Injury Adjuster-FPI

Injury Adjuster-FPI

Requirements

• High School Diploma or General Equivalency Diploma.
• 1 year of injury adjusting or auto liability adjusting experience to include highly complex vehicle physical damage, such as multi-vehicle, non-owned vehicles, or total loss claims.
• Working knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations.
• Demonstrated negotiation, investigation, communication, and conflict resolution skills.
• Proven investigatory, prioritizing, multi-tasking, and problem-solving skills.
• Exercise sound financial judgment and discretion in handling insurance claims.
• Knowledge of coverage evaluation, loss assessment, and loss reserving.
• Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.

Responsibilities

• Adjusts moderately complex and complex 1st party Personal Injury Protection (PIP) and Medical Payments (MP) claims.
• Identifies, confirms, and makes coverage decisions on soft tissue claims.
• Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes.
• Provides advice and sets expectations into next steps to members.
• Collaborates and supports team members to resolve issues and identify appropriate matters for escalation.
• Partners with and/or directs vendors and internal business partners to facilitate timely claims resolution.
• Delivers a best-in-class member service experience through setting appropriate expectations and proactive communication.
• Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
• May be assigned CAT deployment travel with minimal notice during designated CATs.
• Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
• Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.

Preferred Qualifications

• 2+ years Auto Liability/Casualty adjusting experience to include complex/multi vehicle liability.
• 3+ years PIP/MedPay coverage handling experience.
• Ongoing Professional Development with a focus on Insurance.
• Bachelors Degree or higher.