Claim Adjuster Job Description

Claim Adjuster Job Description

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Claim adjuster provides effective and timely communication to all internal and external stakeholders regarding claim status and other inquiries such as fraud, subrogation recovery, reserve adequacy and underwriting risks; build close partnerships throughout the life of the claim.

Claim Adjuster Duties & Responsibilities

To write an effective claim adjuster job description, begin by listing detailed duties, responsibilities and expectations. We have included claim adjuster job description templates that you can modify and use.

Sample responsibilities for this position include:

Interpreting policies for applicable coverage for the loss
This position also includes assigning vendors to complete mitigation and inspections, interpreting policies for applicable coverage for the loss, writing fast track estimates, reviewing claims for payment, reviewing contractor supplements, and negotiating final settlements per the policy provisions
Provide guidance to other personnel on investigations, injury evaluations, liability, coverage, and settlement techniques
Takes recorded statements from insureds, witnesses, medical providers, , conducts investigations into complex auto accidents, determines liability and prepares summaries
Evaluates and determines potential use of experts
Consults with other areas of the company as the work demands
Making first contacts with our policy holders to include detailed investigations into the facts of a loss along with damages being claimed
Assigning vendors to complete mitigation and inspections
Writing fast track estimates, reviewing claims for payment, and reviewing contractor supplements
Negotiating final settlements per the policy provisions

Claim Adjuster Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Claim Adjuster

List any licenses or certifications required by the position: AIC, CPCU, ASE

Education for Claim Adjuster

Typically a job would require a certain level of education.

Employers hiring for the claim adjuster job most commonly would prefer for their future employee to have a relevant degree such as Collage and Bachelor's Degree in Leadership, Public Relations, Performance, The College, Conducting, Business, Legal, Accounting, Construction, Management

Skills for Claim Adjuster

Desired skills for claim adjuster include:

Underwriting guidelines
Inspects risks and makes recommendations to the Underwriting Department as needed
Evaluates risks and makes recommendations to the Underwriting Department as needed
Third party and tort liability
Each phase of the P/C claim handling process
Coverage
Policies
Coaching and mentoring techniques to be able to develop and support others on a day-to-day basis
Accepted industry standards and practices Computer experience with related claims and business software
Adherence to applicable legal compliance standards

Desired experience for claim adjuster includes:

Ability to learn claims computer applications
Prior life claims experience is a plus
Must maintain an acceptable caseload and thrive in a team environment
Must have knowledge of medical, legal and auto repair/construction terminology is an asset
Documenting claim files to comply with company guidelines state regulation
Assessing subrogation potential any potential SIU referral

Claim Adjuster Examples

1

Claim Adjuster Job Description

Job Description Example
Our company is growing rapidly and is looking for a claim adjuster. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for claim adjuster
  • Collects and reviews factual information to determine coverage, liability and/or eligibility of all parties to the claim and explains the claims process
  • Assist co-workers in regard to clarification of contract coverage, parts
  • Handles moderate to complex Casualty claims of high dollar value that may involve complex coverage issues
  • This position requires the ability to lift up to 50 pounds between 33 and 66% of the time (applies to field position only)
  • Production – The ability to work in a fast paced environment and manage a claim file from start to finish
  • Responsible for the review and analysis of complex claim files to ensure quality work products are sent to clients
  • Manages the tracking, reporting and analysis of quality data
  • Partners with other claims technical staff to ensure overall product quality
  • Reviews and verifies information on complex claims to ensure processing with established quality standards
  • Understands and interprets complicated client and vendor specifications
Qualifications for claim adjuster
  • Good computer knowledge including Word and Excel
  • Experience using Xactimate estimating platform
  • Understanding of Xact Analysis
  • Must be willing to be located in Dallas and the surrounding areas
  • The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and at least 6-12 months of directly related experience
  • Develops alternative methods to achieve uniform quality including identifying process variables and training opportunities
2

Claim Adjuster Job Description

Job Description Example
Our innovative and growing company is looking for a claim adjuster. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for claim adjuster
  • Consult on issues of coverage and damages
  • Investigate facts of loss and coverage
  • Verifies corrected material and prepares quality assurance reports as appropriate
  • Use the Guide wire Claims Center System to input and retrieve claim information request checks, create form letters, and other correspondence
  • Assist in the training of claim representatives, including presenting periodic training sessions in various areas of claims adjusting at branch office monthly training meetings
  • Interview all involved parties to determine the facts of the claim
  • Obtains and records required loss information from the insured
  • Under close supervision, investigates, evaluates, negotiates and settles homeowner's property/personal property claims, including adjustment to conclusion
  • Involves low- to high-complexity claims
  • Coordinates task assignments of claims with field adjusters
Qualifications for claim adjuster
  • 0 -3 years insurance industry or financial services customer service experience with 1 year claim experience preferred
  • Bachelors degree in Risk Management, Business or related field
  • Five years of experience handling complex property and/or casualty claims
  • Must have or able to secure adjuster license(s) as required by the state(s) serviced
  • Audit/quality control experience
  • Ability to work independently in a multi-tasking environment with a sense of urgency with little direct supervision
3

Claim Adjuster Job Description

Job Description Example
Our company is growing rapidly and is looking for a claim adjuster. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for claim adjuster
  • Investigates each claim to obtain relevant facts necessary to determine coverage, causation/ damages, extent of liability/establishment of negligence, damages, contribution potential and exposure with respect to the various coverages provided through prompt contact with appropriate parties
  • Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements, and understands how jurisdictional issues impact the claim
  • Is the owning adjuster for all claims assigned, other than those falling outside their scope of authority
  • This position is expected to progress to the competency level of a Claims Specialist
  • Documenting claims file to comply with company guidelines and state regulation is essential to the position, along with determining what claims should be recommended for subrogation and/or referral to SIU
  • Provide exceptional service while investigating, evaluating, and resolving first party medical claims (No Fault - MedPay)
  • Communicate with insureds, providers and other parties to determine the facts of the claim
  • Determine proper amount payable to claimants
  • Negotiates and commits to settlement where appropriate
  • Recommend subrogation and/or SIU referral when required
Qualifications for claim adjuster
  • Demonstrated deep understanding and skill related to each phase of the property, commercial, and farm ranch claim handling process
  • Ability to obtain adjusters license after employeed
  • Position may require longer work hours (some Saturdays and some holidays)
  • Be located in or willing to relocate to Omaha NE
  • Knowledge of laws, statutes, and claims handling practices in multiple states and passed applicable state licensing requirements preferred (CT, VT, NH, NC, SC, W
  • Working towards a professional designation a plus
4

Claim Adjuster Job Description

Job Description Example
Our growing company is hiring for a claim adjuster. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for claim adjuster
  • Conveys complex information (coverage, decisions, outcomes, ) to all appropriate parties, maintaining a professional demeanor in all situations
  • Creates and documents claims file and sets financial reserves to comply with company guidelines and state regulations
  • Achieve a minimum of the quality and quantity targets on a daily basis
  • Carry out all services in a professional manner demonstrating a high degree of quality and accuracy at all times
  • Identify potential risks (possibility of fraud case) and to ensure the company operates in the most efficient manner possible, reducing transactional costs and risks to the business
  • 3+ years of Commercial claims handling experience preferred
  • May be involved with litigated files for experience and developmental purposes
  • Effectively communicate with all business partners and consumers regarding claim approval or denial
  • Review each assigned claim in a timely and accurate manner
  • Document all aspects of claim review in accordance with company procedures
Qualifications for claim adjuster
  • Proficient in Microsoft Excel a plus
  • New York, Maryland and Pennsylvania experience a plus
  • 2 years or more of field roof inspections preferred
  • A Bachelor’s degree in finance, business, accounting, economics, or equivalent preferred
  • Internship or other prior work experience in a corporate financial office is preferred
  • This position will be filled in Charlotte, NC
5

Claim Adjuster Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of claim adjuster. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for claim adjuster
  • Other responsibilities as determined by the Warranty Administration Manager
  • Investigate, negotiate and settle basic property or liability insurance claims
  • Adjust/co-adjust complex property claims
  • Evaluate and investigating fraud and arson cases
  • Testify as to findings in court as appropriate
  • Coordinate and supervise legal counsel for litigation management
  • Develop scope of building losses
  • Retain and manage experts
  • Conduct field office training sessions as requested
  • Participate as storm team member to handle large storm/catastrophe loses
Qualifications for claim adjuster
  • Previous casualty adjusting experience
  • Must have knowledge of medical, legal and auto repair/construction terminology
  • 3+ years of casualty claims handling experience is preferred
  • Some BI experience preferred
  • 1+ year of casualty minor injury claims experience
  • CA claims handling experience preferred

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