1

Direct Claims Jobs in Colorado (NOW HIRING)

Prioritizes and manages assigned claims workload to keep members and other involved parties ... Directors. The above description reflects the details considered necessary to describe the ...

... director. * Documents and maintains claim appeal status in the claim appeal tracking tool. * Sends ... Finalizes claims as needed and communicates with Cognizant on the status of daily pend reports.

Identifies, confirms, and makes coverage decisions on soft tissue claims. * Investigates loss ... Directors. The above description reflects the details considered necessary to describe the ...

Identifies, confirms, and makes coverage decisions on soft tissue claims. * Investigates loss ... Directors. The above description reflects the details considered necessary to describe the ...

Identifies, confirms, and makes coverage decisions on soft tissue claims. * Investigates loss ... Directors. The above description reflects the details considered necessary to describe the ...

Showing results 21-40

Direct Claims information

What is a direct claim?

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.

Can you work remotely in direct claims jobs?

Many direct claims jobs offer remote work options, especially for roles involving claims processing, customer service, or administrative tasks. Employers may require familiarity with claims management software and good communication skills, and remote positions often involve standard office hours and secure internet connections.

Do I need a degree to be a direct claims specialist?

A degree is not typically required to become a direct claims specialist, but relevant experience, knowledge of insurance policies, and strong communication skills are important. Many employers provide on-the-job training and may prefer candidates with a high school diploma or equivalent. Certifications in insurance or claims processing can enhance job prospects.

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?

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.

What cities in Colorado are hiring for Direct Claims jobs? Cities in Colorado with the most Direct Claims job openings:

Sr. Injury Claims Adjuster

USAA

Colorado Springs, CO • On-site, Remote

$63K - $121K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 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 170 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 dedicated Sr. Injury Adjuster, you will work within defined guidelines and framework, responsible to adjust attorney involved moderately complex bodily injury claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations. Accountable for delivering a concierge level of best in class member service through setting appropriate expectations, proactive communications, advice, and compassion.

This hybrid role requires an individual to be in the office 3 days per week. This position can be based in one of the following locations: San Antonio, TX; Chesapeake, VA; Tampa, FL; Colorado Springs, CO and Phoenix, AZ. Relocation assistance is not available for this position.

What you'll do:

  • Identifies and manages existing and emerging risks that stem from business activities and the job role.

  • Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.

  • Follows written risk and compliance policies, standards, and procedures for business activities.

  • Adjusts attorney-involved moderately complex bodily injury claims with demonstrable injuries (e.g. torn meniscus, broken bones, disc herniations), as well as all auto physical damage associated with those claims.

  • Identifies, confirms, and makes coverage decisions on moderately complex bodily injury claims.

  • Investigates loss details, determines legal liability, evaluates, negotiates, and arrives at claim settlement within appropriate authority guidelines.

  • Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.

  • Prioritizes and manages assigned claims workload to keep members and other involved parties informed, provides timely claims status updates.

  • Collaborates and supports team members to resolve issues and identify appropriate matters for escalation.

  • Partners and/or directs vendors and internal business partners to facilitate timely claims resolution.

  • Supports workload surges and/or Catastrophe Operations as needed.

  • May act as an informal resource for team members with less experience.

What you have:

  • High School or General Equivalency Diploma.

  • 1 year of injury adjusting experience.

  • 2 years of auto liability claims adjusting experience.

  • Deep knowledge and understanding of the auto claims contract as well as application of case law and state laws and regulations.

  • Proficient negotiation, investigation, communication, and conflict resolution skills.

  • Demonstrated time-management and decision-making skills.

  • Proven investigatory, prioritizing, multi-tasking, and problem-solving skills.

  • Proficient knowledge of human anatomy and medical terminology associated with bodily injury claims.

  • Ability to exercise sound financial judgment and discretion in handling insurance claims.

  • Proficient knowledge of coverage evaluation, loss assessment, and loss reserving.

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

What sets you apart:

  • Current Early Settlement or have at least one year of previous Early Settlement experience.

  • 2 years of handling attorney represented third party injury claims.

  • 4 or more years auto liability/casualty adjusting experience.

  • Ongoing Professional Development with a focus on Insurance. 

  • Bachelors degree or higher.

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

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.


What USAA employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom