Claims Adjuster - Auto

Job Description

Job Description

Manager's Note :

Must have active NY license and BI litigation experience

Auto casualty

Experienced in complex liability and coverage.

TPA experience a plus.

Bodily injury / uninsured / underinsured motorist handling experience to include demonstrable (fatality, fractures, traumatic brain injury) injury handling.

$ threshold handling up to 1 million.

No fault(Personal Injury Protection) experience.

Licensed in the contiguous 48 states.

Litigation handling experience pertaining to BI / UM / UIM Not all candidates will need this but a minimum of 3 will need litigation handling experience.

Auto Physical Damage handling experience preferred.

Experience working in a fast paced environment, participating in and presenting cases to both internal and external stakeholders.

Primary Purpose :

To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.

Essential Functions and Responsibilities :

Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.

Responsible for litigation process on litigated claims.

Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.

Reports large claims to excess carrier(s).

Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.

Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.

Communicates claim action / processing with insured, client, and agent or broker when appropriate.

Additional Functions and Responsibilities :

Performs other duties as assigned.

Supports the organization's quality program(s).

Travels as required.

Qualifications :

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.

Experience Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverages, principles, and laws.

Skills & Knowledge :

In-depth knowledge of personal and commercial line auto policies, coverages, principles, and laws

Knowledge of medical terminology for claim evaluation and Medicare compliance

Knowledge of appropriate application for deductibles, sub-limits, SIRs, carrier and large deductible programs.

Strong oral and written communication, including presentation skills

PC literate, including Microsoft Office products

Strong organizational skills

Strong interpersonal skills

Good negotiation skills

Ability to work in a team environment

Ability to meet or exceed Service Expectations

Work Environment :

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical : Computer keyboarding, travel as required

Auditory / Visual : Hearing, vision and talking

Note :

Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.

They are not intended to constitute a comprehensive list of functions, duties, or local variances.

Management retains the discretion to add or to change the duties of the position at any time. at any time.