Sr Claims Adjuster - Premises
Reputable company located in Houston but position is remote. If you are located in Houston, it is a plus but not required.
TPA Carrier experience a plus. You will be handling the following type of of claims:
Wrongful death
Slip and Fall
Habitability
Personal Injury
Sexual assault
Trip and Fall
Responsibilities
• Manage caseload of primarily litigated files of approximately 125 claims.
• Direct independent adjusters (when applicable) and defense counsel, as necessary
• Analyzes and processes complex or technically difficult commercial general liability claims by investigating and gathering information to determine the exposure on the claim
• Investigates, analyzes, determines potential liability, and effectively settles with adverse parties.
• Manages claims through well-developed action plans to an appropriate and timely resolution
• Assesses liability, gather investigative information and resolve claims within evaluation
• Negotiates settlement of claims up to designated authority level, request authority timely, as needed
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim
• Approve and makes timely claim payments and adjustments, and settles claims within designated authority level
• Assist litigation manager with the litigation process; ensures timely and cost-effective claims resolution
• Uses appropriate cost containment techniques
• Communicate claim activity with the appropriate parties (supervisor, broker, agent, client)
• Cultivate and maintain professional client relationships
• Participate in monthly claim round table and reserve committee
• Audit files to ensure field completion and data integrity
• Prepare Claim Analysis Reports for all claim reviews (internal/external)
• Complete Plan of Action, Status Updates, Reserve Properly,
• Request all pertinent documents and audit files for closure, field completion, document gathering, financials, etc.
• Request settlement authority and checks
• Identify tender and subrogation opportunities
• Attend mediations, if merited (rare travel, if any).
• Exercises sufficient and independent judgment to settle cases prior to mediation and/or litigation.
• Obtains all necessary documentation from the appropriate parties within established timelines.
• Remains abreast of new case law and statutes.
• Maintains confidentiality of information processed.
• Ensure the maintenance of the data integrity of our RMIS
• Mentors team members.
• Completes other duties and special projects as requested.
Experience
• 7-10+ years of experience handling catastrophic level commercial general liability claims
• Litigated claims experience imperative
• Active license is required (multi-state)
• Real estate/multi-family experience claims handling experience highly preferred
• Comprehensive understanding of General Laws in multi states
Required Characteristics
• Must share our core values
• Must be reliable and dependable
• Must enjoy finding and proposing solutions to problems
• Must thrive in a fast pace, deadline driven environment
• Must be willing to self-learn in addition to taking direction (work independently and as a team)
• Must be comfortable with working on new and sometimes unfamiliar problems. Ability to problem solve and find solutions/answers
• Must be self-motivated, proactive, and detail oriented
• Must be respectful to all colleagues and clients and contribute to a fun, happy and team building atmosphere.
Skills
• Typing (min 65 wpm)
• Experience with automated claims handling systems (RMIS) (paperless environment)
• Extensive understanding of contractual relationships and language
Requirements
Education
• Required - High School Diploma
• Required - Bachelor's Degree from an accredited college or university
• Required – Multi-state Licensed Casualty Adjuster
• AIC/CPCU/ARM Designation highly preferred
Benefits
Medical - UHC
401K plus match
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