Claims Representative II

Pacific Neuroscience Institute (PNI)

. Investigate, evaluate, and resolve assigned claims accurately and promptly .

Posted 11/9/2026full-timeWaukesha • Wisconsin • United StatesJunior💰 $52,000 - $72,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in claims investigation, evaluation, and resolution, with a strong focus on customer service and effective communication. Proficient in handling various types of claims, including auto property damage and workers' compensation, while ensuring compliance with relevant laws and regulations.

Highest-signal resume keywords

Claims HandlingAdjuster's LicenseCustomer Service ExperienceEffective Communication SkillsAttention to Detail

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

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

Hard Skills

Claims InvestigationClaims ResolutionPolicy Coverage VerificationSubrogationBodily Injury Claims HandlingTort Law UnderstandingUnfair Claims Settlement Practices Act KnowledgeReserves AdjustmentField WorkDocumentation Preparation

Soft Skills

Interpersonal SkillsOrganizational SkillsTeam CollaborationDependabilityProblem-Solving

Tools & Technologies

Microsoft ProductsOffice EquipmentAutomated SystemsAssistive Technologies

Certifications & Qualifications

Adjuster's License

Industry Keywords

Property/Casualty ClaimsClaims Service OfficeInsurance Policy ProvisionsMedical TerminologyLegal TerminologyAutomotive TerminologyConstruction Terminology

About the role

Key responsibilities & impact

Investigate, evaluate, and resolve assigned claims accurately and promptly
Prepare complete claim file documentation, including statements, photos, facts, and environmental factors
Contact and negotiate with policyholders, claimants, third parties, medical and legal professionals
Handle arbitration, litigation, subrogation, contribution, and salvage processes
Settle assigned auto property damage, non-complex workers’ compensation, property loss, and simple bodily injury claims
Identify and pursue subrogation and salvage opportunities
Perform basic and intermediate claims handling duties
Verify coverage and policy provisions to determine insurability or compensability
Resolve policyholder, self-insured, and claimant problems or requests
Analyze and resolve coverage and liability issues
Gather and evaluate factual information related to assigned claims
Set or adjust reserves based on liability and claim value
Perform limited field work and low-exposure, low-complexity workers’ compensation and bodily injury claims handling when directed
Generate alternative solutions for assigned claims
Collaborate with Claims Service Office personnel, underwriting, agents, policyholders, claimants, third parties, medical and legal professionals, and vendors
Perform other duties assigned by Claims Service Office leadership

Requirements

What you’ll need

Bachelor's degree preferred
Adjuster’s license or willingness to obtain one as required
Successful completion of Claims Representative II Trainee curriculum or a minimum of 1 year experience in a property/casualty claims handling position
Customer service experience preferred
Effective oral and written communication skills
Effective interpersonal skills
Effective organizational skills and ability to work independently
Detail-oriented, with significant attention to detail
Personal computer skills, especially Microsoft products
Ability to work in a team-oriented, fast-paced, customer-focused environment
Basic understanding of tort and state laws applicable to assigned claims
Basic understanding of the Unfair Claims Settlement Practices Act, insurance policy coverages and provisions, and medical, legal, automotive, and construction terminology
Ability to perform computer-based tasks and access digital information, including through assistive technologies
Ability to use office equipment and automated systems accurately
Ability to communicate effectively with internal and external clients via telephone, electronic, or other communication systems
Ability to present information to individuals and groups
Ability to interpret and apply concepts that may or may not be based upon established guidelines
Acceptable attendance and adherence to scheduled work hours
Dependability

Benefits

Comp & perks

Annual incentive program, depending on eligibility
Generous 401(k) match
Graded profit sharing
Incentive compensation
Remote and hybrid work options
Flexible scheduling
“Dress-for-your-day” culture
Employee recognition programs
Continuing education support
100% tuition reimbursement for academic studies
Professional development opportunities
Tailored designation programs such as CPCU, AINS, CPA, CISSP, and more
Employee volunteering opportunities
Company matches for employee contributions to the annual United Way campaign