Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater.
Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim.
Interacts extensively with various parties involved in the claim process.
Able to clearly communicate concise action plans, and present plans for moving the case to conclusion. Will demonstrate complete knowledge of the claim file process through presentation of actions and responses to client questions.
Processes claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements.
Demonstrated ability to comply with carrier reporting and threshold requirements.
Able to recognize and pursue excess insurance recoveries. Incumbents will have the ability to handle a full case load, with proven ability to handle cases of increased severity.
Bachelor's degree preferred.
10 Years or more of both Commercial Auto Liability and General Liability
Must have Litigation Experience
Will need to have as many active/current Adjuster Licenses as possible
Prior TPA experience is a plus
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses.
Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation.
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.