Senior Adjuster, Field Service Claims

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

📋 Description

• Manage field property claims independently, including those that necessitate external investigations and catastrophe (CAT) responses.

• Conduct detailed investigations, evaluate coverage, and generate necessary documentation such as reservation of rights and coverage letters. Escalate issues as necessary.

• Proactively identify and pursue opportunities to transfer risk to appropriate entities for the advantage of insureds and business partners.

• Keep thorough and organized claim records, ensuring compliance with jurisdictional requirements and proper documentation.

• Recognize and appropriately assign subrogation potential; establish files to facilitate successful recovery efforts.

• Ensure that all claims activities adhere to regulatory and company standards. Implement jurisdictional compliance requirements and assist others in understanding regulatory obligations.

• Investigate and manage suspicious claims utilizing advanced techniques and tools; refer to the Special Investigation Unit (SIU) as necessary. Stay informed of fraud indicators and regulatory reporting duties.

• Set reserves, authorize payments, and make financial decisions within the scope of authority while contributing to the accuracy and efficiency of reserving.

• Collaborate with internal and external stakeholders, including legal, underwriting, vendors, and agents. Lead cross-functional meetings and convey complex information clearly to diverse audiences.

• Utilize advanced tools and analytics to detect trends, rectify inconsistencies, and enhance claims handling efficiency. Ensure accurate data ingestion, labeling, and safeguarding of personally identifiable information (PII).

• Maintain comprehensive and well-organized claim records and prepare detailed reports summarizing findings and recommendations.

• Act as a mentor to junior adjusters, offering guidance on complex claims, compliance, and litigation processes. Support training initiatives and contribute to the development of best practices and educational materials.

• Provide empathetic and clear communication throughout the claims process. Educate claimants and stakeholders, affirm next steps, and ensure a positive customer experience.

• May represent the company in mediations, arbitrations, and trials.

⛳️ Requirements

• Bachelor’s degree or equivalent experience in claims handling, typically requiring 5–10 years of adjusting experience.

• Strong understanding of local geography, regulations, and public safety agencies, along with the ability to build rapport with insureds and navigate the insurance and legal landscape.

• Solid working knowledge of relevant statutes, regulations, case law, and third-party legal liability concepts.

• Proficient in negotiation and developing strategies to influence outcomes.

• Exhibits sound judgment and decision-making skills, particularly regarding litigation and compliance matters.

• Communicates effectively and clearly in both verbal and written formats across diverse situations.

• Highly organized with the capability to manage complex workflows and project tasks.

• Makes informed decisions based on thorough analysis of complex issues. Assesses risks and outcomes, acts independently within authority, and identifies patterns in claims to support resolution strategies.

• Capable of collaborating with internal and external experts, including legal, underwriting, and other stakeholders for comprehensive evaluations.

• Able to quickly assess customer concerns, anticipate questions, and communicate complex and technical terms in easily understandable language; capable of delivering difficult messages when necessary.

• Proficient in using claims systems and Microsoft Office Suite.

• Competent in operating a personal computer and other standard office equipment.

• Able to sit and/or stand for extended periods.

• Required to work on-site as needed.

• Willingness to travel as necessary.

• Ability to thrive in a fast-paced, changing, or stressful environment.

• Capable of performing work in a noisy/loud environment.

• May need to maintain an adequate home-based internet connection.

• Ability to operate a motor vehicle for 4-5 hours per day and to enter and exit the vehicle multiple times throughout the day.

• Able to load and unload equipment and supplies weighing up to 30 pounds from a motor vehicle as required for field work.

• Capable of bending, walking, and climbing for several consecutive hours while inspecting damaged buildings, often with utilities turned off or inoperable.

• Able to safely use a ladder to access roofs and maintain balance during inspections.

• Willing to perform field work in adverse weather conditions.

🏝️ Benefits

• Must have and maintain appropriate state adjuster licenses, continuing education credits, and a valid driver’s license.