Samazon Staffing

Claims Specialist

• Manage caseload of primarily litigated files of approximately 125 claims.
• Direct independent adjusters (when applicable) and defense counsel, as necessary
• Analyzes and processes complex or technically difficult commercial general liability claims by investigating and gathering information to determine the exposure on the claim
• Investigates, analyzes, determines potential liability, and effectively settles with adverse parties.
• Manages claims through well-developed action plans to an appropriate and timely resolution
• Assesses liability, gather investigative information and resolve claims within evaluation
• Negotiates settlement of claims up to designated authority level, request authority timely, as needed
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim
• Approve and makes timely claim payments and adjustments, and settles claims within designated authority level
• Assist litigation manager with the litigation process; ensures timely and cost-effective claims resolution
• Uses appropriate cost containment techniques
• Communicate claim activity with the appropriate parties (supervisor, broker, agent, client)
• Cultivate and maintain professional client relationships
• Participate in monthly claim round table and reserve committee
• Audit files to ensure field completion and data integrity
• Prepare Claim Analysis Reports for all claim reviews (internal/external)
• Complete Plan of Action, Status Updates, Reserve Properly,
• Request all pertinent documents and audit files for closure, field completion, document gathering, financials, etc.
• Request settlement authority and checks
• Identify tender and subrogation opportunities
• Attend mediations, if merited (rare travel, if any).
• Exercises sufficient and independent judgment to settle cases prior to mediation and/or litigation.
• Obtains all necessary documentation from the appropriate parties within established timelines.
• Remains abreast of new case law and statutes.
• Maintains confidentiality of information processed.
• Ensure the maintenance of the data integrity of our RMIS
• Mentors team members.
• Completes other duties and special projects as requested.

Senior Claims Adjuster – Premises