Senior Complex Commercial Property Claims Adjuster

ICW Group•San Diego, CA

2d•$90,560 - $152,723•Remote

About The Position

The Senior Complex Commercial Property Claims Adjuster is responsible for managing complex claims with a focus on providing the highest level of service for policyholders and ICW Group to independently bring claims to an equitable conclusion within Company standards and best practice guidelines. The Senior Complex Commercial Property Claims Adjuster works with a sense of urgency, understands insurance coverage concepts, and manages the lifecycle of the claim to drive strategic outcomes.

Requirements

Bachelor's degree (or equivalent education/experience) along with a minimum 10+ years of closely related claims experience.
Various state adjuster licenses are required. Licenses and certifications may be acquired within a specified timeframe after hire.
Expert working knowledge of commercial property claims handling, reserving, resolution strategies and litigation management.
Solid computer skills in Microsoft Office Suite, claims systems and databases with the ability to learn new technology
Good verbal communication skills, time management, attention to detail and organizational skills
Excellent interpersonal skills with the ability to establish good working relationships.
Flexibility to adapt to changes in a fast-paced environment
Expert working knowledge of claims handling, reserving, resolution strategies and litigation management.
Ability to read, analyze, and interpret technical and legal documents
Ability to write reports and business correspondence
Ability to respond to common inquiries or complaints from customers (insured), claimants and regulatory agencies
Ability to effectively present information to clients and leadership, as well as to other claims professionals
Ability to solve practical problems and deal with a variety of variables in situations where limited standardization exists.
Ability to facilitate and lead meetings across a team of claims professionals for assigned projects.
Ability to respond and follow up on inquiries/complaints from customers, regulatory agencies, or others relevant to the claim.

Nice To Haves

May provide claim examiners with training and guidance on the handling of cases; address complaints and resolve problems; coach team members to further their skills and knowledge; promote/encourage adherence to department policies and procedures.

Responsibilities

Manages and reserves all aspects of an assigned claims inventory to an equitable conclusion.
Communicates with all relevant parties to the claim including policyholders, agents, attorneys, witnesses or public adjusters to gather information and provide the highest possible level of customer service.
Investigates claims to determine exposure, works with appropriate experts and makes strategic recommendations.
Analyzes new and transferred losses to design a plan of action in the management of the claim.
Maintains a good diary system to ensure timely resolution of claims and compliance with state regulations.
Ensures accuracy of data in claims system for compliance with applicable regulatory reporting.
Utilizes appropriate resolution methods (e.g., claim payment, negotiations, denials, etc.) to proactively drive results.
Operates within the requirements of related state and/or the governing entity rules and regulations as well as internal claims handling policies and procedures.
Directs defense counsel through the litigation process in accordance with Company litigation guidelines while monitoring legal fees and costs.
Manages the litigation process and strategizes with defense attorneys
Makes recommendations for streamlining processes and adopting the industry’s best practices
Collaborates with team members from various departments for project and process discussions.
Acts as a Subject Matter Expert (SME) for the department and provides expertise to internal and/or external stakeholders.
Shares knowledge and may train others across the organization.
Provides training and mentorship for less experienced team members.
Continuously seeks to improve technical skills by attending job related training and tracking current case law.
Manages complex high severity claims in multiple jurisdictions or nationwide.
Analyzes relevant claim documents including policies, estimates, reports, leases, contracts, and bylaws.
Escalates claim summaries and makes strategic recommendations for approval.
Researches and analyzes policy language, drafts correspondence with minimal to no guidance for management review.
Frontloads investigations and moves with urgency by gathering information quickly to assess risk accurately.
Builds rapport with insureds and their representatives.
Handles claims against the company and attend related depositions, hearings and settlement conferences as needed.
Prioritizes early resolution options for every claim and attends resolution proceedings as needed.
Drafts coverage letters and correspondence with minimal to no guidance for management review.
Provides advice to underwriters as needed based on inspection reports, including any preexisting damages noted.
Works to understand and learn the nuances of reinsurance.
Maintains current knowledge of the Department of Insurance rules and requirements.