Senior Casualty Claims Adjuster

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $72.7k - $109.8k / year

⏰ Full Time

🟠 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

• Review claim notices, lawsuits, contracts and policies to verify coverage, deductibles, claim payees/mortgagees and compensability • Contact customers, insureds, claimants and witnesses to obtain claim information and explain the claims process • Take statements and document summaries and handling activity in the claims system, including Medicare/MSP modules • Set timely and adequate reserves according to company reserving philosophy and methodology • Select appropriate defense counsel for litigated claims and handle medium- to lower-complexity lawsuits • Resolve coverage, liability and claim-value questions; draft reservation-of-rights and denial letters when appropriate • Assign independent adjusters when necessary with supervisory approval • Secure official reports, claim forms and other necessary documents • Review bills, invoices, receipts, legal invoices and litigation expenses for accuracy and appropriateness • Respond to agents, insureds and claimants regarding claim status • Investigate and pursue recovery opportunities; investigate and resolve Medicare liens • Prepare bodily injury and/or property damage evaluations, negotiation ranges and target settlement numbers • Negotiate claim settlements with insureds, claimants and attorneys • Assist with suits, mediations, arbitrations and depositions • Participate in claims roundtables and issue properly executed settlement documents and timely payments • Submit referrals to specialist review units when necessary • Prepare risk reports for Underwriting and review coverage intent, policy activity and account inspection information with relevant teams • Mentor and coach less experienced claims team members; assist other branches through the Resource Sharing Program • Participate in branch and department projects

🎯 Requirements

• Bachelor’s degree or equivalent relevant experience • Five years of claims adjusting experience • Attainment of all applicable state licenses within six months of hire • Relevant insurance designations preferred • Proven, excellent knowledge of the theory and practice of the claim function • Analytical ability and sound judgment with respect to liability and coverage • Strong knowledge of insurance contracts, medical terminology and legal aspects of court procedures • High standards of professional conduct • Strong knowledge of computers and claims systems • Strong organizational and written and verbal communication skills • Excellent investigative and problem-solving abilities • Travel required; a valid driver’s license with an acceptable motor vehicle report per company standards required if traveling

🏖️ Benefits

• Comprehensive rewards package; benefits information provided at www.emcins.com/careers • Work from home anywhere in the United States • Tobacco-free workplaces and company vehicles