Claims Adjuster

3 weeks ago


Austin, Texas, United States Elite Services Full time

Job Summary:

Elite Services is seeking a highly skilled Claims Adjuster - Loss Control Specialist to manage all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines.

Key Responsibilities:

  • Effectively manage a caseload of 110 to 160 workers' compensation files, including very complex claims.
  • Initiate and conduct investigations in a timely manner.
  • Determine compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.
  • Manage medical treatment and medical billing, authorizing as appropriate.
  • Communicate with claimants, providers, and vendors regarding claims issues.
  • Compute and set reserves within Company guidelines.
  • Maintain a diary system for case review and document files to reflect the status and work being performed.
  • Communicate information promptly to clients to resolve claims efficiently.

Requirements:

  • High School Diploma or GED required.
  • Bachelor's degree in a related field (preferred).
  • Five (5) or more years of related experience.
  • Texas Workers Compensation License.

Preferred Qualifications:

  • Technical knowledge of statutory regulations and medical terminology.
  • Analytical skills.
  • Excellent written and verbal communication skills.
  • Ability to interact with persons at all levels in the business environment.
  • Proficient in Word and Excel.

About Elite Services:

Elite Services is a leading provider of workers' compensation claims management services. We are committed to delivering exceptional results and building long-term relationships with our clients.


  • Claims Adjuster

    3 weeks ago


    Austin, Texas, United States Property Claim Professionals Full time

    Job DescriptionWe are seeking a skilled Claims Adjuster to join our team at Property Claim Professionals. As a Claims Adjuster, you will be responsible for investigating and resolving property and liability claims in a professional and timely manner.Key Responsibilities:Investigate claims by obtaining recorded statements from insureds, claimants, or...

  • Field Claims Adjuster

    4 weeks ago


    Austin, Texas, United States CCMS & Associates Full time

    Job Title: Field AdjusterCCMS & Associates is seeking a skilled Field Adjuster to join our team. As a Field Adjuster, you will be responsible for investigating claims, inspecting damages, and recommending claim reserves.Responsibilities:Conduct thorough property inspections using Xactimate softwareInvestigate claims by obtaining statements from insureds,...


  • Austin, Texas, United States STATE OFFICE OF RISK MANAGEMENT Full time

    Job SummaryThe State Office of Risk Management is seeking an experienced Claims Adjuster or Insurance Adjuster to join our team. As a Claims Examiner, you will be responsible for investigating, analyzing, and paying benefits in accordance with the Texas Workers' Compensation Act and Rules.Key ResponsibilitiesReview and determine compensability of workers'...

  • Field Claims Adjuster

    4 weeks ago


    Austin, Texas, United States Western Mutual Insurance Full time

    Job Title: Field Property Claim RepresentativeWestern Mutual Insurance Company is seeking a highly skilled Field Property Claim Representative to join our team in the Austin area.Job Summary: As a Field Property Claim Representative, you will be responsible for inspecting, investigating, and evaluating property claims from inception to close. You will...


  • Austin, Texas, United States Sedgwick Full time

    Job SummaryAt Sedgwick, we're committed to providing exceptional service to our clients and their customers. As a Property Claims Adjuster, you'll play a critical role in handling losses and claims for property and casualty insurers. Your expertise will help us deliver timely and accurate resolutions, ensuring our clients' needs are met and their customers...

  • Claims Adjuster

    3 weeks ago


    Austin, Texas, United States Texas Mutual Full time

    About this RoleAt Texas Mutual, we're dedicated to creating a safer, stronger Texas. As a Claims Adjuster, you'll play a vital role in our mission by conducting thorough claim investigations and administering benefits to injured workers and their beneficiaries, adhering to the Texas Workers' Compensation Act, Division of Workers' Compensation (DWC) rules,...

  • Claims Adjuster

    3 weeks ago


    Austin, Texas, United States Sedgwick Full time

    Job SummarySedgwick is seeking a highly skilled Claims Adjuster - Liability and Property Specialist to join our team. As a key member of our claims management team, you will be responsible for analyzing and resolving complex general liability claims in a fair and timely manner.Key ResponsibilitiesAnalyze mid- and higher-level general liability claims to...

  • Property Adjuster

    4 weeks ago


    Austin, Texas, United States Allstate Insurance Company Full time

    About the RoleWe are seeking a skilled Field Property Adjuster to join our team at Allstate Insurance Company. As a Field Property Adjuster, you will be responsible for conducting on-site inspections, investigating coverage, preparing estimates, and settling claims promptly and efficiently.Key ResponsibilitiesTravel to customers' homes to conduct on-site...


  • Austin, Texas, United States Tesla Full time

    Claims Adjuster Job DescriptionAt Tesla, we're seeking a skilled Claims Adjuster to join our team. As a Claims Adjuster, you will be responsible for analyzing and resolving low-exposure insurance claims with compassion and effectiveness.Key Responsibilities:Analyze policies to assess coverage and liabilityHandle simple to moderate complexity claims,...

  • Auto Damage Adjuster

    3 weeks ago


    Austin, Texas, United States Allstate Insurance Company Full time

    Auto Damage Adjuster Job DescriptionAt Allstate, we're committed to protecting our customers' assets and providing them with exceptional service. As an Auto Damage Adjuster, you'll play a crucial role in our claims handling process, working directly with customers to assess and finalize estimates.Key Responsibilities:Conduct thorough damage assessments at...


  • Austin, Texas, United States Chubb Full time

    Crop Insurance AdjusterJob SummaryWe are seeking a skilled Crop Insurance Adjuster to join our team at Chubb. As a Crop Insurance Adjuster, you will be responsible for handling claims, working with policyholders, and resolving complaints in a professional and timely manner.Key Responsibilities* Handle claims and work with policyholders to resolve issues*...


  • Austin, Texas, United States Tesla Full time

    As a Claims Resolution Expert at Tesla, you will play a critical role in resolving low exposure insurance claims with compassion and effectiveness. This position requires outstanding customer service skills and the ability to handle a high volume of claims.Analyze and interpret policies to assess coverage and liability.Handle simple to moderate complexity...

  • Claims Manager

    3 weeks ago


    Austin, Texas, United States CROWN ADMINISTRATORS Full time

    Job Title: Claims ManagerCROWN ADMINISTRATORS is seeking a highly skilled Claims Manager to join our dynamic team. As a Claims Manager, you will play a crucial role in managing our Medical Needs environment, optimizing its performance, and driving continuous improvements to support our business goals and enhance our service delivery.Key...


  • Austin, Texas, United States Texas Association of School Boards Full time

    About the RoleWe are seeking a highly skilled Workers' Compensation Adjuster III to join our team at the Texas Association of School Boards. As a key member of our claims team, you will be responsible for investigating and evaluating all assigned Workers' Compensation claims, ensuring timely payment of benefits in accordance with Texas WC statutes and...

  • Claims Advocate

    3 weeks ago


    Austin, Texas, United States Watkins Insurance Group Full time

    About the RoleAs a Claims Advocate at Watkins Insurance Group, you will play a vital role in our team, responsible for assisting clients throughout the claims process. Your primary objective will be to bridge the gap between our staff, clients, and insurance companies, ensuring that claims are handled efficiently and effectively.Key Responsibilities:Review...


  • Austin, Texas, United States Amherst Full time

    Job Title: Insurance Claims ManagerAmherst is seeking an experienced Insurance Claims Manager to oversee the insurance claims processes for the Company related to Property and Casualty, Vehicle, and Workers Compensation coverages.Key Responsibilities:Claims Management:Lead the insurance claims process, from initial claim filing to final settlement, ensuring...


  • Austin, Texas, United States Amherst Full time

    The Insurance Claims Director at Amherst is responsible for overseeing the insurance claims processes related to Property and Casualty, Vehicle, and Workers Compensation coverages. This position will ensure that claims are processed efficiently, accurately, and in compliance with all applicable laws and regulations.Key Responsibilities:Claims...


  • Austin, Texas, United States Watkins Insurance Group Full time

    About the Claims Advocate RoleAs a Claims Advocate at Watkins Insurance Group, you will play a vital part in our team, responsible for assisting clients throughout the claims process. You will serve as a bridge between our staff, clients, and insurance companies, ensuring that claims are handled efficiently and effectively. Your role will involve...


  • Austin, Texas, United States Texas Association of School Boards Full time

    Job DescriptionWe are seeking a highly skilled Medical Claims Examiner II to join our team at the Texas Association of School Boards. As a Medical Claims Examiner II, you will be responsible for investigating and evaluating medical only claims in a timely manner, per Texas WC statutes and guidelines.Key Responsibilities:Investigate and evaluate all assigned...

  • Medical Biller

    3 weeks ago


    Austin, Texas, United States Central Business Office, Ambulatory Surgery Division Full time

    Job SummaryWe are seeking a skilled Medical Biller to join our team at Central Business Office, Ambulatory Surgery Division. As a Medical Biller, you will play a critical role in ensuring the accurate and timely submission of medical claims to third-party payers.Key ResponsibilitiesAssign diagnosis and procedure codes for each caseSubmit and upload insurance...