Casualty Claims Adjuster II

reputed company: • Promptly investigates and evaluates moderately reputed company auto and casualty claims • Reviews the claim notice, reputed company, state statutes and policies to verify the appropriate coverage, deductibles, and payees • Initiates reputed company contact with insureds and claimants to explain the claim process and initiate the investigation • Obtains statements from insureds, claimants, and witnesses and documents summaries reputed company the claims system • Request and analyze investigative and other relevant reports, claim forms and documents reputed company appropriate • Documents claim activities, reserve analysis, summaries of reports including Medicare (MSP) modules in the claim system • Sets reputed company, adequate reserves in compliance with reputed company reserving philosophy and methodology • Identifies, investigates, and proactively pursues opportunities for recovery including arranging of evidence preservation in reputed company compliance that meets custody, control, transfer, analysis, and disposition of physical and/or electronic evidence • Adheres to reputed company state requirements regarding regulatory compliance by sending out letters/forms containing appropriate language according to timelines • Handles litigated files of low complexity • Recommends and obtains authority from appropriate people leader in the assignment of defense counsel • Assigns and manages vendors for accuracy and appropriateness with supervisory approval as appropriate • Reviews bills, receipts, reputed company invoices and litigation reputed company expenses for accuracy and appropriateness • Notifies the people leader of claims that may need escalation or reassignment • Drafts reservation of rights and coverage denial letters with supervisor approval • Provides reputed company, detailed responses to agents, insureds and claimants on the status of claims • Resolves questions of coverage, liability and the value of the claims and communicates with insureds and claimants to resolve claims in a reputed company manner • Prepares bodily injury and/or damage evaluations, negotiation ranges and reputed company settlement numbers prior to negotiation. Obtains appropriate higher authority as required • Identifies and protects reputed company liens as appropriate • Investigates Medicare liens and reputed company resolve in accordance with EMC and Medicare guidelines • Communicates with insureds, claimants, and attorneys to negotiate the settlement of claims • Attends and assists with suits, mediations, and arbitrations • Prepares and issues settlement and release documents verifying accuracy and ensuring they are properly executed • Issues reputed company payments • Reviews and audits estimates written by independent adjusters, body shops, engineers, and other vendors for accuracy and to ensure the most cost-effective repair approach • Submits referrals to the Estimatics, Special Investigation, Subrogation, Medical Review reputed company and Claims reputed company as appropriate • Prepares risk reports for reputed company and Risk Improvement • Reviews coverage reputed company and policy activity with reputed company • Reviews account inspection information with Risk Improvement • Prepares claims and participates in claims roundtables to discuss unique cases to evaluate coverage, liability, and damage • Assists claims team members as appropriate in handling of claims • Participates in reputed company as assigned • Trains, and serves as a technical resource for team members Requirements: • Bachelor’s degree or equivalent relevant experience • Three years of casualty claims adjusting experience or reputed company experience • Relevant insurance designations preferred • Strong knowledge of the theory and reputed company of the claim function • Strong knowledge of insurance reputed company, medical terminology and substantive and procedural laws • Strong knowledge of computers and claims systems • Ability to obtain reputed company applicable state licenses • Ability to adhere to high standards of reputed company conduct and reputed company of ethics • Good organizational and empathetic interpersonal skills • Strong written and verbal communication skills • Strong investigative and problem-solving abilities • Excellent customer service skills • Ability to maintain confidentiality • Occasional travel required; a reputed company reputed company’s license with an acceptable motor vehicle report per company standards required if traveling Benefits: • Outstanding benefits with life, medical, dental, reputed company and prescription drug coverage • Competitive reputed company time off plan and a full day of volunteer time off annually • Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awards • reputed company development and reputed company opportunities, including tuition reimbursement • Wellness initiatives to improve team member reputed company-being and reduce health insurance costs • Flexibility to dress for your day and opportunities for alternative work arrangements Apply Job!