Remote Complex Claims Specialist Jobs
Remote Complex Claims Specialist jobs are open across the U.S. at remote-first insurers, distributed healthcare administrators, and national specialty carriers hiring on distributed teams. Employers posting remote roles right now include Liberty Mutual Insurance, Selective Insurance, and Upland Capital. Find a role that fits below and apply directly.
Find JobsOverview
Open roles8
Top employerLiberty Mutual Insurance
Top industryInsurance
Top credentialBachelor's degree
Companies hiring4
Showing 5 of 8+ Remote Complex Claims Specialist jobs
Complex Claims Specialist
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Added 5d ago
Athens Administrators
Complex Claims Specialist
Lake Mary, Florida
Added 5d ago
Complex Claims Specialist
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Added 6d ago
Upland Capital Group
Complex Claims Specialist
Remote
Added 6d ago
Senior Technical Claims Specialist - Commercial Casualty Complex
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Added 1w ago
Liberty Mutual Insurance
Senior Technical Claims Specialist - Commercial Casualty Complex
Remote
Added 1w ago
Complex Claims Specialist
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Added 1w ago
Liberty Mutual Insurance
Complex Claims Specialist
Remote
Added 1w ago
Senior Complex Casualty Claims Resolution Specialist
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Added 2w ago
Liberty Mutual Insurance
Senior Complex Casualty Claims Resolution Specialist
Remote
Added 2w ago
Added 5d ago
Complex Claims Specialist
Athens Administrators·Lake Mary, Florida
Job functions:
$90k - $126k/yr
Remote (US)
Bachelor of Science
501-1,000 employees
Job Description
ATHENS POSITION DETAILS
Position Title:
Complex Claims Specialist – Property & Casualty
Department:
Property and Casualty Claims
Reports To:
Claims Supervisor
FLSA Status:
Exempt
Job Grade:
14
Career Ladder:
Next step in progression could include Claims Supervisor
ATHENS ADMINISTRATORS
Since our founding in 1976, Athens Administrators has been a recognized leader in third-party claims administration services. However, more important than what we do is how we do it. Athens employees provide service that translates into real and lasting benefits—every single day! With offices throughout the United States, Athens Administrators offers Workers’ Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a third-generation family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. We are so proud that our employees have consistently voted Athens as a Best Place to Work!
POSITION SUMMARY
Athens Administrators has an immediate need for a full-time Complex Claims Specialist to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). This position does allow for work from home if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week.
The Complex Claim Specialist is responsible for the review, investigation, analysis, and processing of complex claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure and often entail litigation and complex coverage. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines.
PRIMARY RESPONSIBILITIES
Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
Advanced knowledge in the following areas: 1) Complex Auto or General Liability claims handling concepts, practices and techniques, to include but not limited to complex coverage issues, and product line knowledge, 2) advanced, functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills.
- Analyze, investigate, and evaluate losses to determine appropriate layers of coverage, settlement value and disposition strategy, including claim merits or denial of liability
- Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level
- Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to clients and senior level management
- Manage the litigation process through the retention of selected counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment
- Document and manage claims (i.e.: statements, diaries, write reports) from inception to closure
- Ensure appropriateness of all coverage memorandums and payments
- Coordinate and work with dedicated vendor services such as law professionals, industry experts, county officials and client executives to manage professional claims and communications
- Facilitate interactions between insured entities, claimants, client contacts, and attorneys in resolution of severe and complex claims
- Lead and conduct comprehensive claim reviews and case analysis discussions with various committees or district level authorities
- Provide superior customer service to all layers of authorities within the county
- Meet with clients, attend hearings, and assist senior management with planning, forecasting and new business opportunities that may arise in the servicing of the account.
- May assist management in hiring other account dedicated examiners
- Provide guidance and serve as a technical expert to less experienced examiners
- May conduct meetings or training sessions to help develop less experienced examiners
- Attend all required meetings and educational seminars for professional development
- Conduct on-sight or frequent claim reviews with the client representatives, as required.
- Maintain required licenses
ESSENTIAL POSITION REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
- High School Diploma or equivalent (GED) required for all positions
- AA/AS or BA/BS preferred but not required
- Possesses a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL preferred
- Additional State Adjuster License(s), may be required within 180 days
- Maintain licenses and continuing education requirements in all states
- Relies on extensive experience and judgement to plan and accomplish goals with a minimum of 10 years complex/major claims experience, including proficiency in investigation and resolution of severe to major casualty and general liability claims
- Experience with relevant insurance laws, codes, and procedures
- Experience with property and casualty insurance policies, insurance tort laws, codes, and procedures
- Understanding Auto and General Liability exposure and unique coverage endorsements
- Understanding of medical, legal terminology and liability concepts
- Proficiency in investigation and resolution of severe to major level casualty claims
- Time Management and project management skills
- Strong negotiation and litigation management skills
- Well-developed verbal and written communication skills with strong attention to detail
- Excellent organizational skills and ability to multi-task
- Ability to type quickly, accurately and for prolonged periods
- Proficient in Microsoft Office Suite
- Ability to learn additional computer programs
- Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
- Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
- Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
- Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner
- Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
- Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
- Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US
We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf.
This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.
Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
THANK YOU!
We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here
Athens Administrators
Complex Claims Specialist
Lake Mary, Florida
Added 5d ago501-1,000 employees
Job functions:
$90k - $126k/yr
Remote (US)
Bachelor of Science
Job Description
ATHENS POSITION DETAILS
Position Title:
Complex Claims Specialist – Property & Casualty
Department:
Property and Casualty Claims
Reports To:
Claims Supervisor
FLSA Status:
Exempt
Job Grade:
14
Career Ladder:
Next step in progression could include Claims Supervisor
ATHENS ADMINISTRATORS
Since our founding in 1976, Athens Administrators has been a recognized leader in third-party claims administration services. However, more important than what we do is how we do it. Athens employees provide service that translates into real and lasting benefits—every single day! With offices throughout the United States, Athens Administrators offers Workers’ Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a third-generation family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. We are so proud that our employees have consistently voted Athens as a Best Place to Work!
POSITION SUMMARY
Athens Administrators has an immediate need for a full-time Complex Claims Specialist to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). This position does allow for work from home if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week.
The Complex Claim Specialist is responsible for the review, investigation, analysis, and processing of complex claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure and often entail litigation and complex coverage. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines.
PRIMARY RESPONSIBILITIES
Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
Advanced knowledge in the following areas: 1) Complex Auto or General Liability claims handling concepts, practices and techniques, to include but not limited to complex coverage issues, and product line knowledge, 2) advanced, functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills.
- Analyze, investigate, and evaluate losses to determine appropriate layers of coverage, settlement value and disposition strategy, including claim merits or denial of liability
- Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level
- Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to clients and senior level management
- Manage the litigation process through the retention of selected counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment
- Document and manage claims (i.e.: statements, diaries, write reports) from inception to closure
- Ensure appropriateness of all coverage memorandums and payments
- Coordinate and work with dedicated vendor services such as law professionals, industry experts, county officials and client executives to manage professional claims and communications
- Facilitate interactions between insured entities, claimants, client contacts, and attorneys in resolution of severe and complex claims
- Lead and conduct comprehensive claim reviews and case analysis discussions with various committees or district level authorities
- Provide superior customer service to all layers of authorities within the county
- Meet with clients, attend hearings, and assist senior management with planning, forecasting and new business opportunities that may arise in the servicing of the account.
- May assist management in hiring other account dedicated examiners
- Provide guidance and serve as a technical expert to less experienced examiners
- May conduct meetings or training sessions to help develop less experienced examiners
- Attend all required meetings and educational seminars for professional development
- Conduct on-sight or frequent claim reviews with the client representatives, as required.
- Maintain required licenses
ESSENTIAL POSITION REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
- High School Diploma or equivalent (GED) required for all positions
- AA/AS or BA/BS preferred but not required
- Possesses a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL preferred
- Additional State Adjuster License(s), may be required within 180 days
- Maintain licenses and continuing education requirements in all states
- Relies on extensive experience and judgement to plan and accomplish goals with a minimum of 10 years complex/major claims experience, including proficiency in investigation and resolution of severe to major casualty and general liability claims
- Experience with relevant insurance laws, codes, and procedures
- Experience with property and casualty insurance policies, insurance tort laws, codes, and procedures
- Understanding Auto and General Liability exposure and unique coverage endorsements
- Understanding of medical, legal terminology and liability concepts
- Proficiency in investigation and resolution of severe to major level casualty claims
- Time Management and project management skills
- Strong negotiation and litigation management skills
- Well-developed verbal and written communication skills with strong attention to detail
- Excellent organizational skills and ability to multi-task
- Ability to type quickly, accurately and for prolonged periods
- Proficient in Microsoft Office Suite
- Ability to learn additional computer programs
- Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
- Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
- Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
- Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner
- Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
- Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
- Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US
We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf.
This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.
Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
THANK YOU!
We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here
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Find JobsRemote Complex Claims Specialist Job Market
Who's Hiring
Top Industries Hiring
- Insurance
What Employers Look For
The qualifications that appear most often in remote complex claims specialist jobs.
- 3-5 years of experience handling complex or litigated insurance claims
- Active state adjuster license in the relevant jurisdiction or multiple states
- Proficiency with claims management systems such as Guidewire or similar platforms
- Strong knowledge of coverage analysis, policy interpretation, and reserving practices
- Experience coordinating with defense counsel, medical providers, and expert witnesses
- Associate in Claims (AIC) or Chartered Property Casualty Underwriter (CPCU) designation preferred
Tips for Your Remote Complex Claims Specialist Job Search
Apply early to remote roles that fit
Migrate Mate lists remote complex claims specialist openings from across the U.S. in one place, so you can find roles that match your specialty line and apply directly without sorting through unrelated postings.
Show your async case management skills
Remote claims employers want proof you can move a complex file forward without real-time check-ins. Document how you managed multi-party correspondence, reserve updates, and coverage decisions through written channels using platforms like Guidewire, Duck Creek, or Salesforce Financial Services Cloud.
Highlight independent reserve and coverage authority
Remote roles carry more individual accountability than office roles because there is no supervisor nearby to consult. Explicitly state the reserve authority level you have held and the coverage lines you analyzed independently. Numbers and line specificity matter to hiring managers reviewing you remotely.
Prepare for structured written interviews
Many remote claims employers conduct initial screening through asynchronous written assessments or scenario-based email exchanges before any video call. Practice writing concise, well-reasoned coverage positions and liability summaries under time pressure so your written voice matches your in-person expertise.
Remote Complex Claims Specialist Jobs: Frequently Asked Questions
How do I get a remote complex claims specialist job?
Target companies that run distributed claims operations, such as remote-first insurers, third-party administrators, and national managed care organizations. Remote employers screen heavily for self-direction, precise written communication, and the ability to manage multi-party files without in-person oversight. Demonstrating experience with claims management software, documentation accuracy, and independent case resolution gives you a clear edge over candidates who rely on office-based workflows.
Which companies hire remote complex claims specialists?
Remote complex claims specialist roles are posted by Liberty Mutual Insurance, Selective Insurance, and Upland Capital and others right now, based on current remote listings on Migrate Mate as of November 2026. Hiring tends to concentrate at remote-first carriers, distributed third-party administrators, and national insurers with decentralized claims teams across property, casualty, workers' compensation, and healthcare lines.
Can you get a remote complex claims specialist job with no experience?
Yes, but remote entry-level roles are harder to land because employers expect you to handle complicated, multi-stakeholder files independently from day one. Candidates with no direct experience can stand out by completing claims adjuster licensing in their state, earning an associate-level insurance designation, or showing documented exposure to medical records review, liability analysis, or customer resolution work in adjacent roles.
Do you need a degree for remote complex claims specialist jobs?
Not always. Remote employers weigh state adjuster licensing, claims-specific certifications such as an Associate in Claims designation, and a verifiable record of resolving high-complexity files at least as heavily as a formal degree. Candidates who can demonstrate accurate reserve-setting, coverage interpretation, and negotiation outcomes on complex cases routinely move forward without a four-year degree.
Which industries hire the most remote complex claims specialists?
The sectors hiring the most remote complex claims specialists are Insurance, based on current remote listings on Migrate Mate as of November 2026. These industries rely on distributed claims teams because complex files, expert networks, and coverage analysis work can be managed entirely through digital case platforms without requiring a central office.
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