Claims Resolution Specialist (Claims Adjuster)
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About The Position
Encova Insurance has an immediate opening for a Claims Resolution Specialist (Claims Adjuster). This role will have the option to work home-based but you must reside in one of our licensed payroll states as seen on our careers page. The primary objective of this position is to investigate, evaluate, negotiate, and settle casualty claims and any related coverages within established best practices and applicable jurisdictional guidelines. The Claims Resolution Specialist will primarily handle claims over the phone with limited in-person contact, focusing on injury and third-party property damage claims under personal and commercial auto, garage, uninsured and underinsured motorists, homeowner's liability, and commercial liability coverages. The injury claims handled will generally be less serious, involving minimal disability, wage loss, and hospital treatment. Additionally, the specialist will manage automobile physical damage claims in conjunction with material damage appraisers. The role requires compliance with claims organization policies, established best practices, and jurisdictional guidelines. This includes adhering to practices and procedures for contact and communication, verification of coverages, determination of liability, investigation of losses, and determination of claims values. The specialist will also be responsible for completing forms and reports, negotiating, and settling claims while complying with all state Fair Claims Practices acts and obtaining state licensing as required. The position demands maintaining competency in the use of multiple claims systems and managing efficient and effective follow-up practices, with an expectation to effectively investigate and close a minimum average of 75-80 losses per month. In addition to the essential functions, the Claims Resolution Specialist will maintain an ongoing understanding of claims processes, procedures, and systems, keeping current on fair claims practices laws, compliance issues, and business-related developments. Limited outside contacts may be made at the discretion of the casualty team lead, and other duties may be assigned as necessary. This position does not require previous insurance experience, but it is preferred. Experience in successfully working with customers is strongly desirable, which may be achieved through sales experience, public service experience (e.g., police, social work), or other professional-level business experience. Continuing education during the first two years of employment is preferred and may be obtained through in-house claims training classes or accredited insurance education providers. A college degree and the ability to read, write, and speak fluent Spanish is strongly desired, along with some state insurance licensing requirements.
