Senior Claims Adjuster, TX Non-Sub

About SPG:

Specialty Program Group (SPG) is the wholesale & MGA division of HUB International (5th Largest Global Broker). SPG acts in a holding company capacity acquiring best in class underwriting businesses to operate independently under discrete brands (portfolio companies).

About Avant:

Avant is a risk management organization that services several industries. Avant was born through innovation. In 1976, we created the game-changing product known as Non-Trucking Liability. Today, we are reviving that innovative culture on which we were built. Avant continues a forward thinking quest of developing new products and creating new markets.

 Avant is the holding company under which our subsidiaries reside:

• Avant Underwriters (AU

• Avant Specialty Claims (ASC)

• Avant Brokerage (AB)

• Avant Supermarket Group (ASG)

• SafeHerb Flexible Workforce

• AvantCare

Each of these centers of innovation contribute to our strength and unique value within the marketplace. At Avant, we will continue to attract like-minded, leading edge talent and organizations. The result is a one-stop source for insurance solutions

Job Description:

Investigate, coordinate, evaluate, and negotiate complex Non-Subscriber/Occupational Accident claims presented by insured’s or claimants. This includes, but is not limited to, evaluating and verifying coverage, evaluating legal liability, communicating with Insured’s, Claimants, Attorneys and Independent Adjusters. It also includes file documentation, negotiating settlements within authority and taking the action necessary to bring all assigned files to a reasonable resolution.

We are seeking a detail oriented Non-Subscriber or Occupational Accident Claims Adjuster to join Avant Specialty Claims, a Third-party administrator.  We are looking for a claims professional with 10+ years’ experience adjusting Workers Compensation or Texas Non-Subscriber claims.
 

The ideal candidate is knowledgeable or experienced in Texas Non-Subscriber, Occupational Accident, Worker’s Compensation, disability or medical management.  The Non-Subscriber/Occupational Accident adjuster is responsible for investigating and adjusting employee injury claims, benefit determination, wage replacement, and medical management for Texas Non-Subscriber claims.  This includes, but is not limited to, evaluating and verifying coverage, assessing benefit compensability, communicating with Insureds, Attorneys and medical professionals. It also includes file documentation, policy interpretation and taking the action necessary to bring all assigned files to a reasonable resolution.

Job Responsibilities:

• Ensure that claims handling is conducted in compliance with applicable statutes, regulations, and other legal requirements, and that all applicable company procedures and policies are followed. 
• Receive new loss assignments and review all information on new loss reports.
• Handle files involving catastrophic damages in accordance with our Catastrophic Guidelines.
• Interview insured’s, claimants, witnesses and investigate loss details as required, including any paper documents that may be required. This includes, but is not limited to; police reports, various public records, Bills Of Lading, lease agreements, releases, Proof of Loss, etc.
• Confirm and evaluate coverage, including coverage dates and appropriate limits, terms and conditions, insuring agreements, etc. Document the file relative to the coverage analysis and prepare any coverage position letter required (i.e. ROR, Denial, Tender Letter, etc.).
• Assign claim to outside appraiser and/or adjuster with instructions for investigation and evaluation as needed.
• Review reports from adjusters and/or appraiser and evaluate, make judgments and formulate action plans to carry claim to final disposition.
• Evaluate all key components of the claim and formulate plan to carry file to conclusion. This includes applying appropriate coverage application, liability analysis, Injury/Damage analysis, settlement value range and action plan to resolve the file;
• Negotiate claim to conclusion with the insured, the claimant or legal representatives, as needed.
• Manage litigated files to conclusion. This includes, but is not limited to; assigning counsel, managing counsel assigned to the case in connection with our Litigation Guidelines and handling all and attorney assigned files in connection with our Best Practices.
• Secure all required closing documents from the insured, claimant, lien holder or other parties as needed. This includes releases, dismissal entries, proofs of loss, etc. 
• Ensure Claims payments are issued in a timely and accurate manner.
• Identify files with subrogation potential and refer files to Subrogation Representative for evaluation and pursuit of potential subrogation claim.
• Document file activity notes and prepare written reports and letters as required.

Required Experience:

• 10+ years claims experience or equivalent combination of education and experience.
• Candidate fluent in Spanish a plus but not mandatory.

Education:

Bachelor's Degree in Business, Accounting, Finance or related field preferred.

Disclosure required under applicable state or municipality regulations: The expected salary range for this position is $80,000-$90,000 and will be impacted by factors such as the successful candidate’s skills, experience and working location, as well as the specific position’s business line, scope and level. HUB International is proud to offer comprehensive benefit and total compensation packages which could include health/dental/vision/life/disability insurance, FSA, HSA and 401(k) accounts, paid-time-off benefits, and eligible bonuses, equity and commissions for some positions.

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HUB International Limited is an equal opportunity and affirmative action employer that does not discriminate on the basis of race/ethnicity, national origin, religion, age, color, sex, sexual orientation, gender identity, disability or veteran's status, or any other characteristic protected by local, state or federal laws, rules or regulations. The EEO is the Law poster and its supplement is available here at http://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm .

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