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Claims Adjuster I

2 months ago

Jacksonville, United States Olympus Insurance Company Full time
Job title: Claims Adjuster I
Reports to: Claims Manager I
Direct Reports: None
Position type: Full Time
FLSA Status: Exempt
Location: Jacksonville/In office

THIS POSITION IS IN OFFICE

Position Summary:
The Claims Adjuster I will assist policyholders throughout the entire claims process. Ability to work extended hours, including evenings and weekends, based on customer and business needs, as well as in response to catastrophic weather, with travel as required.

The Claims Adjuster I will handle a caseload which encompasses all levels of complexity for first-party claims, may include third-party and litigated claims, including establishing facts of loss, conducting proper reserve and coverage analysis, assessing and estimating property damage, assigning experts as needed, identifying potential fraud, complete file documentation and timely investigating claim for proper resolution.

A competitive candidate will have a high level of technical competence, attend training, assist management with other duties and work collaboratively with co-workers.

Job Description/Essential Functions:
  • Verify facts of loss and pertinent information to analyze and confirm coverage.
  • Establish case reserves (anticipated cost to bring file to closure based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.
  • Explain and appropriately respond to insureds, public adjusters, attorneys and contractors during telephone contacts; as well as, contact the appropriate parties to obtain any needed information, provide timely investigation status updates, explain settlements and/or ultimate claim disposition.
  • Timely login to phone system and be available for phone calls.
  • Timely submit reserve and payment approval requests, as appropriate.
  • Identify claims and draft a Reservation of Rights letter for claims management approval.
  • Draft denial letters for claims management approval.
  • Identify claims which should be resolved through DFS Mediation and/or appraisal and timely demand.
  • Attend mediations, as assigned, and apply technical knowledge to facilitate claim resolution negotiations.
  • Apply advanced negotiation skills to effectuate direct resolution of disputed claims.
  • Coordinate appraisal process, maintaining communication necessary to ensure appraisal process is timely moved forward toward binding award.
  • Identify and refer claims with subrogation potential to the subrogation department.
  • Identify and refer cases with potential NICB fraud indicators
  • Report all serious injuries/liability claims to claims management
  • Report all large loss claims to claims management
  • Attend and give sworn testimony in depositions and court proceedings involving property claims
  • Must be proficient in writing and reconciling EMS and reconstruction estimates for property claims involving all perils.
  • Virtually investigate and resolve claims, as appropriate, with the use of video technology.
  • Strictly adhere to Claim Handling Guidelines and Claims Best Practices as well as all statutory requirements.
  • Complete file documentation in a timely and complete manner,
  • Close all files as appropriate in a timely and complete manner .
  • Must meet minimum expectations when passing internal and external audits, which include those performed by regulatory, agencies, carriers, and clients.
  • Assist management when required with projects or leadership requests including travel as needed
Education:
  • High School graduate, college degree preferred.
Experience/ Skills:
  • 3-5 years of Florida property claims handling experience
  • Must have Florida 620 All Lines Adjuster License
  • Xactimate proficiency required
  • XactAnalysis experience is required
  • Strong analytical, organizational, negotiation and communication skills
  • Ability to work independently, multi-task and adapt to frequent priority changes
  • Ability to plan, prioritize workload, organize and coordinate multiple tasks and projects
  • Possesses strong customer service skills and can address customer escalations

EEOC Compliance:

We are an equal opportunity employer and provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to of race, color, religion, sex, national origin age, disability, sexual orientation, or any other characteristic protected by federal, state, or local law.