Insurance Claims Specialist

1 week ago


Wilson, North Carolina, United States Ncfbins Full time

Join Our Team

At Ncfbins, we pride ourselves on our integrity and commitment to our employees. We offer a supportive environment where your career can flourish.

Position: Office Adjuster

Location: Wilson, NC

Department: Claims

Reports To: District Claims Manager

Overview

The Office Adjuster (OA) plays a crucial role in the assessment, evaluation, and negotiation of specific categories of claims within an office environment. OAs in our Field District Claims Office handle both casualty and property claims of limited complexity, while those in our Medical Claims District focus on claims related to Medical Payments coverage.

Essential Qualifications

A bachelor’s degree or equivalent professional experience is preferred. Strong verbal and written communication skills are essential. The ability to conduct business professionally, whether in person or through written correspondence, is required. Candidates must demonstrate reliability and the capacity to work both independently and collaboratively. Compliance with continuing education requirements set by the N.C. Department of Insurance and Ncfbins is necessary. Familiarity with medical and legal terminology is advantageous for those in the Medical Claims District, while an interest in auto and home repair, as well as contract analysis, is beneficial for those in the Field District Claims Offices.

Key Responsibilities

  1. Verify coverage on loss assignments.
  2. Maintain consistent communication with insured parties and claimants.
  3. Establish and update reserves as necessary.
  4. Adhere to regulatory guidelines.
  5. Assess covered damages using available resources.
  6. Investigate claims and apply relevant policy coverage.
  7. Determine legal liability for losses and damages.
  8. Facilitate payment or denial of claims.
  9. Keep detailed notes and reports on claims at various stages of processing.
  10. Manage and control expenses effectively.
  11. Participate in meetings and training sessions as required.
  12. Perform additional duties as assigned by management.

Senior Office Adjuster Qualifications

Recommendations from the District Claim Manager and Regional Claim Manager are required. A minimum of five years of experience as an Office Adjuster or in a comparable adjusting role with Ncfbins is necessary. Successful completion of all mandated industry coursework is expected, along with passing assessments on company contracts and general claims knowledge.

Equal Opportunity Employer

Ncfbins is committed to providing a workplace free from discrimination, intimidation, and harassment. All employment decisions are based on merit, qualifications, and abilities, without regard to race, color, creed, religion, sex, national origin, age, physical or mental disabilities, veteran status, or any other characteristic protected by law.



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