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Direct Claims Jobs (NOW HIRING)

Trean Corporation

Senior Claims Adjuster

Ontario, CA · On-site

$85K - $95K/yr

Direct claims assistants to facilitate adjuster assignments as required. This includes directing clerical staff in duties such as copying documents, scheduling medical appointments for injured ...

Trean Corporation

Senior Claims Adjuster

Ontario, CA · On-site

$85K - $95K/yr

Direct claims assistants to facilitate adjuster assignments as required. This includes directing clerical staff in duties such as copying documents, scheduling medical appointments for injured ...

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Trean Corporation

Senior Claims Adjuster

Ontario, CA

$85K - $95K/yr

Direct claims assistants to facilitate adjuster assignments as required. This includes directing clerical staff in duties such as copying documents, scheduling medical appointments for injured ...

JT2 Integrated Resources

Claims Examiner

Oakland, CA · On-site

Train and direct Claims Assistants to meet goals and deadlines. * Review and approve priority payments and other documents from Claims Assistants. * Performs other duties as assigned Knowledge ...

Aston Carter

Claims Assistant

Portland, OR · On-site

$22/hr

Direct claims that exceed assigned authority levels to the Claims Specialist and Claims Manager as appropriate. * Interact professionally via phone and email with homeowners, roofers, distributors ...

Aston Carter

Claims Assistant

Portland, OR · On-site

$22/hr

Direct claims that exceed assigned authority levels to the Claims Specialist and Claims Manager as appropriate. * Interact professionally via phone and email with homeowners, roofers, distributors ...

Brookfield

Director, Claims Triage

Los Angeles, CA · On-site

Creates and maintains a positive working relationship with all direct reports, peers, and other claims department managers to ensure the Triage Department operations adds value and meets or exceeds ...

Brookfield

Director, Claims Triage

New York, NY · On-site

Creates and maintains a positive working relationship with all direct reports, peers, and other claims department managers to ensure the Triage Department operations adds value and meets or exceeds ...

Brookfield

Director, Claims Triage

Richmond, VA · On-site

Creates and maintains a positive working relationship with all direct reports, peers, and other claims department managers to ensure the Triage Department operations adds value and meets or exceeds ...

Brookfield

Director, Claims Triage

Chicago, IL · On-site

Creates and maintains a positive working relationship with all direct reports, peers, and other claims department managers to ensure the Triage Department operations adds value and meets or exceeds ...

Brookfield

Director, Claims Triage

Rockwood, PA · On-site

Creates and maintains a positive working relationship with all direct reports, peers, and other claims department managers to ensure the Triage Department operations adds value and meets or exceeds ...

Brookfield

Director, Claims Triage

Albany, NY · On-site

Creates and maintains a positive working relationship with all direct reports, peers, and other claims department managers to ensure the Triage Department operations adds value and meets or exceeds ...

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All JobsDirect Claims Jobs

Direct Claims information

See salary details

$30.5K

$64.6K

$90K

How much do direct claims jobs pay per year?

As of Jul 1, 2026, the average yearly pay for direct claims in the United States is $64,609.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,000.00 and $75,500.00 per year, depending on experience, location, and employer.

What are direct claims?

Direct claims refer to insurance claims that are filed directly by the policyholder with their own insurance company, rather than going through a third party or the at-fault party's insurer. This process is common in situations like auto accidents, where the policyholder seeks compensation for damages or losses under their own policy. Direct claims help streamline the process, reduce delays, and ensure the policyholder receives prompt assistance and settlements. They are often associated with 'first-party' insurance coverage, such as collision, comprehensive, or health insurance claims.

What are some common challenges faced by professionals in Direct Claims roles, and how can they effectively manage these challenges?

Professionals in Direct Claims often face the challenge of balancing a high volume of claims with the need for thorough investigation and timely resolution. Managing customer expectations and handling sensitive situations, such as denied claims or complex cases, can also be demanding. Effective communication, strong organizational skills, and staying updated on policy guidelines are crucial for success. Building collaborative relationships with adjusters, underwriters, and other departments helps ensure accurate and efficient claims processing.

What are the key skills and qualifications needed to thrive as a Direct Claims Specialist, and why are they important?

To thrive as a Direct Claims Specialist, you need a solid understanding of insurance policies, claims processes, and relevant legal regulations, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, customer relationship management (CRM) systems, and sometimes industry certifications like AIC or CPCU is typical. Exceptional attention to detail, problem-solving abilities, and strong communication skills set top performers apart in this role. These skills and qualifications ensure claims are processed accurately and efficiently, leading to customer satisfaction and minimized risk for the insurer.

What is the difference between Direct Claims vs Claims Adjuster?

AspectDirect ClaimsClaims Adjuster
CredentialsInsurance license, knowledge of policiesInsurance license, sometimes certifications like AIC or CPCU
Work EnvironmentCustomer service, office or remoteFieldwork, office, or remote
Employer & IndustryInsurance companies, agenciesInsurance companies, third-party administrators
Search & Comparison IntentUnderstanding direct claims handlingEvaluating claims adjustment roles

Direct Claims professionals primarily handle claims directly from policyholders, focusing on processing and resolving claims within the insurance company. Claims Adjusters evaluate, investigate, and settle claims, often working in the field or remotely. Both roles require insurance licensing, but Claims Adjusters may have additional certifications. While their work overlaps in claims processing, Direct Claims roles are more customer-facing, whereas Claims Adjusters focus on assessment and negotiation.

More about Direct Claims jobs
What cities are hiring for Direct Claims jobs? Cities with the most Direct Claims job openings:
What states have the most Direct Claims jobs? States with the most job openings for Direct Claims jobs include:
What job categories do people searching Direct Claims jobs look for? The top searched job categories for Direct Claims jobs are:
Direct Claims jobs near you
Infographic showing various Direct Claims job openings in the United States as of June 2026, with employment types broken down into 99% Full Time, and 1% Part Time. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $64,609 per year, or $31.1 per hour.
Senior Claims Adjuster

Senior Claims Adjuster

Trean Corporation

Ontario, CA • On-site

$85K - $95K/yr

Full-time

Posted 23 days ago

Job description

POSITION SUMMARY:
The Senior Claims Adjuster is responsible for managing complex workers compensation claims and assisting the process of determining benefits due the injured worker, ensure ongoing adjudication of claims within company standards and industry best practices and comply with all statutory and regulatory requirements for the administration of workers compensation benefits on behalf of the Company.
KEY RESPONSIBILITIES AND ESSENTIAL FUNCTIONS:
  • New Claims: All new lost time claims require an initial contact with the employer, the injured worker and the medical provider. This must be done within 24 hours of receipt of the claim or notification of a claim.
  • Ensure that all claim determinations and payments are completed timely including but not limited to, acceptance/denial letters, wage determination letters including required enclosures and appeal forms. In jurisdictions requiring the letters be provided in Spanish and English the adjuster is responsible to make sure all letters are completed.
  • The initial payment of TTD is to be completed within 14 days from the receipt of an accepted claim. Wage information is to be solicited from the employer and either an average weekly wage or average monthly (jurisdiction dependent) be established and the information documented in Claims System. In the event actual payroll documentation cannot be obtained from the employer an "estimated wage" is established and a payment reconciliation is done when the verified wage is secured. Initial compensation benefits should NOT be delayed due to the failure of the employer to provide wage documentation.
  • Timely claims determinations for all services including but not limited to: acceptance, denials, authorizations for treatment, benefit payment start, termination are to be included within the statutory or regulatory time frames of the jurisdiction. Denials requiring certified mailing are to be completed timely with appropriate tracking.
  • Regulatory notices are to be completed timely when required by jurisdictions.
  • Approvals and denials of medical bills should be completed within 24 hours of receipt so bills can be repriced and paid timely.
  • Identify the medical providers and medical treatment plan and ensure timely and appropriate medical care is provided to the injured worker. In cases requiring complex or unusual medical care a nurse case manager is to be assigned to facilitate the timely and appropriate care.
  • All communications with all parties and reference to all determinations and correspondence are to be included in the claim notes of Claim System. Each office is "paperless" offices, and all documents need to be scanned and added to the claim claims system and a claim note generated. notes.
  • Manage the legal aspects of the claim and appropriately assign and direct designated attorneys.
  • Assign claims for investigations, including surveillance, medical surveys and social media checks when required and seek supervisor support on related questions.
  • Ensure that all bills for various expenses, including legal bills, managed care bills and similar expenses are paid timely or direct claims assistants to pay such when appropriate.
  • Answer phone calls immediately when in the office. Return all calls and voice mail messages with 24 hrs. Respond to all e-mails when required within 24 hrs.
  • Direct claims assistants to facilitate adjuster assignments as required. This includes directing clerical staff in duties such as copying documents, scheduling medical appointments for injured workers and filing of documents. Coordinate assignments with the supervisor of the assistants.
  • Establish a Plan of Action (POA) on each claim and update the POA monthly.
  • Monitor claims for reinsurance/excess insurance reporting and provide initial reports and quarterly updates on all claims meeting reporting requirements.
  • Performs other activities, assignments and duties as assigned.

Requirements
MINIMUM QUALIFICATIONS:
  • High school diploma or GED required
  • Bachelor's degree or equivalent experience preferred
  • 5 or more years' claims experience preferred
  • Insurance industry knowledge required
  • Excellent analytical skills and verbal and written communication skills
  • Strong organizational skills
  • Strong oral and written communication skills

Salary Description
$85,000 - $95,000

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