Claim Rep Sr. SIU, Casualty (Hybrid or Remote)
About The Position
MAPFRE is seeking an experienced casualty claims professional to handle complex bodily injury, No-Fault, Med Pay, UM/UIM, and fraud-related claims. The role involves managing litigation exposure and delivering outstanding customer service, while working independently and collaborating with legal and investigative partners to protect customers and the organization through strategic claim handling. A higher-level opportunity may be available based on experience and qualifications. The position also includes mentoring less experienced adjusters, contributing to training and process improvements, and representing the organization professionally in internal and external interactions. The posting describes a hybrid or remote work arrangement.
Requirements
- Bachelor's degree or an equivalent combination of education and related experience.
- At least 2 years of casualty claims handling experience, including Bodily Injury and related coverages.
- Strong investigative, analytical, and negotiation skills.
- Experience interpreting insurance policies, coverage provisions, and applicable statutes.
- Excellent written and verbal communication skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Ability to obtain and maintain required state adjuster licenses.
Nice To Haves
- Experience handling SIU, fraud-related, or highly complex casualty claims.
- Litigation management experience.
- Insurance coursework, professional designations, or industry certifications.
- Bilingual language skills.
- Experience working with attorneys, medical experts, and law enforcement agencies.
Responsibilities
- Manage a diverse caseload of casualty claims, including Bodily Injury, PIP/No-Fault, Med Pay, UM/UIM, and suspected fraud-related matters.
- Investigate claims through recorded statements, scene reviews, witness interviews, database research, and collaboration with field investigators.
- Analyze policy coverage, liability exposures, damages, and applicable statutes across multiple jurisdictions.
- Evaluate medical treatment, wage loss claims, and other damages using investigative resources.
- Develop claim strategies to support timely and fair resolutions.
- Negotiate settlements through phone conferences, mediations, arbitrations, and face-to-face discussions.
- Maintain accurate reserves and manage claim expenses responsibly.
- Partner with experts, medical professionals, and vendors on claim evaluations and investigations.
- Direct and oversee defense counsel on litigated claims.
- Participate in depositions, examinations under oath, mediations, arbitrations, and trial-related activities.
- Prepare responses to regulatory inquiries, consumer complaints, and Department of Insurance matters.
- Ensure compliance with state regulations and company claim-handling standards.
- Mentor and serve as a resource for less experienced adjusters.
- Share best practices and contribute to training initiatives.
- Recommend process improvements to enhance efficiency and customer experience.
- Represent the organization professionally in internal and external interactions.
Benefits
- Flexible PTO combining vacation, personal, volunteer, and sick time.
- 401(k) plan with company matching contributions, subject to plan terms.
- Profit sharing.
- Medical insurance coverage.
- Dental insurance coverage.
- Vision insurance coverage.
- Short-term disability insurance.
- Long-term disability insurance.
- Life insurance.
- Flexible spending account (FSA).
- Health savings account (HSA).
- Wellness programs.
- Tuition reimbursement.
- Leadership programs and internal mobility opportunities.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
