Claims Adjuster II
4 weeks ago
A Claims Adjuster II is responsible for the timely and efficient adjustment and disposition of self-administered casualty claims in multiple jurisdictions. This role extends to all aspects and phases of investigations, evaluations, negotiations, and settlements/denials of workers' compensation, auto liability, no-fault uninsured motorist, and general liability claims. The Claims Adjuster II will manage a caseload ranging from casualty claims, with varying acceptable caseloads based on jurisdiction(s), mix, and complexity of Worker's Compensation and General Liability cases as determined by the Claims Unit Manager.
Key Responsibilities
- Investigate claims promptly, taking statements as necessary, to determine liability/compensability.
- Evaluate damages and pay benefits as prescribed by law and/or Marriott policies and procedures.
- Secure necessary documentation to facilitate timely loss adjustment and maintain primary responsibility for settlement decisions up to individual authority.
- Complete and monitor timely WC payments/state filings.
- Monitor and actively manage WC medical treatment with the goal of minimizing disability. Consult Occupational Health Services as necessary.
- Manage litigation cases, including controlling/directing outside attorneys, assisting in discovery/trial preparation, and strategy.
- Evaluate claims for potential third-party or subrogation recovery.
- Participate in the Service Call Program and complete required Service Call reports detailing current case status.
- Actively participate in regularly scheduled unit meetings and department meetings.
- Comply with Marriott Casualty Claims Policy and Procedure Manual requirements.
- Effectively utilize the Valley Oaks System (iVOS) to manage all claims electronically.
- Enter action plan notes/website notes into iVOS.
- Participate in activities that foster teamwork and continuous quality improvement.
- Perform other duties as business demands.
Candidate Profile
- At least one year of claims adjusting experience with applicable industry licensing.
Knowledge and Skills
- Ability to grasp and apply technical knowledge, including litigation case management and adjusting skills.
- Effective reasoning, analysis, and decision-making skills.
- Effective influence skills.
- Strong negotiation skills.
- Ability to organize work and other priorities to ensure timely completion of all deliverables/deadlines.
- Strong customer-oriented/hospitality skills.
- Demonstrate strong leadership abilities.
- Ability to prioritize work.
- Good communication skills (verbal, listening, writing), including the ability to deliver difficult messages to customers and/or claimants.
- Good investigation skills.
- Basic knowledge of claims process.
- Working knowledge of Claims software platforms, Microsoft suite (Excel, Outlook, etc.).
- Ability to work well in a team, providing assistance to fellow associates and representing the mission of the unit.
- Possess a willingness to accept and respond positively to constructive criticism.
- Present oneself with a positive, professional demeanor.
- Communicate often with supervisor, keeping him/her informed.
- Show dependability.
Education or Certification
- High School Diploma or GED.
- Associate degree (or higher) in Claims or Associate in Risk Management or related field is desirable.
- California Experienced Claims Adjuster Designation and current on education hours.
- California Self-Insured Administrator's Certificate required.
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