12/02/2021

SENIOR CASUALTY CLAIMS ADJUSTER

  • The Carlisle Group
  • Wilmington, DE, United States

Job Description

SENIOR CASUALTY CLAIMS ADJUSTER


Our client has Retained The Carlisle Group to conduct a Search for a Senior Casualty Claims Adjuster in their Delaware office.



This position will allow remote work 3 days a week.



Job Requirements:

Job Duties:

  • Verify coverage
  • Assign new losses to independent adjusters and staff adjusters; property, casualty and workers comp
  • Review independent adjuster reports, bills and fee schedule in Imaging
  • Determine investigation needed. Evaluate information to adjust reserves or settle claims
  • Flag to the Underwriting Department for adverse risk information
  • Request payments, losses and expenses
  • Process reserve changes
  • Maintain current diary in Imaging on all files and request NJ Unfair Claims letters as appropriate
  • Answer insured and Agent inquiries for status and coverage
  • Issue Coverage Denials, Non-Waivers or Reservation of Rights letters and all other written correspondence as appropriate
  • Comply with New Jersey Unfair Claims Act and Claims Ombudsman Standards
  • Maintain adjuster, expert and attorney lists
  • Notify reinsurers of treaties, reserves and payments. Follow up on outstanding recoveries
  • In-house Claims
  • Send out appropriate forms
  • Review documentation
  • Set and update reserves as needed
  • File CIB and Section 111 Forms
  • Call and verify facts and damages; take recorded statements as appropriate
  • Finalize settlement with appropriate documents
  • Request settlement checks
  • Professional telephone skills required
  • Handle claims through Imaging Workflow including diary, mail review and 1st Reports
  • Import adjuster reports and attorney reports received via e-mail into Imaging System
  • Keep abreast of any trends in claims that impact handling
  • Handle files in litigation. Monitor case and participate in decision making. Evaluate and negotiate claims directly with plaintiff attorney where appropriate. Give authorization to settle claims within your evaluation to defense council. Determine whether case should be tried to verdict or settled. Monitor trial results.
  • Be able to evaluate medical specials, lost wages and liability in order to negotiate and settle claims
  • Knowledge of medical terminology
  • Interview prospective adjusters, experts, and subro attorneys and make recommendations to manager
  • Understand daily, monthly and quarterly reports and be able to review and calculate information
  • Knowledge of New Jersey Court System and comparative negligence laws, including Title 59
  • Excellent command of English language, both written and oral
  • Deliver timely, quality customer service in all aspects of job position

Claims Adjusting Authority:

  • $100,000 on claims without Supervision
  • Over $100,000 on claims with Supervision

Education or Equivalent Job Experience:

  • College Degree or equivalent experience and 7-10 years insurance experience or related claims exposure

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