Senior Claims Adjuster - Litigation & Coverage Expert

Why You’ll Love Working With Us

• Professional Growth: Plenty of opportunities to advance your career.
• Remote Work: Enjoy the flexibility of working from anywhere.
• Comprehensive Benefits: Medical, dental, and vision insurance effective from your start date—no waiting period.
• Work/Life Balance: We understand the importance of balancing your personal and professional life.
  
  

Job Overview

As a Claims Adjuster, you’ll manage a caseload of up to 150 pending claims, which may vary in complexity. Your role will involve:

• Keeping Claims Current: Ensure that all claim metrics are up-to-date.
• Managing Cases: Handle everything from loss facts and coverage analysis to settlement negotiations and fraud detection.
• Coordinating Care: Work with medical providers and manage litigation as needed.
• Mentoring and Collaboration: Attend conferences, client meetings, and mentor fellow adjusters.
  
  

You will be expected to follow state statutes, client guidelines, and best practices, and handle additional duties as assigned, which may include travel.

Key Responsibilities

• Coverage Analysis: Identify, analyze, and confirm coverage details.
• Customer Service: Make initial contact within 8 business hours, and maintain communication throughout the life of the file.
• Subrogation: Refer potential subrogation cases and maintain closing ratios.
• Investigation: Verify facts, evaluate claims, and manage settlement negotiations.
• Litigation Management: Develop litigation plans, attend mediations and trials, and manage filings and defenses.
• Reserves Management: Set and adjust reserves based on claim developments and ensure timely payment of benefits.
• Reporting: Report serious injuries and large loss claims, pass audits, and follow client and internal guidelines.
  
  

What We’re Looking For

• Education & Licensing: High school diploma required; a 2-year degree or higher preferred. 7+ years of claim adjusting experience, with heavy litigation experience for non-Worker's Compensation lines and 5+ years in Construction Defect or related experience if applicable. Must be eligible for reserve/payment authority of $50,000+ and hold or be able to obtain the relevant adjuster's license.
• Technical Skills: Strong negotiation and litigation management skills, with the ability to handle sensitive and confidential information.
  
  

About Us

We are a leading third-party claims administrator, dedicated to delivering exceptional results for our clients. Founded in 1996, we manage claims for a variety of entities, including insurers, brokerages, and self-insured funds.

Interested? Apply today to explore how this role could be the perfect fit for you!

Employment Type: Full-Time