Senior Casualty Claims Adjuster

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together. **This position is eligible to work from home anywhere in the United States** Essential Functions Reviews the claim notices, lawsuits, contracts and policies to verify coverage, deductibles, claim payee/mortgagees and compensabilityInitiates prompt contact with customers to obtain information on the claim and explain the claim processTakes statements from insureds/claimants/witnesses and documents summaries within the claims systemDocuments handling activity including Medicare (MSP) modules in the claims systemSets timely, adequate reserves in compliance with the company reserving philosophy andmethodologyObtains authority in the selection of appropriate defense counsel for assignment based on the type of suit and complexity of the matter for litigated claimsHandles medium to lower complexity lawsuitsResolves questions of coverage, liability and the value of claimsDrafts reservation of rights and denial letters when appropriateAssigns independent adjusters when necessary with supervisory approvalSecures all necessary official reports, claim forms and documentsReviews bills, invoices and receipts for accuracyReviews legal invoices and litigation related expenses for accuracy and appropriatenessProvides prompt, detailed responses to agents, insureds and claimants on the status of claimsIdentifies, investigates, and proactively pursues opportunities for recoveryPrepares bodily injury and/or property damage evaluations, analyzes negotiation ranges and target settlement numbers prior to negotiationCommunicates with insureds/claimants/attorneys to negotiate the settlement of claimsAssists in suits, mediations, arbitrations and attending depositionsParticipates in Claims roundtablesIssues settlement documents and verifies that they are properly executedIssues timely payments within check authority limitInvestigates Medicare liens and timely resolve in accordance with EMC and Medicare guidelinesSubmits referrals to the Estimatics Review, Special Investigation, Property Review, Subrogation, Corporate Office Coverage Counsel, and Medical Review Units, when necessaryPrepares risk reports for UnderwritingReviews coverage intent and policy activity with UnderwritingReviews account inspection information with Risk ImprovementAssists own branch claims team members as needed. Acts as a mentor/coach for less experienced branch claims team members. Assists other branches in handling of claims (due to storms or temporary staffing gaps) through Resource Sharing Program. Participates in branch and department projects. Education & Experience Bachelor’s degree or equivalent relevant experienceFive years of claims adjusting experienceAttainment of all applicable state licenses within six months of hireRelevant insurance designations preferred Knowledge, Skills & Abilities Proven, excellent knowledge of the theory and practice of the claim functionAnalytical ability and sound judgment with respect to liability and coverageStrong knowledge of insurance contracts, medical terminology and legal aspects of court proceduresHigh standards of professional conductStrong knowledge of computers and claims systemsStrong organizational and written and verbal communication skillsExcellent investigative and problem-solving abilitiesTravel required; a valid driver’s license with an acceptable motor vehicle report per company standards required if traveling Per the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $74,059.31 - $95,108.00. The hiring range for other locations may vary. The hiring salary range for this position will vary based on geographic location, falling within either of the following: $72,726 - $99,800 or $79,834 - $109,786 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers. Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.