Liability Claims Adjuster
CCMSI
Liability Claims Adjuster III
Intercare Holdings Insurance Services
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $150,000 - $185,000 per year
Job Level
SeniorLead
About the role
- Maintain a culture of positivity, respect, supportiveness, collaboration, patience, accountability, and excellence.
- Assist with team building ideas and events.
- Lead by example and through service.
- Develop and maintain strong and collaborative client relationships.
- Establish prompt contact on all new losses within 24 hours of receipt of the claim, including the insured, claimant, or claimant representative to document relevant facts and obtain information for liability and damage analysis.
- Thoroughly and accurately evaluate coverage on a timely basis, document coverage analysis, identify coverage issues, and draft appropriate coverage letters.
- Thoroughly and accurately investigate all claims, document ongoing case facts, perform and document ongoing evaluations, and note progress toward claim resolution.
- Litigation Management: Direct, manage, and control the litigation process for nationwide programs.
- Maintain all assigned claims on an active 30–45 day diary and keep an up-to-date plan of action.
- Obtain consultant and/or expert reviews for early evaluation.
- Aggressively pursue contribution on multi-defendant cases or those involving employment/independent contractor agreements with shared liability.
- Ensure all claims are handled in accordance with applicable statutes, service contracts, and company guidelines.
- Establish, monitor, and adjust reserves according to authority levels and client instructions.
- Exhibit a courteous and helpful attitude and project a professional image for the company and clients.
- Respond to phone messages within 24 hours and to written inquiries within one week.
- Travel for mediations, trials, client meetings, and/or industry conferences.
- Maintain working knowledge of medical terminology and jurisdictional issues.
- Handle other duties as assigned by Supervisor or Manager.
Requirements
- JD and/or RN preferred.
- Bachelor's degree from four-year college or university; at least seven years related experience and/or training; or equivalent combination of education and experience.
- Requires a high degree of claims handling expertise to include a minimum of at least five years experience managing medical professional liability cases, many with complex litigation or high potential value.
- Ability to read, analyze, and interpret insurance policies, statutes, legal opinions, general business periodicals, professional journals, technical procedures, and governmental regulations.
- Ability to write complex coverage letters, reports, business correspondence, procedure manuals, and correspondence to clients, colleagues and industry peers.
- Ability to effectively present information, both verbally and written, and respond to questions from groups of managers, clients, customers, and the general public.
- Fluent spoken and written English is required.
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
- This position requires strong problem solving and analytical skills. It requires the ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. It requires the ability to deal with problems involving several concrete variables in standardized situations.
- To perform this job successfully, an individual must be proficient with Word, Excel, Outlook, PowerPoint, RMIS software, RingCentral, Zoom, TEAMS, WebEx, GoToMeeting and other tele-video conferencing software and apps.
- JS and or RN licensure preferred. Appropriate jurisdictional adjuster license required.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims handling expertisemedical professional liabilitylitigation managementcoverage analysisinsurance policy interpretationproblem solvinganalytical skillsdata interpretationreport writingclient correspondence
Soft skills
collaborationcommunicationleadershippatienceaccountabilitypositivitysupportivenessprofessionalismteam buildingcourteous attitude
Certifications
JDRNjurisdictional adjuster license
