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Field Adjuster (Tri-County – Miami, Broward & Palm Beach). in West Palm Beach, FL at Heritage Insurance

Date Posted: 2/17/2018

Job Snapshot

Job Description

This position will be based out of the employees home, and visit the assignments given to them.

Qualified Candidate Analyzes and reviews claims for accuracy, completeness and eligibility.  Resolves claims by investigating losses, calculating and negotiating settlements.  Prepares and maintains reports and records for processing. 

Investigates, evaluates, reserves, negotiates and settles assigned claims in accordance with Best Practices. Provides quality claim handling and superior customer service on assigned claims, while engaging in indemnity and expense management. Promptly manages claims by completing essential functions including contacts, investigation, damages development, evaluation, reserving, and disposition. 

Responsibilities:

  • Follow and maintain claims management guidelines to determine insurance coverage by examining claims forms, policies, and other records as appropriate.
  • Perform detailed investigations by coordinating field audits, and performing in-depth interviews both telephone and in person to research claims.  Resolves claims by comparing claim information with evidence obtained to determine eligibility.
  • Settles claim by determining insurance carrier’s liability and negotiating agreement with appropriate parties according to company policy provisions
  • Collects, updates and maintains all claim documentation including statements, pictures, reports, estimates, etc. and verifies the accuracy and completeness of claim forms.
  • Reports on pending claims and findings to the Claims Manager
  • Provide updates on customer problems and safety or policy violations. Responds to inquiries and requests for information from customers and staff.
  • Identifies exposures to the company and facilitates senior-level management’s knowledge of pending claims and litigation that may have an adverse impact on the corporate goals.
  • Acts as the liaison to attorneys, insurance companies and individuals investigating any incidents that may result in asset loss.
  • Travels within an assigned region in the course of processing claims. 
  • Maintains the integrity of the company and products offered by complying with federal and state regulations as well as company policies and procedures.
  • Investigates each claim through prompt contact with appropriate parties such as policyholders, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential.  Records necessary statements.
  • Identifies resources for specific activities required to properly investigate claims such as Subro, Fire or Fraud investigators and to other experts. Requests through Unit Manager and coordinates the results of their efforts and findings.
  • Negotiate disposition of claims with insured’s and claimants or their legal representatives.  Recognizes and implements alternate means of resolution.
  • Maintains and document claim file activities in accordance with established procedures.
  • Attends depositions and mediations and all other legal proceedings, as needed.
  • Protects organization's value by keeping information confidential.
  • Maintains compliance with Claim Department's Best Practices.
  • Provides quality customer service and ensures file quality
  • Supports workload surges and/or Catastrophe operations as needed to include working significant overtime during designated CATs.
  • Communicates with co-workers, management, clients, vendors, and others in a courteous and professional manner. 

Job Requirements

 

  • A High School Diploma or equivalent is required; Associate’s Degree preferred. A combination of education and significant directly related experience may be considered in lieu of degree.
  • 620 Licensure required.
  • Three to five years of experience processing claims; in the property and casualty segment preferred.
  • Demonstrated ability to research, conduct proactive investigations and negotiate successful resolutions.
  • Proficiency with Microsoft Office products required; claims software and internet research tools preferred.
  • Experience with Xactware products preferred.
  • Demonstrate customer service focus / superior customer service skills.
  • Ability to work in a fast paced environment; ability to multitask.
  • Collaborative partner; ability to contribute to a positive work environment.
  • Excellent communication skills and ability to interact on a professional level with internal and external personnel
  • Results driven with strong problem solving and analytical skills.
  • Ability to work independently in a fast paced environment; meets deadlines, and manages changing priorities effectively.
  • Detail-oriented and exceptionally organized
  • Collaborative partner; ability to contribute to a positive work environment.

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