Liability Claims Representative

Position Summary:

The Liability Claims Adjuster is responsible for managing and resolving liability claims efficiently, accurately, and in compliance with applicable regulations. This role involves investigating claims, assessing coverage and damages, coordinating with internal and external stakeholders, and supporting system operations and process improvements.

• Review and analyze liability claims for coverage and validity.
• Collect and assess evidence including police reports, witness statements, and photographs.
• Conduct interviews with claimants, insured parties, and witnesses to determine fault and damages.
• Evaluate liability and recommend settlement amounts based on policy terms and legal standards.
• Approve or deny claims based on investigative findings.
• Negotiate settlements with claimants, attorneys, and third parties.
• Process claims and execute payments in accordance with guidelines.
• Maintain accurate documentation and update system records throughout the claim lifecycle.
• Compliance & Communication
• Ensure adherence to state, federal, and municipal insurance regulations.
• Communicate claim status and decisions to claimants and insured members.
• Format and review Reservation of Rights and Denial letters.
• Review legal invoices and releases, obtaining necessary approvals.
• Operational Support
• Manage mail processing and correspondence distribution.
• Track claims metrics and identify opportunities for process improvement.
• Prepare status reports for management and stakeholders.
• Support onboarding and provide system administration assistance to staff and members.
• Liaise with internal departments, legal teams, and external vendors.
• Participate in system upgrades, troubleshooting, and quality improvement initiatives.
• Manage CMS and ISO reporting to ensure all compliance requirements are met.
• Serve as backup for adjusters, business operations, and executive support as needed.

• Perform all other duties as assigned to support departmental goals and organizational success.

• Bachelor’s degree in Business Administration, related field or equivalent experience required.
• Professional certifications (e.g., CPCU, AIC) preferred.
• Minimum of 5 years of experience handling Auto Liability, Bodily Injury (BI), General Liability, and Litigation claims. Municipal and Employment Practice liability experience preferred but not required.
• Proven track record of managing complex claims from investigation through resolution.

• Strong understanding of insurance policies, legal standards, and regulatory compliance.
• Proficient in claims management systems and Microsoft Office Suite.
• Excellent analytical, investigative, and decision‑making skills.
• Effective written and verbal communication, including negotiation and conflict resolution.
• Ability to manage multiple priorities in a fast‑paced environment.
• High attention to detail and commitment to accuracy.
• Strong interpersonal skills with the ability to collaborate across teams.
• Ability to maintain confidentiality and exercise sound judgment.
• Regular and reliable attendance is required.

• Experience with CMS and ISO reporting.
• Knowledge of Wisconsin Municipal Law.
• Familiarity with financial documentation and 1099 reporting.
• Background in system administration or user support.

• Regularly required to talk, hear, and sit for extended periods while reviewing claims, speaking with members, and documenting case details.
• Frequent use of computer equipment including keyboard, monitor, mouse, and telephone.
• Occasionally required to lift and/or move items up to 10 pounds, such as files or promotional materials.
• Occasional travel for company business, including member meetings, trainings, and conferences. Travel may involve various modes of transportation (e.g., airplane, train, bus, rental car). Must be able to travel without restrictions.
• Specific vision abilities required include close vision, peripheral vision, depth perception, and the ability to adjust focus.
• Hybrid Work Model:
  Primarily remote, with residence in Wisconsin required (within reasonable driving distance).
• In‑person participation is expected for scheduled office meetings, trainings, and member‑related travel.
• Work may occasionally involve high‑pressure situations requiring timely decision‑making and clear communication with members and stakeholders.