Insurance Coverage Specialist
3 days ago
Job Summary
This position is responsible for adjusting insurance claims for the State of Delaware, its agencies, school districts, higher education institutions, and its employees. The ideal candidate will have a strong understanding of insurance laws, regulations, and industry standards.
Key Responsibilities
- Conduct thorough investigations and evaluations of insurance claims to determine coverage, legal liability, and damages.
- Provide expertise on insurance programs and claims questions to stakeholders.
- Make informed decisions on claim settlements and negotiate with claimants and vendors.
- Direct and manage contracted appraisers, investigators, rehabilitation specialists, adjusters, and attorneys in adjudicating claims.
- Develop and implement Request For Proposals (RFPs) for insurance coverage and other contracted services.
- Stay up-to-date on federal and state statutes and insurance regulations, and provide guidance on their impact on the State.
- Maintain accurate and detailed records of claims, including files, exhibits, and reports.
- Ensure subrogation is promptly identified and documented, and subrogation letters are sent to responsible parties.
Requirements
- Possession of a Delaware Insurance Adjuster's License in one or more of the following lines of authority: Casualty, Motor Vehicle, Workers Compensation, or Property.
- At least six months of experience in investigating, evaluating, and negotiating insurance claims and making determinations for coverage, legal liabilities, and damages.
- Three years of experience in interpreting insurance laws, rules, regulations, standards, policies, and procedures.
- Knowledge of medical terminology and narrative report writing.
Working Conditions
The State of Delaware Executive Branch participates in the Federal E-Verify system to confirm the eligibility of all new hires to work in the United States.
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