Claim Rep Sr, SIU - No Fault Litigation (Hybrid or Remote)

MAPFRE•Webster, MA

1d•$52,100 - $82,200•Hybrid

About The Position

This role offers the opportunity to work independently, collaborate with legal and investigative partners, and play a critical role in protecting both our customers and the organization through thoughtful, strategic claim handling. The role involves managing complex No-Fault, Med Pay, and fraud-related claims while managing litigation exposure and delivering outstanding customer service.

Requirements

Bachelor's degree or equivalent combination of education and related experience.
3+ years of No Fault claims handling experience.
Strong investigative, analytical, and negotiation skills, including coordination of benefits.
Experience interpreting insurance policies, coverage provisions, and applicable case law and 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 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 claims, including PIP/No-Fault, Med Pay, and suspected fraud-related matters.
Conduct detailed investigations through recorded statements, scene reviews, witness interviews, database research, and collaboration with field investigators.
Analyze policy coverage including coordination of benefits, liability exposures, damages, and applicable statutes across multiple jurisdictions.
Evaluate medical treatment, wage loss claims, and other damages using a variety of investigative resources.
Develop effective claim strategies that lead to 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 to support 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.
Serve as a mentor and resource for less experienced adjusters.
Share best practices and contribute to training initiatives.
Recommend process improvements that enhance efficiency and customer experience.
Represent the organization with professionalism in all internal and external interactions.