Casualty Claims Adjuster II

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $60.8k - $92.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

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EMC Insurance Companies

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1911

🛡️ Insurance

Insurance

EMC Insurance Companies is a mutual insurance firm providing specialized business insurance solutions. They focus on commercial property insurance, liability insurance, workers' compensation, and business owners' policies. With a strong emphasis on personalized service, EMC collaborates closely with local agents to deliver comprehensive and tailored coverage. EMC is committed to understanding the unique challenges faced by its policyholders, offering risk management and loss control resources to help businesses safeguard their assets. Known for their dedicated partnerships and exceptional customer service, EMC ensures that businesses are prepared for the unexpected with their superior insurance solutions.

📋 Description

• Investigate and evaluate moderately complex auto and casualty claims • Confirm coverage, deductibles, and payees against policies and regulations • Contact insureds, claimants, and witnesses to explain the process and gather statements • Collect, review, and document investigative reports, claim forms, and supporting materials • Maintain claim documentation, activity logs, report summaries, and reserve analysis, including Medicare/MSP • Establish and adjust timely, appropriate reserves • Identify and pursue subrogation and recovery opportunities • Ensure adherence to state regulatory requirements and timely issuance of required communications and forms • Manage low-complexity litigated files and coordinate defense counsel assignments • Oversee and evaluate vendors, invoices, and expenses • Draft coverage determinations, reservation of rights, and denial letters • Provide status updates and escalate issues as needed • Evaluate liability and damages, prepare negotiation strategies, resolve liens, and negotiate settlements • Finalize settlements, including documentation, releases, payments, mediations, and arbitrations • Collaborate with SIU, Subrogation, Legal, Underwriting, and Risk • Contribute to team support, training, and projects

🎯 Requirements

• Bachelor’s degree or equivalent relevant experience • Three years of casualty claims adjusting experience or related experience • Relevant insurance designations preferred • Strong knowledge of the theory and practice of the claim function • Strong knowledge of insurance contracts, medical terminology, and substantive and procedural laws • Strong knowledge of computers and claims systems • Ability to obtain all applicable state licenses • Ability to adhere to high standards of professional conduct and code of ethics • Good organizational and empathetic interpersonal skills • Strong written and verbal communication skills • Strong investigative and problem-solving abilities • Excellent customer service skills • Ability to maintain confidentiality • Occasional travel required • Valid driver’s license with an acceptable motor vehicle report per company standards required if traveling

🏖️ Benefits

• Comprehensive rewards package; benefits details provided at www.emcins.com/careers • Work from home • Tobacco-free workplaces and company vehicles