Claims Adjuster

4 weeks ago

Houston, United States Samazon Staffing Full time
Job DescriptionJob Description

Responsibilities

• Manage caseload of primarily litigated files of approximately 125 claims.

• Direct independent adjusters (when applicable) and defense counsel, as necessary

• Analyzes and processes complex or technically difficult commercial general liability claims by investigating and gathering information to determine the exposure on the claim

• Investigates, analyzes, determines potential liability, and effectively settles with adverse parties.

• Manages claims through well-developed action plans to an appropriate and timely resolution

• Assesses liability, gather investigative information and resolve claims within evaluation

• Negotiates settlement of claims up to designated authority level, request authority timely, as needed

• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim

• Approve and makes timely claim payments and adjustments, and settles claims within designated authority level

• Assist litigation manager with the litigation process; ensures timely and cost-effective claims resolution

• Uses appropriate cost containment techniques

• Communicate claim activity with the appropriate parties (supervisor, broker, agent, client)

• Cultivate and maintain professional client relationships

• Participate in monthly claim round table and reserve committee

• Audit files to ensure field completion and data integrity

• Prepare Claim Analysis Reports for all claim reviews (internal/external)

• Complete Plan of Action, Status Updates, Reserve Properly,

• Request all pertinent documents and audit files for closure, field completion, document gathering, financials, etc.

• Request settlement authority and checks

• Identify tender and subrogation opportunities

• Attend mediations, if merited (rare travel, if any).

• Exercises sufficient and independent judgment to settle cases prior to mediation and/or litigation.

• Obtains all necessary documentation from the appropriate parties within established timelines.

• Remains abreast of new case law and statutes.

• Maintains confidentiality of information processed.

• Ensure the maintenance of the data integrity of our RMIS

• Mentors team members.

• Completes other duties and special projects as requested.

Experience

• 7-10+ years of experience handling catastrophic level commercial general liability claims

• Litigated claims experience imperative

• Active license is required (multi-state)

• Real estate/multi-family experience claims handling experience highly preferred

• Comprehensive understanding of General Laws in multi states

Required Characteristics

• Must share our core values

• Must be reliable and dependable

• Must enjoy finding and proposing solutions to problems

• Must thrive in a fast pace, deadline driven environment

• Must be willing to self-learn in addition to taking direction (work independently and as a team)

• Must be comfortable with working on new and sometimes unfamiliar problems. Ability to problem solve and find solutions/answers

• Must be self-motivated, proactive, and detail oriented

• Must be respectful to all colleagues and clients and contribute to a fun, happy and team building atmosphere.

Skills

• Typing (min 65 wpm)

• Experience with automated claims handling systems (RMIS) (paperless environment)

• Extensive understanding of contractual relationships and language

Requirements

Education

• Required - High School Diploma

• Required - Bachelor's Degree from an accredited college or university

• Required – Multi-state Licensed Casualty Adjuster

• AIC/CPCU/ARM Designation highly preferred

Benefits

Medical - UHC

401K plus match

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