Experienced Personal Auto Senior Casualty Claims Adjuster

PRIORIS CLAIMS MANAGEMENT SOLUTIONS L.L.C.; Battle Creek (MI); Hybrid; USD 72,000 - 80,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Paid Time Off

Paid Licensing & Renewal Fees

401(k) Plan

Job summary

Prioris Claims Management Solutions, LLC in Battle Creek, MI, is seeking an experienced Personal Auto Senior Casualty Claims Adjuster to manage a caseload from investigation to resolution. The role emphasizes liability assessment, medical documentation review, and fair settlements with claimants and attorneys.

The ideal candidate has 5+ years of BI claims handling, active Texas license, and the ability to work in a hybrid environment with strict regulatory compliance and high service standards.

Qualifications

• Minimum of five (5) years of personal auto bodily injury claims handling experience.
• Current, active Texas Adjuster License and any required home-state license, as applicable.
• Demonstrated experience conducting bodily injury investigations, evaluating damages, and negotiating settlements.
• Strong knowledge of liability analysis, medical documentation, bodily injury evaluation, and claim resolution practices.
• Ability to manage claims within assigned settlement authority and identify when additional review or approval is required.
• Strong analytical, investigative, negotiation, and decision-making skills.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Outlook, Word, and Excel.
• Ability to manage multiple claims and competing priorities effectively.
• Comfort communicating professionally with customers, claimants, and attorneys by telephone and email.
• Ability to work effectively in a hybrid environment and report to the local office at the manager's discretion.

Responsibilities

• Manage a caseload of personal auto bodily injury claims of varying levels of complexity, from initial investigation through resolution.
• Conduct thorough investigations by analyzing accident facts, obtaining statements, reviewing supporting documentation, and determining coverage, liability, and compensability.
• Evaluate bodily injury damages, including medical documentation and other relevant evidence, to determine appropriate claim exposure and settlement strategies.
• Analyze policy coverage, applicable laws, regulations, and policy provisions to support sound claim decisions.
• Negotiate fair and appropriate claim settlements with claimants, attorneys, insureds, and other involved parties, as applicable.
• Complete Bodily Injury Evaluation forms and prepare settlement recommendations for claims exceeding individual settlement authority.
• Exercise sound judgment when evaluating claims and elevate complex or high-exposure claims for additional review and approval.
• Compile claim information and present findings and recommendations for claims committee review when appropriate.
• Identify potential fraud indicators, coverage concerns, and inconsistencies, escalating issues when necessary.
• Maintain accurate, complete, and timely claim documentation in accordance with company standards and regulatory requirements.
• Ensure compliance with applicable Department of Insurance regulations, state requirements, and company claims handling guidelines.
• Deliver professional, responsive service to customers, claimants, attorneys, and business partners.
• Manage competing priorities and meet established productivity, quality, and performance objectives in a metrics-driven environment.
• Participate in team meetings, training programs, and claim reviews to support consistent and effective claim outcomes.

Skills

Claims handling

Investigation

Negotiation

Communication

Analytical thinking

Office suite

Education

Texas Adjuster License

Home-state license (as applicable)

Tools

Claims management systems

Microsoft Outlook

Word/Excel

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Experienced Personal Auto Senior Casualty Claims Adjuster

Claims Full Time Battle Creek, MI, US

2 days ago Requisition ID: 1003

Salary Range: $72,000.00 To $80,000.00 Annually

Prioris Claims Management Solutions, LLC

Join a Growing Team of Claims Professionals

Prioris Claims Management Solutions is seeking an experienced and motivated Personal Auto Senior Casualty Claims Adjuster to join our growing claims team. This position is responsible for investigating, evaluating, negotiating, and resolving personal auto bodily injury claims of varying levels of complexity.

The ideal candidate will have strong technical claims knowledge, excellent investigative and analytical skills, and the ability to assess liability, evaluate damages, and negotiate fair and appropriate settlements. The successful candidate will independently manage claims within assigned settlement authority and provide recommendations for claims requiring additional review and approval.

This role requires sound judgment, attention to detail, effective communication, and a commitment to exceptional customer service, regulatory compliance, and timely claims resolution.

Please Note:

Applicants must have a minimum of five (5) years of personal auto bodily injury claims handling experience and hold a current, active Texas Adjuster License. Applicants residing outside Texas must also maintain any required home-state license.

Applicants who do not meet these requirements will not be considered.

What You\'ll Do

• Manage a caseload of personal auto bodily injury claims of varying levels of complexity, from initial investigation through resolution.
• Conduct thorough investigations by analyzing accident facts, obtaining statements, reviewing supporting documentation, and determining coverage, liability, and compensability.
• Evaluate bodily injury damages, including medical documentation and other relevant evidence, to determine appropriate claim exposure and settlement strategies.
• Analyze policy coverage, applicable laws, regulations, and policy provisions to support sound claim decisions.
• Negotiate fair and appropriate claim settlements with claimants, attorneys, insureds, and other involved parties, as applicable.
• Complete Bodily Injury Evaluation forms and prepare settlement recommendations for claims exceeding individual settlement authority.
• Exercise sound judgment when evaluating claims and elevate complex or high-exposure claims for additional review and approval.
• Compile claim information and present findings and recommendations for claims committee review when appropriate.
• Identify potential fraud indicators, coverage concerns, and inconsistencies, escalating issues when necessary.
• Maintain accurate, complete, and timely claim documentation in accordance with company standards and regulatory requirements.
• Ensure compliance with applicable Department of Insurance regulations, state requirements, and company claims handling guidelines.
• Deliver professional, responsive service to customers, claimants, attorneys, and business partners.
• Manage competing priorities and meet established productivity, quality, and performance objectives in a metrics-driven environment.
• Participate in team meetings, training programs, and claim reviews to support consistent and effective claim outcomes.

Required Qualifications

Must Have

• Minimum of five (5) years of personal auto bodily injury claims handling experience.
• Current, active Texas Adjuster License and any required home-state license, as applicable.
• Demonstrated experience conducting bodily injury investigations, evaluating damages, and negotiating settlements.
• Strong knowledge of liability analysis, medical documentation, bodily injury evaluation, and claim resolution practices.
• Ability to manage claims within assigned settlement authority and identify when additional review or approval is required.
• Strong analytical, investigative, negotiation, and decision-making skills.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Outlook, Word, and Excel.
• Ability to manage multiple claims and competing priorities effectively.
• Comfort communicating professionally with customers, claimants, and attorneys by telephone and email.
• Ability to work effectively in a hybrid environment and report to the local office at the manager's discretion.

Preferred

• Experience handling complex or high-exposure personal auto bodily injury claims.
• Experience preparing bodily injury evaluations and settlement recommendations for management or claims committee review.
• Familiarity with industry-standard claims management systems.
• Proven ability to meet established performance, quality, and productivity metrics.
• Experience working in a high-volume claims environment.

Why Prioris?

At Prioris Claims Management Solutions, we believe great employees deserve recognition, support, and opportunities for growth. Our leadership team brings extensive combined claims administration and management experience, providing an environment where professionals can continue developing their expertise and advancing their careers.

If you\'re looking for a company that values accountability, teamwork, technical expertise, and professional development, we\'d like to hear from you.

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Paid Time Off (Vacation & Sick Leave)

Paid Licensing & Renewal Fees

401(k) Plan

Work Environment

This is a full-time hybrid position. Employees may be required to report to their local office at the discretion of their manager, based on business needs. The role involves working with computers, telephones, claims management systems, and other standard office equipment, as well as prolonged periods of sitting and computer work. Employees are expected to maintain productivity, professionalism, and effective communication in both remote and office settings.

Prioris Claims Management Solutions, LLC is an Equal Opportunity Employer committed to creating an inclusive workplace for all employees.

Hybrid
Full-time position, 40 hours per week, Monday through Friday. Eight (8) working hours per day, excluding unpaid meal breaks.