Senior Claims Adjuster

Allianz Insurance•Baltimore, MD

4d•$78,000 - $90,000•Remote

About The Position

Job Purpose: The main task of the role is to settle claims, in accordance with the segregation of duties principle. The Senior Claims Adjuster is responsible for processing claims received (settlement), managing a portfolio of claims and maintaining an appropriate service level. He/she denies, settles, or authorizes payments to routine claims based on coverage, appraisal, and verifiable information. Responsibilities also include corresponding with policyholders, brokers and agents and preparing report of findings of an investigation.

Requirements

Market knowledge:
Knowledge of Claims and Collections processes and systems
Knowledge of Quality Standards , C&C operational guidelines
Ability to identify mandatory documents per type of claims / collection
Strong interpersonal and communication skills
Comfortable with numbers; strong analytical skills
Strong attention to detail
Ability to determine the appropriate course of action in settling claims
Result oriented & Team player
Customer centric
Business expertise
Strong knowledge of policies, contract law and local insolvency
Strong knowledge of claims settlement processes and systems
Strong knowledge of collections process
Strong knowledge of quality standards and claims and collection operational guidelines
Bachelor’s Degree in Business Administration or a relevant field.
5-10 years experience in claims settlement with insurance company
Excellent communication skills in English, both spoken and written
Must be liscensed
Looking for candidates that possess a basic awareness of Artificial Intelligence technologies and are enthusiastic about learning and integrating AI into everyday business processes. (Generative) Artificial Intelligence or GenAI or AIData Analysis(Microsoft) CopilotChatGPT Data Analysis (Microsoft) Copilot ChatGPT

Responsibilities

Complete second level check of compliance with all policy terms and conditions utilizing commercial, risk and collection systems
Complete claim payment calculation by incorporating exclusions such as policy deductibles
Validate claim payment and loss settlement packages up to authority level of $225,000
Reject claim up to personal authority level of $270,000, with strong compliance with internal communication process to enhance customer experience
Strong two-way communication with policyholders / brokers : request, if necessary, additional documents / information, provide updates on the status of the claim (assessed, settled), handle possible appeals (complaints)
Strong collaboration with Collections on disputed debts, to assess policyholders’ collection efforts and compliancy with obligations under policy, and to answer Collections requests/ authorizations
Close claims file following closing of Collections file
Handle objections to claims through negotiations with policyholders and any other stakeholders
Resolve claims issues which may have a major impact on claims settlements and business retention
Develop and maintain good relationships with policy holders and brokers by understanding their business and responding promptly to their questions
On a rotational basis take responsibility for the Claims Help Desk and in a timely manner respond to all enquiries received
Review payment plan submissions and approve up to authority level of $250,000 and 6 months
Review claim filing extensions up to authority level of $250,000 and 6 months