Segmentation Claim Specialist

Everest•Boston, MA

1d•Hybrid

About The Position

Everest is seeking an early career Claims Professional to join their Casualty Claims team. In this role, the specialist will investigate newly reported Casualty losses, often with limited initial details, by gathering critical facts, clarifying the narrative of what occurred, and determining whether each claim should be assigned to the Fast Track, Mainstream, or Complex claim teams. The role involves working closely with insureds, brokers, other insurance carriers, and attorneys, often by phone, to obtain timely and accurate information, and then summarizing findings for internal claim teams. This position provides exposure to a wide range of claim types, injuries, damages, and legal scenarios and is described as an excellent launchpad for recent graduates exploring careers in insurance, legal services, risk management, or related professional fields.

Requirements

Bachelor's degree in legal studies, Criminal Justice, PreLaw, Political Science, Business, Finance, or a related field (recent graduates and early career candidates encouraged to apply)
Strong written and verbal communication skills, with the ability to translate complex information into clear and professional claim narratives
Analytical, organizational, and investigative strengths with curiosity and persistence in resolving missing or conflicting details
Comfort and professionalism on the phone, including confidence making outbound calls to attorneys, carriers, and other stakeholders
Ability to interpret information, summarize findings, and draw logical and well supported conclusions
Strong time management skills with the ability to prioritize multiple tasks while maintaining attention to detail
Interest in pursuing a career in insurance, risk management, legal services, or related fields; ideal for candidates seeking broad exposure and varied work
Collaborative and team-oriented mindset

Responsibilities

Serve as a primary point of contact for policyholders and brokers on newly reported claims
Review initial documentation and request any missing or clarifying information
Respond promptly and professionally to inquiries related to assigned claims
Make outbound calls to carriers, attorneys, insureds, and claim professionals to obtain details not captured in written reports
Ask targeted follow-up questions and resolve incomplete or conflicting information
Conduct investigation and analysis to support accurate claim evaluation
Review applicable insurance policies to confirm coverage, limits, and exposures
Develop clear and concise claim narratives explaining what happened, how the insured is involved, and what injuries or damages are being alleged
Assess potential injury severity and identify issues requiring escalation
Use investigative findings to triage and route claims appropriately, applying sound judgment regarding complexity, severity, coverage, or litigation indicators
Monitor incoming updates and reassess claim severity as necessary
Document key facts, call outcomes, and recommended next steps in internal systems to provide downstream teams with actionable information
Enter claim data accurately and prepare standard correspondence
Ensure compliance with all state and federal regulations, as well as Everest policies and procedures