Future Medical Claims Examiner | Brea, CA

Per Diem General Liability Adjuster

Part-time · Telecommuter TX
✓ Verified live on the employer's own system · added 6 days ago
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Senior · 8+ yrs exp

Requirements

Education: Bachelor's degree

Experience: 8+ years

Skills & tools

LitigationManagementCommunicationsMS OfficeTroubleshootingFinancial Analysis
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Full job description

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

- Adjusts claims that arise on Automobile, Homeowner and Excess Liability policies. - Develops exposures and evaluates injury claims based on damages, the insurance contract, company policies, and applicable state laws. - Investigates and evaluates coverage, liability and damages in handling of claims involving serious and catastrophic injuries, coverage, and other legal issues. - Ensures timely referral of suits to counsel and evaluates changes in exposure through the course of discovery, considering costs and strategic plan of actions to prepare for trial or determine settlement capability. - Responsible for managing defense counsel in litigation of serious and complex claim , litigated claims as well as complex coverage scenarios; manages defense counsel in litigation of serious and complex claims. - Formulates effective plans to bring the claims to resolution while focusing on indemnity and expense leakage. - Evaluates coverage and drafts coverage letters to include both reservation of rights and coverage denials. - Maintains proper reserves on all pending claims.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

- Performs other duties as assigned. - Travel as required

QUALIFICATIONS
Education & Licensing

Bachelor's degree from an accredited college or university preferred. State mandated adjusting licenses as required. Insurance designations such as CPCU, AIC, ARM preferred.

Experience

Eight (8) years of related experience to include experience in personal lines claims, evaluating coverage and drafting coverage letters to include both reservation of rights and coverage denials, or equivalent combination of education and experience required. Experience with commercial lines claims and litigation in multiple states preferred.

Skills & Knowledge

- Exposure to and knowledge of affluent market segment - Strong knowledge of tort theories, legal concepts, negotiation strategies, and litigation management - Excellent oral and written communication skills, including presentation skills - PC literate, including Microsoft Office products - Analytical and interpretive skills - Strong organizational skills - Excellent interpersonal skills - Excellent negotiating skills - Ability to create and complete comprehensive, accurate and constructive written reports - Ability to work in a team environment - Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical : Computer keyboarding, travel as required
Auditory/Visual : Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.

You may be just the right candidate for this or other roles.

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This posting was published by Future Medical Claims Examiner | Brea, CA on their own careers system and is shown here with a direct link to apply there. Employers: for corrections or removal, contact jobs@veritahire.com.