Casualty Claims Adjuster I

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

📋 Description

• Conduct independent investigations, assessments, negotiations, and resolutions for moderate-complexity casualty claims.

• Examine and assess low- to moderate-complexity auto and casualty claims, confirming coverage, deductibles, and payees.

• Communicate with insured individuals, claimants, and witnesses; gather and document statements and relevant claim information.

• Collect, review, and analyze investigative reports, claim forms, contracts, policies, and supporting documents.

• Maintain claim documentation, reserve analyses, and Medicare reporting within the claims system.

• Establish and oversee reserves in accordance with company guidelines.

• Identify recovery opportunities, pursue subrogation, preserve evidence, and ensure compliance with regulations.

• Review bills, invoices, receipts, appraisals, and repair estimates.

• Compose coverage correspondence, suggest escalation or reassignment, and provide updates on claim status.

• Assess coverage, liability, damages, and claim value; develop settlement strategies and negotiate resolutions.

• Manage liens and Medicare-related matters; prepare settlement, release, and payment documentation.

• Collaborate with Estimatics, SIU, Subrogation, Medical Review, and Claims Legal teams.

• Generate risk reports and participate in claim roundtables.

⛳️ Requirements

• Bachelor’s degree or equivalent relevant experience.

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

• Preferred relevant insurance designations.

• Strong understanding of the theory and practice of claims management.

• Familiarity with insurance contracts, medical terminology, and substantive and procedural laws.

• Proficient in computer systems and claims management software.

• Capability to obtain all necessary state licenses.

• Commitment to high standards of professional conduct and ethical practices.

• Strong organizational skills and empathetic interpersonal abilities.

• Excellent written and verbal communication skills.

• Proficient investigative and problem-solving skills.

• Outstanding customer service capabilities.

• Ability to maintain confidentiality.

• Occasional travel may be required.

• Valid driver’s license with an acceptable motor vehicle report per company standards is necessary for travel.

🏝️ Benefits

• Comprehensive rewards package; details regarding benefits available on the EMC careers website.

• Opportunity to work remotely from anywhere in the US.