Litigation Claims Adjuster - Complex

CRC Group; North Carolina; On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

AD&D insurance

401(k) with company match

Paid time off

Restricted stock units

Deferred compensation

Job summary

CRC Group is seeking an experienced Claims Professional to lead and adjudicate complex property and casualty claims in North Carolina. You will analyze coverage, assess liability, and collaborate with brokers, legal counsel, and underwriters to determine fair outcomes.

The role requires strong negotiation, risk assessment, and regulatory compliance knowledge, with guidance to junior staff and familiarity with claims management systems.

Qualifications

• Bachelor’s degree in business, insurance, risk management, or related field preferred.
• 5+ years of experience handling claims, preferably in specialty or complex lines.
• Experience with brokers, legal professionals, and regulatory agencies.
• Licenses in applicable U.S. states; insurance certifications (e.g., AIC, CPCU) preferred.

Responsibilities

• Investigate, assess, and resolve complex claims within authority limits.
• Analyze policy coverage and liability to determine appropriate outcomes.
• Develop strategies to mitigate financial risk exposure.
• Collaborate with legal counsel, underwriters, and external vendors.
• Prepare reports and documentation for claim decisions.
• Ensure regulatory requirements and compliance standards are met.
• Manage communications with clients, brokers, and internal stakeholders.
• Participate in audits and quality control reviews.
• Contribute to process improvement within the claims department.

Skills

Advanced claims analysis

Negotiation

Communication skills

Policy interpretation

Regulatory compliance

Mentorship

Claims management systems

Risk assessment

Education

Bachelor’s degree in business, insurance, risk management, or related field

Tools

Claims management systems

Technology platforms

Job description

Regular

Language Fluency: English (Required)

Work Shift: 1st Shift (United States of America)

Please review the following job description:

KEY RESPONSIBILITIES

Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.

• Investigate, assess, and resolve complex claims within authority limits.
• Analyze policy coverage and liability to determine appropriate claim outcomes.
• Develop and execute strategies to mitigate potential financial risk exposure.
• Collaborate with legal counsel, underwriters, and external vendors as necessary.
• Prepare comprehensive reports and documentation for claim decisions.
• Ensure all regulatory requirements and compliance standards are met.
• Manage communications with clients, brokers, and internal stakeholders throughout the claims process.
• Participate in audits and quality control reviews to ensure best practices.
• Contribute to process improvement initiatives within the claims department.

EDUCATION AND EXPERIENCE

The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Bachelor’s degree in business, insurance, risk management, or related field is preferred.
• 5 or more years of experience handling claims, preferably in specialty or complex lines.
• Demonstrated expertise in managing complex or high-risk claims scenarios.
• Experience working with brokers, legal professionals, and regulatory agencies.

CERTIFICATIONS / LICENSES / REGISTRATIONS

• Must hold and maintain all required licenses in all U.S. states where licensing is required to perform the duties of this position.
• Insurance-specific certifications (e.g., AIC, CPCU) are preferred.

FUNCTIONAL SKILLS

• Advanced claims analysis and adjudication techniques.
• Strong negotiation and settlement skills.
• Excellent written and verbal communication abilities.
• Proficient in policy interpretation, risk assessment, and regulatory compliance.
• Ability to mentor and provide guidance to less experienced team members.
• Proficiency with claims management systems and related technology platforms.

General Description of Available Benefits for Eligible Employees of CRC Group: At CRC Group, we're committed to supporting every aspect of teammates' well-being - physical, emotional, financial, social, and professional. Our best-in-class benefits program is designed to care for the whole you, offering a wide range of coverage and support. Eligible full-time teammates enjoy access to medical, dental, vision, life, disability, and AD&D insurance; tax-advantaged savings accounts; and a 401(k) plan with company match. CRC Group also offers generous paid time off programs, including company holidays, vacation and sick days, new parent leave, and more. Eligible positions may also qualify for restricted stock units and/or a deferred compensation plan.

CRC Group supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC Group is a Drug Free Workplace.

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