Senior Claims Adjuster - Desk - Remote

Location
Palm Beach Gardens, FL
Salary
Competitive compensation, benefits, 401K, PTO and bonus program. If you want to take your career to
Posted
Jun 18, 2019
Closes
Aug 17, 2019
Ref
ID 92
Category
Claims
Job Type
Full Time

Position Overview:

The Claim Adjuster will assist policyholders throughout the entire claims process.  Ability to work extended hours, including evenings and weekends, based on customer and business needs, (e.g. in response to claim volume fluctuation due to catastrophic weather) may be required.

The Claim Adjuster will handle a caseload which encompasses all levels of complexity for first-party claims, including establishing facts of loss, conducting proper reserve and coverage analysis, assessing and estimating property damage, assigning experts as needed, identifying potential fraud and timely investigate claim for proper resolution.

Successful candidate must be able to attend trainings and assist management with other duties and responsibilities, as requested.

 

This is a remote-worker position. Remote workers must reside in the State of Florida. Remote workers will be required to work core business hours and will staff the web-based phone system during their assigned schedule

 

          ** This is a remote position- must reside in the state of Florida**

 

Job Description:

  • Verify facts of loss and pertinent information to analyze and confirm coverage.

  • Establish ultimate reserves (anticipated cost to bring file to closure based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.

  • Explain and appropriately respond to insured’s, public adjusters, attorney’s and contractors during telephone contacts; as well as, contact the appropriate parties to obtain any needed information, provide timely investigation status updates, explain settlements and/or ultimate claim disposition.  

  • Timely submit reserve and payment approval requests, as appropriate.

  • Identify claims requiring a Reservation of Rights and refer for management approval.

  • Draft denial letters for carrier approval.

  • Identify and refer claims with subrogation potential to the subrogation department.

  • Identify and refer cases with potential NICB fraud indicators.  

  • Virtually investigate and resolve claims, as appropriate, with the use of video technology.

  • Close all files as appropriate in a timely and complete manner.

  • Strictly adhere to client’s Best Practices and operational guidelines; as well as all statutory requirements.

  • Follow reporting requests as outlined by client’s files and T.E.C.H. guidelines.

  • Report all serious injuries/liability claims to the Liability Claim Manager.

  • Report all large loss claims to appropriate Unit Manager.

  • Must pass internal and external audits, which include those performed by regulatory, agencies, carriers, and clients

  • Assist Management when required with projects or leadership requests

 

Education/Experience:

  • High School diploma, College degree preferred
  • 2 years of Florida first-party property field or 5 years of desk adjusting experience
  • One year staff carrier experience handling property files in their entirety
  • Must have or able to obtain a Florida Adjuster's license
  • Xact Level 1 certification or able to obtain within 90 days of hire
  • Xactanalysis experience in required
  • Must reside in the state of Florida

 

Skills:

  • Advanced level of organization and time management skills
  • Advanced level of interpersonal skills to handle sensitive and confidential situations and information
  • Advanced level of written and verbal communication skills


     
 

We are an equal opportunity employer and do not discriminate against any applicant because of race, color, religion, national origin, sex,age, disability, sexual orientation or any other class protected by federal, state or local law.