Sr Claim Advisor

The Claim Adjuster provides various functions in the management of claims administered by the Risk Management department:

Serves as a dedicated resource to Risk Management customers for handling and communication of property and casualty claims Oversees Claims, including Complex Litigation for cases in suit Analyzes and interprets coverages on manuscript policies Coordinates reservation of rights letters to group self-insureds Makes contacts, investigates losses, documents facts surrounding the incident, to include decision regarding liability/compensability, as well as action plan and reserve rationale Explains benefits, close contact with claimants and their attorneys Uses outside vendors to determine damages or mitigate exposures, use of vendors who assist with coordination of repairs, and use of defense counsel on litigated claims may be necessary Identifies and pursues fraudulent claims Investigates potential subrogation and pursues third-party continuing through the recovery process Uses strong diary system to ensure timely follow up and monitors treatment, receipt of bills or records, reserve adequacy, negotiation of settlement, payment and closure Maintains a strong back-up process with the other Adjusters, and with the Claim Technician to assure consistent service during absences of any member of the team Makes sure the team is functioning at a high level at all times, to include providing feedback on performance of Claim Technician to the Manager, Risk Management Claims

Job Specifications

Competencies

Bachelor’s degree from an accredited four-year college or university, or equivalent experience 5 Years’-Experience in equivalent field Strong written and verbal communication skills Strong organizational skills Ability to apply mathematical concepts Ability to work successfully in a deadline driven environment Ability to attend social functions for clients and carriers in order to build relationships Working knowledge of Microsoft products (Word, Excel, Outlook, etc.) Working knowledge and comfort level with claims management systems; and comfort working in a paperless environment

Supervisory Responsibility

This position has no direct supervisory responsibilities however it may act as a team leader for special projects. 

Work Environment

This job operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. 

Physical Demands

This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand as necessary. 

Position Type/Expected Hours of Work

This is a full-time position. Exempt employees are expected to work hours as needed to accomplish the functions and responsibilities as indicated above. Evening and weekend work may be required as job duties demand.

Travel

This position may require travel.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Risk Strategies is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about working at Risk Strategies by visiting our careers page: www.risk-strategies.com/careers.