Claims Specialist

Jewelers Mutual • Neenah, WI

5d

About The Position

Summary: Responsible for adjudicating PL, CL, Shipping, and CarePlan claims as assigned. The claims specialist also assists with administrative duties for the department, helping the team effectively negotiate and resolve claims in a timely manner and in accordance with established good faith handling procedures. A secondary responsibility within this role is to provide support to the Jewelry Recovery Specialist with salvage-related documentation including salvage-related invoices, payments, and recoveries. Why Jewelers Mutual: Since 1913 we’ve been committed to supporting the Jewelry industry and putting customers at the center of everything we do. With over a century of trusted expertise, we’re financially strong, forward-thinking, and driven by curiosity. Guided by our core values of Agility, Accountability, and Relevancy, we lead through innovation. As a technology focused organization, we embrace cutting-edge tools and data-driven insights to continuously improve our products, services, and customer experience. Our mission is to be the industry’s most trusted advisor by investing in our people, adopting new technologies, and striving for excellence. We’re dedicated to fostering growth through collaboration, powered by bold thinking, teamwork, and the passion of our people. Here, you’ll: Move fast and embrace change Always look for better ways Grow, thrive, and help shape what’s next Join us and be part of a culture where you can make an impact while building your future.

Requirements

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Property/casualty insurance adjusting experience is desired.
• Jewelry expertise, including experience working in the jewelry trade, is desired.
• Proficient in Microsoft suite applications including Word, Excel, Outlook, and PowerPoint.
• Proficiency in Guidewire software desired.
• CERTIFICATES, LICENSES, REGISTRATIONS None
• PHYSICAL REQUIREMENTS Prolonged periods sitting at a desk and working on a computer.
• Occasionally required to stand; walk; use hands to finger, handle, or touch objects or controls; and talk or hear.

Responsibilities

• Investigates, evaluates, and resolves multi-line claims in accordance with established procedures, good faith practices, and in accordance with the policy.
• Examines claim adjustors’ reports or similar claims/precedents to determine extent of coverage and liability.
• Pays claimant/insured amount due according to our contractual obligation and in alignment with our company procedures.
• Identifies and refers questionable claims to the special investigation unit in accordance with established fraud reporting procedures.
• Maintains excellent written and verbal correspondence with all parties involved on the claim.
• Evaluates and obtains damage documentation to accurately set reserves and effectively resolve claims.
• Maintains current status on claims and reviews claims on diary system.
• May be required to provide testimony under oath on claims in litigation.
• Provides quality customer service along with accurate and timely claim investigations and payments.

Benefits

• Competitive Compensation & Benefits: Includes performance bonuses, generous paid time off, and a top-tier retirement program with 401(k) matching and additional company contributions.
• Collaborative Culture : Work alongside talented, passionate peers who value ownership and continuous learning.
• Community & Giving : Benefit from 50% charitable gift matching and paid volunteer time to support nonprofit causes
• Great Place to Work® Certified : Join a team recognized for an environment of innovation and growth.
• Accessibility and Accommodations We are committed to providing an inclusive and accessible recruitment process. If you require accommodation at any stage of the application or interview process, please let us know by contacting [email protected].

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed