Claim Specialist, Casualty (Hybrid or Remote)

MAPFRE•Webster, MA

5d•$58,800 - $83,700•Hybrid

About The Position

The Claim Specialist, Casualty manages a diverse caseload of moderate- to high-severity Bodily Injury and Uninsured/Underinsured Motorist claims, which may include multi-jurisdictional claims. The role evaluates coverage, investigates liability and damages, negotiates settlements, and works to resolve claims fairly and promptly. The specialist reviews Personal and Commercial Auto policies and related legal materials, coordinates with customers and other involved parties, and manages claims involving litigation or arbitration. The position also focuses on delivering a timely, professional, and empathetic customer experience while making prompt, well-supported coverage and liability determinations. The specialist maintains detailed claim evaluations, action plans, and documentation; uses experts as appropriate; and represents the company in claim-related proceedings. Experienced team members may serve as peer trainers, support others’ development, and contribute to process improvements and departmental initiatives. The role is hybrid for local candidates in Webster, Massachusetts, with two days in-office and three days remote, or fully remote for candidates outside a commutable distance. It is non-exempt. The typical starting salary range is $58,800–$83,700, with some roles eligible for commission and/or bonus earnings under the compensation plan.

Requirements

At least 3 years of claims adjusting experience.
Bachelor’s degree or professional-level knowledge in a specialized field, or equivalent related experience.
An associate degree or equivalent education combined with approximately 4 to 6 years of related experience may also be considered.
Strong knowledge of Personal and Commercial Auto policies.
Excellent written, verbal, negotiation, and customer service skills.
Ability to communicate professionally and empathetically with customers, claimants, attorneys, and medical providers.
Strong organizational skills and ability to prioritize and manage a high-volume caseload in a fast-paced environment.
Strong analytical, mathematical, business, and decision-making skills.
Ability to learn new responsibilities quickly and work effectively independently and as part of a team.
Comfort using claims systems and standard PC applications.
Ability to maintain a high degree of confidentiality.
Completion of the Casualty Claims training program is required.

Nice To Haves

Insurance industry education is strongly preferred.
Experience handling Bodily Injury and/or Uninsured/Underinsured Motorist claims is highly desirable.

Responsibilities

Manage moderate- to high-severity Bodily Injury and Uninsured/Underinsured Motorist claims, including possible multi-jurisdictional claims.
Review and interpret Personal and Commercial Auto policies, endorsements, exclusions, statutes, and case law.
Screen new losses for coverage issues, exposures, and appropriate next steps.
Investigate coverage, liability, and damages, gathering and evaluating evidence such as police reports, witness statements, medical documentation, photographs, recorded or written statements, and accident reconstruction information.
Communicate with customers, claimants, attorneys, medical providers, employers, experts, and other involved parties.
Evaluate bodily injury claims and develop fair, accurate, and timely settlement strategies.
Negotiate settlements by telephone and in person, including through settlement conferences, mediations, and arbitrations.
Manage claims involving litigation and/or arbitration, partnering with attorneys and experts as appropriate.
Identify subrogation opportunities and potential additional responsible parties.
Investigate damages that may be excessive, unrelated, or require additional review.
Prepare comprehensive claim evaluations, action plans, and documentation addressing coverage, liability, damages, and resolution strategy.
Draft technical correspondence, including Reservation of Rights and Disclaimer letters, responses to Insurance Department complaints and 93A/176D demand letters, litigation documents, arbitration briefs, and other claim-related correspondence.
Maintain an organized, proactive pending while meeting productivity, diary, and claim closure expectations.
Ensure payments and required communications are accurate and completed within established timeframes.
Maintain confidentiality and exercise sound business judgment throughout the claims process.
Provide timely, professional, clear, and empathetic communication and respond promptly to customer and claimant needs throughout the claim.
Maintain proficiency with claims operational systems and required documentation.
Use experts when appropriate to evaluate damages and support cost containment.
Represent the company in arbitrations, mediations, settlement conferences, and other claim-related proceedings.
Serve as a peer trainer or resource for less experienced adjusters and new team members, as appropriate.
Support professional development of other claims personnel and identify opportunities to improve workflows, systems, and claim service.
Participate in committees, projects, and other departmental initiatives.
Demonstrate professionalism, accountability, dependability, and commitment to company standards.