Claims Supervising Adjuster - Examiner
Position is responsible for full oversight of assigned claims throughout the claim life cycle. Responsibilities include managing task assignments, providing direction and oversight of adjusters, ongoing communication during the claim with the insured and/or their representative, ensuring adjuster’s handling is done in a timely manner and in compliance with claim best practices, assignment of experts when applicable, gathering of all information and make a final coverage decision/payment determination, reviewing the coverage decision/payment with the insured and/or representative and the agent, prompt completion of file, and submittal to accounting to issue payment/send denial/close file.
The Supervising Adjuster’s work performance will be measured based on ability to meet or exceed productivity goals, monthly claim file audits, management of claim cycle time, effectiveness of decision making and customer feedback/satisfaction.
- Reviews first notice of loss and determines tasks needed; assigns tasks to field/desk adjusters, providing direction for items to be completed.
- Contacts insured and/or insured representative upon receipt of claim to answer immediate questions, provides contact information, and explains the claims process.
- Ensures that field/desk adjusters are adhering to claim guidelines regarding contact, inspection, initial and final reports, and assures that claim field inspections are being handled per departmental and statutory guidelines.
- Responds to inquiries from adjusters and IA firm management and works together to address coverage questions.
- Authorizes use of experts as part of the claim investigation, as needed.
- Reviews reports and claim file documentation to ensure timely claim handling, keeps insured current on claim status, and is actively moving claim to conclusion. Upon final examination ensures all information, including adjuster’s estimates, appropriately address scope of damage and supports claim coverage decisions/payments.
- Communicates with customers, public adjusters and/or attorneys on a regular basis;
- Reviews the coverage decision and settlement with customers, public adjusters and/or attorneys prior to submitting claim to accounting for payment processing and closure.
- Prepares all letters needed during the handling of the claim, to include final payment/denial letters.
- Responds to customers and their representatives regarding claim inquiries and/or correspondence received; reconciles issues and/or directs adjusters when further claim handling is needed.
- Works closely with other claim team members and other departments within Florida Peninsula Insurance/Edison Insurance.
- Responsible to make sure reserves are appropriately set and revised as needed, per departmental guidelines.
- Preset examining settlement authority will be assigned by management.
- Ability to work extended hours to handle additional claim file examination in the event of a Catastrophe (CAT)
REQUIRED EDUCATION AND EXPERIENCE:
- High School diploma required; College degree preferred.
- Florida licensed All-Lines adjuster (620), at least 12 hours of yearly Continuing Education as required by licensing division of DFS.
- 5+ years of property claims adjustment experience or similar experience required.
- Knowledge of property insurance policy and coverage analysis.
- Excellent verbal and written communication skills.
- Experience working with customers and providing outstanding service.
- Strong organizational and time management skills.
- Must be able to work under deadlines.
- Proficient in MS Office, including Word, Excel, PowerPoint and Outlook.
- Strong skills and experience with Xactimate estimating program.