Key activities associated with the position include, customer acknowledgement and communication throughout the claim process, investigation into the applicability of policy coverage and application to the loss, evaluation of damages, negotiation and settlement of the claim. Claim Adjuster must be licensed and follow all regulatory and jurisdictional requirements associated with state insurance guidelines and regulations including continuing education. Position will require that all assigned claims are concluded promptly, equitably and economically within the provisions of the policy contract and in accordance with the damages presented. Requires that the adjudication of the claim be within company guidelines and all state regulatory requirements. Claim adjuster position will be responsible for a pending inventory of 100-150 claims per month and assignment of 5-10 claims per day.

Job Duties

• Investigate, evaluate, negotiate and determine accurate damage payment of financial institution claims; CPI, VSI and GAP.
• Assign damage claims to appraisers and follow-up as needed to ensure accurate damage estimates and timely inspections

• Customer acknowledgement and establishment of new claims assigned daily including same day to 24 hour contact of 5-10 claims assigned daily.
• Ensure acknowledgement of claim and that needed documents and insurance proofs are supplied by client within 24-72 hours of the claim and that proper 3 day follow-up occurs until they are received.
• Review all required claim documentation including security agreements, loan histories, payment histories, NADA valuations, underlying claim evaluations, collection notes, statements by pertinent parties and request pertinent information from lenders to ensure all information to adjudicate the claim is provided in order to ensure accurate and thorough settlement.
• Determine the appropriate application of coverage and review the Master policy and specific certificates and waiver forms to determine the policy that applies and the damages that may or may not fall within the policy guidelines.
• Adjudicate claims within the guidelines of the appropriate underwriting company. There are approximately 6-8 different underwriting carriers to review and apply correct policy conditions.

Ability to review and understand loan and payment documents from financial institutions to properly prepare and determine accurate settlement figures.

• Ability to use and understand programs associated with auto valuation including CCC, Auto Appraisal information (AUDATEX), ISO, NADA, Kelley Blue Book and other adjusting tools.
• Handle the total loss automobile valuation process and salvage requirements of each state.
• Meet and exceed all established claim service standards and benchmarks for an adjuster I. This includes 100% production per month, settling claims within a 10-14 day cycle time, ensuring all customer contact is made and communication requirements met, working all claims to conclusion within 72 hours of having all required documents.
• Process and settle claims per policy and procedures put in place within standard company guidelines
• Promptly and effectively answer and respond to borrowers and lenders claim inquiries and correspondence in a professional manner.
• Answer incoming calls to the claims department and handle or direct as necessary
• Answer incoming email correspondence via the live chat queue as necessary
• Other special projects and duties as assigned

• College degree required except in the following circumstances:
  • Internal insurance claim experience as a claim processor or specialist with a minimum of 2 years of internal experience
  • A HS degree with a minimum of 2 years of insurance claim experience
• P and C administrative insurance experience of 2-5 years is highly preferred
• Preference given to those with claim processor or specialist experience
• Property & Casualty Adjuster License required Must be obtained within six months of hire.
• Excellent telephone, written and verbal communication skills required
• Strong decision making and organizational skills required
• Strong customer service skills and the ability to explain complex insurance policy language necessary
• Strong drive for results with a proven track record of achievement
• Ability to evaluates claims of up to moderate complexity, which would include using one's intellect to interpret policy provisions and apply the policy language to individual claim losses and issues payments based upon the value of the individual claim loss
• Ability to discern important file facts and documents all pertinent issues associated with individual claim files with some level of supervision.
• Ability to determine coverage and damages owed on moderately complex claims by assessing the merits of individual claim files and applying the facts of the loss and tangible evidence to the representative's past experience and statutory/regulatory case law.
• Ability to analyze a client's issues and communicates effectively within certain levels of the organization, any and all proposed solutions.
• Seeks and implements resolutions for customers in individual claim files and overall CPI or GAP insurance programs within minimal to moderate authority levels.
• Ability to verify coverage and determine all applicable coverages for an individual claim file pertaining to a specific set of loss facts with minimal supervision.
• Ability to Interprets and comply with all regulatory mandates within individual jurisdictions including state adjusting licensing requirements.
• Ability with oversight to investigate the potential for recovery by examining the evidence of the loss and confirming the existence of other carriers or responsible parties.
• Ability to effectively and professionally present information in one-on-one and small group situations to customers, clients, and other employees of the organization
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals; Ability to compute rate, ratio, and percent and to draw and interpret statistical material
• Solve practical problems and deal with a variety of concrete variables in situations where only limited standardizations exist.
• Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.
• Familiarity with Microsoft office products with ability to use internal e-mail system; the ability to type at least 45 WPM
• Strong attention to detail.
• Ability to work independently in a fast-paced environment production environment