Claims Adjuster

Seven Corners, Inc.

. Review and process claims . Communicate with insureds and third parties to obtain information needed for processing . Obtain medical reviews and translations as needed . Prepare files for Tiered Authorization when

Posted 11/3/2026full-timeRemote • United StatesJuniorMid-Level💰 $55,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in claims processing, including the ability to review and authorize claims according to insurance policy terms and conditions. Proficient in identifying suspicious activities and managing third-party liabilities while maintaining quality and production standards.

Highest-signal resume keywords

Claims ProcessingProperty & Casualty Adjuster LicenseSuspicious Activity IdentificationSubrogation ProcessMS Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ReviewClaims AuthorizationFile Notation MaintenanceMedical Review ProcessingInvestigation Procedures

Soft Skills

Effective CommunicationAttention to DetailTime Management

Tools & Technologies

MS OfficeClaims Processing Software

Certifications & Qualifications

Property & Casualty Adjuster License

Industry Keywords

Insurance Policy TermsQuality StandardsProduction StandardsThird-Party LiabilityCarrier Authority Guidelines

About the role

Key responsibilities & impact

Review and process claims
Communicate with insureds and third parties to obtain information needed for processing
Obtain medical reviews and translations as needed
Prepare files for Tiered Authorization when claims exceed adjuster authority
Prepare files for Carrier Review when required
Identify suspicious activity on claim files and follow investigation procedures
Identify third-party liability and follow the necessary process for subrogation
Review assigned escalations quickly and efficiently
Maintain set quality and production standards
Maintain proper file notations indicating review outcomes
Process claims according to insurance policy terms and conditions
Authorize payment and denial as appropriate

Requirements

What you’ll need

Bachelor’s Degree preferred
Minimum 2 years claims processing preferred
Property & Casualty adjuster license required or ability to acquire one within 90 days of hire
Proficient in MS Office and other relevant software
Ability to process claims according to insurance policy terms and conditions
Ability to adhere to carrier authority guidelines
Ability to authorize payments and denials as appropriate
Ability to identify suspicious claim activity and follow investigation procedures
Ability to identify third-party liability and follow the subrogation process
Ability to maintain quality and production standards
Ability to maintain proper claim file notations

Benefits

Comp & perks

Competitive health plans
HSA contributions
Employer-paid Life & AD&D
Short- and Long-Term Disability
Competitive employer retirement matching program
Paid parental leave for birthing parents, partners, adoptive, and foster parents
Flexible paid time off
Hybrid and remote work opportunities
Flexible scheduling around core hours
Internal mobility opportunities
Leadership development
Ongoing coaching
Exclusive discounts on travel, entertainment, wellness, and more
Training and mentoring