Multi-Line Claims Adjuster

Job Responsibilities Include:

Handle property and/or liability claims.

Inform manager of any claim that exceeds authority level.

Ability to make claim related decisions up to authority level.

Prepare and Issue all written correspondence as appropriate.     

Option to review any aspect of claim file with management, including claims within authority level.

Comply with Unfair Claims Settlement Practices Act for all states.

Understand policy coverages.

Use Image Right and Finys in conjunction with claim adjusting functions.

Ensure all correspondence is made part of the Image Right claim file.

Research Underwriting file for applicable coverage forms and endorsements and include in claim file as needed.  

Verify policy is active.   

Send underwriting alerts when appropriate.

Clearly explain claims process to insureds and agents.

Review Independent adjuster reports, determine investigation needed and applicable coverage, evaluate information to adjust reserves.

Obtain Public Adjuster Licenses and retainers as needed.

Provide settlement authority to independent adjusters, based on authority level.

Finalize settlements by obtaining appropriate documents and/or documentation.

Issue Loss and Expense payments, and manage reserves, appropriately.

Issue Compliance Letters.

Prepare coverage denial letters and Reservation of Rights letters, with manager review.     

Prepare responses to Insurance Department Complaints, with manager review.

Provide claim status updates when requested.

Handle files through litigation, with manager oversight.

Prepare Re-insurance notices as required and send to accounting department, Guy Carp, and support staff following department procedures.

Follow Large Loss Notification procedure related to Excel report and Large Loss Group.

Identify subrogation potential and follow through to recovery per department procedures.

Coordinate subrogation efforts with Cause & Origin investigators and subrogation attorneys as needed.

Manage Image Right workflows to ensure timely handling of claims.

FNOL workflows

Mail & re-indexing workflows

Diary

Option to participate in scene investigations with independent adjusters, engineers, and contractors.   

Option to participate in legal proceedings with defense attorneys i.e. mediations, settlement conferences, depositions, or trials.

Opportunity to participate in on or off-site claims or insurance education or events.

Deliver timely, quality customer service in all aspects of job position.

Willingness to work outside of normal hours during catastrophic weather events.

Other jobs as assigned.

Is expected to keep confidential all information obtained during employment.

Job Competencies:

Ability to evaluate, negotiate, and settle claims

Basic understanding of Medicare Section 111 process

Basic understanding of legal liability

Knowledge of building and medical terminology

Basic understanding of court system and negligence laws

Claims and Insurance Education to keep current with Industry Standards, and internal policy form changes or adoption of new policy/coverage forms

Ability to work well both independently and in a team environment

Maintain and display a positive attitude at all times

Good Customer Service Skills

Good Verbal and Written Communication skills

Ability to multi-task, and shift between priorities as needed throughout the workday

Planning, Organizing, and Time Management skills

Computer Skills – Excel, Word, Power Point, and ability to learn insurance systems

Education and Experience:

College Degree or Equivalent Experience

1-3 years insurance-related exposure and/or insurance courses required