Senior Adjuster - Professional Liability

Foundation Risk Partners-posted about 1 month ago

Full-time • Senior

Edison, NJ

1,001-5,000 employees

Insurance Carriers and Related Activities

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This position requires an experienced medical professional liability (medical malpractice) or general liability adjuster to proactively manage the complex claims, to include investigation and evaluation of liability and damages, performing a complete and thorough review of legal documents, review and recommend ensure carrier adjusters place appropriate reserves, aid clients with mediations analysis, discovery, and assist clients in negotiating settlements when appropriate.

Examine claim forms, insurance policies, and clients' instructions to determine coverage and/or scope of assignment.
Maintain company reputation by complying with federal and state regulations, company procedures, and industry best practices.
Document all activity to support the outcome of the claim file.
Interview relevant parties to obtain information needed to evaluate liability and/or damages.
Recommend loss reserves.
Analyze information gathered through investigation and prepare authority request reports.
As directed by client, and within settlement authority granted by client, negotiate fair and equitable settlements and obtain proper closing documents.
Confer with legal counsel on claims in litigation.
Attend depositions, mediations, arbitrations and trials.
Ensure customer service by proactively communicating information; responding to inquiries; following customer protocols and may participating in customer marketing efforts.
Establish positive and productive relationships with co-workers, clients, policyholders, claimants, agents, repair facilities and others associated with the claims process.

Knowledge of the healthcare industry and various types
Effective verbal and written communication skills
Strong analytical, critical thinking and problem-solving skills
Strong multi-tasking and prioritization skills
Experience collaborating in a team environment and building cross functional working relationships
Proactively shares and promotes sharing of insights
Ability to gather unique perspectives from other teams/functions to optimize outcomes
Understands, analyzes, and applies the component parts of an insurance policy for complex claims
Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims
Ability to determine the scope and exposure for complex claims
Ability to leverage trend and relationships to provide high-quality customer service.
Well-versed in identifying, understanding, and explaining complex financial and/or actuaria trends/concepts
Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims
Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies
Experience with MS Office
Bachelor's Degree and 6 or more years of experience in the Claims and/ or Litigation Management area
Minimum 4+ years of commercial liability claims experience
Prior claims experience in handling complex liability claims under various types of policies

Professional designations, such as AIC, ARM, CPCU (preferred but not required)

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