The Claims Adjuster will inspect multi-line insurance claims, including both property and liability claims. The adjuster will be responsible for determining coverage issues, access claim costs, and will report to carriers with reserves and recommendations for settlement in accordance with company practices and procedures. Additionally the Claims Adjuster will be responsible for reporting overpayments, underpayments, and other irregularities and will confer with legal counsel on claims requiring litigation as needed.
Essential Job Duties & Responsibilities
- Adjust reserves and provide reserve recommendations to ensure reserving activities consistent with corporate policies.
- Prepare timely reports to be submitted to company's claim department.
- Communicate with reinsurance brokers to obtain information necessary for processing claims.
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- Confer with legal counsel on claims requiring litigation.
- Contact and/or interview claimants, doctors, medical specialists, or employers to get additional information.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
- Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
- Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
- Pay and process claims within designated authority level.
- Present cases and participate in their discussion at claim committee meetings.
- Report overpayments, underpayments, and other irregularities.
- Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
- Network with industry professionals for marketing purposes.
- Bachelor’s Degree or equivalent experience.
- 1-3 years of prior personal lines claims adjusting experience or similar equivalent with P&C automobile property damage and bodily injury claims.
- Knowledge of residential and commercial construction techniques and technology.
- Ability to diagram buildings to scale.
- Ability to adjust claims in all lines of insurance including property and liability investigations.
- Experience obtaining recorded and written statements from insureds, claimants, and witnesses.
- Experience in preparing computerized structure repair estimates.
- Beginner knowledge of Microsoft Word and Excel.
- Estimating skills (preferably Xactimate)
- Strong organizational skills and ability to work in a fast paced environment.
- Excellent written and verbal communication skills.
- Ability to interact and communicate with individuals at all levels of the organization.
- Ability to work independently and in a team environment required.