Claims Adjuster
WFH Flexible CA
Job Type
Full-time
Description

For 70 years George Hills has offered our clients unparalleled service and innovative excellence in claims administration and offered our employees a positive and collaborative culture that builds relationships based on pride and respect. As an “Employer of Choice”, we are pleased to offer employees a flexible hybrid work schedule, competitive salary, and excellent benefits including medical, dental, vision, PTO, holidays, and 401k. To learn more, please visit our website at https://georgehills.com/ . George Hills is an equal-opportunity employer.

  

The Claims Adjuster investigates, evaluates, and adjusts General and Automobile Liability claims. Although assigned claims generally consist of low to medium exposure, first and third-party automobile bodily injury and property damage claims, as well as premises liability accidents, product liability claims, the claims adjuster must be qualified legally and technically to handle all claims competently.

Requirements

Primary responsibilities:

  

Based on the area of responsibility, the employee shall be asked to all of the following essential functions:

· Investigate, analyze, and determine the extent of insurance provider's liability concerning personal, casualty, or property loss or damages, and attempt to effect settlement with claimants. 

· Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of claims within a certain monetary limit.

· Investigate claims:

  • Assess and estimate vehicle damage.  
  • Assist with business or managerial research. 
  • Compile information through interviews. 
  • Evaluate customer records. 
  • Examine evidence to determine if it will support claims.
  • Follow contract, property, or insurance laws. 
  • Follow rules of evidence procedures in legal setting. 
  • Gather physical evidence. 
  • Inspect property to determine damages. 
  • Research property records. 
  • Search legal records Interviews, telephones, and or corresponds with claimant and witnesses.

· Evaluate liability exposure:

  • Review insurance applications.
  • Review insurance policies to determine appropriate coverage.
  • Obtain, review and evaluate records, police, medical, etc.
  • Recommend claim action.
  • Properly reserve for the claim.
  • Adjust reserve as appropriate.
  • Comply with accepted guidelines regarding reserving practice and authority levels.

· Create and maintain records

  • Maintain records, reports, and files which are primarily found on the SIMS and/or Renaissance system.
  • Maintain all cases on an active diary on the SIMS and/or Renaissance system pursuant to established Company criteria.
  • Prepare timely reports to clients.
  • Comply with all reporting requirements/steps set out in the GHC Procedure Manual.
  • Comply with regulatory requirements.
  • Diary spoken or written information.

· Litigation management support: 

  • Collect evidence to support contested claims in court. 
  • Keep clients advised.

· Other duties as assigned.


Requirements

Education and Experience

•Bachelor’s degree preferred.

•At least three (3) years of experience with insurance claims, self-insurance, pooled insurance, or Joint Powers Authorities.

•Possess comprehensive knowledge relating to the handling of public entity liability claims.

•At least three (3) years of using Microsoft Windows on a PC including Microsoft Word, Excel, Outlook and PowerPoint.

•At least two (2) years of using streaming video conferencing including Teams and Zoom with the ability to set and host group meetings with all included functionality.

•At least two (2) years of using claims management software and/or ability to quickly learn new software systems related to claims management.

•Excellent written and verbal communication skills.

Please see our privacy policy:

https://georgehills.com/wp-content/uploads/General-Notice-at-Collection-for-Applicants.pdf


Equal Employment Opportunity 

George Hills Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race (including natural hair texture and hairstyles), color, sex/gender (including pregnancy, childbirth, breastfeeding, or related medical conditions), gender identity or expression, transgender (including whether or one is transitioning, have transitioned, or may be perceived to be in transition), religious creed (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition (including genetic characteristics or information, cancer or record or history of cancer, or AIDS/HIV status), sexual orientation, military or veteran status, reproductive health decisions, off-duty cannabis use (that does not cause on-the-job impairment), any combination of the above characteristics, or any other characteristic protected by applicable federal, state, or local laws, regulations or ordinances.  George Hills Company strictly prohibits discrimination, harassment, and retaliation in all employment practices, including recruitment, hiring, promotion, training, compensation, benefits, and termination.  

Salary Description
$66,560 to $80,000 DOE