Required Info

First Name

Last Name

Suffix

Nick Name

To opt in for texting deployment opportunities, please text "Claims" to 474747

Cell Phone

Home Phone

Email Address

Email Address Again

Date of Birth

Social Security Number

Drivers License #

Drivers License State

Drivers License Expiration

How did you hear about Miller Claims Services

Please Select

Speaks Spanish

You Can Text Me If Needed

Demographic Info

Your cooperation in providing this information is voluntary. This information will not be used in the hiring process.

Male

Female

Are you a veteran?

Yes

No

Are you a disabled veteran?

Yes

No

Branch of Service

Positions

Check the position(s) you're applying for:

Physical Address

Address Line 1

Address Line 2

City

State

Postal Code

Mailing Address REQUIRED if not phyical address

Same As Physical Address

Address Line 1

Address Line 2

City

State

Postal Code

Previous Address - ( If less than 7 years) REQIRED

Address Line 1

Address Line 2

City

State

Postal Code

Carriers Worked For

Carrier

Last Date Worked

Certified

Yes

Claims Handling Experience

(You may include decimals for months, For Example, 1.5 equals 1 year 5 months)

Experience Type

Years Experience

Total Number of Assignments

Auto - Bodily Injury

Auto - Liability

Auto - Med Pay

Auto - Physical Damage

Auto - PIP Claims

Auto - Total Loss

Casualty

Commercial

Commercial - Liability

Commercial - Physical Damage

Commercial - Business Interruption- BIT

Earthquake

Farm / Ranch

Flood

Freeze / Ice Damming

Inside Claim Handling

Large Loss

Liability - Property

Manufactured Homes

Marine

Mold

Residential

Rope & Harness

Sewer Backup - BUSD

Staff

Total Loss - Property

Wind / Hail

Worker's Compensation

Related Experience

Experience Type

Years of Experience

Auto Body Estimating

Auto Body Repair

Construction General Contractor

Insurance Claims Admin/Processor

Other

What & How Many Years

Software Experience

Experience Type

Years of Experience

Audatex

Mitchell Ultramate

Pathways

Symbility

XactAnalysis

XactContents

Xactimate

Certifications

What certifications do you currently hold?

TWIA

American Family

CA Earthquake Adccred.

Related Experience & Skills

List any additional skils or experience that you possess that you think are relevant or related to adjusting

Insurance Company Experience

List any insurance companies you have worked for as staff which are not listed above

Company

Position

Start Date

End Date

Education

What is your highest level of education?

Military

If you have served in the United States Military, please explain branch, dates, duties,rank attained and discharge status

References

Name

Phone

Company or How Known

Number of Years Known

Please attach your resume

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Submit Package

Please be aware that a comprehensive criminal background check is mandatory and will be performed on or before deployment for ALL Adjusters. Pending review, your background check must come back free of felony convictions, deferred adjudications and certain misdemeanor convictions or deferred adjudications involving dishonesty or breach of trust, intentional injury or endangerment of others while under the influence of alcohol or other substances. Miller Claims Services is an equal opportunity employer and all applicants are considered on their qualifications regardless of race, sex, religion, national origin or age. This package will be given every consideration; however receipt of this information does not guarantee future employment.

Miller Claims Services Consent & Authorization

To complete this applicaton, please type your name in the box below. This will signify your understanding and consent.

Your Name