Litigation Claims Adjuster - Complex

CRC Group • Remote - North Carolina, SC

2d • Onsite

About The Position

The Claims Senior Professional manages complex claims processes, including investigating, evaluating, and resolving high-severity claims in compliance with company standards and regulations. This role ensures timely adjudication while minimizing risk exposure and maintaining superior customer and broker relationships.

Requirements

• Bachelor’s degree in business, insurance, risk management, or related field is preferred.
• 5 or more years of experience handling claims, preferably in specialty or complex lines.
• Demonstrated expertise in managing complex or high-risk claims scenarios.
• Experience working with brokers, legal professionals, and regulatory agencies.
• Must hold and maintain all required licenses in all U.S. states where licensing is required to perform the duties of this position.
• Advanced claims analysis and adjudication techniques.
• Strong negotiation and settlement skills.
• Excellent written and verbal communication abilities.
• Proficient in policy interpretation, risk assessment, and regulatory compliance.
• Ability to mentor and provide guidance to less experienced team members.
• Proficiency with claims management systems and related technology platforms.

Nice To Haves

• Insurance-specific certifications (e.g., AIC, CPCU) are preferred.

Responsibilities

• Investigate, assess, and resolve complex claims within authority limits.
• Analyze policy coverage and liability to determine appropriate claim outcomes.
• Develop and execute strategies to mitigate potential financial risk exposure.
• Collaborate with legal counsel, underwriters, and external vendors as necessary.
• Prepare comprehensive reports and documentation for claim decisions.
• Ensure all regulatory requirements and compliance standards are met.
• Manage communications with clients, brokers, and internal stakeholders throughout the claims process.
• Participate in audits and quality control reviews to ensure best practices.
• Contribute to process improvement initiatives within the claims department.

Benefits

• medical, dental, vision, life, disability, and AD&D insurance
• tax-advantaged savings accounts
• 401(k) plan with company match
• generous paid time off programs, including company holidays, vacation and sick days, new parent leave
• restricted stock units
• deferred compensation plan

What This Job Offers

• Job Type: Full-time
• Career Level: Senior