Senior Claims Representative, Analyst

Society Insurance

. Independently resolve large and significantly complex claims by investigating losses and negotiating settlements .

Posted 9/15/2026full-timeRemote • Colorado • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in handling complex claims, including investigation, negotiation, and settlement processes, while ensuring compliance with insurance regulations and legal standards. Proficient in mentoring and training staff, managing high-exposure claims, and maintaining strong relationships with stakeholders.

Highest-signal resume keywords

Complex Claims HandlingInsurance Policy KnowledgeLitigation Process ExpertiseClaims NegotiationMentoring and Training

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims InvestigationClaims SettlementCommercial Property ClaimsCasualty ClaimsLegal ResearchClaims DocumentationClaims AnalysisRegulatory ComplianceDiscretionary Decision-MakingMedical Terminology

Soft Skills

Relationship BuildingCommunicationProblem-SolvingCollaborationMentoring

Tools & Technologies

PC ApplicationsWord Processing SoftwareSpreadsheetsEmail SoftwareClaims Management Systems

Certifications & Qualifications

AICARMCICCPCUState Adjuster License

Industry Keywords

Insurance RegulationsClaims ProceduresMediationArbitrationSubrogationCatastrophe TeamsState StatutesLegal TerminologyClaims Vendor ManagementField Investigations

About the role

Key responsibilities & impact

Independently resolve large and significantly complex claims by investigating losses and negotiating settlements
Determine insurance coverage by examining claim forms, policies, records, and evidence; interviewing claimants, injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting experts
Determine carrier liability and settle claims according to policy provisions and authority levels
Handle mediations, arbitrations, subrogation, and litigated files
Mentor and train claims representatives, shared claims staff, and interns
Provide after-hours claims emergency support when on call
Collect, analyze, and summarize claim information and recommend reserve changes and future file handling
Investigate questionable claims and compare claims information with evidence
Recommend litigation and evaluate negotiated settlement options and evidence
Manage higher-exposure and highly complex claim files
Oversee independent adjusters and attorneys to ensure company guidelines and procedures are followed
Prepare reports and ensure proper file documentation in accordance with claims guidelines and state requirements
Participate on catastrophe teams, determine department investigation guidelines, provide underwriting feedback, build agent relationships, and help select vendors
Maintain professional and technical knowledge through training and continuing education
Research state statutes, laws, regulations, case law, technical bulletins, and jurisdictional changes
Communicate changes and impacts to claims handling with Claims Managers, Senior Quality Specialists, and the Claims Director
Analyze business processes and workflows, recommend compliance improvements, and streamline processes
Collaborate with Claims leadership on training and facilitate state meetings
Troubleshoot workers' compensation vendor issues with Claims Vendor Managers and Claims Managers
Assist with state interest credit, penalties, physician panels, annual state reporting, and compliance reviews
Update state materials on the Claims Insider/SharePoint site and communicate updates to staff

Requirements

What you’ll need

Bachelor's degree in business or related field and 7+ years of handling complex claims OR 10+ years of claims handling experience involving discretionary decision-making and increasing levels of claims complexity
Valid driver's license and satisfactory driving record
Willingness to travel in person to mediations, agency visits, key discovery depositions, and field investigations throughout the service area when necessary
Technical proficiency in commercial property and/or casualty claims
Knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology
Ability to obtain and maintain proper licensing prior to handling a state where Society requires it
Familiarity with PC applications including word processing, Internet, spreadsheets, and email software
Ability to develop and maintain good working relationships
Professional designations of AIC, ARM, CIC, CPCU, or equivalent coursework preferred
Valid state adjuster license where required preferred
Knowledge of medical terminology preferred
Advanced knowledge of litigation processes, procedures, terminology, and legal research preferred

Benefits

Comp & perks

Salary with bonus plan
Health, dental, life, and vision insurance
Traditional or Roth 401(k) Defined Contribution Plan
Profit-Sharing Plan
Company-paid holidays
Flexible scheduling
PTO
Telecommuting options
Career Coaching
Company-paid courses
Student loan and tuition reimbursement
Charitable Match
Paid volunteer time
Team sponsorships
Employee Assistance Program
Wellness initiatives/rewards
Health coaching