Claims Adjuster - In-House Examiner II
- Career Level
- Experienced (Non-Manager)
Job Description Claims Adjuster- In-House Examiner II As a Claim Adjuster, you will work with outside unaffiliated adjusters for first and third party claims which pertain to Texas, Oklahoma and Arkansas “Preferred” Private Passenger Automobile Insurance coverage. You will help people resolve problems and have the opportunity to use your investigative and negotiation skills in a fast paced environment while protecting our insureds. We are seeking an individual dedicated to providing our policy holders with the highest quality Claims services.
Essential Duties & Functions · Make decisions and resolve complex issues inherent in handling claims by using the claim report, the insurance policy coverage’s and administers applicable state statues in accordance with established company guidelines.
· Conducts a prompt, thorough and fair investigation by obtaining relevant facts from the outside Adjusters to determine coverage, origin and extent of loss.
· Keeps the insured and others informed about the claims status with patience, clarity, timely and accurate written/verbal communications to resolve claims efficiently and effectively.
· Achieves a prompt, fair and equitable settlement of a claim.
· Documents and communicates all claims activities timely and effectively supports the outcome of the claims file.
· Other duties as assigned by Supervisor/Manager.
· Handle inbound first and third party claimants inquires on first notice of losses, field questions on existing and new claims.
· Assign new claims to outside adjusting firms.
· Administer claims files, assess liability exposure and determine applicable coverage.
· Calculates and assigns appropriate reserves throughout the life of the claim.
· Provide settlement authority to outside adjusters for first and third party claims.
· First-party Personal Injury Protection (PIP), Medical Pay, collision, comprehensive, loss-of-use, third-party property damage and third-party bodily injury exposures.
· Responsible for managing subrogation recoveries on assigned claims.
· Conduct quarterly claim reviews.
Minimum Requirements · Basic understanding of statutory and regulatory requirements, knowledge of automobile claims, coverage evaluation, claims investigation, loss assessment, evaluation and reserves, insurance regulation, negotiation and settlement.
5 years’ experience preferred in automobile claims handling. (Knowledge of claims handling in other states is a plus). · A Texas P&C Adjusting License is required. (Multi-State License is a plus)
· Self-directed individual who works well with a Team.
· Must have strong analytical skills necessary to make decisions, resolve issues inherent in handling claims effectively by dealing with situations at various levels of intensity and reach a resolution.
· Must be able to interpret insurance policies and various contracts, perform analytical research and make sound decisions using good judgment.
· Interpersonal skills and ability to work with all levels of the organization. Ability to effectively operate a computer and have working knowledge of MS Office applications.
Working Conditions · Physical work demands require the ability to sit and work at a computer keyboard for extended periods of time.
· Able to stoop, kneel, bend at the waist and reach on a daily basis.
· Able to perform general office administrative activities; copying, filing, delivering and using the telephone.
· Able to lift and move up to 25 pounds occasionally
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