Senior Claims Adjuster, Field Service

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

📋 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.

• Recognize and actively seek opportunities to transfer risk to suitable entities for the benefit of insured clients and business partners.

• Keep detailed and comprehensive claim records, ensuring all documentation is in compliance with jurisdictional requirements.

• Properly identify and assign subrogation potential; establish files to facilitate successful recovery efforts.

• Ensure all claims activities align with regulatory and company standards.

• Implement jurisdictional compliance requirements and assist others in understanding regulatory obligations.

• Investigate and oversee suspicious claims utilizing advanced techniques and tools; refer to the Special Investigation Unit (SIU) when necessary.

• Stay informed about fraud indicators and regulatory reporting responsibilities.

• Set reserves, authorize payments, and make financial decisions within designated authority, contributing to reserving precision 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.

• Utilize advanced tools and analytics to identify 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.

⛳️ Requirements

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

• Extensive knowledge of local geography, regulations, and public safety agencies, alongside the ability to build rapport with insured clients and navigate the insurance and legal landscape.

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

• Proficient in negotiation and formulating 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 forms across various situations.

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

• Makes well-informed decisions based on comprehensive analysis of intricate issues.

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

• Capable of quickly assessing customer concerns and anticipating inquiries, while clearly communicating and translating complex technical terms.

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

• Ability to operate a personal computer and other standard office equipment.

• Required to work on-site as necessary.

• Willingness to travel as needed.

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

• Capacity to perform work in a noisy or loud work setting.

• Ability to operate a motor vehicle for 4-5 hours per day.

🏝️ Benefits

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