Senior Adjuster, Field Service Claims

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🔥 4 hours ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

⏰ Full Time

🟠 Senior

📋 Claims Specialist

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Dayforce

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

👥 HR Tech

☁️ SaaS

🏢 Enterprise

💰 $1G Post-IPO Debt - Dayforce on 2024-03

HR Tech • SaaS • Enterprise

Dayforce is a cloud-based human capital management (HCM) and workforce management platform (offered by Ceridian). Dayforce provides a unified SaaS application that combines payroll, HR, benefits administration, time and attendance, workforce scheduling, and talent management to help employers manage employees, payroll, and compliance workflows. It is primarily sold to businesses and enterprises as an HR/payroll workforce solution.

📋 Description

• Independently manage field property claims, including those requiring outside field investigations and catastrophe (CAT) response. • Lead thorough investigations, assess coverage, and issue appropriate documentation including reservation of rights and coverage letters. Escalate issues as needed. • Identify and proactively pursue opportunities to transfer risk to the appropriate entities for the benefit of insureds and business partners. • Maintain comprehensive and detailed claim records, ensuring proper documentation and compliance with jurisdictional requirements. • Identify and assign subrogation potential appropriately; set up files to support successful recovery efforts. • Ensure all claims activities comply with regulatory and company standards. Execute jurisdictional compliance requirements and support others in understanding regulatory obligations. • Investigate and manage suspicious claims using advanced techniques and tools; refer to the Special Investigation Unit (SIU) as needed. Maintain awareness of fraud indicators and regulatory reporting obligations. • Set reserves, authorize payments, and make financial decisions within authority and contribute to reserving accuracy and efficiency. • Coordinate with internal and external stakeholders including legal, underwriting, vendors, and agents. Lead cross-functional meetings and communicate complex information clearly to diverse audiences. • Use advanced tools and analytics to identify trends, correct inconsistencies, and improve claims handling efficiency. Ensure proper data ingestion, labeling, and protection of personally identifiable information (PII). • Maintains comprehensive factual and organized claim records and prepares detailed reports summarizing findings and recommendations. • Serve as a mentor to junior adjusters, providing guidance on complex claims, compliance, and litigation processes. Support training initiatives and contribute to the development of best practices and educational materials. • Deliver empathetic, clear communication throughout the claims process. Educate claimants and stakeholders, affirm next steps, and ensure a positive customer experience. • May represent the company in mediations, arbitrations, and trials.

🎯 Requirements

• Bachelor’s degree or equivalent experience with claim handling. • Typically requires 5–10 years of adjusting experience. • Strong knowledge of local geography, regulations, and public safety agencies, as well as the ability to build rapport with insureds and navigate the insurance and legal climate. • Strong working knowledge of applicable statues, regulations, case law, and third-party legal liability concepts. • Skilled in negotiation and developing strategies to influence outcomes. • Demonstrates sound judgment and decision-making, including litigation and compliance matters. • Communicates clearly and effectively in both verbal and written formats across a variety of situations. • Highly organized with the ability to manage complex workflows and project work. • Strong time management and desk management skills. • Makes informed decisions based on thorough analysis of complex issues. • Ability to collaborate with internal and external experts, including legal, underwriting, and other stakeholders.

🏖️ Benefits

• Must have and maintain appropriate state adjuster licenses, continuing education credits, and a valid driver’s license.