Senior Claims Adjuster, Occupational Accident and Worker's Compensation

Hub International Insurance•Brentwood, TN

2d•$75,000 - $90,000•Remote

About The Position

About Specialty Program Group: Our goal is to partner with industry-leading specialty businesses to provide them with the ability to achieve their goals and optimize their businesses. Specialty Program Group offers access to capital and investment, deep carrier relationships, creative thinking, product development and broad distribution, while allowing our businesses to maintain the essence of what makes them successful. Specialty Program Group delivers leading-edge specialty expertise backed by transformative digital capabilities and sophisticated data and analytics. About Avant: Avant is a risk management organization that services several industries. Avant was born through innovation. In 1976, we created the game-changing product known as Non-Trucking Liability. Today, we are reviving that innovative culture on which we were built. Avant continues a forward thinking quest of developing new products and creating new markets. Avant is the holding company under which our subsidiaries reside: Avant Underwriters (AU Avant Specialty Claims (ASC) Avant Brokerage (AB) Avant Supermarket Group (ASG) SafeHerb Flexible Workforce AvantCare Each of these centers of innovation contribute to our strength and unique value within the marketplace. At Avant, we will continue to attract like-minded, leading edge talent and organizations. The result is a one-stop source for insurance solutions Job Summary Investigate, evaluate, and adjudicate claims for workplace injuries that fall under an occupational accident policy, which covers non-traditional workers such as independent contractors and/ or commercial truck drivers. This includes, but is not limited to, coverage verification, medical management, communicating with Insured’s, Claimants, Attorneys and medical experts. It also includes file documentation, negotiating settlements within authority and taking the action necessary to bring all assigned files to a reasonable resolution. We are seeking an experienced adjuster to join our Occupational Accident team. The ideal candidate is knowledgeable or experienced in disability or medical management as well as policy language and interpretation. We also require excellent customer service, clear and effective communication and analytical skills.

Requirements

5-10+ years claims experience or equivalent combination of education and experience.
High school diploma or equivalent required.
Work experience in the P&C insurance industry.

Nice To Haves

A college degree is preferred, but we also value a strong mix of relevant work experience.
Candidate with Occupational Accident experience a plus; experience managing bodily injury claims is preferred.

Responsibilities

Ensure that claims handling is conducted in compliance with applicable statutes, regulations, and other legal requirements, and that all applicable company procedures and policies are followed.
Receive new loss assignments and review all information on new loss reports.
Handle files involving catastrophic injuries in accordance with our Catastrophic Guidelines.
Interview insured’s, claimants, witnesses and investigate loss details as required, including any paper documents that may be required. This includes, but is not limited to; police reports, various public records, Bills Of Lading, lease agreements, releases, Proof of Loss, etc.
Confirm and evaluate coverage, including coverage dates and appropriate limits, terms and conditions, insuring agreements, etc.
Document the file relative to the coverage analysis and prepare any coverage position letter required (i.e. ROR, Denial, Tender Letter, etc.).
Assign claim to outside appraiser and/or adjuster with instructions for investigation and evaluation as needed.
Review reports from adjusters and/or appraiser and evaluate, make judgments and formulate action plans to carry claim to final disposition.
Evaluate all key components of the claim and formulate plan to carry file to conclusion. This includes applying appropriate coverage application, liability analysis, Injury/Damage analysis, settlement value range and action plan to resolve the file
Negotiate claim to conclusion with the insured, the claimant or legal representatives, as needed.
Manage litigated files to conclusion. This includes, but is not limited to; assigning counsel, managing counsel assigned to the case in connection with our Litigation Guidelines and handling all and attorney assigned files in connection with our Best Practices.
Secure all required closing documents from the insured, claimant, lien holder or other parties as needed. This includes releases, dismissal entries, proofs of loss, etc.
Ensure Claims payments are issued in a timely and accurate manner.
Identify files with subrogation potential and refer files to Subrogation Representative for evaluation and pursuit of potential subrogation claim.
Document file activity notes and prepare written reports and letters as required.

Benefits

health/dental/vision/life/disability insurance, FSA, HSA and 401(k) accounts, paid-time-off benefits such as vacation, sick, and personal days, and eligible bonuses, equity and commissions for some positions.

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