Sr Claims Adjuster - Casualty

Brotherhood Mutual Insurance Company; Fort Wayne (IN); On-site; USD 70,000 - 100,000; Full time

Job summary

Brotherhood Mutual Insurance Company is seeking a senior claims analyst at our Corporate Office in Fort Wayne, IN to analyze and resolve serious/complex claims in line with department standards and company objectives.

You will collaborate with policyholders, agents, attorneys, medical providers and independent adjusters, manage documentation, and provide timely status updates while pursuing cost containment and subrogation opportunities.

Qualifications

• Must be able to take and pass mandatory adjuster licensing requirements.
• Five+ years of claim technical experience.
• Seven+ years of Brotherhood Mutual claims experience preferred.

Responsibilities

• Resolve primarily serious/complex claims within established settlement authority in a prompt, fair and equitable manner.
• Identify and investigate coverage, damage, and reserve adequacy on assigned claims.
• Communicate with policyholders, agents, claimants, attorneys, medical providers and other persons as needed.
• Acquire, record and maintain all essential file documentation.
• Provide timely status reports regarding assigned claims to management and others.
• Identify and pursue cost containment, loss mitigation and subrogation opportunities.
• Travel for training programs, conferences, mediations/other legal proceedings, and investigations.
• Assist in setting initial reserves and other department projects.

Skills

Effective communication

Strong negotiation skills

Organizational skills

Independent decision making

Claims knowledge

Education

Five+ years of claim technical experience

Seven+ years of Brotherhood Mutual claims experience

Adjuster licensing

Job description

FLSA Status: Exempt

Job Family: Claims

Department: Casualty Claims

Location: Corporate Office (Fort Wayne, IN)

JOB SUMMARY

Responsible for effectively analyzing and resolving assigned serious/complex claims consistent with claims department standards and company objectives.

POSITION ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Resolve primarily serious/complex, (including but not limited to claims involving unusual damage or coverage issues or need to involve expert analysis or that require early recognition of policyholder concerns), claims within established settlement authority in a prompt, fair and equitable manner. Identify and investigate coverage, damage, and reserve adequacy on assigned claims.
• Apply statutes, common law, and other applicable legal and regulatory concepts for the effective, efficient and equitable resolution of assigned claims.
• Communicate with policyholders, agents, claimants, attorneys, medical providers and other persons as needed and direct independent adjusters, appraisers and other support service providers to ensure effective, efficient, and equitable claims resolution.
• Acquire, record and maintain all essential file documentation in accordance with established guidelines.
• Provide timely status reports regarding assigned claims to department management and others.
• Identify and pursue appropriate cost containment, loss mitigation and subrogation recovery opportunities.
• Participate and provide input in departmental meetings or interdepartmental meetings, projects or processes that relate to the claims function.
• Travel as needed to attend training programs, conferences, mediations/other legal proceedings, and to conduct investigation relating to claims resolution.
• Further the attainment of overall department objectives by assisting other claims personnel as needed.
• Participate as needed in the orientation or training of new department personnel.
• Assist in the setting of initial reserves as needed.
• Complete other projects as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES

The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to effectively communicate with others (both oral and written). Must be able to communicate complex coverage and legal concepts in both an oral and written format.
• Must be able to make independent decisions.
• Must have strong organizational and interpersonal skills.
• Must have the ability to handle confrontational situations in a productive manner. Must possess strong negotiation skills and utilize them in the resolution of serious/complex claims.
• Must have a thorough understanding of all issues related to claims. Must have a thorough understanding of coverage.
• Must be able to access, input and retrieve information from a computer. Must have a thorough understanding of all automated claims department processing systems and workflows.
• Must be able to train others on claims department policies, procedures and systems.
• Should be able to sit for prolonged periods of time. Should have the ability to inspect losses by walking, lifting, climbing or bending.
• Effectively interface with external contacts, Brotherhood employees, managers, and department staff members.

EDUCATION AND/OR EXPERIENCE

List Degree Requirement, Years' Experience, and Certifications

• Must be able to take and pass mandatory adjuster licensing requirements.
• Must have five or more years of claim technical experience.
• Seven years or more of Brotherhood Mutual claims technical experience is desired.

Terms and Conditions

This description is intended to describe the general content of and requirements for the performance of this position. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements.

Because the company's niche is the church and related ministries market, and because effective service requires a thorough understanding of this market, persons in this position must be familiar with church operations and must conduct themselves in a manner that will neither alienate nor offend persons within this target niche.

Brotherhood Mutual Insurance Company reserves the right to modify, interpret, or apply this position description in any way the company desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. This position description is not an employment contract, implied or otherwise. The

employment relationship remains "at-will".

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.