P&C Claims Adjuster
P&C Claims Adjuster
SUMMARY
Investigates and evaluates losses while developing a plan of action to bring claims to proper resolution in a timely manner. Experience level preferably between 1-5 years.
JOB REQUIREMENTS:
•Determines extent of insurance coverage and liability on each filed claim
•Investigates claims, including interviewing claimants, clients and witnesses
•Obtains necessary records/documentation, including but not limited to, hospital records, police reports, physician records, etc.
•NMVTIS and CMS/Section 111 reporting
•Utilizes appropriate preferred vendors
•Presents thorough and accurate reports to clients and excess carriers on claims investigations/situations
•Negotiates settlements for resolutions with claimants and their attorneys
•Maintains control of litigation activities and costs per account requirements and ASC billing guidelines
•Effectively addresses and maintains incoming Docuclass documents in a consistent and timely manner
•Attends meetings; mediations, conferences; workshops or training sessions; and reviews written material to maintain current knowledge on principles, practices and new developments in assigned work areas
•Maintains and meets state specific licensing requirements
•Responds to client questions and comments in a courteous and timely manner
•Is responsible for catastrophic losses, complex litigation, and other sensitive issues
•All other duties as assigned
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
•Ability to understand and follow oral and/or written policies, procedures and instructions
•Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines
•Ability to conduct investigations in multi-party situations
•Ability to use standard or customized software applications appropriate to assigned tasks
•Ability to prepare and present accurate, reliable and factual reports with recommendations
•Thorough knowledge of current principles and practices associated with claims investigations, adjustment and related practices
•Extensive knowledge of medical and legal terminology with a thorough understanding of legal principles/litigation management
•Ability to handle confidential information
•Ability to communicate effectively with others both orally and in writing
•Ability and willingness to learn quickly and utilize new skills as a result of rapidly changing information and/or technology
•Ability to comprehend multi-state laws and regulations to assist other offices, as necessary
Required Experience:
Should have 1-5 years' experience in handling property and casualty claims. A college degree or equivalent business experience needed. Experience in public school claims handling is a plus.
