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Property & Casualty Claims Adjuster III (Public Entity)

Company: York Risk Services Group
Location: Oxnard
Posted on: March 13, 2019

Job Description:

Employer is a premier provider of insurance, risk management, alternative risk, pool administration and claims management solutions to clients across hundreds of industries. Recently named by Forbes as one of "America's Best Midsized Companies Two Years in a Row" We firmly believe that our employees drive the success of the company. With success in mind as the ultimate goal, we strive to create and provide an environment that offers challenging, stimulating and financially rewarding opportunities.Job DescriptionJOB SUMMARY:The role of the Senior Casualty Claims Adjuster is to investigate, evaluate and adjust Commercial General and Automobile Liability claims. Assigned claims typically consists of medium to complex non-litigated and litigated general liability and third party automobile bodily injury and property damage claims, and may include claims involving more specialized lines of business such as employment practices liability, construction defect, and errors, and omissions. Must also be able to handle more complex, litigated claims.ESSENTIAL JOB RESPONSIBILITIES:Evaluate insurance coverage based on claim report, the insurance policy, applicable statutes and case law to determine if a claim can be accepted as within coverage.Comply with all statutory and regulatory requirements in all applicable jurisdictions.Obtain and review medical records.Interview, telephone, and/or correspond with claimant and witnesses; obtains and reviews police hospital records, appraisals and repair estimates to evaluate injuries property damage; Reports to client as required by contractual account instructions; varying method of investigation according to type of coverageIdentify key issues and investigation required.Meet detailed quality assurance standards of performanceObtain and maintain all required licenses and certifications and meet all continuous training and certification requirements. Determine extent of the clients financial exposure with respect to claims; set case reserves for use by clients and regulatory authoritiesRevise case reserves based on developments in the course of adjusting the claimSettle claims within assigned levels of authority as set forth in complex, detailed client account instructionsHandle complex litigated claims with limited input from the Unit Manager and/or AVPEffectuate prompt payment (with clients funds) to claimants and service providersSelect and manage defense and coverage counselSelect and manage expertsWork with and provide claim-specific guidance to Field AdjustersBe alert to insurance fraud and implement special procedures if fraud is suspected. Involve client in decision-making as appropriate and/or follow client-specific requirements for escalation when client decision-making and/or notification is required. Interact successfully with co-workersStrong proficiency in keyboarding and data entry skills; most time spent in front of a computer entering text with applications.Must be able to type accurately, enter information into a computerized systemOther duties as assignedQUALIFICATIONS:EDUCATION:Bachelors degree in related field from four-year college or university preferredEXPERIENCE:Extensive knowledge of investigation management including, but not limited to, taking and using recorded statements, determining coverage and application of coverage to claims, delivering case value and negotiation and resolution of claims.Minimum of 5 + years of industry experience in Property and Casualty ClaimsSKILLS/ABILITIESExcellent negotiation skillsEngage and manage coverage counsel and defense counselReview and analyze medical recordsReview and analyze experts reportsExcellent oral and written communication and presentation skillsAnalytical and interpretive skillsStrong organizational skillsSolid interpersonal skillsStrong customer service skillsAble to multitaskCapable of setting prioritiesWorks well under pressureSpanish fluency is a plusKNOWLEDGE:In-depth knowledge of multi-jurisdictional claims handling issuesPC literate, including Microsoft Office productsCalifornia TORT CodePublic Entity experience a plus15-20% field work5+ years of casualty experienceAdjusters license not requiredlitigation experience

Keywords: York Risk Services Group, Oxnard , Property & Casualty Claims Adjuster III (Public Entity), Other , Oxnard, California

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