Senior Claims Adjuster – GL

Elite Tek Services, Inc.; Houston (TX); In loco; USD 81.000 - 114.000; Tempo pieno

Descrizione del lavoro

Elite Tek Services, Inc. seeks a Senior Claims Adjuster for General Liability to review, analyze and resolve complex GL claims within authority and policy guidelines.

You will handle high-exposure cases, often involving litigation, while delivering quality service to clients in a Texas-based environment. The role requires strong investigation, negotiation and regulatory knowledge, along with leadership to mentor junior examiners and coordinate with clients, brokers and counsel.

Competenze

• 8–10 years of complex/major claims experience.
• Licensed in at least one state (TX, NY or FL preferred).
• Strong investigation and resolution skills for severe to major claims.
• Proficiency in law and insurance regulation knowledge.

Mansioni

• Investigate, evaluate and determine settlement values.
• Manage reserves within authority and advise on reserves.
• Prepare reports and identify claim trends.
• Oversee litigation with counsel and budget/bill reviews.
• Coordinate with clients, brokers and claimants.
• Provide training to junior examiners.

Conoscenze

Claims handling

General liability

Negotiation

Licensing

Communication

Formazione

High School Diploma or GED

AA/AS or BA/BS preferred

Strumenti

Microsoft Office Suite

Descrizione del lavoro

• Salary -- $81,000-$114,000 (dependent on experience and geographic location)
• The schedule for this position is Monday through Friday at 37.5 hours per week.
• Exempt in all states but California

Senior Claims Adjuster – GL

• Salary -- $81,000-$114,000 (dependent on experience and geographic location)
• The schedule for this position is Monday through Friday at 37.5 hours per week.
• Exempt in all states but California

The Senior Claims Examiner is responsible for the review, analysis and processing of complex general liability claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure and often entail litigation and coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests.

PRIMARY RESPONSIBILITIES

Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned.

Advanced knowledge in the following areas:

1. claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge
2. functional knowledge of law and insurance regulations in various jurisdictions
3. demonstrated advanced verbal and written communications skills
4. demonstrated advanced analytical, decision making and negotiation skills

• Investigate, evaluate, and determine settlement value or denial of liability for severe to major-level general liability claims
• Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at an appropriate level for claims outside of authority level.
• Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management.
• Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment.
• Document and manage claims (i.e.: record statements, updated diaries, write reports) from inception through closure
• Ensure appropriateness of all payments
• Capability to adjust general liability property damage claims
• Exchange information with clients, claimants, insurance brokers, inspectors producers and account managers
• Assist in training of new employees
• Provide training and daily guidance to other examiners
• Some oversight of less experienced examiners and claims assistants
• May fill-in for supervisor if necessary
• Attend meetings and educational seminars for professional development and to maintain required licenses
• Coordinate and work with vendor services such as contractors, emergency repair, cleaning services and various replacement services.
• Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims.
• Superior customer service skills.
• Participate and/or conduct department meetings
• Present company abilities in new client meetings
• Conduct quarterly file reviews with the client

ESSENTIAL POSITION REQUIREMENTS

The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.

• High School Diploma or equivalent (GED) required for all positions
  • AA/AS or BA/BS preferred but not required
• Relies on extensive experience and judgment to plan and accomplish goals with a minimum 8-10 years of complex/major claims experience including proficiency in investigation and resolution of severe to major casualty and general liability claims
• High exposure general liability experience required
• Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX or FL
  • Additional State Adjuster License(s) may be required within 180 days
  • Maintain licenses and continuing education requirements in all states.
• Experience with property and casualty insurance policies, insurance tort laws, codes and procedures
• Understanding of medical, legal terminology and liability concepts
• Proficiency in investigation and resolution of severe to major-level casualty claims
• Time Management and project management skills
• Negotiation skills
• Well-developed verbal and written communication skills with strong attention to detail
• Excellent organizational skills and ability to multi-task
• Ability to type quickly, accurately and for prolonged periods
• Proficient in Microsoft Office Suite
• Ability to learn additional computer programs
• Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
• Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
• Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
• Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
• Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
• Company operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
• Must be able to reliably commute to meetings and events as required by this position

This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.

Company is an Equal Opportunity/ Affirative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.

Company is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc.