POSITION MISSION: Effectively and efficiently investigate, evaluate, and settle Commercial Casualty Claims according to policy provisions in an equitable, fair manner while promoting a high level of customer service on assigned line(s) of business in support of Claims’ mission

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.

• Review applicable coverage forms and endorsements, providing thorough analysis of coverage and any coverage, and document the claim file accordingly.
• Conduct investigations, damage assessments, cause and origin determinations and claim evaluations
• Provide thorough reporting and documentation of all reserves and claim information on a timely basis to allow proper tracking, statistical analysis, and review by claims management
• Adjusts claims within delegated authority complying with all regulatory and reporting requirements including Fair Claims Practices Act and relevant laws.
• Make recommendations to management pertaining to coverage, settlement positions, and file reserves based on well supported reports
• Negotiate with claimants, carriers, and attorneys to reach fair and equitable settlements within assigned authority 
• Review lawsuits and provide recommendations for handling
• Monitor defense counsel adherence to litigation procedures, including prompt budget submissions
• Attend depositions, settlement conferences and trials when necessary
• Identify and respond to all emerging issues impacting company in the area of claim adjustment and loss control

OTHER DUTIES:

• Participate in Claim Reviews with Large Accounts and/or Program Partners
• Performs other duties or special projects as required or as assigned by a supervisor
• Support the corporate culture and create a positive work environment

KNOWLEDGE, SKILLS, AND ABILITIES:

The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform each essential duty satisfactorily.

• Thorough knowledge of claims operations to include adjusting, LAE, customer experience, salvage, subrogation, and payment processes
• Having the ability to negotiate high value physical damage (PD) and bodily injury (BI) claims to appropriate resolution for the insured and company
• Demonstrate ability to apply multiple policy exclusions and endorsements to evaluate a construction defect claim for reserve, coverage letter, and settlement purposes.
• Working knowledge and understanding of basic construction and medical concepts.
• Experience with Medicare reporting and requirements before settlement of Medicare eligible claimants/plaintiffs.
• Properly analyze information in an efficient manner than promotes timely resolution of a claim 
• Exhibits strong and effective verbal and written communication skills that are professional and diplomatic including ability to competently spell, write, compose, and proofread copy 
• Exhibits a sound understanding of department goals and objectives
• Understands the company’s products, services, department function and overall organization
• Displays a clear understanding of who the customer is, both internal and external. Comfortable working with all clients and business partners
• Understands MGA and GA partnerships
• Well organized and uses time effectively with ability to balance competing priorities
• Demonstrates initiative and innovation in daily performance of responsibilities. Shows personal integrity, inspires trust, and sets a positive example through a strong work ethic, commitment, and enthusiasm
• Excellent technology skills; effectively utilizes and maximizes technology to optimum productivity advantage
• Ability to work independently yet be a complete team player

COMPETENCIES:

• Critical Thinking
• Negotiation
• Time Management
• Communication
• Analytical

QUALIFICATIONS:

• Bachelor’s degree preferred 
• Minimum 5 years commercial casualty adjusting experience
• Contractors general liability and claims knowledge preferred.
• AIC, or other professional designations preferred
• Adjuster license in multiple jurisdictions preferred 

PHYSICAL DEMANDS:

Please note, this position description is not designed to cover a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

• Position operates in a professional office environment and routinely uses standard office and mobile equipment such as computers, phones, and photocopiers.
• Position requires regularly traveling to agent offices, attending both internal and external meetings, attending conferences and other training events.
• Flexibility in daily work times and telecommuting is allowed; average 40-hour week; occasional evening, weekend work, or overnight travel may be required as job duties demand.