Segmentation Claims Specialist

Everest; New York (NY); On-site; USD 77,000 - 105,000; Full time

Benefits offered by this job

Health insurance

Wellness program

Life and disability insurance

401k match

Retirement savings plan

Paid holidays

Paid time off

Job summary

Everest Insurance Company is seeking an Segmentation Claims Specialist to join the Casualty Claims team. The role centers on investigating newly reported claims, gathering critical facts, and determining appropriate claim pathways from Fast Track to Complex teams.

You will interact with insureds, brokers, attorneys, and other carriers, explaining findings and supporting timely, accurate evaluations. This is an excellent launchpad for recent graduates exploring insurance or risk management

Qualifications

• Bachelor's degree in legal studies, Criminal Justice, PreLaw, Political Science, Business, Finance, or related field (recent grads encouraged)
• Strong written and verbal communication; translate complex info into clear narratives
• Analytical, organizational, investigative strengths; resolve missing or conflicting details
• Comfortable making outbound calls to attorneys, carriers, and other stakeholders
• Interpret information, summarize findings, and draw logical conclusions
• Strong time management with ability to handle multiple tasks with detail
• Interest in insurance, risk management, or related fields; broad exposure
• Curiosity and willingness to learn and responsibly use approved AI/automation technologies

Responsibilities

• Serve as a primary contact for policyholders and brokers on newly reported claims
• Review initial documentation and request missing or clarifying information
• Respond promptly to inquiries related to assigned claims
• Make outbound calls to carriers, attorneys, insureds, and claim professionals to obtain details
• Ask targeted questions and resolve incomplete information
• Conduct investigation and analysis to support accurate claim evaluation
• Review policies to confirm coverage, limits, and exposures
• Develop clear claim narratives explaining what happened and involved injuries/damages
• Assess injury severity and escalation needs
• Use findings to triage and route claims appropriately
• Monitor updates and reassess severity as needed
• Document key facts, call outcomes, and next steps in internal systems
• Enter claim data accurately and prepare standard correspondence
• Ensure compliance with regulations and Everest policies

Skills

Communication skills

Analytical skills

Investigation skills

Time management

Outreach calling

Narrative writing

Education

Bachelor's degree

Job description

Title: Segmentation Claims Specialist

Company: Everest Insurance Company

Job Category: Claims

Everest is a global leader in risk management, rooted in a rich, 50+ year heritage of enabling businesses to survive and thrive, and economies to function and flourish. We are underwriters of risk, growth, progress and opportunity. We are a global team focused on disciplined capital allocation and long-term value creation for all stakeholders, who care deeply about our impact on communities and the wider world.

About The Role

Everest is seeking an early career Claims Professional to join our Casualty Claims team. In this role, you will investigate newly reported Casualty losses, often with limited initial details, by gathering critical facts, clarifying the narrative of what occurred, and determining whether each claim should be assigned to our Fast Track, Mainstream, or Complex claim teams.

You will work closely with insureds, brokers, other insurance carriers, and attorneys, often by phone, to obtain timely and accurate information, and then summarize your findings for internal claim teams. This position provides exposure to a wide range of claim types, injuries, damages, and legal scenarios. It is an excellent launchpad for recent graduates exploring careers in insurance, legal services, risk management, or related professional fields.

As a Segmentation Claims Specialist, You Will

Claim Intake and Communication

• Serve as a primary point of contact for policyholders and brokers on newly reported claims
• Review initial documentation and request any missing or clarifying information
• Respond promptly and professionally to inquiries related to assigned claims

Information Gathering and Investigation

• Make outbound calls to carriers, attorneys, insureds, and claim professionals to obtain details not captured in written reports
• Ask targeted follow-up questions and resolve incomplete or conflicting information
• Conduct investigation and analysis to support accurate claim evaluation
• Review applicable insurance policies to confirm coverage, limits, and exposures

Analysis, Narrative Development, and Triage

• Develop clear and concise claim narratives explaining what happened, how the insured is involved, and what injuries or damages are being alleged
• Assess potential injury severity and identify issues requiring escalation
• Use investigative findings to triage and route claims appropriately, applying sound judgment regarding complexity, severity, coverage, or litigation indicators
• Monitor incoming updates and reassess claim severity as necessary

Documentation And Administrative Responsibilities

• Document key facts, call outcomes, and recommended next steps in internal systems to provide downstream teams with actionable information
• Enter claim data accurately and prepare standard correspondence
• Ensure compliance with all state and federal regulations, as well as Everest policies and procedures

Qualifications

• Bachelor's degree in legal studies, Criminal Justice, PreLaw, Political Science, Business, Finance, or a related field (recent graduates and early career candidates encouraged to apply)
• Strong written and verbal communication skills, with the ability to translate complex information into clear and professional claim narratives
• Analytical, organizational, and investigative strengths with curiosity and persistence in resolving missing or conflicting details
• Comfort and professionalism on the phone, including confidence making outbound calls to attorneys, carriers, and other stakeholders
• Ability to interpret information, summarize findings, and draw logical and well supported conclusions
• Strong time management skills with the ability to prioritize multiple tasks while maintaining attention to detail
• Interest in pursuing a career in insurance, risk management, legal services, or related fields; ideal for candidates seeking broad exposure and varied work
• Curiosity and willingness to learn and responsibly use approved AI, automation, and emerging technologies to enhance productivity, effectiveness, and business outcomes.
• Collaborative and team-oriented mindset

The base salary range for this position is $77,000- $105,000 annually. The offered rate of compensation will be based on individual education, experience, qualifications and work location. All offers include access to a variety of benefits to employees, including health insurance coverage, an employee wellness program, life and disability insurance, 401k match, retirement savings plan, paid holidays and paid time off (PTO).

What if I don’t meet every requirement? At Everest we are dedicated to building an inclusive and authentic workplace. So, if you are excited about this role but your past experience doesn’t align perfectly with every element in the job description, we still encourage you to apply. You may be just the right candidate for this or other roles. Please let us know if you need any accommodations throughout the application or interview process.

Our Culture

At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture.

• Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Inclusion and Belonging.
• Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together.

All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve.

Type: Regular

Time Type: Full time

Primary Location: Warren, NJ

Additional Locations: New York, NY, Philadelphia, PA

Everest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy), sexual orientation, gender identity or expression, national origin or ancestry, citizenship, genetics, physical or mental disability, age, marital status, civil union status, family or parental status, veteran status, or any other characteristic protected by law. As part of this commitment, Everest will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Everest Benefits at [e-mail].

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