Casualty Specialist II

First Acceptance•Marianna, FL

12d•Onsite

About The Position

This role involves planning and conducting investigations to analyze coverage, determine liability, compensability, and extent of damages for casualty claims. The specialist will complete Bodily Injury Evaluation forms, make recommendations for claim dispositions, and compile information for claims committee review. They will also determine the need for external experts, assess damages, conduct negotiations, and evaluate subrogation opportunities. Additionally, the role requires evaluating policy coverage, determining reserve requirements, managing medical injury exposure, and ensuring timely payments. Maintaining accurate records, updating status notes, and communicating with internal and external customers are key responsibilities. The specialist will also evaluate claims for potential fraud and collaborate with the Special Investigations Unit as needed. Other duties may be assigned.

Requirements

High School Diploma or equivalency required.
At least one year of automobile liability experience is required.
Must currently hold or have the ability to secure and maintain adjuster license(s) within 60 days of employment.
Knowledge and understanding of applicable insurance statutes, regulations and case law.
Insurance industry knowledge.
Proficiency in Microsoft Office Suite products such as Word, Excel, PowerPoint, etc.
Strong customer service skills.
Time management, prioritization, and organizational skills.
Ability to make effective decisions on behalf of the organization with regards to casualty claims processing.
Ability to think critically and anticipate, recognize, identify, and develop solutions to problems in a timely manner.
Excellent interpersonal and communication skills, including presentation skills.
Commitment to First Acceptance’s company values.

Nice To Haves

A 2-year degree or higher in a field related to the position is preferred.
A minimum of 2 years of previous auto liability claim handling experience or minimum 1 year of bodily injury claims experience is preferred.

Responsibilities

Plans and/or conducts investigations to analyze coverage and determine liability, compensability, and extent of damages.
Completes Bodily Injury Evaluation forms and/or makes recommendations for the disposition of claims in excess of individual settlement authority.
Compiles information for discussion and decision-making by the claims committee where appropriate.
Determines the need for independent adjusters, cause and origin experts, independent medical examiners, economists, accident re-constructionists, and engineers.
Assesses actual damages associated with claims and conducts negotiations to settle claims.
Determines if subrogation is appropriate and takes steps necessary to initiate recovery efforts.
Evaluates policy coverage, and contacts insureds, claimants, attorneys, body shops and medical staff to determine injuries stemming from an accident while determining and establishing reserve requirements.
Evaluates the medical injury exposure within guidelines, obtaining authority when appropriate, and makes proper and timely payments.
Maintains accurate records and handles administrative responsibilities associated with the processing and payment of claims.
Records/updates status notes and documents results of contacts, the duration of contacts and relevant medical information; reports are consistent with internal procedures and best practices.
Maintains computer log indicating results of claim review and intentions for claim handling.
Keeps internal and/or external customers advised of file status and other matters as required.
Responds timely and appropriately to all settlement demands.
Evaluates each claim for potential fraud and works with Special Investigations Unit as required.
Performs other duties as assigned.