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 field investigations and catastrophe (CAT) response.

• Conduct in-depth investigations, evaluate coverage, and generate necessary documentation such as reservation of rights and coverage letters. Escalate issues as required.

• Recognize and proactively seek opportunities to transfer risk to the appropriate entities, benefiting both insureds and business partners.

• Keep thorough and detailed claim records, ensuring all documentation meets jurisdictional compliance requirements.

• Appropriately identify and assign subrogation potential; establish files to aid in successful recovery efforts.

• Ensure all claim activities adhere to regulatory and company standards, executing jurisdictional compliance requirements and assisting others in understanding regulatory obligations.

• Investigate and oversee suspicious claims utilizing advanced techniques and tools; refer to the Special Investigation Unit (SIU) when necessary. Remain vigilant regarding fraud indicators and regulatory reporting requirements.

• Set reserves, authorize payments, and make financial decisions within given authority, contributing to accurate and efficient 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 spot trends, rectify inconsistencies, and enhance claims handling efficiency. Ensure proper data ingestion, labeling, and safeguarding of personally identifiable information (PII).

• Maintain comprehensive, factual, 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.

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

⛳️ Requirements

• Bachelor’s degree or equivalent experience in claim handling.

• Generally requires 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. Comprehensive knowledge of applicable statutes, regulations, case law, and third-party legal liability concepts.

• Proficient in negotiation and strategizing to influence outcomes. Exhibits sound judgment and decision-making, especially in litigation and compliance matters.

• Communicates effectively in both verbal and written forms across a variety of situations. Chooses appropriate communication channels and consistently demonstrates empathy towards all stakeholders.

• Highly organized with the ability to manage complex workflows and project work, showcasing strong time management and desk management skills.

• 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 to ensure comprehensive evaluation.

• Able to quickly assess customer concerns and anticipate questions, clearly communicating complex and technical terms in easily understood language; delivers difficult messages when necessary.

• Proficient in using claims systems and the Microsoft Office Suite.

• Capable of operating a personal computer and other standard office equipment.

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

• Required to work on-site as necessary.

• Willingness to travel as needed.

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

• Able to perform work in a noisy/loud work environment.

• May be required to maintain a sufficient 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.

• Capable of loading and unloading equipment and supplies weighing up to 30 pounds from a motor vehicle as needed for field work.

• Ability to bend, walk, and climb for several consecutive hours while inspecting damaged buildings, often with utilities turned off or inoperable.

• Capable of using a ladder safely to access roofs and maintain balance while inspecting.

• Ability to perform fieldwork in adverse weather conditions.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance plans.

• Retirement savings plan with company match.

• Generous paid time off and holiday schedule.

• Opportunities for professional development and continuing education.