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Casualty Attorney Rep Adjuster

Casualty Attorney Rep Adjuster

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Adjuster handles first and third party bodily injury and assignment of property damage claims. Role focuses on claim resolution with attorney involvement and with authority of up to $12,500 handling claims in excess of this authority with manager supervision.

Job Responsibilities:

  • Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution.
  • Analyzes facts of loss, injury, and possible exposure potential for proper reserving.
  • Documents files to include all key activities, contacts made, statements taken, including outline covering all aspects of the claim and for resolution; Negotiates bodily injury claims with attorneys.
  • Determines liability exposures for moderate impact losses to include comparative negligence issues and utilization of outside investigators or experts to assist in the review or investigation of more complex claims
  • Completes material damage assignments and handles initial rental assignments
  • Reviews medical records and bills to validate accuracy of services provided.
  • Completes bodily injury evaluation summary including liability, damages, causation, diagnosis, treatment, reserves, and general damages; Evaluates soft tissue injuries will be primary focus.
  • Utilizes expert systems to assist in the review and evaluation of claims.
  • Identifies referrals, completes proper summaries and forwards files to subrogation for collection in a timely manner
  • Refers files for specialization such as SIU focus, minor damage focus and sends correspondences related to claim and department of insurance regulations.
  • Determines with manager assistance on investigative activities such as surveillance, or neighborhood canvasses.
  • Reviews demand packages and complete evaluations in accordance with the best practices.

  • Detail-oriented with strong organizational, negotiation, influential, and customer service skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently.
  • Demonstrated ability to work effectively independently and within a collaborative team oriented environment using sound judgment in decision-making.
  • Demonstrated ability to manage relationships with both internal and external customers.
  • Excellent communication skills both oral and written with strong presentation skills.
  • Strong analytical and problem solving skills.
  • Demonstrated knowledge with MS Office products (Outlook, Word, Excel, PowerPoint) and claims related software applications.
  • Demonstrated knowledge of medical treatments and understanding of the relationship between vehicle impact and claimed injuries.
  • Demonstrated knowledge with handling minor to moderate claims involving issues of coverage.
  • Demonstrated knowledge in receiving and negotiating liens with healthcare providers and worker?s compensation carriers for first and third party injury claims.

    Experience / Education:
  • Bachelor?s degree in Business Administration, a related field, and/or equivalent education required.
  • Three to five years of claims adjuster attorney experience.

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