Sr. General Liability Claims Adjuster-

2 months ago

Philadelphia, United States NARS Full time
Job DescriptionJob Description

Job Description:

Must have Dram shop, experienced coverage and NY license.

Multi Line Senior level Adjuster with emphasis in handling General Liability claims in litigation. Mediation and Trial Experience necessary. .
Must have 5+ years prior claim adjusting or similar experience, with the majority handling complex litigation, preferably in the line of business being handled.

 

Handle a caseload of approximately 150 pending claims that encompass all levels of complexity. Requires establishing facts of loss, coverage analysis, investigation, compensability/liability/negligence determination, coordination of medical care (as appropriate), litigation management, damage assessment, settlement negotiations, identifying potential fraud and appropriate use of authorized vendors. Also includes timely and appropriate reserve analysis and report completion. Ability to attend conferences, client meetings, mentor other adjusters and assist management as requested. All file handling must be within state statutes, Client Claims Handling Guidelines and NARS Best Practices. Other miscellaneous duties as assigned, which may include travel.

Essential Duties and Responsibilities:

Coverage:

  • Identify, analyze and confirm coverage.

    Customer Service/Contact:

  • Contact appropriate parties and providers to determine liability, compensability, negligence and subrogation potential.
  • Contact appropriate parties to obtain any needed information and explain benefits as appropriate. Continue contact throughout the life of the file as appropriate.
  • Answer phones, check voice mail regularly, and return calls as needed.
  • Assist with training/mentoring of Claims Adjusters.
  • Assist management when required with projects or leadership as requested.
  • Handle the various duties/responsibilities of the Assistant Unit Manager/Unit Manager as delegated in their absence.

    Subrogation:

  • Refer all files identified with subrogation potential to the subrogation department.

    Investigation:

  • Verify facts of loss and pertinent claims facts such as employment, wages, or damages and establish disability with treating physicians as appropriate.
  • Identify cases for settlement. Evaluate claims and request authority no later than 30 days prior to mediation date and negotiate settlement.
  • Evaluate and negotiate liens.
  • Recognize and report potential fraud cases.

    Litigation Management:

  • Develop and direct a litigation plan with defense attorney (if assigned), utilizing all defenses and tools to bring the file to closure. Ensure all filings and state mandated forms are completed timely. Litigated files must be diaried effectively based on current activity, but no greater than every 60 days.
  • Review claim files involving active litigation on a monthly basis at minimum, and document responses to filings, development of defenses, depositions, and timely referral to defense counsel.
  • Direct the actions of defense counsel on litigated files.
  • Attend mediations and trials as required for cost effective litigation management.

    Reserves:

  • Establish ultimate reserves (anticipated cost to bring file to close based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.
  • Pay all known benefits, ensuring they are paid timely on state statute.
  • Verify all provider bills have been appropriately reviewed and paid within standard timeframes.

    Reporting Requirements:

  • Report all serious injuries/liability issues and potential large loss claims to the client and/or reinsurer based upon the criteria provided by the client.
  • Must pass all internal and external audits, which include those performed by regulatory agencies, carriers, and clients.
  • Follow reporting requests as outlined by client files and NARS guidelines.

    Resolution:

  • Document plan of action in the claim system and set appropriate diaries.
  • Maintain a regular diary for monitoring and directing medical care, case development, or litigation.
  • Close all files as appropriate in a timely and complete manner.
  • Maintain closing ratio as dictated by management team.

Qualification Requirements:

Education / Licensing:

  • High School Diploma, college degree preferred.
  • Must have 3+ years prior claim adjusting or similar experience, with the majority handling CD and complex litigation. Must have 5 to 7 years of overall claims experience, preferably in the line of business being handled.
  • Must have 5+ years heavy litigation experience for all other lines except workers compensation.
  • Must have 3+ years Construction Defect or similar/related experience if handling that line of business.
  • Must be eligible for reserve/payment authority level of $50,000+ when appropriate
  • Must possess, or have the ability to obtain, a Florida Adjuster’s license or other required jurisdictional licensing.

    Technical skills:

  • Advance level of interpersonal skills to handle sensitive and confidential situations and information.
  • Requires advanced ability to negotiate claims and to direct litigation.
  • Must have negotiation and litigation skills for significant work with attorneys and arbitration on first and third party claims.
  • Requires advanced ability to work independently.
  • Requires an advanced level of organization and time management skills.
  • Must possess advanced level written and verbal communication skills.
  • Must be able to explain and appropriately respond to auditors, clients, and potential clients during in-person presentations.

    Abilities:

  • Requires long periods of sitting.
  • Requires working indoors in environmentally controlled conditions.
  • Requires lifting of files and boxes up to approximately 20 pounds.
  • Repeated use of a keyboard, mouse, and exposure to computer screens.
  • Requires travel as assigned, which can at times be extensive (5 to 7 days per month).
Company DescriptionNorth American Risk Services (NARS) is a premier third-party claims administrator that is dedicated to producing the best possible results for our clients. Founded in 1996, we handle claims for insurers, brokerages, managing general agencies, reinsurers, liquidation bureaus, self-insured funds and entities.Company DescriptionNorth American Risk Services (NARS) is a premier third-party claims administrator that is dedicated to producing the best possible results for our clients. Founded in 1996, we handle claims for insurers, brokerages, managing general agencies, reinsurers, liquidation bureaus, self-insured funds and entities.

  • Claims Adjuster

    9 hours ago

    Philadelphia, Pennsylvania, United States Sedgwick Full time

    About the RoleSedgwick is a leading provider of technology-enabled risk, benefits, and integrated business solutions. We are seeking a highly skilled Claims Adjuster - Liability Expert to join our team of talented professionals.Key ResponsibilitiesAnalyze mid- and higher-level general liability claims to determine benefits due and ensure ongoing adjudication...

  • Professional Liability Adjuster

    3 months ago

    Philadelphia, United States Berkshire Hathaway GUARD Insurance Companies Full time

    Overview Professional Liability Adjuster Berkshire Hathaway GUARD offers a collaborative company culture with outstanding benefits and competitive compensation. Our organization is hiring and we’re looking for talented individuals to join our team and establish a rewarding career with us. Our success is founded on our strong reputation, and we...

  • Senior Liability Claims Examiner

    16 hours ago

    Philadelphia, Pennsylvania, United States Independence Blue Cross Full time

    In the role as a Senior Claims Adjuster, you will handle claims for bodily injury and property damage claims. These claims include auto accidents, premises liability, police professional liability, and subrogation. A working knowledge of the New Jersey Tort Claim Act (Title 59) is preferred.Promptly investigates all assigned claims for coverage, liability...

  • Field Property Claims Adjuster-Philadelphia, PA

    5 months ago

    Philadelphia, United States Farmers Insurance Group Full time

    Investigates, determines liability, confirms coverage, establishes damages, and negotiates settlement of claims. Will also be required to maintain an active adjusters license in states where required. Essential Job Functions Investigates, confirms co Claims, Adjuster, Property, Field, Insurance, Damage

  • Senior Property Claims Adjuster

    1 week ago

    Philadelphia, Pennsylvania, United States RYZE Claim Solutions Full time

    Job OverviewPosition Type: Full-Time Staff Position with Salary and BonusRole Summary:The Senior Property Claims Adjuster is responsible for investigating and assessing daily property claims for clients, adhering to both client and company protocols. This role demands the delivery of timely, precise, equitable, and professional service to all clients and...

  • Claims Adjuster

    3 months ago

    Philadelphia, United States Berkshire Hathaway GUARD Insurance Companies Full time

    Overview Berkshire Hathaway GUARD Insurance Companies is looking to hire a Workers Compensation Claims Associate (Entry Level) to conduct office investigations and adjusting workers compensation claims. We are looking to fill this position in our Corporate Office in Wilkes-Barre, PA or Philadelphia, PA. We are seeking candidates that are...

  • General Liability Defense Attorney

    3 weeks ago

    Philadelphia, United States gpac Full time

    General Liability Defense Attorney Dynamic and growing Philadelphia law firm dedicated to providing top-tier legal services in the field of insurance defense and civill litigation is seeking a junior General Liability Defense Attorney to join their team. The firm prides itself on fostering a supportive and collaborative work environment where every team...

  • General Liability Defense Attorney

    4 weeks ago

    Philadelphia, Pennsylvania, United States gpac Full time

    General Liability Defense AttorneyDynamic and growing Philadelphia law firm dedicated to providing top-tier legal services in the field of insurance defense and civill litigation is seeking a junior General Liability Defense Attorney to join their team. The firm prides itself on fostering a supportive and collaborative work environment where every team...

  • General Liability Defense Attorney

    3 weeks ago

    Philadelphia, United States Gpac Full time

    General Liability Defense AttorneyDynamic and growing Philadelphia law firm dedicated to providing top-tier legal services in the field of insurance defense and civill litigation is seeking a junior General Liability Defense Attorney to join their team. The firm prides itself on fostering a supportive and collaborative work environment where every team...

  • Attorney - General Liability

    2 months ago

    Philadelphia, United States Trandon Associates, Inc Full time

    Job DescriptionJob DescriptionLaw Firm is looking for an experienced self-starting Associate to join our litigation group. Successful applicants will have exceptional writing, research, and litigation skills. This position is full-time. The Associate will work directly with and learn from a highly experienced group of attorneys and staff members. A candidate...

  • Senior Claim Specialist-Life Sciences

    1 month ago

    Philadelphia, United States CHUBB Full time

    Chubb is seeking a Senior Claim Specialist for our Life Sciences Claims team. The Life Sciences Claims Team provides claim handling with regard to some of the largest medical products manufacturers and providers of instruments with worldwide distribution on the cutting edge of innovation, research and technology. Typical Life Sciences claims include...

  • Litigation Associate

    1 week ago

    Philadelphia, Pennsylvania, United States Trandon Associates, Inc Full time

    Position OverviewTrandon Associates, Inc. is seeking a skilled and proactive Associate to enhance our litigation team. The ideal candidate will possess outstanding writing, research, and litigation capabilities. This is a full-time role where the Associate will collaborate closely with a seasoned group of attorneys and support staff. A strong commitment to...

  • General Liability Attorney

    2 weeks ago

    Philadelphia, United States Interlink Talent Solutions Full time

    My Client is currently recruiting motivated professionals with exceptional talent and promise to join there nationally ranked firm. With a culture built on collaboration and teamwork, they reward skill and initiative with new opportunities and dynamic challenges. They foster a supportive and inclusive work environment that provides our attorneys and staff...

  • Attorney - General Liability Specialist

    5 days ago

    Philadelphia, Pennsylvania, United States Trandon Associates, Inc Full time

    Job OverviewTrandon Associates, Inc. is seeking an experienced and skilled Attorney to join our litigation team. As a key member of our team, you will be responsible for providing exceptional legal services to our clients.Key ResponsibilitiesFile Review and Analysis: Conduct thorough reviews of claims and causes of action to ensure accurate and effective...

  • General Liability Attorney

    4 weeks ago

    Philadelphia, United States Interlink Talent Solutions Full time

    My Client is currently recruiting motivated professionals with exceptional talent and promise to join there nationally ranked firm. With a culture built on collaboration and teamwork, they reward skill and initiative with new opportunities and dynamic challenges. They foster a supportive and inclusive work environment that provides our attorneys and staff...

  • General Liability Attorney

    4 weeks ago

    Philadelphia, United States Interlink Talent Solutions Full time

    My Client is currently recruiting motivated professionals with exceptional talent and promise to join there nationally ranked firm. With a culture built on collaboration and teamwork, they reward skill and initiative with new opportunities and dynamic challenges. They foster a supportive and inclusive work environment that provides our attorneys and staff...

  • General Liability Attorney

    2 weeks ago

    philadelphia, United States LHH Full time

    The Philadelphia office of a regional mid-sized law firm is seeking to hire a General Liability Associate. The ideal candidate will have:· At least two years of general liability or at least litigation defense experience· Strong writing, research, and analytical skills· Great communication skills· The ability to develop relationships with clients· The...

  • General Liability Attorney

    1 week ago

    philadelphia, United States LHH Full time

    The Philadelphia office of a regional mid-sized law firm is seeking to hire a General Liability Associate. The ideal candidate will have:· At least two years of general liability or at least litigation defense experience· Strong writing, research, and analytical skills· Great communication skills· The ability to develop relationships with clients· The...

  • General Liability Attorney

    2 months ago

    Philadelphia, United States LHH Full time

    The Philadelphia office of a regional mid-sized law firm is seeking to hire a General Liability Associate. The ideal candidate will have:· At least two years of general liability or at least litigation defense experience· Strong writing, research, and analytical skills· Great communication skills· The ability to develop relationships with clients· The...

  • General Liability Attorney

    3 months ago

    Philadelphia, United States LHH Full time

    The Philadelphia office of a regional mid-sized law firm is seeking to hire a General Liability Associate. The ideal candidate will have:· At least two years of general liability or at least litigation defense experience· Strong writing, research, and analytical skills· Great communication skills· The ability to develop relationships with clients· The...