Bodily Injury - Pre-Litigation Adjuster

EDGE CLAIMS LLC; United States; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Job summary

EDGE CLAIMS LLC seeks a Bodily Injury Pre-Litigation Adjuster to review complex claims pre-suit. You’ll research, evaluate, negotiate, and communicate with insureds and claimants to secure prompt settlements.

You will investigate coverage, establish reserves, and draft clear, fact-based file notes while upholding company standards. A Bachelor's degree or equivalent experience and valid adjuster licenses in states handled are required.

Qualifications

• Bachelor's degree or equivalent work experience.
• Commercial Bodily Injury Claims Handling Experience or 4+ years related claim experience.
• Licensed and/or certified in all states in which claims are being handled.
• Highly organized with excellent time management skills.
• Excellent oral, written and interpersonal communication skills.
• Excellent MS Office, Word, Power Point, and Excel expertise.

Responsibilities

• Interprets and determines policy coverages under personal and commercial lines.
• Investigates the claim or coverage by making timely contact with involved or interested parties including the insured or employer representatives, claimant, witnesses and producers.
• Gathering and evaluate evidence, including medical bills and injury and reports.
• Verifies coverage and policy conditions and drafts positions as needed.
• Depending on the type of claim may interact internally or externally to gather information.
• Establishes reserves by estimating the most likely outcome of a claim and adjusts as evidence is received.
• Effectively negotiates and settles high-priority claims before litigation.
• Builds critical thinking and decision-making skills for root-issue analysis.
• Maintains effective relationships with customers with trust and respect.
• Demonstrates ability to absorb technical information and learn from mistakes.

Skills

Time management

Communication skills

Organizational skills

Negotiation skills

Attention to detail

Education

Bachelor's degree or equivalent

Tools

MS Office

Word

Excel

PowerPoint

Job description

The Bodily Injury Pre-Litigation Adjuster is responsible for prompt review of insurance claims through effective research, evaluation, investigation, negotiation and interaction with insureds and claimants. This Adjuster is often assigned to review and resolve complex bodily injury claims before a lawsuit is filed. The Bodily Injury Pre-Litigation Adjuster maintains a solid understanding of the company mission, vision, and values, and upholds the standards of the Company.

Pre-litigation adjusters are responsible for investigating coverage and liability as well as evaluating insurance claims on behalf of insurance companies. They investigate the circumstances of insurance claims by consulting with witnesses, reviewing police reports, and compiling evidence from other sources. They will negotiate claim settlements and ensure a prompt and satisfactory settlement for claimants while avoiding the costs and complexities of the litigation process.

RESPONSIBILITIES

• Interprets and determines policy coverages under personal and commercial lines.
• Investigates the claim or coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimant, witnesses and producers.
• Gathering and evaluate evidence, including medical bills and injury and reports
• Verifies coverage and policy conditions. Reviewed coverage issues as needed with supervisor. Typically utilized standardized language to draft positions if needed.
• Depending on the type of claim may interact internally or externally to gather information.
• Establishes reserves by estimating the most likely outcome of a claim. Evaluates the facts of each exposure using evidence, experience, and company procedures. Adjusts reserves timely as additional evidence is received.
• Effectively negotiates, and settles, high priority claims and bring claims to a timely and satisfactory resolution before a lawsuit can be filed.
• Builds critical thinking and decision-making skills to gather, assess, analyze, question, verify, interpret, and understand key or root issues.
• Establishes and maintains effective relationships with customers and gains their respect and trust.
• Demonstrates ability to absorb technical information and learns from mistakes in order to achieve best possible outcomes for claimant, customer and company.
• Writes in a clear, succinct, and fact-based manner in Claims files as well as in other written communication.
• Manages time and diary entries effectively and efficiently, prioritizing work in a fast-paced environment.
• Performs other functional duties as required.

KNOWLEDGE, SKILLS AND ABILITIES

Requirements:

• Bachelor's degree/or equivalent work experience (with high school diploma).
• Commercial Bodily Injury Claims Handling Experience or 4-years related claim experience required.
• Appropriately licensed and/or certified in all states in which claims are being handled.
• Highly Organized and excellent time management skills required.
• Excellent oral, written and interpersonal communication skills.
• Excellent MS Office, Word, Power Point, and Excel expertise.

Candidates Must Have:

• Decisive and purposeful
• Strong moral character and work ethic
• The ability to manage time, meet deadlines and prioritize tasks effectively
• Independent and self-starting
• Strong verbal and written communication skills
• Ability to thrive in a "fast pace," challenging environment
• Ability to show initiative, exhibit a "can do" attitude, and provide ideas while working within a team environment
• Ability to successfully manage a high-volume case load
• Ability to effectively negotiate; and use stated adjuster authority responsibly
• Ability to simplify, analyze and explain complex coverage and legal issues
• Ability to be able to review processes and determine opportunities for improvement