investigation of facts and approve settlement checks within authority.
Review reports, design and support the implementation of procedures which improve claim settlement and customer service levels, and ensure that desired quality and quantity levels are maintained.
Oversee the implementation and monitoring of procedures to assure effectiveness and compliance.
Determine training needs of the department and establish and participate in programs to ensure training needs of personnel and processes.
Work with staff relative to any suits drawn on cases with respect to litigation handling.
Develop and manage a cost effective defense strategy.
Identify Systems issues/problems/suggestions for enhancements.
Manage the administrative functions of the unit which include:
Review, provide direction and assign new losses
Screening and selecting candidates
Setting performance objectives and monitoring performance results
Conduct performance appraisals
Complete reports as necessary
Daily review of files for payment approvals over adjuster authority and the transfer of files to appropriate areas (SIU, Litigation, Total Loss, Subrogation, etc.)
Conduct unit meetings
Review and respond to Department of Insurance complaints
Review and direct claim activity on customer inquiries
Complete special projects as assigned.
QUALIFICATIONS REQUIRED:
5+ years auto liability claims and supervisory experience.
5+ years managing litigated personal auto files.
Strong technical and administrative background in auto claims handling.
Ability to work independently on technical and administrative matters in accordance with company policy and procedures.
Good leadership, training and development skills.
Excellent communication, interpersonal and organizational skills.
Ability to pass written examinations where required by state statutes to become a licensed claim.
Claims Specialist
Claim Specialist Job In Hoffman Estates, IL
Pay Philosophy 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.
Description
The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim's management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.
This is a hybrid position, however, those within 50 miles of our offices in Boston, MA; Suwanee, GA; Plano, TX; Hoffman Estates, IL must report to the office twice a month. Please note that this policy is subject to change.
Responsibilities:
* Manages an inventory of claims to evaluate compensability/liability.
* Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
* Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
* Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
* Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
* Performs other duties as assigned.
Qualifications
* BS/BA degree or equivalent work experience.
* Minimum of 2 years experience in claims adjustment, general insurance or formal claims training.
* Required to obtain and maintain all applicable licenses.
* Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU).
* Knowledge of claims investigation techniques, medical terminology and legal aspects of claims.
About Us
As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally.
At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow.
We are proud to support a diverse, equitable and inclusive workplace, where all employees feel a sense of community, belonging and can do their best work. Our seven Employee Resource Groups (ERGs) offer a centralized, open space to bring employees and allies together to connect, learn and engage.
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: ***********************
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.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
Claims Specialist - Construction Defect
Claim Specialist Job In Chicago, IL
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims under both occurrence based CGL policies and claims made E & O policies according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
JOB DESCRIPTION:
Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:
Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols.
Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
Demonstrated ability to develop collaborative business relationships with internal and external work partners.
Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
Demonstrated investigative experience with an analytical mindset and critical thinking skills.
Strong work ethic, with demonstrated time management and organizational skills.
Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
Developing ability to negotiate low to moderately complex settlements.
Adaptable to a changing environment.
Knowledge of Microsoft Office Suite and ability to learn business-related software.
Demonstrated ability to value diverse opinions and ideas
Education & Experience
Bachelor's Degree or equivalent experience.
Typically a minimum four years of relevant experience, preferably in claim handling.
Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
Professional designations are a plus (e.g. CPCU)
#LI-MM1
#LI-Hybrid
In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut,
Illinois
,
Maryland,
Massachusetts
,
New York and Washington,
the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
Cargo Claims Specialist
Claim Specialist Job In Oak Brook, IL
This position is responsible for handling and resolving claims with shippers, consignees, and carriers relating to cargo damage claims. In this role, the Cargo Claims Specialist will evaluate, negotiate, and authorize settlements with all stakeholders within their designated level of authority.
Essential Job Functions:
* Evaluate and resolve cargo claims across all of Hub Group's transportation and logistics solutions.
* Proactively and aggressively monitor and manage cargo claims.
* Develop and maintain strong relationships with internal and external stakeholders to ensure superior customer service.
* Notify customer, carrier, and draymen of claim filings and/or rejected claims and work with the customer to understand the value of damaged products and how the product should be handled.
* Determine next steps and oversee inspections to support settlement decisions.
* Interpret law enforcement and/or independent inspector reports.
* Negotiate and determine settlements and claim resolutions, process payment requests and final case paperwork following discussion of valid claims with customers, carriers, and appropriate Hub personnel.
* Duties, responsibilities, and activities may be assigned or changed from time to time.
* Investigate and gather information necessary to pursue subrogation from responsible parties.
Minimum Qualifications:
* High school diploma required.
* One to three years of experience handling cargo and/or insurance claims preferred.
* Ability to learn, understand and apply knowledge of DOT and other federal regulations applicable to the transportation industry.
* Excellent written and oral communication skills necessary to prepare reports and to interpret and communicate complex material, statistical data, and results to management.
* Creative ability to find innovative improvement opportunities while balancing accountabilities, specifically with external customers.
* Proficient with Microsoft Office products, including Excel, and with web-based applications, claims database software and the ability to determine trend analysis and produce reports to support findings.
* Ability to manage multiple priorities as well as flexibility to adapt to change with new systems and methods while working in a team environment.
BEWARE OF FRAUD!
Hub Group has become aware of online recruiting related scams in which individuals who are not affiliated with or authorized by Hub Group are using Hub Group's name in fraudulent emails, job postings, or social media messages. In light of these scams, please bear the following in mind:
* Hub Group will never solicit money or credit card information in connection with a Hub Group job application.
* Hub Group does not communicate with candidates via online chatrooms such as Signal or Discord using email accounts such as Gmail or Hotmail.
* Hub Group job postings are posted on our career site: ********************************
Salary Range: $45,000 - $55,000/year
This is an estimated range based on the circumstances at the time of posting, however it may change based on a combination of factors, including but not limited to skills, experience, education, market factors, geographical location, budget, and demand.
Benefits We offer a comprehensive benefits plan including:
* Medical
* Dental
* Vision
* Flexible Spending Account (FSA)
* Employee Assistance Program (EAP)
* Life & AD&D Insurance
* Disability
* Paid Time Off
* Paid Holidays
Workers Compensation RTW Claim Representative
Claim Specialist Job In Downers Grove, IL
Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Compensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range
$65,300.00 - $107,600.00
Target Openings
1
What Is the Opportunity?
Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery The injured worker is working modified duty and receiving ongoing medical treatment. The injured worker as returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and there has been a change in the current position. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered.
What Will You Do?
* Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability
* Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions.
* Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment.in collaboration with internal nurse resources where appropriate.
* Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome.
* Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits.
* Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment.
* Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations.
* Negotiate settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction.
* In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
* Perform other duties as assigned.
What Will Our Ideal Candidate Have?
* 2 years Workers Compensation claim handling experience preferred.
* Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making.
* Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. Ability to effectively present file resolution to internal and/or external stakeholders.
* Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise.
* General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract.
* Principles of Investigation: Intermediate investigative skills including the ability to take statements. Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss.
* Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves.
* Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package.
* Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
* Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed.
* WC Technical:
* Intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state.
* Intermediate knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
* Customer Service:
* Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes
* Teamwork:
* Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result
* Planning & Organizing:
* Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals
* Maintain Continuing Education requirements as required or as mandated by state regulations
What is a Must Have?
* High School Diploma or GED required.
* Minimum of 1 year Workers Compensation claim handling experience or successful completion of the WC trainee program required.
What Is in It for You?
* Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
* Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
* Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
* Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
* Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
Employment Practices
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit *********************************************************
Auto Property Damage Claims Specialist with a HIRING BONUS
Claim Specialist Job In Bedford Park, IL
Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Liability Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities?
If you answered YES to the above, it's time to talk to First Chicago Insurance Company!
We offer:
* Competitive Salaries
* First Year Hiring Bonus for direct applicants
* Excellent benefits
* Growth opportunities!
Apply only if you consider yourself a career professional who loves to work, because we work hard here!
If you are an experienced CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!!
We have openings in our Bedford Park, IL and Oak Brook, IL offices!
This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First and Third Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims.
DUTIES & RESPONSIBILITIES:
* Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss
* Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim
* Honor/decline/negotiate first and third party liability claims upon completion of coverage/policy investigation and analysis of damages and liability
* Work directly with internal and external customers to develop evidence and establish facts on assigned claims
* Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims
* Prepare and present claim evaluations for the appropriate settlement authority
* Notify the Underwriting Department of any adverse information uncovered in the course of the investigation
* Familiarity with unfair claim practices in states where doing business
* Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service
* Provide customer service both to internal and external customers
* Handle other duties as assigned
QUALIFICATIONS REQUIRED:
* 2-3 years previous auto insurance or other auto related experience A MUST!
* Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills
* General working knowledge of policies, file procedures, state rules and regulations
* Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster
Preferred:
* College degree
* Prior claims experience
* Ability to use on-line claims system
* Bi-lingual a plus!
First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive:
* Competitive Salaries
* Commitment to your Training & Development
* Medical and Dental
* Short Term Disability/Long Term Disability
* Life Insurance
* Flexible Spending Account
* Telemedicine Benefit
* 401k with a generous company match
* Paid Time Off and Paid Holidays
* Tuition Reimbursement Training Programs
* Wellness Program
* Fun company sponsored events
* And so much more!
Estimated Compensation Range: $41,600/year-$75,000/year*
* Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location. In addition, starting salary may vary by position depending on whether the position is in-office, hybrid or remote.