General Liability Claims Adjuster Analyst I

Loyalty360; Scarborough (ME); Hybrid; USD 60,000 - 75,000; Full time

Job summary

A leading company in the food retail sector is seeking a Claims Management Specialist to investigate and evaluate complex claims. The role involves ensuring compliance with legal obligations and providing excellent customer service. Candidates should possess strong organizational skills and a desire for professional development. The position offers a flexible hybrid work schedule, allowing for remote work alongside in-person collaboration.

Qualifications

• Minimum of 3 years claims management experience.
• Licensed adjuster or eligible for licensing exam.

Responsibilities

• Performs thorough investigations and evaluations of claims.
• Negotiates settlements within authority limits.
• Provides coaching and mentoring to team members.

Skills

Time Management

Organizational Skills

Communication

Education

Bachelor's Degree

Tools

Office 365

Job description

Category/Area of Expertise:

Legal

Job Requisition:

429280

Address:

USA-ME-Scarborough-145 Pleasant Hill Rd

Store Code:

Claims Management (5157507)

Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.

Position Summary:

Initiates the investigation of more complex types of claims made against the company to determine the proximate cause and evaluate the loss exposure. Based on the investigation results, provides the appropriate response for claim disposition.

Work Schedule:

Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days.

Eligibility:

Applicants must be currently authorized to work in the United States on a full-time basis.

Principle Duties and Responsibilities:

Claims Management

• Performs thorough investigations, evaluations, and disposition of all claims in adherence with departmental Claims Standards and Procedures.
• Ensures all claims comply with statutory and legal obligations.
• Maintains quality file control using the claim diary system and reporting guidelines.
• Provides excellent customer service through timely contact and follow-up.
• Determines proximate cause based on detailed loss investigations and initiates settlement or denial plans in accordance with jurisdictional and statutory requirements.
• Maintains accurate reserve levels based on severity and extent of loss exposure.
• Recommends and presents settlement values to management for approval.
• Negotiates settlements within authority limits unless otherwise authorized.
• Issues timely payments to control costs.

Financial Impact Administration

• Identifies claims with subrogation potential and submits reimbursement requests.
• Uses National Index Bureau to identify and follow up on fraud indicators.
• Partners with Safety department to identify hazards and minimize risks.
• Audits and approves bills for legal and vendor services.
• Sets personal and business goals involving legal, loss prevention, and safety interactions.
• Provides coaching and mentoring to less experienced team members.
• Enhances technical skills through training and educational opportunities.
• Collaborates with Litigation Specialists for skill and knowledge enhancement.

Self-Development

• Establishes personal and business goals for skill enhancement.
• Provides coaching and mentoring.
• Attends outside training to improve technical skills.
• Works with Litigation Specialists to improve knowledge.

Basic Qualifications:

• Licensed adjuster or eligible to sit for licensing exam after in-house training.
• Bachelor's degree preferred; minimum of 3 years claims management experience.
• Thorough knowledge of legal procedures in claims handling.
• Knowledge of rules, regulations, statutes related to workers' compensation and liability claims.
• Knowledge of coaching principles and medical terminology for complex claims.
• Understanding customer relations principles and techniques.

Skills and Abilities:

• A desire for professional claims career development.
• Strong time management and organizational skills.
• Ability to multi-task and find innovative solutions.
• Self-motivated with organizational and prioritization skills.
• Ability to work under pressure and as part of a team.
• Excellent written and verbal communication skills.
• Ability to develop and maintain professional relationships.
• Proficiency in Office 365 and related software.

#LI-SM1 #LI-Hybrid

At Ahold Delhaize USA, we value diversity, equity, inclusion, and belonging. We invest in our people and support their growth and well-being, fostering a culture of collaboration, curiosity, and continuous learning.