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Homeowners Claims Adjuster

2 months ago

Bakersfield, California, United States Direct Auto Full time
Job Summary

We are seeking a highly skilled and detail-oriented Homeowners Claims Adjuster to join our team at Direct Auto Insurance. As a Claims Adjuster, you will be responsible for examining claims data, investigating losses, determining coverage and liability, and adjusting claims within the limit of authority.

Key Responsibilities
  • Receive and verify claim assignments, gathering facts and evidence to determine coverage and document all relevant information.
  • Determine claim approval and denial up to $7,500 per exposure or $10,000 per file, using independent judgment and discretion.
  • Establish investigative plans, gather facts and evidence, complete reports, and review loss reserves to adjust or open hidden exposures as necessary.
  • Evaluate and adjust claims within the limit of authority, using strong negotiation skills and professional communication.
  • Track and document the quality of service provided by defense counsel and manage litigation and recovery costs.
  • May work with attorneys in resolving lawsuits and participate in investigations of medical providers and attend EUOs.
  • Conduct negotiations and settlements within authority level, using independent judgment, or within discretionary levels granted above individual authority level.
  • Perform other projects and assignments as directed, demonstrating a high degree of initiative, mature judgment, and discretion.
Requirements
  • Bachelor's Degree or equivalent education, training, and work-related experience.
  • Successfully completes Claim Representative trainee program or equivalent external training program.
  • Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint).
  • Obtain and maintain appropriate licensing or educational requirements.
  • Demonstrate the capability of consistently handling aggregate file exposures of at least $2,500.
  • Demonstrate proficiency in file audits to agreed standard of efficient claims quality.
  • Has a solid command of the claims policies and procedures, exhibit basic interpretation of policies & procedures in resolving claims, but may still need some assistance from supervisor.
  • Demonstrate the ability to interpret and apply written coverage accurately to establish claim and determine an action plan, and often requires assistance on more complex files.
  • Demonstrate a solid understanding of the repair and replacement of property damages, to include mechanical components of a vehicle, homeowner damages, and other potential exposures.
  • For claims involving injuries, has solid understanding of how to review, evaluate, and negotiate injury claims.
  • Demonstrate ability to handle litigation in accordance with company guidelines, and be able to recognize legal issues and will utilize ADR when appropriate.
  • High degree of initiative, mature judgment, and discretion.
  • Ability to resolve conflicts and empathize with customers is critical.
  • Strong negotiation skills.
  • Demonstrate professional oral and written communication skills.
  • Organization and time management skills are critical for this position.
  • Demonstrate an understanding of insurance law as it relates to claims.