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Claims Adjudication Remote Jobs in Indiana (NOW HIRING)

Sr. TLE Auto Appraiser

Goshen, IN · On-site +1

$63K - $121K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... and accurate claims adjudication. * Responsible for reviewing additional damages received from ...

Sr. TLE Auto Appraiser

South Bend, IN · On-site +1

$63K - $121K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... and accurate claims adjudication. * Responsible for reviewing additional damages received from ...

Claims Adjudication Remote information

What are the key skills and qualifications needed to thrive as a claims adjudication remote specialist, and why are they important?

To thrive as a Claims Adjudication Remote specialist, you need a solid understanding of insurance policies, medical terminology, and claims processing, often supported by a high school diploma or relevant experience. Familiarity with claims management software, electronic data interchange (EDI) systems, and occasionally industry certifications like AAPC or AHIMA is beneficial. Attention to detail, analytical thinking, and strong communication skills help ensure accuracy and effective collaboration with team members and clients. These skills are essential for timely and accurate claims processing, minimizing errors, and maintaining regulatory compliance in a remote work environment.

What is claims adjudication in a remote job setting?

Claims adjudication is the process of reviewing and processing insurance claims to determine their validity and the amount payable to policyholders. In a remote setting, claims adjudicators use specialized software and secure access to company databases to evaluate claims from home or another remote location. They verify the details of each claim, check compliance with policy terms, and communicate with clients or healthcare providers as needed. Remote claims adjudicators must be detail-oriented, have strong analytical skills, and maintain confidentiality while handling sensitive information.

What are some common challenges faced by remote claims adjudicators, and how can they be effectively managed?

Remote claims adjudicators often encounter challenges such as maintaining clear communication with team members, staying updated with frequently changing policies, and managing a high volume of complex cases independently. To manage these effectively, it's important to leverage collaboration tools, participate in regular virtual team meetings, and stay proactive in seeking clarification on policies or procedures. Additionally, strong organizational skills and self-discipline are crucial for meeting deadlines and maintaining accuracy in remote settings.

What are the most commonly searched types of Claims Adjudication jobs in Indiana?

The most popular types of Claims Adjudication jobs in Indiana are:

What cities in Indiana are hiring for Claims Adjudication Remote jobs?

Cities in Indiana with the most Claims Adjudication Remote job openings:

Sr. TLE Auto Appraiser

USAA

Goshen, IN • On-site, Remote

$63K - $121K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 14 days ago


USAA rating

8.2

Company rating: 8.2 out of 10

Based on 262 frontline employees who took The Breakroom Quiz

51st of 171 rated banks


Job description

Why USAA?

At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.

Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.

We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs.

The Opportunity

As a Sr. TLE Auto Appraiser, within defined guidelines and framework, will be responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in compliance with state laws and regulations. Accountable for delivering exceptional member service through setting appropriate expectations, proactive communications, advice, and empathy.

This role is remote eligible in the state of Michigan with occasional business travel.

What you'll do:

  • With the use of digital tools, evaluates and appraise highly complex auto physical damage claims in accordance with the terms and conditions of the contract, corporate guidelines and state laws and regulations.

  • Investigates claim damages including communicating with the insured, internal claims adjusters, and third parties/vendors. May require face-to-face interactions with members and third parties.

  • Reviews facts of loss and vehicle damage to determine if subrogation opportunities exist and ensures all supporting physical damage documentation is in the claim.

  • Demonstrates advanced knowledge of P&C insurance industry products, services, contracts, and internal processes/systems/procedures to ensure compliance with laws, regulations, and policy provisions.

  • Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for handling, if applicable.

  • Maintains accurate and current claim file documentation throughout the claims process for complex claims.

  • Maintains high standards of productivity through effective desk management, timely follow ups, and accurate mapping of repair plan and timeline for repair in support of fast and accurate claims adjudication.

  • Responsible for reviewing additional damages received from repair facilities to either complete a supplement or triage to field provider method of inspection.

  • May serve as a subject matter expert representative for disputed claims or trials. Serves as a resource for team members on escalated issues of a routine nature.

  • Partners with vendors and internal business partners to facilitate highest complexity claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance.

  • Proactively provides policyholders with information regarding their coverage, repair estimate or total loss valuation, and claims/repair process while setting appropriate expectations.

  • Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.

  • May be assigned CAT deployment travel with minimal notice during designated CATs.

  • Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.

  • Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

What you have:

  • High School Diploma or General Equivalency Diploma.

  • 2 years of auto appraising experience.

  • Proficient knowledge of P&C insurance policy contracts and coverages, auto parts distribution process and claim appraisal process and procedures.

  • Advanced working knowledge of estimating losses using CCC or similar estimating platforms.

  • Demonstrated written and verbal skills to communicate with members, claimants, repair facilities, and other internal and external stakeholders.

  • Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.

What sets you apart:

  • US military experience gained through military service or gained as a military spouse / domestic partner

  • I-CAR certification

Compensation range: The salary range for this position is: $63,590 - $121,530.

USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).

Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.

For more details on our outstanding benefits, visit our benefits page on USAAjobs.com

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.


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