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Direct Claims Jobs in Florida (NOW HIRING)

1 Legacy, Inc

Manager I Claims

Miami, FL

Responsible for directing the planning, design, development, implementation and evaluation of policies and procedures that assure accurate, timely claims and encounter processing and provider ...

1 Legacy, Inc

Manager I Claims

Doral, FL · On-site

Responsible for directing the planning, design, development, implementation and evaluation of policies and procedures that assure accurate, timely claims and encounter processing and provider ...

1 Legacy, Inc

Manager I Claims

Doral, FL · On-site

Responsible for directing the planning, design, development, implementation and evaluation of policies and procedures that assure accurate, timely claims and encounter processing and provider ...

INTEGRO

Ancillary Claims Adjuster

Tampa, FL · On-site

$45K - $55K/yr

As an Ancillary Claims Adjuster, you'll play a critical role in the claims administration process ... Weekly payroll with direct deposit * Comprehensive healthcare options, including medical, vision ...

INTEGRO

Ancillary Claims Adjuster

Orlando, FL · On-site

As an Ancillary Claims Adjuster, you'll play a critical role in the claims administration process ... Weekly payroll with direct deposit * Comprehensive healthcare options, including medical, vision ...

ARC Group

Claims Adjustor (BI)

Oakland Park, FL · Remote

CLAIMS ADJUSTER (remote) ARC Group seeks two Bodily Injury Claims Adjuster to work in a remote contract role for our direct client based in Fort Lauderdale, FL. This is a 90 day contract to start and ...

Assuranceamerica

Claims Adjuster Trainee

Tampa, FL

The Claims Adjuster Trainee will work with minimal authority under direct supervision. Job Responsibilities: Complete required training courses with a successful score Obtain State of Georgia ...

Slide Insurance

Claims Adjuster

Tampa, FL · On-site

Proactively communicate and set accurate claims expectations with customers throughout the Claims ... Assign, direct, and monitor vendors conducting mitigation and/or other services during the ...

Corvel

Claims Specialist

Tampa, FL · Hybrid

$52K - $85K/yr

... direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers ...

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All JobsDirect Claims JobsDirect Claims Jobs in Florida

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.

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 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 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 are popular job titles related to Direct Claims jobs in Florida?

For Direct Claims jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Direct Claims jobs in Florida look for?

The top searched job categories for Direct Claims jobs in Florida are:

What cities in Florida are hiring for Direct Claims jobs?

Cities in Florida with the most Direct Claims job openings:

Direct Claims jobs near you

Senior Claims Adjuster, Specialty

LotSolutions, Inc.

Jacksonville, FL

$90K - $150K/yr

Full-time

Re-posted 6 days ago

Job description

This full-time position will report to the Manager of Specialty Claims. As a direct report to the Manager of Specialty Claims, you should possess the ability to handle and manage a wide variety of severity/complex claims with coverage issues as well as coverage litigation within our Professional Liability line of business.

Minimum Qualifications:

  • A Bachelor’s degree in Business Administration, Accounting, Finance, or a related field, or the equivalent education and/or experience.
  • 5-10 years of relevant and progressive experience handling Professional Liability claims.
  • Adjuster licenses, as mandated by specific states, are required.

Primary Job Functions:

  • Direct management and oversight of professional lines claims with potential for significant severity and complexity.

  • Direct management of coverage disputes.

  • Formulating claims and litigation strategies, assigning, directing, and managing outside counsel.

  • Promptly investigating all assigned claims to complete coverage, liability, and damages analysis.

  • Ensures timely disposition of all claims in accordance with regulatory and statutory requirements.

  • Maintain and manage a diary system to efficiently and effectively resolve all claims.

  • Present recommendations to management pertaining to coverage, settlement positions and loss reserves.

  • Build and maintain key relationships with internal and external stakeholders (e.g. Reinsurers, Underwriters, Actuarial, Brokers, Attorneys, Vendors, etc.).

  • Participate in Claim Reviews and claim audits.

  • Attend depositions, settlement conferences and trials when necessary.

  • Performs other duties or special projects as required or as assigned by a supervisor.

The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.

Skills & Competencies Required:

  • Excellent written and verbal communication skills
  • Strong analytical skills
  • Strong negotiation skills
  • In-depth knowledge of claims, litigation, and trial process
  • Excellent organizational and time management skills
  • Proficiency in MS Office (Word, Excel, Outlook)
  • Ability to work independently with limited supervision
  • Ability to successfully obtain the required state adjusters’ licenses 

Additional Information:

  • Full benefit package including medical, dental, life, vision, company paid short/long term disability, 401(k), tuition assistance and more.
  • The anticipated salary for this position is $90,000 - $150,000 per year, based on qualifications and experience.
  • Internal Notice: As part of our commitment to talent development, this position is open for internal promotion applications at the time of public posting.
  • Fortegra is not accepting unsolicited resumes from search firms for this position.
  • Please be aware of job fraud(s) – all correspondence emails regarding your candidacy will come from our Fortegra.com email address. Thank you.
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