Sr Claims Adjuster - Casualty

FLSA Status: Exempt

About the role

Responsible for effectively analyzing and resolving assigned serious/complex claims consistent with claims department standards and company objectives.

Responsibilities

• Resolve primarily serious/complex claims (including but not limited to claims involving unusual damage or coverage issues, expert analysis, or policyholder concerns) within established settlement authority in a prompt, fair, and equitable manner.
• Identify and investigate coverage, damage, and reserve adequacy on assigned claims.
• Apply statutes, common law, and other applicable legal and regulatory concepts for the effective, efficient, and equitable resolution of assigned claims.
• Achieve established claim file audit objectives.
• Communicate with policyholders, agents, claimants, attorneys, medical providers, and other persons as needed; direct independent adjusters, appraisers, and other support service providers to ensure effective claims resolution.
• Acquire, record, and maintain all essential file documentation in accordance with established guidelines.
• Provide timely status reports regarding assigned claims to department management and others.
• Identify and pursue appropriate cost containment, loss mitigation, and subrogation recovery opportunities.
• Participate and provide input in departmental or interdepartmental meetings, projects, or processes related to the claims function.
• Travel as needed to attend training programs, conferences, mediations/other legal proceedings, and to conduct investigations relating to claims resolution.
• Assist other claims personnel to further overall department objectives.
• Participate in the orientation or training of new department personnel as needed.
• Assist in the setting of initial reserves as needed.
• Complete other projects as assigned.

Requirements

• Bachelor’s degree required.
• Must be able to take and pass mandatory adjuster licensing requirements.
• Five or more years of claim technical experience.
• CPCU designation strongly desired.
• Seven years or more of Brotherhood Mutual claims technical experience is desired.
• Must be familiar with church operations and conduct themselves in a manner that aligns with the company’s niche in the church and related ministries market.

Skills

• Effectively communicate with others (both oral and written), including complex coverage and legal concepts.
• Make independent decisions.
• Strong organizational and interpersonal skills.
• Ability to handle confrontational situations productively.
• Strong negotiation skills for resolving serious/complex claims.
• Thorough understanding of all issues related to claims and coverage.
• Ability to access, input, and retrieve information from a computer.
• Thorough understanding of automated claims department processing systems and workflows.
• Ability to train others on claims department policies, procedures, and systems.
• Ability to sit for prolonged periods and inspect losses by walking, lifting, climbing, or bending.
• Effectively interface with external contacts, employees, managers, and department staff.