Remote Complex Claims Adjuster

Overview of the Role

Step into a career that challenges your analytical mind and empowers you to help people at critical moments. As a Remote Complex Claims Adjuster, you'll navigate high-stakes scenarios involving intricate insurance claims while working comfortably from home. This position suits professionals who excel in interpreting policy language, assessing multi-faceted situations, and delivering resolution with clarity and fairness. With an annual salary of $65,895, this opportunity offers a blend of financial growth, remote flexibility, and professional integrity. Your decisions will directly impact people during vulnerable moments, making this role both meaningful and intellectually stimulating.

Primary Responsibilities and Daily Functions

Claims Investigation and Evaluation

• Assess complex property, liability, or casualty claims with an emphasis on thoroughness and timeliness.
• Determine coverage, identify liability, and calculate accurate settlements based on internal guidelines and industry benchmarks.
• Examine policy contracts and interpret exclusions, endorsements, and clauses in context.
• Analyze supporting documentation, including legal, medical, or technical reports, to determine claim validity and extent of damages.
• Conduct recorded statements, interviews, or inspections virtually and evaluate third-party input to complete a well-rounded investigation.
• Collaborate with forensic experts and field adjusters to support large-loss or specialty claims.

Communication and Negotiation

• Maintain professional and consistent communication with insureds, claimants, attorneys, adjusters, and other external stakeholders.
• Prepare settlement offers and negotiate terms to ensure a fair resolution and regulatory compliance.
• Communicate decisions with empathy and transparency, helping parties understand claim outcomes and next steps.
• Coordinate with legal teams on litigated claims and respond effectively to discovery requests or depositions

Documentation and Compliance

• Maintain accurate, real-time claim file notes in accordance with internal protocols and external regulations.
• Generate detailed investigative summaries, loss assessments, and liability analysis reports.
• Submit required state-specific forms within mandated timeframes
• Monitor claim progress and ensure deadlines, KPIs, and benchmarks are consistently met
• Participate in internal audits and incorporate feedback to maintain compliance standards

Work Environment and Team Structure

Remote Workflow Setup

• Remote-first work culture promotes independence, accountability, and results-based evaluation
• Clear communication channels established through platforms like Slack, Teams, or proprietary systems
• Regular virtual huddles with regional supervisors and collaborative case discussions with peers
• Shared knowledge base and continuous access to policy libraries, regulatory updates, and case precedents

Organizational Culture

• Emphasis on employee well-being, professional growth, and long-term career paths
• Diversity in thought, experience, and expertise is highly valued and welcomed
• Performance is measured not by hours clocked but by impact made and quality of decisions

Tools and Technology Utilized

Core Systems and Platforms

• Industry-standard claims management software such as Guidewire, Xactimate, CCC, or proprietary platforms
• VoIP systems and digital conferencing tools to manage remote interviews and meetings
• Secure cloud-based documentation tools to store, update, and retrieve files quickly and safely
• Analytics dashboards and reporting tools that track settlement trends, claim frequency, and process efficiency
• AI-powered fraud detection systems and predictive modeling tools to streamline the decision-making process

Candidate Qualifications and Preferred Background

Required Qualifications

• Minimum of 3 years handling complex, multi-line insurance claims in a remote or hybrid capacity
• Demonstrated understanding of claims regulations across multiple states
• Ability to navigate ambiguous situations using investigative skills and industry knowledge
• High-level communication skills for engaging with diverse audiences in sensitive contexts
• Strong documentation practices and technological fluency with virtual claims processing platforms

Desired Experience

• Licensure to adjust claims in multiple jurisdictions or commitment to acquiring within the first 90 days
• Background in litigation support or handling claims with subrogation, arbitration, or mediation components
• Experience managing claims in specialized sectors such as healthcare, transportation, or environmental loss
• Understanding of current trends in insurance technology, remote workflows, and digital claims transformation

Compensation and Employee Benefits

Financial and Workplace Perks

• Competitive annual salary of $65,895, reflective of your experience and specialization
• Full remote equipment package including laptop, headset, secure VPN, and dual monitors
• Monthly internet and home office stipends to support productivity
• Inclusive medical, dental, and vision coverage tailored to support you and your dependents
• Retirement savings plans with company contributions and optional investment advising
• Generous paid time off, including vacation, personal days, holidays, and sick leave
• Performance bonuses and merit-based salary reviews are offered annually

The Value You Bring

As a Remote Complex Claims Adjuster, you serve as a strategic problem-solver, bridging technical precision with human understanding. Whether interpreting complex clauses or managing emotionally charged conversations, your role directly influences outcomes that shape lives. You ensure every case is treated with fairness, accuracy, and diligence. You are more than an adjuster—you’re a trusted advocate during moments of disruption. Your ability to balance policy expertise with compassion is what drives client satisfaction and strengthens organizational trust. By joining this team, you become part of a mission to uphold ethical standards, reduce delays, and ensure people receive what they are entitled to.

Apply Today to Begin Your Remote Journey

If you're ready to be part of a high-impact team that values integrity, insight, and initiative, we invite you to apply now. This is your opportunity to thrive in a remote environment while making decisions that truly matter. Let your career evolve in a space where your voice is heard, your skills are sharpened, and your work is deeply meaningful. Apply today and help us redefine the future of remote claims adjustment—one fair resolution at a time.