Casualty Claims Adjuster I

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluates the claim notice, contracts, state regulations, and policies to confirm the correct coverage, deductibles, and payees.

• Establishes prompt communication with insured parties and claimants to clarify the claims process and commence the investigation.

• Gathers statements from insured individuals, claimants, and witnesses, documenting summaries within the claims system.

• Requests and analyzes investigative reports and other pertinent documents, claim forms, and materials as necessary.

• Records claim activities, reserve evaluations, and report summaries, including Medicare (MSP) modules in the claims system.

• Sets appropriate reserves in a timely manner, adhering to the company's reserving philosophy and methodology.

• Identifies, investigates, and proactively seeks opportunities for recovery.

• Engages with insureds, claimants, and attorneys to negotiate claim settlements.

• Prepares and issues settlement and release documents, ensuring their accuracy and proper execution.

⛳️ Requirements

• Bachelor's degree or equivalent relevant experience.

• Minimum of one year of experience in casualty claims adjusting or a related field.

• Preferred relevant insurance designations.

• Solid understanding of the concepts and practices related to claims functions.

• Good grasp of insurance contracts, medical terminology, and relevant substantive and procedural laws.

• Proficient in computer systems and claims software.

• Capability to acquire all necessary state licenses.

• Commitment to maintaining high standards of professional conduct and ethical guidelines.

• Strong organizational skills and empathetic interpersonal abilities.

• Excellent written and verbal communication skills.

• Strong investigative and problem-solving capabilities.

• Exceptional customer service skills.

• Ability to uphold confidentiality.

• A valid driver's license with a satisfactory motor vehicle report in accordance with company standards is required for travel.

🏝️ Benefits

• Comprehensive benefits package, including life, medical, dental, vision, and prescription drug coverage.

• Competitive paid time off policy and a full day of volunteer leave each year.

• Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus program, and recognition and anniversary awards.

• Opportunities for professional development and growth, including tuition reimbursement.

• Wellness programs aimed at enhancing team member well-being and reducing health insurance costs.

• Flexibility in work attire and options for alternative work arrangements.