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.

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  • 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