Claims Senior Casualty Adjuster

About the role

The Claims Senior Casualty Adjuster handles moderate to high complexity claims involving material damage, property, and/or liability lines of insurance. The primary functions include liability investigation, coverage evaluation, negotiation strategies, and claims resolution of moderate to high complexity claims. Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.

Responsibilities

• Conduct phone and/or field investigations to determine liability and damages.
• Attend and participate in legal proceedings as needed.
• Identify and obtain statements from insureds, claimants, and witnesses.
• Communicate and interact with insureds, claimants, and other individuals to explain benefits, coverages, fault, and claims processes in compliance with regulatory and statutory requirements.
• Recognize and address moderate complexity coverage issues.
• Evaluate and determine claim values based on property, bodily injury, and liability data.
• Negotiate within settlement authority to resolve first and third-party claims.
• Update database production reports and document claim files via company systems (e.g., CACS, HUON, HOC, Guidewire).
• Control expenses for areas of responsibility.
• Verify, interpret, and resolve coverage by gathering necessary information to ensure policy applicability.
• Coordinate with internal and external departments as required.
• Respond quickly to customer needs and problems.
• Independently resolve claims within authority level.

Requirements

• Bachelor’s degree or equivalent combination of education and experience.
• 7-9 years of prior claims handling experience preferred.
• 4-6 years of property, auto, casualty, or relevant claims administration experience required.
• Comprehensive knowledge of claims administration best practices and procedures.
• Advanced knowledge of insurance, fault assessment, negligence, and subrogation principles.
• Comprehensive understanding of building and vehicle repair procedures and third-party liability issues.
• Advanced knowledge of Microsoft Office suite, general computer software, and claims software.
• Advanced organization, planning, and recognition skills.
• Advanced oral and written communication skills.
• Advanced interpersonal and leadership skills among peers.
• Proficiency and understanding of medical terminology and causality.
• Valid Driver’s License, acceptable Department of Motor Vehicles record, and minimum liability insurance issued by the state.
• Chartered Property Casualty Underwriter (Insurance Institute of America) preferred.
• Associate in Claims (Insurance Institute of America) preferred.
• An insurance/claims adjuster license may be required for claims administration in specific states.

Occasional travel to business meetings or conferences (approximately 5%).

Benefits

• Health coverage for medical, dental, and vision.
• 401(K) savings plans with company match and pension.
• Tuition assistance.
• Floating holidays and PTO for community volunteer programs.
• Paid parental leave.
• Wellness programs.
• Employee discounts (membership, insurance, travel, entertainment, services, and more).