Desk Adjuster

Eberl•Lakewood, CO

9d•Onsite

About The Position

The Desk Adjuster will investigate claims by verifying facts through policy review, endorsements, and interviews with insured parties and other relevant individuals. This role involves writing estimates or denials based on coverage determination, reviewing documentation for completeness, accuracy, and compliance with carrier policies, and identifying potentially fraudulent activity. The Desk Adjuster will set appropriate reserves, recommend claim payments, and adhere to carrier Service Level Objectives (SLOs) and claim closure requirements. This position requires drafting clear correspondence, exercising sound judgment to resolve complex claim issues, and communicating effectively with all stakeholders. Maintaining detailed file documentation, serving as a technical subject matter expert, and preparing required claim documentation are also key responsibilities. The role involves providing regular updates to management, attending training sessions, and delivering excellent customer service while adhering to all applicable State Insurance Regulation requirements and laws. The Desk Adjuster must maintain the requisite state license for assigned states and perform additional duties as assigned.

Requirements

High School Diploma or equivalent
Minimum of two years’ experience in claim handling, estimating, and policy interpretation required
Must have experience handling weather water and non-weather water perils
Must be familiar with water mitigation practices
Proficient computer skills with Microsoft Word, Excel, PowerPoint, and Adobe Acrobat
Strong focus on customer service.
Self-motivated, and critical thinker who can work independently and use sound judgment to solve problems
Strong written and verbal communication skills
High level of time management skills
Ability to multitask and quickly adapt to changing/conflicting priorities
Excellent attention to detail
Strong relationship building skills and ability to work well with others
Possess the requisite state license for the state(s) assigned.

Nice To Haves

Experience handling claims in the California market is a plus
Proficient with complex claims handling procedures preferred
Proficient in Xactimate, Snapsheet and Guidewire CMS experience is a plus.
Proficient in writing estimates over the phone and from various sources
Experience with taking recorded statements is a plus

Responsibilities

Investigate claims by verifying facts through policy review, endorsements, and interviews with insured parties and other relevant individuals.
Write estimates or denial based on coverage determination.
Review documentation for completeness, accuracy, and compliance with carrier policies.
Ensure all collected information is accurate and identify potentially fraudulent activity, following up on discrepancies.
Set appropriate reserves and recommend reasonable and accurate claim payments in a timely manner.
Adhere to carrier Service Level Objectives (SLOs) and claim closure requirements.
Draft and deliver clear, professionally written correspondence, including claim-related letters and communications.
Exercise sound judgment and critical thinking to resolve complex claim issues.
Communicate effectively and promptly with insureds, claimants, and internal stakeholders in a courteous and professional manner.
Maintain detailed, organized file documentation to support the claim; when needed, make revisions and/or collaborate on files.
Serve as technical subject matter expert and support team members by sharing knowledge and assisting with workload when needed.
Prepare and submit all required claim documentation in a timely manner.
Provide regular updates on claim status to management and leadership and escalate to management when necessary following established procedures.
Attend and participate in training sessions, team meetings, and projects as needed.
Deliver excellent customer service and maintain a high level of professionalism in all interactions.
Adhere to all applicable State Insurance Regulation requirements and other applicable laws, regulations, and standards.
Assume personal responsibility for maintaining the requisite state license for the state(s) assigned.
Perform additional duties as assigned.