Claims Adjusters, Examiners, and Investigators

**About this role:**

Wells Fargo is seeking a Lead Analytics Consultant within Fraud & Claims Management (FCM) as part of Consumer and Small Business Banking Operations (CSBBO). Learn more about the career areas and lines of business at wellsfargojobs.com .

**In this role, you will:**

+ Utilize analytic capabilities to perform event-based and root cause analysis in the ACH and on-us check victim fraud space

+ Consult and perform complex analyses involving data mining from multiple sources and/or predictive modeling, regression/multivariate, financial, comparative analysis, customer/demographic analysis, etc.

+ Provide insights, develop analytical strategies, performing analytical support and/or modeling regarding a wide array of business initiatives related to fraud

+ Present findings and partner in the development or enhancement of fraud strategies and upstream controls to mitigate risk of event/intel and/or loss to Wells Fargo and its clients with specific focus on victim fraud while engaging other fraud strategy and risk teams as needed

+ Identify opportunities for statistical models and/or create sophisticated computer modeling approaches to analyze and forecast business performance; participating in and/or leading management information capabilities development work; interpreting and presenting results of analyses and recommendations to senior management

+ Ensure adherence to data management/data governance regulations and policies

+ Collaborate and consult with peers, colleagues, and more experienced managers to resolve issues and achieve goals

+ Lead projects, small teams, or serve as a peer mentor

**Required Qualifications, US:**

+ 5+ years of Analytics experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education

**Desired Qualifications:**

+ 3+ years of experience with SAS, SQL, or other data management, reporting and query tools

+ 3+ years of experience using data and analytics to inform and develop risk mitigation strategies

+ 2+ years experience designing and optimizing complex SQL queries involving table joins and correlated sub-queries on large scale data tables

+ 5+ years of experience creating pivot tables and performing data analysis in Excel

+ Extensive knowledge and understanding of research and analysis

+ Strong analytical skills with high attention to detail and accuracy

+ Excellent verbal, written, and interpersonal communication skills

+ Knowledge and understanding of fraud risk and mitigation including strategies to reduce or mitigate loss and fraud exposures

+ Outstanding problem solving and analytical skills with ability to turn findings into strategic imperatives

+ Ability to interact with integrity and a high level of professionalism with all levels of team members and management

+ Ability to think creatively to find innovative solutions to complex analytical questions

+ Ability to learn and assimilate information from multiple people and sources

+ Certified Fraud Examiner (CFE)

**Job Expectations:**

+ This position is not eligible for Visa sponsorship

**Position Location:**

1525 W W T Harris Blvd, Charlotte NC

800 S Jordan Creek Pkwy, West Des Moines IA

2850 S Price Rd, Chandler, AZ

1336 W Alameda, Tempe, AZ

7711 Plantation Rd, Roanoke, VA

5201 W Amelia Earhart Dr, Salt Lake City, UT

4101 Wiseman Blvd, San Antonio, TX

2200 Concord Pike, WILMINGTON, DE

**Pay Range**

Reflected is the base pay range offered for this position. Pay may vary depending on factors including but not limited to achievements, skills, experience, or work location. The range listed is just one component of the compensation package offered to candidates.

$87,000.00 - $188,900.00

**Benefits**

Wells Fargo provides eligible employees with a comprehensive set of benefits, many of which are listed below. Visit Benefits - Wells Fargo Jobs for an overview of the following benefit plans and programs offered to employees.

+ Health benefits

+ 401(k) Plan

+ Paid time off

+ Disability benefits

+ Life insurance, critical illness insurance, and accident insurance

+ Parental leave

+ Critical caregiving leave

+ Discounts and savings

+ Commuter benefits

+ Tuition reimbursement

+ Scholarships for dependent children

+ Adoption reimbursement

**Posting End Date:**

10 Oct 2024

*** Job posting may come down early due to volume of applicants.**

**We Value Diversity**

At Wells Fargo, we believe in diversity, equity and inclusion in the workplace; accordingly, we welcome applications for employment from all qualified candidates, regardless of race, color, gender, national origin, religion, age, sexual orientation, gender identity, gender expression, genetic information, individuals with disabilities, pregnancy, marital status, status as a protected veteran or any other status protected by applicable law.

Employees support our focus on building strong customer relationships balanced with a strong risk mitigating and compliance-driven culture which firmly establishes those disciplines as critical to the success of our customers and company. They are accountable for execution of all applicable risk programs (Credit, Market, Financial Crimes, Operational, Regulatory Compliance), which includes effectively following and adhering to applicable Wells Fargo policies and procedures, appropriately fulfilling risk and compliance obligations, timely and effective escalation and remediation of issues, and making sound risk decisions. There is emphasis on proactive monitoring, governance, risk identification and escalation, as well as making sound risk decisions commensurate with the business unit's risk appetite and all risk and compliance program requirements.

Candidates applying to job openings posted in US: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected characteristic.

**Applicants with Disabilities**

To request a medical accommodation during the application or interview process, visit Disability Inclusion at Wells Fargo .

**Drug and Alcohol Policy**

Wells Fargo maintains a drug free workplace. Please see our Drug and Alcohol Policy to learn more.

**Wells Fargo Recruitment and Hiring Requirements:**

a. Third-Party recordings are prohibited unless authorized by Wells Fargo.

b. Wells Fargo requires you to directly represent your own experiences during the recruiting and hiring process.

**Company:** WELLS FARGO BANK

**Req Number:** R-405902-2

**Updated:** Sat Oct 05 02:41:10 UTC 2024

**Location:** CHANDLER,Arizona

Sr. Claims Specialist, Workers Compensation

117126

Zurich North America is seeking an experienced Senior Workers' Compensation Claims Specialist to join our team. While we prefer candidates based near our Woodland Hills, CA office on a Hybrid work schedule, we are open to considering remote applicants provided they hold CAaccreditation.

The Senior Workers Compensation Claims Specialist will handle multi-party commercial line Workman’s Compensation claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.

In this role you will be responsible for:

+ Document claims file by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party personal or commercial line claims of moderate to high exposure and complexity.

+ Exercise judgment to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.

+ Exercise judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.

+ Work to have a timely resolution to claims by developing case strategy; developing a case evaluation; escalating issues as appropriate.

+ Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims.

+ Assess damages by calculating applicable damages or range of damages allowed by law.

+ Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.

+ Meet quality standards by following best practices

Basic Qualifications:

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

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

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

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

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

+ Must obtain and maintain required adjuster license(s)

+ Microsoft Office experience

+ Knowledge of insurance regulations, markets and products

Preferred Qualifications:

+ 5 or more years of experience handling Workers Compensation claims with high severity and exposure

+ Currently holds an active adjusters license in the state of California

+ Effective verbal and written communication skills

+ Strong analytical, critical thinking and problem-solving skills

+ Strong multi-tasking and prioritization skills

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

+ Proactively shares and promotes sharing of insights

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

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

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

+ Ability to determine the scope and exposure for complex claims

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

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

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

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

Compensation for roles at Zurich varies depending on a wide array of factors including but not limited to the specific office location, role, skill set, and level of experience. As required by local law, Zurich provides in good faith a reasonable range of compensation for roles. For additional information about our Total Rewards, Clickhere (https://www.zurichna.com/careers/benefits) . Other rewards may include short term incentive bonuses and merit increases. **Candidates with salary expectations outside of the range are encouraged to apply, and will be considered based on experience, skill, and education.** The salary provided is a nationwide market range and has not been adjusted for the applicable geographic differential associated with the location where the position may be filled. The starting salary range for this position is$72,800.00 - $119,200.00.

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

As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time ( https://www.zurichna.com/careers/faq ).

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

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

As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet

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

Location(s): AM - Woodland Hills, AM - Arizona Virtual Office, AM - California Virtual Office, AM - Nevada Virtual Office, AM - Remote Work (US)

Remote Working: Hybrid

Schedule: Full Time

Employment Sponsorship Offered: No

Linkedin Recruiter Tag: #LI-MD1 #LI-ASSOCIATE #LI-REMOTE

**About this role:**

Wells Fargo is seeking a Lead Analytics Consultant within Fraud & Claims Management (FCM) as part of Consumer and Small Business Banking Operations (CSBBO). Learn more about the career areas and lines of business at wellsfargojobs.com .

**In this role, you will:**

+ Utilize analytic capabilities to perform event-based and root cause analysis in the ACH and on-us check victim fraud space

+ Consult and perform complex analyses involving data mining from multiple sources and/or predictive modeling, regression/multivariate, financial, comparative analysis, customer/demographic analysis, etc.

+ Provide insights, develop analytical strategies, performing analytical support and/or modeling regarding a wide array of business initiatives related to fraud

+ Present findings and partner in the development or enhancement of fraud strategies and upstream controls to mitigate risk of event/intel and/or loss to Wells Fargo and its clients with specific focus on victim fraud while engaging other fraud strategy and risk teams as needed

+ Identify opportunities for statistical models and/or create sophisticated computer modeling approaches to analyze and forecast business performance; participating in and/or leading management information capabilities development work; interpreting and presenting results of analyses and recommendations to senior management

+ Ensure adherence to data management/data governance regulations and policies

+ Collaborate and consult with peers, colleagues, and more experienced managers to resolve issues and achieve goals

+ Lead projects, small teams, or serve as a peer mentor

**Required Qualifications, US:**

+ 5+ years of Analytics experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education

**Desired Qualifications:**

+ 3+ years of experience with SAS, SQL, or other data management, reporting and query tools

+ 3+ years of experience using data and analytics to inform and develop risk mitigation strategies

+ 2+ years experience designing and optimizing complex SQL queries involving table joins and correlated sub-queries on large scale data tables

+ 5+ years of experience creating pivot tables and performing data analysis in Excel

+ Extensive knowledge and understanding of research and analysis

+ Strong analytical skills with high attention to detail and accuracy

+ Excellent verbal, written, and interpersonal communication skills

+ Knowledge and understanding of fraud risk and mitigation including strategies to reduce or mitigate loss and fraud exposures

+ Outstanding problem solving and analytical skills with ability to turn findings into strategic imperatives

+ Ability to interact with integrity and a high level of professionalism with all levels of team members and management

+ Ability to think creatively to find innovative solutions to complex analytical questions

+ Ability to learn and assimilate information from multiple people and sources

+ Certified Fraud Examiner (CFE)

**Job Expectations:**

+ This position is not eligible for Visa sponsorship

**Position Location:**

1525 W W T Harris Blvd, Charlotte NC

800 S Jordan Creek Pkwy, West Des Moines IA

2850 S Price Rd, Chandler, AZ

1336 W Alameda, Tempe, AZ

7711 Plantation Rd, Roanoke, VA

5201 W Amelia Earhart Dr, Salt Lake City, UT

4101 Wiseman Blvd, San Antonio, TX

2200 Concord Pike, WILMINGTON, DE

**Pay Range**

Reflected is the base pay range offered for this position. Pay may vary depending on factors including but not limited to achievements, skills, experience, or work location. The range listed is just one component of the compensation package offered to candidates.

$87,000.00 - $188,900.00

**Benefits**

Wells Fargo provides eligible employees with a comprehensive set of benefits, many of which are listed below. Visit Benefits - Wells Fargo Jobs for an overview of the following benefit plans and programs offered to employees.

+ Health benefits

+ 401(k) Plan

+ Paid time off

+ Disability benefits

+ Life insurance, critical illness insurance, and accident insurance

+ Parental leave

+ Critical caregiving leave

+ Discounts and savings

+ Commuter benefits

+ Tuition reimbursement

+ Scholarships for dependent children

+ Adoption reimbursement

**Posting End Date:**

10 Oct 2024

*** Job posting may come down early due to volume of applicants.**

**We Value Diversity**

At Wells Fargo, we believe in diversity, equity and inclusion in the workplace; accordingly, we welcome applications for employment from all qualified candidates, regardless of race, color, gender, national origin, religion, age, sexual orientation, gender identity, gender expression, genetic information, individuals with disabilities, pregnancy, marital status, status as a protected veteran or any other status protected by applicable law.

Employees support our focus on building strong customer relationships balanced with a strong risk mitigating and compliance-driven culture which firmly establishes those disciplines as critical to the success of our customers and company. They are accountable for execution of all applicable risk programs (Credit, Market, Financial Crimes, Operational, Regulatory Compliance), which includes effectively following and adhering to applicable Wells Fargo policies and procedures, appropriately fulfilling risk and compliance obligations, timely and effective escalation and remediation of issues, and making sound risk decisions. There is emphasis on proactive monitoring, governance, risk identification and escalation, as well as making sound risk decisions commensurate with the business unit's risk appetite and all risk and compliance program requirements.

Candidates applying to job openings posted in US: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected characteristic.

**Applicants with Disabilities**

To request a medical accommodation during the application or interview process, visit Disability Inclusion at Wells Fargo .

**Drug and Alcohol Policy**

Wells Fargo maintains a drug free workplace. Please see our Drug and Alcohol Policy to learn more.

**Wells Fargo Recruitment and Hiring Requirements:**

a. Third-Party recordings are prohibited unless authorized by Wells Fargo.

b. Wells Fargo requires you to directly represent your own experiences during the recruiting and hiring process.

**Company:** WELLS FARGO BANK

**Req Number:** R-405902-6

**Updated:** Sat Oct 05 02:41:10 UTC 2024

**Location:** TEMPE,Arizona

**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**

$63,700.00 - $105,100.00

**Target Openings**

4

**What Is the Opportunity?**

Travelers' Claim Organization is at the heart of our business by providing assurance to our customers during life's rainy days. As a Property Claim Representative you will walk our customers through home and business claims while evaluating damage and negotiating on their behalf. You will leverage your interpersonal and critical thinking skills to evaluate and resolve personal and business property claims. When a catastrophe happens, you will be first to respond while keeping customers' peace of mind a top priority.

This is a hybrid work arrangement requiring three days in office and allowing for two days work from home.

As of the date of this posting, Travelers anticipates that this posting will remain open until 12/1/2024.

**What Will You Do?**

+ Provide quality claim handling throughout the claim life cycle while maintaining full compliance with internal and external standards and state specific regulations. Resolves previously closed 1st party PI and BI Property claims that vary in severity and/or complexity.

+ Resolve inquiries from customers, contractors, agents or other participants on open or closed Property claims.

+ Participate in our Catastrophe Response Program which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.

+ Complete virtual inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.

+ Handle claims and other functional work involving one or more lines of business other than property.

+ Acquire and maintain relevant Insurance License(s) to comply with state and Travelers requirements.

+ Perform other duties as assigned.

**What Will Our Ideal Candidate Have?**

+ Bachelor’s Degree.

+ Customer Service experience.

+ Two years of outside property claim handling experience.

+ Excellent interpersonal and customer service skills with the ability to use sound judgement to analyze and resolve claims.

+ Ability to work independently, manage time, and prioritize multiple claims simultaneously.

+ Excellent written and verbal communication skills with the ability to negotiate, convey, and receive information effectively.

+ Interpersonal and customer service skills - Advanced

+ Organizational and time management skills - Intermediate

+ Ability to work independently - intermediate

+ Judgment, analytical and decision making skills - Intermediate

+ Negotiation skills- Intermediate

+ Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively - Intermediate

+ Investigative skills - Intermediate

+ Ability to analyze and determine coverage - Intermediate

+ Analyze, and evaluate damages - Intermediate

+ Resolve claims within settlement authority - Intermediate

**What is a Must Have?**

+ High School Diploma or GED.

+ One year of outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program.

**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 believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. We are committed to recruiting, retaining and developing the diverse talent of all of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results.

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 ([email protected]) 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 http://careers.travelers.com/life-at-travelers/benefits/ .

Location:

2721 N Central Ave, Phoenix, Arizona 85004 United States of America

Repwest Insurance is seeking a Claims Adjuster to handle Truck, Trailer and Storage property damage claims.

This is an in-office position in our Phoenix, Arizona office.

As an adjuster at Repwest, you will be responsible for investigating, evaluating, and resolving property damage claims.

Essential Duties:

+ Review claims to determine coverage

+ Identify potential fraud

+ Contact all parties, via phone, text, email and mail; to investigate coverage and liability

+ Assign independent adjusters as needed for field work

+ Prepare formal denial letters

+ Gather necessary documents to determine settlement value of claim

+ Maintain productivity within company set standards

+ Communicate with U-Haul to identify areas of potential improvement

Requirements:

+ High School Diploma or equivalent

+ Must obtain an Arizona adjuster’s license within the first 2 weeks of employment

+ Good communication and organizational skills

+ Basic computer skills with knowledge of Microsoft Word and Excel

U-Haul/Repwest Offers:

+ Full Medical coverage

+ Prescription plans

+ Dental & Vision Plans

+ New indoor fitness gym

+ Gym Reimbursement Program

+ Registered Dietitian Program

+ Weight Watchers

+ Onsite medical clinic for you and your family

+ Career stability

+ Opportunities for advancement

+ Valuable on-the-job training

+ Tuition reimbursement program

+ Free online courses for personal and professional development at U-Haul University®

+ Business and travel insurance

+ You Matter Employee Assistance Program

+ Paid holidays, vacation, and sick days

+ Employee Stock Ownership Plan (ESOP)

+ 401(k) Savings Plan

+ Life insurance

+ Critical Illness/Group Accident

+ 24-hour physician available for kids

+ MetLaw Legal program

+ MetLife auto and home insurance

+ Mindset App Program

+ Discounts on cell phone plans, hotels, and more

+ LifeLock Identity Theft

+ Savvy consumer wellness programs - from health care tips to financial wellness

+ Dave Ramsey’s SmartDollar Program

+ U-Haul Federal Credit Union

+ Wellness Program

U-Haul Holding Company, and its family of companies including U-Haul International, Inc. (“U-Haul”), continually strives to create a culture of health and wellness. Consistent with applicable state law, U-Haul will not hire or re-hire individuals who use nicotine products. The states in which U-Haul will decline to hire nicotine users are: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Pennsylvania, Texas, Utah, Vermont, Virginia, and Washington. U-Haul has observed this hiring practice since February 1, 2020 as part of our commitment to a healthy work environment for our team.

U-Haul is an equal opportunity employer. All applicants for employment will be considered without regard to race, color, religion, sex, national origin, physical or mental disability, veteran status, or any other basis protected by applicable federal, provincial, state or local law. Individual accommodations are available on requests for applicants taking part in all aspects of the selection process. Information obtained during this process will only be shared on a need to know basis.

Specialist Claims - CH07DE

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

The Claim Specialist is the highest claim handling designation within the Complex Claims Unit – Bodily Injury (CCU BI) and is a visible and important role. CCU BI is a highly specialized claim team responsible for the management of The Hartford's long-tail asbestos, sexual molestation/harassment, sports-related head injury, opioid, and toxic tort claims . Claims in CCU are often associated with complex fact patterns and coverage issues that may involve multiple years and types of insurance coverage. CCU claims also commonly involve litigation, require subject matter expertise to manage and can involve higher exposures.

RESPONSIBILITIES:

The Claim Specialist must demonstrate the ability to independently and timely manage all aspects of the most complex, high-value claims while exhibiting a detailed knowledge of the claim, a well-reasoned analytical focus and a clear strategy for resolution. The Claim Specialist must also be willing to share their expertise and contribute to broader claim goals by participating in audits, projects and training initiatives.

Other responsibilities include:

+ Provide proactive communications to customers and business partners in the management and resolution of claims;

+ Respond to inquiries from customers and provide superior customer service;

+ Review and analyze multiple complex policies and coverage parts (including general liability and umbrella/excess liability) ;

+ Write and articulate clear, concise and accurate coverage positions;

+ Conduct investigations regarding claims and/or lawsuits;

+ Effectively manage litigation and counsel, inclusive of litigation planning/budgeting, and proactively position claims for resolution;

+ Develop and persuasively articulate complex coverage, liability and damage assessments;

+ Provide detailed impactful recommendations to leadership;

+ Pursue and finalize coverage and liability risk transfer against other liable parties and insurance carriers;

+ Conduct complex negotiations and articulate coverage/liability positions;

+ Attend mediations and trials as necessary;

+ Proactively manage accurate expense, reserve and financial transactions;

+ Consistently maintain up-to-date claims metrics.

REQUIRED QUALIFICATIONS:

+ 5+ years latent bodily injury claims experience;

+ Experience in handling affirmative/defensive risk transfer; including additional insured tenders;

+ Excellent verbal and written communication skills;

+ Excellent analytical and critical thinking ability;

+ Ability to present in a roundtable setting with a well-reasoned and analytical evaluation;

+ Experience in the creation and delivering of presentations;

+ Superior customer service skills and active listening skills;

+ Proven track record of prioritizing and managing multiple responsibilities;

+ Proven track record of effective negotiations/settlement of high-value general liability claims;

+ Demonstrated negotiation and conflict resolution skills;

+ Proficiency with MS Office, especially Word and Excel;

+ Active Property & Casualty State Insurance Adjuster license.

PREFERRED QUALIFICATIONS:

+ Bachelor's degree;

+ 10+ years latent bodily injury claims experience;

+ Proficiency handling litigated claims

+ Experience in analyzing personal and advertising injury coverage parts;

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

Compensation

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

$101,200 - $151,800

Equal Opportunity Employer/Females/Minorities/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

About Us (https://www.thehartford.com/about-us) | Culture & Employee Insights (https://www.thehartford.com/careers/employee-stories) | Diversity, Equity and Inclusion (https://www.thehartford.com/about-us/corporate-diversity) | Benefits (https://www.thehartford.com/careers/benefits)

Human achievement is at the heart of what we do.

We believe that with the right encouragement and support, people are capable of achieving amazing things.

We put our belief into action by ensuring individuals and businesses are well protected, and by going even further – making an impact in ways that go beyond an insurance policy.

Nearly 19,000 employees use their unique talents in careers that span a variety of disciplines – from developing the latest technology to creating and promoting our products to evaluating future financial risks.

We’re also committed to programs that drive education and support volunteerism, which put human beings first. We do it because it’s the right thing to do, and because when our customers, communities and employees succeed, we all do.

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

Culture & Employee Insights

Diversity, Equity and Inclusion (https://www.thehartford.com/about-us/corporate-diversity)

Benefits

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

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

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

California Privacy Policy

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

International Privacy Policy

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

**Become a part of our caring community and help us put health first**

The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized at the Inpatient level. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work.

The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope.

The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. Medical Directors support Humana values, and Humana's Bold Goal mission, throughout all activities.

**Use your skills to make an impact**

**Required Qualifications**

+ MD or DO degree

+ 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).

+ Board Certified in an approved ABMS Medical Specialty with continued certification throughout employment.

+ A current and unrestricted license in at least one jurisdiction and willing to obtain additional license(s), if required.

+ No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.

+ Excellent verbal and written communication skills.

+ Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services (such as inpatient rehabilitation) **Preferred Qualifications**

+ **Understands Medicare Inpatient Guidelines**

+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.

+ Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.

+ Experience with national guidelines such as MCG® or InterQual

+ Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialization

+ Advanced degree such as an MBA, MHA, or MPH

+ Exposure to Public Health principles, Population Health, analytics, and use of business metrics.

+ Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.

+ The curiosity to learn, the flexibility to adapt and the courage to innovate

+ **Additional Information** Typically reports to a Director of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. Some medical directors may join a centralized team for several months after training, until positions become available for specific markets. May participate on project teams or organizational committees. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

+ Satellite, cellular and microwave connection can be used only if approved by leadership

+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

+ This is a remote position\#LI-Remote

**Scheduled Weekly Hours**

40

**Pay Range**

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$199,400 - $274,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

**Description of Benefits**

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

**About us**

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

**Equal Opportunity Employer**

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®

Most Loved Workplace®

Forbes Best-in-State Employer

(Hybrid) Claims Examiner - General Liability / Litigation | Midwest Region

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

+ Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

+ Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

+ Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

+ Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

+ Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

+ Enjoy flexibility and autonomy in your daily work, your location, and your career path.

+ Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

**ARE YOU AN IDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

**PREFERRED GEOGRAPHIC LOCATIONS**

Richfield, MN - Agile

Additional office locations as noted in posting.

Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

**PRIMARY PURPOSE OF THE ROLE:** To analyze high-level commercial general liability claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**

+ Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

+ Negotiating settlement of claims within designated authority.

+ Communicating claim activity and processing with the claimant and the client.

+ Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

**QUALIFICATIONS**

Education & Licensing: 5+ years of claims management experience or equivalent combination of education and experience required.

+ High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

+ Professional certification as applicable to line of business preferred.

**Licensing / Jurisdiction Knowledge: Active adjusters license preferred.**

**TAKING CARE OF YOU**

+ Flexible work schedule.

+ Referral incentive program.

+ Career development and promotional growth opportunities.

+ A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

\#claimsexaminer #claims #L-DV1 #hybrid

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

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

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®

Most Loved Workplace®

Forbes Best-in-State Employer

Auto Bodily Injury Claims Examiner | Remote

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

+ Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

+ Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

+ Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

+ Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

+ Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

+ Enjoy flexibility and autonomy in your daily work, your location, and your career path.

+ Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

**ARE YOU AN IDEAL CANDIDATE?** To analyze Auto Bodily Injury claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

**PRIMARY PURPOSE OF THE ROLE:** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**

+ Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

+ Negotiating settlement of claims within designated authority.

+ Communicating claim activity and processing with the claimant and the client.

+ Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

**QUALIFICATIONS**

Education & Licensing: 5 years of claims management experience or equivalent combination of education and experience required.

+ High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

+ Professional certification as applicable to line of business preferred.

Licensing: Florida 620 license preferred but not required

**TAKING CARE OF YOU**

+ Flexible work schedule.

+ Referral incentive program.

+ Opportunity to work in an agile environment.

+ Career development and promotional growth opportunities.

+ A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work environment requirements for entry-level opportunities include –

Physical: Computer keyboarding

Auditory/visual: Hearing, vision and talking

Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (54,225 - 84,915/year). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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

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

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®

Most Loved Workplace®

Forbes Best-in-State Employer

Auto Bodily Injury Claims Examiner | Remote

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

+ Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

+ Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

+ Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

+ Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

+ Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

+ Enjoy flexibility and autonomy in your daily work, your location, and your career path.

+ Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

**ARE YOU AN IDEAL CANDIDATE?** To analyze Auto Bodily Injury claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

**PRIMARY PURPOSE OF THE ROLE:** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**

+ Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

+ Negotiating settlement of claims within designated authority.

+ Communicating claim activity and processing with the claimant and the client.

+ Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

**QUALIFICATIONS**

Education & Licensing: 5 years of claims management experience or equivalent combination of education and experience required.

+ High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

+ Professional certification as applicable to line of business preferred.

Licensing: Florida 620 license preferred but not required

**TAKING CARE OF YOU**

+ Flexible work schedule.

+ Referral incentive program.

+ Opportunity to work in an agile environment.

+ Career development and promotional growth opportunities.

+ A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work environment requirements for entry-level opportunities include –

Physical: Computer keyboarding

Auditory/visual: Hearing, vision and talking

Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (54,225 - 84,915/year). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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

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

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)