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Claims • albuquerque nm

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Sr. Liability Claims Representative

Sr. Liability Claims Representative

AMERINDAlbuquerque, New Mexico, United States, 2F7Q+4F
[job_card.full_time]
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AMERIND is a federally chartered, tribally owned corporation, formed under Section 17 of the Indian Reorganization Act (25 U. Members, the governmental units of federally recognized Tribal Nations t...[show_more][last_updated.last_updated_30]
  • [promoted]
Remote Claims Adjusters, Examiners, and Investigators - AI Trainer ($60-$100 per hour)

Remote Claims Adjusters, Examiners, and Investigators - AI Trainer ($60-$100 per hour)

MercorAlbuquerque, New Mexico, US
[filters.remote]
[job_card.full_time]
Role Overview • •Mercor is collaborating with a top-tier AI research group to model real-world claims workflows for property and casualty insurance. We are seeking experienced independent contractors—...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Director Claims Healthplan

Director Claims Healthplan

Presbyterian Healthcare ServicesAlbuquerque, New Mexico, USA
[job_card.full_time]
Director of Claims and Encounters.Presbyterian Health Plan (PHP) Claims Operations and Encounter Resolution teams.This leader is responsible for directing the operations of the Claims Department fo...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
ESIS Senior Claims Representative, WC

ESIS Senior Claims Representative, WC

ChubbAlbuquerque, NM, US
[job_card.full_time]
Focus on the core content of the job post, removing all extra metadata, navigation mentions, and redundant headers.Keep the content beautiful and high signal to noise ratio.[show_more][last_updated.last_updated_30]
Independent Claims Adjuster Flexible, Impactful Career

Independent Claims Adjuster Flexible, Impactful Career

MileHigh Adjusters Houston IncAlbuquerque, NM, United States
[job_card.full_time]
A leading claims adjustment firm in Albuquerque, New Mexico, is seeking Independent Insurance Claims Adjusters.This role offers flexibility, competitive compensation, and comprehensive training to ...[show_more][last_updated.last_updated_1_day]
Commercial Auto Claims Adjuster / Examiner - REMOTE

Commercial Auto Claims Adjuster / Examiner - REMOTE

Work At Home Vintage ExpertsAlbuquerque, NM, US
[filters.remote]
[job_card.full_time] +2
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Put your Insurance Experience to work – FROM HOME!.Our unique platform provides you with.WHAT YOU’LL LOVE ABOUT WAHVE.We created a welcoming place to work with friendly and professional...[show_more][last_updated.last_updated_variable_days]
Daily Claims Adjuster – Albuquerque, NM Region

Daily Claims Adjuster – Albuquerque, NM Region

CENCO CLAIMS LLCAlbuquerque, New Mexico, United States
[job_card.full_time]
CENCO is a trusted leader in claims solutions, proudly partnering with top insurance carriers to provide dependable and efficient claims handling. We are currently seeking experienced Daily Property...[show_more][last_updated.last_updated_30]
  • [promoted]
Senior Environmental Claims Adjuster (CONTRACT)

Senior Environmental Claims Adjuster (CONTRACT)

Argonaut Management Services, IncAlbuquerque, NM, United States
[job_card.full_time]
Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...[show_more][last_updated.last_updated_30]
  • [new]
Field Claims Adjuster

Field Claims Adjuster

EAC Claims Solutions LLCAlbuquerque, New Mexico, United States
[job_card.full_time]
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency.Join us in delivering exceptional service while upholding the highest standards of professionalism and co...[show_more][last_updated.last_updated_variable_hours]
FEMA Claims Specialist

FEMA Claims Specialist

CDM SmithAlbuquerque, New Mexico
[job_card.full_time]
CDM Smith has been supporting FEMA for two years in developing policy, procedures, and processing claims in support of the Hermit’s Peak Calf / Canyon fire. We are looking for additional staff to proc...[show_more][last_updated.last_updated_variable_days]
Team Lead, Claims and Quality Control

Team Lead, Claims and Quality Control

AtkinsRéalisAlbuquerque, NM, United States
[job_card.permanent]
Team Lead, Claims and Quality Control.We are gearing up for a high-volume hiring effort in support of the Hermit's Peak / Calf Canyon claims operation through DHS. This project is part of a major fe...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Senior Product Manager - Claims Solutions

Senior Product Manager - Claims Solutions

Gradient AIAlbuquerque, NM, US
[job_card.full_time]
Senior Product Manager - Claims Solutions.Gradient AI is revolutionizing Group Health and P&C insurance with AI-powered solutions that help insurers predict risk more accurately, improve profitabil...[show_more][last_updated.last_updated_30]
  • [promoted]
Analyst, Claims Research

Analyst, Claims Research

New Mexico StaffingAlbuquerque, NM, US
[job_card.full_time]
Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing ...[show_more][last_updated.last_updated_1_day]
Medical Claims Specialist

Medical Claims Specialist

Critical Nurse Staffing, LLCAlbuquerque, NM
[job_card.full_time]
Full-Time, In-Office, Monday-Friday.Medical, dental, vision, and 401K.On behalf of CNS Cares, LLC (“CNS” or “Company”), this position is responsible for developing relationships with leads and clai...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Claims Team Lead, Transportation (APD)Remote Atlanta, Georgia, United States

Claims Team Lead, Transportation (APD)Remote Atlanta, Georgia, United States

ReservAlbuquerque, NM, US
[filters.remote]
[job_card.full_time]
Claims Team Lead, Transportation (APD).Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims.Founded by insurtech vet...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Investigator - Experienced

Claims Investigator - Experienced

Command InvestigationsAlbuquerque, NM, US
[job_card.full_time]
Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE / COE, Auto, and Homeowners. SIU experience is highly desired, but not require...[show_more][last_updated.last_updated_30]
Claims Intake Specialist

Claims Intake Specialist

New Mexico MutualAlbuquerque, NM, United States
[job_card.full_time]
Job Title : Claims Intake Specialist.Department : Provider Relations.Reports to : Claims Administration Supervisor.The Claims Intake Specialist will function in a fast-paced and high-volume environmen...[show_more][last_updated.last_updated_30]
  • [promoted]
Senior Analyst, Claims Research

Senior Analyst, Claims Research

Molina HealthcareAlbuquerque, NM, United States
[job_card.full_time]
The Senior Claims Research Analyst provides senior-level support for claims processing and claims research.Analyst, Claims Research serves as a senior-level subject matter expert in claims operatio...[show_more][last_updated.last_updated_variable_days]
Sr. Liability Claims Representative

Sr. Liability Claims Representative

AMERINDAlbuquerque, New Mexico, United States, 2F7Q+4F
[job_card.30_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
  • [filters_job_card.quick_apply]
[job_card.job_description]

AMERIND is a federally chartered, tribally owned corporation, formed under Section 17 of the Indian Reorganization Act (25 U.S.C. § 5124) by its Members, the governmental units of federally recognized Tribal Nations that administer federally funded housing programs for American Indian and Alaska Native families.  AMERIND has the operating authority to work with Tribal Governments, Enterprises, and Citizens for Property and Liability, Workers Compensation, Homeowners and Renters, Employee Benefits coverage, Fleet Auto coverage, and Critical Infrastructure development.

Position Characteristics and Competencies

  • Excellent time and project management skills
  • Meticulous attention to detail
  • Advanced knowledge of industry-specific software applications
  • Excellent customer relations skills
  • Ability to provide transparent information and demonstrate high customer service
  • Team collaboration
  • Excellent fundamental understanding of insurance policy terminology
  • Problem-solving and analytical thinking
  • Strong verbal and written communication skills
  • Strong negotiation skills
  • Ability to speak and present in public
  • Interest in discovering and developing new ideas.
  • Service and people-oriented.
  • Agile and adaptable decision-making
  • Problem-solving approach that suggests trustworthiness
  • Familiarity with technology infrastructure and user of technology tools

Job Summary

We are currently seeking an experienced Senior General Liability Adjuster to investigate complex liability insurance claims. This role entails determining fault and damages, negotiating settlements, and managing claims from inception to closure in accordance with both legal and company guidelines. Key responsibilities involve evaluating intricate bodily injury and property damage cases, collaborating with legal counsel on litigated claims, working with various departments, mentoring junior staff, and maintaining comprehensive claim files. Essential qualifications typically include extensive experience in claims adjustment, strong analytical and communication skills, and a thorough understanding of insurance regulations and company policies. Additionally, we seek a Senior Auto Adjuster to investigate, evaluate, and settle complex auto claims. This position includes determining coverage, liability, and damages while managing negotiations and collaborating with various stakeholders to reach resolutions within established authority limits and regulatory guidelines. The role requires expert knowledge of auto policies, a solid understanding of the vehicle repair process, excellent communication and negotiation skills, and the ability to document decisions and mentor team members effectively.

This job description does not represent an inclusive list of all duties encompassed in this position.

Job Responsibilities

  • Communicates with customers and associates virtually, over the telephone, in person, and in written correspondence.
  • Takes initial calls and provides instructions on claim filing requirements.
  • Investigates claims on-site, evaluates damages, completes coverage analysis, damage assessments, cause / origin determination, and submits a field report with a narrative, estimate, photos, and any other pertinent information for the damages.
  • Utilizes policy and investigation reports to determine compliance and validity of claims for processing or denial.
  • Interviews claimants, specialists, witnesses, physicians, or other professionals as necessary.
  • Determines liability and total value of claim; negotiates settlements and makes recommendations regarding litigation.
  • Issues denial notification regarding claim issues, i.e., claim not covered or does not meet deductible level.
  • Obtains police reports, issue restitution notifications, requests deductible payments, and processes claim payments.
  • Consults with attorneys regarding claims to control costs and assists in making decisions and actions.
  • Negotiates directly with the claimants as necessary.
  • Assists with workflow and the number of claims that are assigned to each examiner.
  • Manages the daily task list of claims which are assigned to each examiner.
  • Reviews and follows up on claims as needed and closes files as appropriate.
  • Performs subrogation and recovery of property claims where there is another responsible party.
  • Maintains claim files and other related documents pertinent to insurance claim activities.
  • Acts as a resource to all other claims staff.  Provides support, direction, advice, and mentoring.
  • Assists in the development of claims staff policy, procedure, and protocol.
  • Assist and develop training presentation material.
  • Maintains confidentiality of all information.
  • Participates in cross-functional team process improvement projects.
  • Performs other duties as assigned.

    • Supervision of Others

    N / A

    Minimum Qualifications

  • Bachelor’s degree in insurance, Economics, Business Administration, or related field and ten years’ experience in insurance, claims handling, or risk management required.
  • Designations and certificates from accredited insurance institutions preferred.
  • Minimum of five years of desk adjusting experience involving property claims required.
  • Minimum of five years of field adjusting experience involving property + liability claims required.
  • Minimum of five years of field adjusting experience using software applications such as Symbility, Xactimate, or Xactanalysis preferred.
  • Minimum of three years of carrier risk information system experience such as Guidewire or Sapiens preferred.
  • Must possess a valid driver’s license
  • Must be able to successfully pass a background investigation; no felony, theft or fraud convictions.
  • Must be able to travel 50% as needed.

    • Additional Eligibility Requirements

  • New employees must complete the Associate in Insurance (AINS) designation within six months from the end of the 90-day evaluation period to be eligible for advancement and incentive compensation.
  • For continued employment, employees must complete an elective course and six hours of professional development within 12 months after the end of the 90-day evaluation period.

    • Knowledge / Skills / Abilities

  • Knowledge of applicable federal, state, Tribal, and local laws, regulations, and requirements.
  • Knowledge of property, auto, liability insurance laws, policies, and regulations.
  • Knowledge of medical and insurance terminology, and of claims processing practices.
  • Knowledge of occupational safety theory, principles, and practices.
  • Knowledge of modern office practices, procedures, and equipment.
  • Ability to communicate effectively in the English language, both verbally and in writing.
  • Ability to analyze situations and adopt appropriate courses of action.
  • Ability to work effectively under stressful conditions.
  • Ability to interact and maintain good working relationships with individuals of varying social and cultural backgrounds, employees and officials.
  • Ability to develop and interpret policies, procedures, and regulations.
  • Ability to maintain an accurate and organized filing system of complex insurance records and reports.
  • Ability to handle multiple tasks and meet deadlines.
  • Ability to exercise independent judgment.
  • Ability to train and present information to others.
  • Ability to follow oral and written instructions.
  • Ability to collect and analyze data and prepare and present accurate reports and recommendations.
  • Ability to act with integrity and maintain confidentiality.
  • Skill in performing statistical and mathematical computations.
  • Skill in preparing, presenting, reviewing, and analyzing insurance claims, forms, and reports.
  • Skill in providing excellent customer service.
  • Skill in operating business computers and office machines, including in a Windows environment, specifically Word, Excel, Access, and presentation software (such as PowerPoint).
  • Database management skills.
  • Excellent telephone communication skills.

    • Working Conditions & Physical Demands

  • Typical business office setting with moderate noise level and outdoor settings with a high noise level.
  • Non-office environment may be encountered for offsite presentations and support of company activities.
  • While performing outdoor duties, one may be exposed to natural weather conditions and temperatures, various dusts, smoke, and mists, as well as normal debris and hazards.
  • Must be able to sit for work at a computer and phone for more than 6 hours per day.
  • Must be able to speak clearly.
  • Must be able to use hands for dexterity of motion.
  • Frequently required to stand, walk and reach with hands and arms.
  • Must have ability to occasionally lift 20 + lbs.
  • Must have ability to climb ladders for a property inspection.
  • Must be willing to travel as necessary.
  • Minimal business travel required.

    • Physical Exam

    Employee is required to successfully pass an annual physical exam to certify that the incumbent is capable of performing the physical demands of the job as described above.

    Hiring of AMERIND employees is subject to Section 7(b) of the Indian Self-Determination Act (25 U.S.C. §5307(b)), which requires that, to the greatest extent feasible, preference and opportunities for training and employment shall be given to Native Americans and Alaska Natives.

    PI279869060