Sr. Liability Claims Representative

Amerind•Albuquerque, NM

14d

About The Position

AMERIND is a federally chartered, tribally owned corporation, formed under Section 17 of the Indian Reorganization Act (25 U.S.C. § 5124) by its Members, the governmental units of federally recognized Tribal Nations that administer federally funded housing programs for American Indian and Alaska Native families. AMERIND has the operating authority to work with Tribal Governments, Enterprises, and Citizens for Property and Liability, Workers Compensation, Homeowners and Renters, Employee Benefits coverage, Fleet Auto coverage, and Critical Infrastructure development. We are currently seeking an experienced Senior General Liability Adjuster to investigate complex liability insurance claims. This role entails determining fault and damages, negotiating settlements, and managing claims from inception to closure in accordance with both legal and company guidelines. Key responsibilities involve evaluating intricate bodily injury and property damage cases, collaborating with legal counsel on litigated claims, working with various departments, mentoring junior staff, and maintaining comprehensive claim files. Essential qualifications typically include extensive experience in claims adjustment, strong analytical and communication skills, and a thorough understanding of insurance regulations and company policies. Additionally, we seek a Senior Auto Adjuster to investigate, evaluate, and settle complex auto claims. This position includes determining coverage, liability, and damages while managing negotiations and collaborating with various stakeholders to reach resolutions within established authority limits and regulatory guidelines. The role requires expert knowledge of auto policies, a solid understanding of the vehicle repair process, excellent communication and negotiation skills, and the ability to document decisions and mentor team members effectively. This job description does not represent an inclusive list of all duties encompassed in this position.

Requirements

Excellent time and project management skills
Meticulous attention to detail
Advanced knowledge of industry-specific software applications
Excellent customer relations skills
Ability to provide transparent information and demonstrate high customer service
Team collaboration
Excellent fundamental understanding of insurance policy terminology
Problem-solving and analytical thinking
Strong verbal and written communication skills
Strong negotiation skills
Ability to speak and present in public
Interest in discovering and developing new ideas.
Service and people-oriented.
Agile and adaptable decision-making
Problem-solving approach that suggests trustworthiness
Familiarity with technology infrastructure and user of technology tools
Bachelor’s degree in insurance, Economics, Business Administration, or related field and ten years’ experience in insurance, claims handling, or risk management required.
Minimum of five years of desk adjusting experience involving property claims required.
Minimum of five years of field adjusting experience involving property + liability claims required.
Must possess a valid driver’s license
Must be able to successfully pass a background investigation; no felony, theft or fraud convictions.
Must be able to travel 50% as needed.
New employees must complete the Associate in Insurance (AINS) designation within six months from the end of the 90-day evaluation period to be eligible for advancement and incentive compensation.
For continued employment, employees must complete an elective course and six hours of professional development within 12 months after the end of the 90-day evaluation period.
Knowledge of applicable federal, state, Tribal, and local laws, regulations, and requirements.
Knowledge of property, auto, liability insurance laws, policies, and regulations.
Knowledge of medical and insurance terminology, and of claims processing practices.
Knowledge of occupational safety theory, principles, and practices.
Knowledge of modern office practices, procedures, and equipment.
Ability to communicate effectively in the English language, both verbally and in writing.
Ability to analyze situations and adopt appropriate courses of action.
Ability to work effectively under stressful conditions.
Ability to interact and maintain good working relationships with individuals of varying social and cultural backgrounds, employees and officials.
Ability to develop and interpret policies, procedures, and regulations.
Ability to maintain an accurate and organized filing system of complex insurance records and reports.
Ability to handle multiple tasks and meet deadlines.
Ability to exercise independent judgment.
Ability to train and present information to others.
Ability to follow oral and written instructions.
Ability to collect and analyze data and prepare and present accurate reports and recommendations.
Ability to act with integrity and maintain confidentiality.
Skill in performing statistical and mathematical computations.
Skill in preparing, presenting, reviewing, and analyzing insurance claims, forms, and reports.
Skill in providing excellent customer service.
Skill in operating business computers and office machines, including in a Windows environment, specifically Word, Excel, Access, and presentation software (such as PowerPoint).
Database management skills.
Excellent telephone communication skills.
Must be able to sit for work at a computer and phone for more than 6 hours per day.
Must be able to speak clearly.
Must be able to use hands for dexterity of motion.
Frequently required to stand, walk and reach with hands and arms.
Must have ability to occasionally lift 20 + lbs.
Must have ability to climb ladders for a property inspection.
Must be willing to travel as necessary.

Nice To Haves

Designations and certificates from accredited insurance institutions preferred.
Minimum of five years of field adjusting experience using software applications such as Symbility, Xactimate, or Xactanalysis preferred.
Minimum of three years of carrier risk information system experience such as Guidewire or Sapiens preferred.

Responsibilities

Communicates with customers and associates virtually, over the telephone, in person, and in written correspondence.
Takes initial calls and provides instructions on claim filing requirements.
Investigates claims on-site, evaluates damages, completes coverage analysis, damage assessments, cause/origin determination, and submits a field report with a narrative, estimate, photos, and any other pertinent information for the damages.
Utilizes policy and investigation reports to determine compliance and validity of claims for processing or denial.
Interviews claimants, specialists, witnesses, physicians, or other professionals as necessary.
Determines liability and total value of claim; negotiates settlements and makes recommendations regarding litigation.
Issues denial notification regarding claim issues, i.e., claim not covered or does not meet deductible level.
Obtains police reports, issue restitution notifications, requests deductible payments, and processes claim payments.
Consults with attorneys regarding claims to control costs and assists in making decisions and actions.
Negotiates directly with the claimants as necessary.
Assists with workflow and the number of claims that are assigned to each examiner.
Manages the daily task list of claims which are assigned to each examiner.
Reviews and follows up on claims as needed and closes files as appropriate.
Performs subrogation and recovery of property claims where there is another responsible party.
Maintains claim files and other related documents pertinent to insurance claim activities.
Acts as a resource to all other claims staff.  Provides support, direction, advice, and mentoring.
Assists in the development of claims staff policy, procedure, and protocol.
Assist and develop training presentation material.
Maintains confidentiality of all information.
Participates in cross-functional team process improvement projects.
Performs other duties as assigned.