Claims Examiner

1 day ago


Albuquerque, New Mexico, United States New Mexico Municipal League Full time
Job Title: Claims Adjuster

The New Mexico Municipal League is seeking a skilled Claims Adjuster to join our team. As a Claims Adjuster, you will be responsible for reviewing, processing, and investigating claims for various policies and programs, including workers' compensation, general liability, and law enforcement.

Key Responsibilities:
  • Receive and process claims from insured members
  • Determine coverage eligibility and evaluate negligence, liability, and applicable coverage for losses
  • Investigate claims and make recommendations to deny, defend, negotiate, or pay claims
  • Utilize various resolution processes, including settlement offers, mediation, arbitration, or litigation
  • Perform cost control actions and set reserves for claims to ensure financial resources are available
  • Manage reserve pools and coordinate with reserve adjusters to adjust reserves as necessary
  • Coordinate and supervise contract work of independent adjusters for claims investigation
  • Monitor case progress and verify accuracy of results from independent adjusters
  • Manage and monitor professional services related to settlements, such as medical care, legal consultation, and therapy
  • Participate in claims committee meetings and provide case details to the risk services director, executive director, and Fund trustees
Requirements:
  • Knowledge of general liability, civil rights, law enforcement, workers' compensation, life, and medical claims adjudication policies, procedures, and processes
  • Familiarity with legal, medical, and insurance industry technology
  • Strong organizational, communication, and interpersonal communication skills
  • Expertise in negotiation techniques and technical writing
  • Ability to draft technical reports and analyze a variety of claims issues
  • Skilled in making informed recommendations and communicating effectively both in writing and orally
  • Ability to establish and maintain effective working relationships with professionals, executives, department heads, co-workers, and the public
  • Capable of working independently
Education and Qualifications:
  • Licensed as an adjustor in the State of New Mexico under Section 18-40
  • Bachelor's Degree or five years of relevant experience, or any combination of the two
Work Location:

The primary work location is the NMML/NMSIF Santa Fe office. This is a full-time, in-person job.

Compensation:

The pay range is $60,000 to $120,000 annually, dependent on qualifications and experience. Compensation includes a comprehensive benefits package, including automatic 10 percent retirement contribution from employer, and up to additional 8 percent retirement fund matching contribution.



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