Senior Adjuster, Field Service Claims

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

📋 Description

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

• Conduct thorough investigations, evaluate coverage, and produce necessary documentation such as reservation of rights and coverage letters.

• Identify and actively seek opportunities to transfer risk to suitable entities for the advantage of insureds and business partners.

• Keep detailed and comprehensive claim records, ensuring that all documentation meets jurisdictional requirements.

• Appropriately assess and assign subrogation potential; create files to facilitate successful recovery efforts.

• Ensure compliance with regulatory and company standards in all claims activities. Implement jurisdictional compliance requirements and assist others in understanding their regulatory responsibilities.

• Investigate and manage suspicious claims utilizing advanced techniques and tools; refer cases to the Special Investigation Unit (SIU) as necessary. Stay alert to fraud indicators and reporting obligations.

• Set reserves, approve payments, and make financial decisions within designated authority, contributing to accuracy and efficiency in reserving.

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

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

• Maintain well-organized and factual claim records and compile detailed reports summarizing findings and recommendations.

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

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

⛳️ Requirements

• Bachelor's degree or equivalent experience in claims 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.

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

• Skilled in negotiation and formulating strategies to influence outcomes.

• Demonstrates sound judgment and decision-making capabilities, particularly in litigation and compliance matters.

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

• Highly organized, capable of managing complex workflows and project tasks. Exhibits strong time management and desk management abilities.

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

• Ability to collaborate with internal and external experts, including legal, underwriting, and other stakeholders for thorough evaluations.

• Capable of quickly assessing customer concerns and anticipating questions, able to communicate and simplify complex technical terms into easily understood language; delivers difficult messages when necessary.

• Proficient in using claims systems and Microsoft Office Suite.

🏝️ Benefits

• Must possess and maintain the appropriate state adjuster licenses, continuing education credits, and a valid driver's license.