Sr Claims Adjuster - Casualty

Brotherhood Mutual CareersFort Wayne, IN
Onsite

About The Position

Responsible for effectively analyzing and resolving assigned serious/complex claims consistent with claims department standards and company objectives. The company's niche is the church and related ministries market, and effective service requires a thorough understanding of this market. Persons in this position must be familiar with church operations and must conduct themselves in a manner that will neither alienate nor offend persons within this target niche.

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.
  • 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.
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