Fast Track Claims Adjuster Trainee

North American Risk Services; United States; On-site; USD 40,000 - 60,000; Full time

Job summary

A leading company in risk management is seeking an Adjuster Trainee to manage claims, conduct investigations, and negotiate settlements. The role requires strong interpersonal skills and a Florida Adjuster's license, with the opportunity for career advancement. Ideal candidates should possess a high school diploma and the ability to work independently in a fast-paced environment.

Qualifications

• Must possess a Florida Adjuster’s license or be willing to obtain one.
• Hold or obtain a New York 17-70 adjuster’s license.
• Advanced negotiation skills required.

Responsibilities

• Handle caseload and conduct coverage analysis.
• Verify facts of loss and evaluate claims for settlement.
• Monitor and adjust reserves as necessary.

Skills

Interpersonal Skills

Negotiation

Time Management

Written Communication

Verbal Communication

Education

High School Diploma

2-year college degree preferred

Job description

Job Description:Handle a caseload commensurate with the complexity level of claims assigned. The position requires establishing facts of loss, coverage analysis, investigation, /liability/negligence determination, damage assessment, settlement negotiations, identifying potential fraud, and appropriate use of authorized vendors. The adjuster trainee must also complete a timely and appropriate reserve analysis. All file handling must be within state statutes, Client Claims Handling Guidelines, and NARS Best Practices.Essential Duties and Responsibilities:Coverage:

• Identify, analyze, and confirm coverage.

Customer Service/Contact

• Contact appropriate parties and providers to determine liability, compensability, negligence, and subrogation potential.
• Contact appropriate parties to obtain any needed information and explain benefits as appropriate. Continue contact throughout the life of the file as appropriate.
• Answer phones, check voice mail regularly and return calls within 8 business hours.
• Assist management when required with projects as requested.

Subrogation:

• Timely refer all files identified with subrogation potential to the subrogation department.

Investigation:

• Verify facts of loss and pertinent claims facts such as employment, wages, or damages and establish disability with treating physicians as appropriate.
• Identify cases for settlement. Evaluate claims and request authority and negotiate settlement.
• Recognize and report potential fraud cases.

Reserves:

• Establish ultimate reserves (anticipated cost to bring file to close based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.
• Verify all provider bills have been appropriately reviewed and paid within standard timeframes.

Reporting Requirements:

• Must pass all internal and external audits, which include those performed by regulatory agencies, carriers, and clients.
• Follow reporting requests as outlined by client files and NARS guidelines.

Resolution:

• Document plan of action in the claim system and set appropriate diaries.
• Maintain a regular diary and follow up as required.
• Close all files as appropriate in a timely and complete manner.
• Maintain 1:1 closing ratio.
• Other jobs duties as assigned.

Qualification Requirements:Education / Licensing:

• High School Diploma, 2-year college degree preferred.
• Must possess a Florida Adjuster’s license or other required jurisdictional licensing. (Or be willing, as a condition of employment, to obtain one within 30 days of the start date).
• Hold or obtain a New York 17-70 adjuster’s license.

Technical Skills:

• Advance level of interpersonal skills to handle sensitive and confidential situations and information.
• Requires advanced ability to negotiate claims.
• Requires advanced ability to work independently.
• Requires an advanced level of organization and time management skills.
• Must possess advanced level written and verbal communication skills.
• Must be able to explain and appropriately respond to auditors, clients, and potential clients during in-person presentations.

Abilities:

• Must be able and agree to work overtime as needed, especially during a catastrophe.
• Requires long periods of sitting.
• Requires working indoors in environmentally controlled conditions
• Requires lifting of files and boxes up to approximately 20 pound
• Repeated use of a keyboard and mouse and exposure to computer screens.