Segmentation Claims Specialist

Everest Group • Warren, NJ

1d • Hybrid

About The Position

Everest is seeking an early-career claims professional to join its Casualty Claims team. The Segmentation Claims Specialist investigates newly reported casualty losses, often with limited initial information, by gathering facts, clarifying what occurred, and determining whether claims should be assigned to Fast Track, Mainstream, or Complex claim teams. The specialist works with insureds, brokers, other insurance carriers, and attorneys—often by phone—to obtain accurate information and summarize findings for internal claims teams. The role offers exposure to a range of claim types, injuries, damages, and legal scenarios, and is described as a launchpad for recent graduates interested in insurance, legal services, risk management, or related fields.

Requirements

• Bachelor’s degree in legal studies, Criminal Justice, PreLaw, Political Science, Business, Finance, or a related field.
• Strong written and verbal communication skills, including the ability to translate complex information into clear, 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, well-supported conclusions.
• Strong time-management skills and ability to prioritize multiple tasks while maintaining attention to detail.
• Collaborative and team-oriented mindset.

Nice To Haves

• Recent graduates and early-career candidates are encouraged to apply.
• Interest in pursuing a career in insurance, risk management, legal services, or related fields.
• Curiosity and willingness to learn and responsibly use approved AI, automation, and emerging technologies to enhance productivity, effectiveness, and business outcomes.

Responsibilities

• Serve as a primary point of contact for policyholders and brokers on newly reported claims.
• Review initial claim documentation and request missing or clarifying information.
• Respond promptly and professionally to inquiries about assigned claims.
• Call 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, concise claim narratives explaining the event, the insured’s involvement, and alleged injuries or damages.
• Assess potential injury severity and identify issues requiring escalation.
• Triage and route claims based on complexity, severity, coverage, and litigation indicators.
• Monitor incoming updates and reassess claim severity as needed.
• Document key facts, call outcomes, and recommended next steps in internal systems.
• Enter claim data accurately and prepare standard correspondence.
• Ensure compliance with state and federal regulations and Everest policies and procedures.

Benefits

• Health insurance coverage
• Employee wellness program
• Life and disability insurance
• 401(k) match
• Retirement savings plan
• Paid holidays
• Paid time off (PTO)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level