Senior Complex Claims Master Adjuster (Remote)

Westfield-Insurance; Westfield Center (OH); Remote; USD 85,000 - 125,000; Full time

Job summary

Westfield-Insurance is seeking a Complex Claims Master Adjuster to exercise the highest authority on the most complex claims with substantial exposure. The role leads and mentors claims teams, determines coverage, negotiates settlements, and drives risk and financial controls across investigations and reserves.

The position requires 10+ years in complex claims, a related degree, and a valid driver’s license.

Qualifications

• 10+ years of Complex Claims handling experience.
• Bachelor's degree in Business Administration or related field.
• Valid driver’s license and a driving record that conforms to company standards.

Responsibilities

• Determines whether coverage exists for the type of complex claim assigned and investigates thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage, liability, legal climate, potential exposure, and damages, and makes decisions, where appropriate, on claim resolution.
• Selects, directs, and supervises internal and external resources and experts impacting short and long-term claim results.
• Maintains effective and ongoing communication with claims staff, internal and external business partners, insureds, claimants, agents, attorneys, other insurance companies, claims leadership, vendors/contractors, and public adjusters.
• Establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience and completes appropriate reports so that the status of the claim is clearly always documented.
• Negotiates timely and appropriate settlements with insureds, claimants, vendors, attorneys, and other insurance companies and refers claims exceeding authority to appropriate leader with recommendations.
• Remains current on industry topics, trends, processes, technology, best practices through research, industry events, networking, etc.
• Assists less experienced claims professionals in the handling of large or complicated losses and actively participates in the coaching, development, training, and education of claims professionals.
• Participates in large/complex exposure file analysis and strategy development via roundtable discussions.
• Travels as often as needed including regular utilization of assigned fleet vehicle to cover assigned territory. May involve traveling on short notice or other daily driving duties as assigned regardless of location.

Skills

Collaborates

Communicates Effectively

Customer Focus

Decision Quality

Nimble Learning

Claims Adjustment

Claims Evaluation

Claims Investigation

Data Analysis and Reporting

Cost Optimization

Education

Bachelor's degree in Business Administration or related field

Tools

Claims Management System

Job description

Westfield-Insurance is seeking a Complex Claims Master Adjuster to exercise the highest authority on the most complex claims with substantial exposure. The role leads and mentors claims teams, determines coverage, negotiates settlements, and drives risk and financial controls across investigations and reserves.

The position requires 10+ years in complex claims, a related degree, and a valid driver’s license.