Sr Claims Adjuster - Casualty

Brotherhood Mutual Insurance Company•Fort Wayne, IN

3d•Onsite

About The Position

Responsible for effectively analyzing and resolving assigned serious/complex claims consistent with claims department standards and company objectives. This role involves resolving claims involving unusual damage or coverage issues, requiring expert analysis, or needing early recognition of policyholder concerns. The position requires applying statutes, common law, and legal/regulatory concepts for effective claims resolution, achieving audit objectives, and communicating with various parties including policyholders, agents, attorneys, and medical providers. The adjuster will also direct independent adjusters and support services, maintain essential file documentation, provide status reports, identify cost containment and subrogation opportunities, and participate in departmental meetings and projects. Travel may be required for training, conferences, mediations, legal proceedings, and claim investigations. The role also involves assisting other claims personnel, participating in training new employees, and setting initial reserves as needed.

Requirements

Must be able to effectively communicate with others (both oral and written).
Must be able to communicate complex coverage and legal concepts in both an oral and written format.
Must be able to make independent decisions.
Must have strong organizational and interpersonal skills.
Must have the ability to handle confrontational situations in a productive manner.
Must possess strong negotiation skills and utilize them in the resolution of serious/complex claims.
Must have a thorough understanding of all issues related to claims.
Must have a thorough understanding of coverage.
Must be able to access, input and retrieve information from a computer.
Must have a thorough understanding of all automated claims department processing systems and workflows.
Must be able to train others on claims department policies, procedures and systems.
Should be able to sit for prolonged periods of time.
Should have the ability to inspect losses by walking, lifting, climbing or bending.
Effectively interface with external contacts, Brotherhood employees, managers, and department staff members.
Bachelor’s degree required.
Must be able to take and pass mandatory adjuster licensing requirements.
Must have five or more years of claim technical experience.

Nice To Haves

CPCU designation strongly desired.
Seven years or more of Brotherhood Mutual claims technical experience is desired.

Responsibilities

Resolve primarily serious/complex claims within established settlement authority in a prompt, fair and equitable manner.
Identify and investigate coverage, damage, and reserve adequacy on assigned claims.
Apply statutes, common law, and other applicable legal and regulatory concepts for the effective, efficient and equitable resolution of assigned claims.
Achieve established claim file audit objectives.
Communicate with policyholders, agents, claimants, attorneys, medical providers and other persons as needed and direct independent adjusters, appraisers and other support service providers to ensure effective, efficient, and equitable claims resolution.
Acquire, record and maintain all essential file documentation in accordance with established guidelines.
Provide timely status reports regarding assigned claims to department management and others.
Identify and pursue appropriate cost containment, loss mitigation and subrogation recovery opportunities.
Participate and provide input in departmental meetings or interdepartmental meetings, projects or processes that relate to the claims function.
Travel as needed to attend training programs, conferences, mediations/other legal proceedings, and to conduct investigation relating to claims resolution.
Further the attainment of overall department objectives by assisting other claims personnel as needed.
Participate as needed in the orientation or training of new department personnel.
Assist in the setting of initial reserves as needed.
Complete other projects as assigned.