Claims Complex Property Adjuster
About The Position
This position supports the Property Claims operation by handling high-complexity claims reported on Homeowner policies written by the Interinsurance Exchange, while complying with regulatory and statutory requirements. The role interprets First Notice of Loss reports, investigates losses, evaluates coverage and damages, develops negotiation strategies, and resolves claims. It uses discretion and independent judgment to ensure compliance with state and federal laws and applies technical and customer-service best practices in accordance with company guidelines. The adjuster communicates with members, insureds, claimants, witnesses, vendors, counsel, and internal and external departments. The position evaluates and negotiates first-party claims within settlement authority, addresses complex coverage and subrogation issues, assists with mentoring and training less experienced personnel, and may participate in legal proceedings or provide sworn expert testimony. It also prepares formal reports on high-profile claims for senior management and responds promptly to customer needs.
Requirements
- 7–9 years of prior claims handling experience.
- Working knowledge of claims administration best practices and procedures.
- Advanced knowledge of insurance, coverage investigation, scope and damage assessment, negligence, and subrogation principles.
- Advanced knowledge of Microsoft Office, general computer software, and claims software.
- Comprehensive understanding of building and vehicle repair procedures and third-party liability issues.
- Advanced leadership skills among peers.
- Advanced organization and planning recognition skills.
- Advanced oral and written communication skills.
- Advanced interpersonal skills.
- Valid driver's license, acceptable Department of Motor Vehicles record, and minimum liability insurance issued by a state.
- An insurance or claims adjuster license may be required for claims administration in specific states.
Nice To Haves
- Bachelor's degree or equivalent combination of education and experience.
- 7–9 years of property claims administration experience.
- Chartered Property Casualty Underwriter designation from the Insurance Institute of America.
- Associate in Claims designation from the Insurance Institute of America.
Responsibilities
- Identify and obtain statements from insureds, claimants, and witnesses.
- Conduct phone investigations to determine coverage and damages and distinguish allegations from facts.
- Determine policy obligations by assessing liability and damage components of losses.
- Maintain appropriate claim activities and service levels.
- Communicate with members, insureds, claimants, vendors, and internal and external departments.
- Explain policy coverages, benefits, and the claims process verbally or in writing in compliance with regulatory and statutory requirements.
- Recognize and address complex coverage and subrogation issues.
- Evaluate, assess, and negotiate first-party claims within settlement authority across multiple markets.
- Assess personal property, property damage, coverage, loss of use, arbitration responses, and damage evaluations, and use claims technology and tools.
- Objectively identify and address issues that may be questioned in an audit.
- Mentor and assist in training less experienced personnel, and provide file coaching.
- Attend and participate in legal proceedings as needed.
- Direct and interact with in-house and outside counsel on litigated files.
- Provide sworn expert testimony in courtroom or deposition settings.
- Prepare comprehensive formal reports on high-profile claims for senior management.
- Respond quickly to customer needs and problems.
- Travel occasionally to off-site business meetings or conferences.
Benefits
- Medical, dental, and vision health coverage.
- 401(k) savings plan with company match and a pension.
- Tuition assistance.
- Floating holidays and PTO for community volunteer programs.
- Paid parental leave.
- Wellness programs.
- Employee discounts on membership, insurance, travel, entertainment, services, and more.
- Eligibility to participate in an incentive program based on organization, team, and personal performance.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
