Segmentation Claims Specialist

Everest

. Serve as a primary point of contact for policyholders and brokers on newly reported claims .

Posted 11/6/2026full-timeUnited StatesMid-LevelSenior💰 $77,000 - $105,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong analytical and investigative skills to evaluate claims accurately while ensuring compliance with state and federal regulations. Exhibits excellent communication abilities and a collaborative mindset to effectively engage with policyholders, brokers, and legal professionals.

Highest-signal resume keywords

Claims EvaluationAnalytical SkillsWritten And Verbal CommunicationInvestigative SkillsTime Management

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims DocumentationData EntryPolicy ReviewClaim AnalysisTriage And Routing

Soft Skills

Organizational SkillsProfessionalismCollaborationCuriosityAttention To Detail

Industry Keywords

InsuranceRisk ManagementLegal ServicesComplianceClaim Management

About the role

Key responsibilities & impact

Serve as a primary point of contact for policyholders and brokers on newly reported claims
Review initial documentation and request 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 additional details
Ask targeted follow-up questions and resolve incomplete or conflicting information
Conduct investigations and analysis to support accurate claim evaluation
Review applicable insurance policies to confirm coverage, limits, and exposures
Develop clear and concise claim narratives explaining events, insured involvement, injuries, and alleged damages
Assess potential injury severity and identify issues requiring escalation
Triage and route claims to Fast Track, Mainstream, or Complex claim teams
Monitor incoming updates and reassess claim severity as necessary
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
Work closely with insureds, brokers, other insurance carriers, attorneys, and internal claim teams

Requirements

What you’ll need

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
Analytical, organizational, and investigative strengths
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 and ability to prioritize multiple tasks while maintaining attention to detail
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
Collaborative and team-oriented mindset

Benefits

Comp & perks

Health insurance coverage
Employee wellness program
Life and disability insurance
401k match
Retirement savings plan
Paid holidays
Paid time off (PTO)
Reasonable accommodations for persons with disabilities