Sr. Claims Adjuster - Liability

Location
Saint Petersburg, Florida
Salary
Not Specified
Posted
Oct 19, 2020
Closes
Dec 18, 2020
Ref
SRADJLIA81820#GIJ--American-Strategic-Insuran
Category
Claims
Job Type
Not Specified
Career Level
Not Specified

Sr. Claims Adjuster - Liability

*Remote opportunities available

POSITION SUMMARY:


Ensures claims are fairly and accurately investigated and evaluated in accordance with established timelines, customer service standards, and quality standards. Responsible for assessing coverage, completing a thorough liability and damage analysis of complex third-party bodily injury and property damage claims and effectively negotiating settlements fairly and equitably with all parties. Offers a high level of professionalism and expertise for the department's benefit. A Sr. Liability Claims Adjuster will demonstrate proficiency in handling bodily injury and property damage claims, attorney represented files and large losses.

Essential Job Functions
  • Determines insurance coverage.
  • Examines and appropriately interprets insureds' policies, forms in force, and other records.
  • Identifies other available excess or concurrent coverage.
  • Demonstrates a clear understanding of policy provisions related to the insuring agreement, exclusions and endorsements which affect coverage.
  • Investigates all relevant facts needed to evaluate coverage, liability, and damages on casualty claim files that involve complex issues, severe injuries and/or multiple parties.
  • Determines extent of insured's liability.
  • Interviews, telephones, or corresponds with insureds, claimants, attorneys and witnesses.
  • Uses varying methods of investigation, including taking recorded statements, consulting with police, inspecting property damage, and reviewing documents.
  • Understands and applies applicable state laws on negligence and liability.
  • Sets cases for pre-suit mediations or hearings where appropriate.
  • Possesses a comprehensive understanding of medical terminology and procedures.
  • Evaluates and determines injury/damage causality to the loss taking into account prior or subsequent occurrences and pre-existing injuries.
  • Responds to demands, decisions, agreements, and/or court orders; creates action plan; determines need for peer review and CME.
  • Negotiates claim settlements within authority limits
  • Establishes appropriate initial case reserves; reviews and revises case reserves on assigned files to allow for probable costs.
  • Submits assignments to vendors as appropriate.
  • Effectively manages pending file s diaries and tasks in the Claims System.
  • Prepares report of findings and negotiates settlement.
  • Prepares settlement letters, denial letters, Reservation of Rights, and other letters as needed.
  • Writes clear and concise diary notes, uses the Special Handling area, sets field assignments, sets and saves contacts, and makes payments.
  • Recognizes the need for SIU involvement and flags files for potential subrogation.
  • Appropriately applies knowledge of multiple state statutes, including the insurance code of ethics, rules, regulations and guidelines.
  • Effectively handles and responds to calls from customers, vendors, and others.
  • Presents claims in a concise, but comprehensive manner at monthly brainstorm meetings.
  • Performs other duties as assigned.
Job Qualifications
  • Motivation to lead an adjuster's life.
  • Willingness to work flexible shifts, 7 days per week with 12-hour shifts for major catastrophes, and overtime as needed for claim spikes.
  • Ability to grasp concepts quickly, pay attention to details, think through problems logically, apply high-school-level math skills, and make appropriate decisions.
  • Demonstrates integrity.
  • Possesses strong English vocabulary, basic grammar skills, and professional decorum. Writing is clear and easy-to-read. Bi-lingual skills helpful.
  • Strong organizational skills and the ability to multi-task in a fast-paced environment.
  • Demonstrates active listening skills through effective use of questions, reflection, and empathy.
  • Demonstrates a bias toward exceptional customer service; experience providing customer service preferred.
  • Possesses strengths in negotiation.
  • Demonstrates the ability to get along with work associates.
  • Proficiency in Microsoft Word required. Proficiency in Excel preferred.
  • General knowledge of insurance and adjusting.
Education and/or Experience:
  • Bachelor's degree or higher; four years of prior work experience within claims, financial services, customer service, construction, property management, medical or related field; or some combination thereof.
  • Minimum three years of casualty claims experience required.
  • Property and casualty experience helpful.
  • Adjuster 620 License required in applicable states.

Benefits & Perks:

As an employee, you will enjoy an inclusive environment that embraces strategic thinking, drive and passion. As a company committed to our employees, its not surprising that we offer great benefits that include:

  • Paid training, tuition assistance and career development.
  • Diverse, welcoming culture.
  • Casual dress (yes, you can wear jeans to work!)
  • Medical, dental, vision, paid time off and a 401K plan that is 100% vested!

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