Senior Injury Adjuster

Key Responsibilities

• Adjust attorney-involved soft tissue and moderately complex injury claims (e.g., torn meniscus, broken bones, disc herniations) and related auto physical damage.
• Identify and confirm coverage decisions on soft tissue and moderately complex bodily injury claims.
• Investigate loss details, determine liability, evaluate, negotiate, and adjudicate claims timely with clear documentation within authority guidelines.
• Manage claims workload, keep members and parties informed, provide timely updates.
• Collaborate with team members to resolve issues and escalate when appropriate.
• Coordinate with vendors and internal partners to facilitate claim resolution.
• Deliver excellent member service with appropriate expectations and communication.
• Support workload surges and catastrophe (CAT) response including on-call duties, possible evenings, weekends, holidays.
• May travel for CAT deployments with minimal notice.
• Handle claims of higher complexity and additional duties as needed.
• Ensure effective risk management per policies and procedures.

Must Have Qualifications

• High School Diploma or GED.
• 2 years auto claims adjusting experience.
• 1 year injury adjusting experience with attorney-represented claims.
• Proficient knowledge of auto claims contract, investigation, evaluation, negotiation, adjudication, case law, and state regulations.
• Strong negotiation, investigation, communication, and conflict resolution skills.
• Time management and decision-making skills.
• Investigatory, prioritizing, multi-tasking, and problem-solving skills.
• Knowledge of human anatomy and medical terminology related to injury claims.
• Ability to exercise sound financial judgment.
• Proficient in coverage evaluation, loss assessment, and reserving.
• Obtain and maintain insurance adjuster license within 90 days and 3 attempts.

Nice to Have Qualifications

• 4+ years auto liability/casualty adjusting experience.
• 1+ year claims experience.
• Ongoing professional development in insurance.
• Bachelor's degree or higher.