Senior Adjuster, Field Service Claims

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

📋 Description

• Manage field property claims independently, including those requiring external field investigations and catastrophe (CAT) response.

• Conduct comprehensive investigations, evaluate coverage, and produce necessary documentation, such as reservation of rights and coverage letters. Escalate issues as needed.

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

• Keep detailed and thorough claim records, ensuring proper documentation and adherence to jurisdictional requirements.

• Accurately identify and assign subrogation potential; create files to facilitate successful recovery efforts.

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

• Investigate and manage suspicious claims using advanced techniques and tools; refer to the Special Investigation Unit (SIU) when necessary. Stay alert to fraud indicators and regulatory reporting responsibilities.

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

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

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

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

• Act as a mentor to junior adjusters, offering guidance on intricate 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. Inform claimants and stakeholders, confirm 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 claim handling, typically requiring 5–10 years of adjusting experience.

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

• In-depth knowledge of applicable 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 concerning litigation and compliance matters.

• Effectively communicates in both verbal and written formats across various situations. Chooses appropriate communication channels and consistently displays empathy towards all stakeholders.

• Highly organized with the capability to manage intricate workflows and project work. Demonstrates strong time management and desk management abilities.

• 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.

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

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

• Proficient in using claims systems and Microsoft Office Suite.

• Able to utilize a personal computer and other standard office equipment.

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

• Required to work on-site as necessary.

• Willingness to travel as required.

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

• Ability to perform work in a noisy/loud work setting.

• May need to have and maintain a sufficient home-based internet connection.

• Capable of operating a motor vehicle for 4-5 hours per day and getting in and out of the vehicle multiple times throughout the day.

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

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

• Ability to safely use a ladder to access roofs and maintain balance while conducting inspections.

• Ability to perform fieldwork in adverse weather conditions.

🏝️ Benefits

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