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Casualty Attorney Rep Adjuster

Casualty Attorney Rep Adjuster

Location 
US-TX-Richardson
Job ID 
34234

More information about this job

Responsibilities

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.

    Qualifications:
  • 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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