Senior Injury Claims Adjuster

• • Adjusts attorney-involved moderately complex bodily injury claims with demonstrable injuries (e.g. torn meniscus, broken bones, disc herniations), as well as all auto physical damage associated with those claims
• • Identifies, confirms, and makes coverage decisions on moderately complex bodily injury claims
• • Investigates loss details, determines legal liability, evaluates, negotiates, and arrives at claim settlement within appropriate authority guidelines
• • Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions
• • Prioritizes and manages assigned claims workload to keep members and other involved parties informed, provides timely claims status updates
• • Collaborates and supports team members to resolve issues and identify appropriate matters for escalation
• • Partners and/or directs vendors and internal business partners to facilitate timely claims resolution
• • Supports workload surges and/or Catastrophe Operations as needed
• • May act as an informal resource for team members with less experience

• High School or General Equivalency Diploma
• 1 year of injury adjusting experience
• 2 years of auto liability claims adjusting experience
• Deep knowledge and understanding of the auto claims contract as well as application of case law and state laws and regulations
• Proficient negotiation, investigation, communication, and conflict resolution skills
• Demonstrated time-management and decision-making skills
• Proven investigatory, prioritizing, multi-tasking, and problem-solving skills
• Proficient knowledge of human anatomy and medical terminology associated with bodily injury claims
• Ability to exercise sound financial judgment and discretion in handling insurance claims
• Proficient knowledge of coverage evaluation, loss assessment, and loss reserving
• Acquisition and maintenance of insurance adjuster license within 90 days and designated number of attempts

Demonstrates expertise in adjusting bodily injury claims, including negotiation, investigation, and coverage evaluation, while effectively managing claims workload and collaborating with team members. Possesses strong knowledge of auto claims contracts, human anatomy, and relevant state laws.

• Injury Adjusting Experience
• Auto Liability Claims Adjusting Experience
• Negotiation Skills
• Knowledge of Human Anatomy
• Insurance Adjuster License

• Bodily Injury Claims Adjustment
• Coverage Evaluation
• Loss Assessment
• Loss Reserving
• Investigation Skills
• Conflict Resolution Skills
• Time Management
• Decision Making
• Multi-tasking
• Problem Solving

• Communication Skills
• Prioritization Skills

• Insurance Adjuster License

• Auto Claims Contract
• State Laws and Regulations
• Legal Liability
• Claims Settlement
• Catastrophe Operations