Claims Adjuster II - Casualty

Job Title: Claims Adjuster II - Casualty

FLSA Status: Exempt

Job Family: Claims

Department: Casualty Claims

Location: Corporate Office (Fort Wayne, IN)

JOB SUMMARYResponsible for effectively analyzing and resolving assigned claims consistent with Claims Departmentstandards and company objectives.

POSITION ESSENTIAL FUNCTIONS AND RESPONSIBILITIES• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential• functions.

• Resolve all assigned claims (including the occasional serious/complex claim, which could includebut not be limited to unusual damage or coverage issues, or that need the involvement of expertanalysis or require early recognition of policyholder concerns) within established settlementauthority in a prompt, fair and equitable manner. Identify and investigate coverage, damage, andreserve adequacy on assigned claims.
• Apply statutes, common law, and other applicable legal and regulatory concepts for the effective,efficient and equitable resolution of assigned claims.
• Achieve established claim file audit objectives.
• Communicate with policyholders, agents, claimants, attorneys, medical providers and otherpersons as needed and direct independent adjusters, appraisers and other support serviceproviders to ensure effective, efficient, and equitable claims resolution.
• Acquire, record and maintain all essential file documentation in accordance with establishedguidelines.
• Provide timely status reports regarding assigned claims to claims department management andothers.
• Identify and pursue appropriate cost containment, loss mitigation and subrogation recoveryopportunities.
• Participate and provide input in departmental meetings or interdepartmental meetings, projects orprocesses that relate to the claims function.
• Travel as needed to attend training programs, conferences, mediation/other legal proceedings,and to conduct investigation relating to claims resolution.
• Further the attainment of overall department objectives by assisting other claims personnel asneeded.
• Participate as needed in the orientation or training of new department personnel.
• Complete other projects as assigned.

POSITION RESPONSIBILITES (supplement to the Position Description)

• Handle assigned auto claims involving 1^st and 3^rd party property damage, represented bodily injury, UM/UIM, and PIP.
• Investigate, evaluate, and resolve auto claims by reviewing coverage, liability, damages, and reserves and by obtaining and documenting relevant facts, statements, reports, estimates, photos, and other supporting information.
• Apply policy language and legal requirements in the handling and resolution of auto claims.
• Communicate with insureds, claimants, agents, attorneys, appraisers, repair facilities, and other service providers to support timely and effective claim resolution.
• Handle litigated auto claims by retaining and managing legal counsel as needed and coordinating claim activity through resolution.
• Identify opportunities for cost containment, loss mitigation, subrogation, SIU escalation, and other appropriate next steps in accordance with departmental guidelines.
• Maintain accurate claim file documentation, data entry, and communication in accordance with departmental, policy, legal, and regulatory requirements.

ADDITIONAL SKILLS (supplement to the Position Description)

• Ability to communicate effectively, orally and in writing, regarding coverage, liability, damages, and reserving on auto claims.
• Ability to apply working knowledge of applicable laws, regulations, and claim handling requirements.
• Ability to handle difficult or confrontational situations professionally and use sound judgment in claim resolution.
• Ability to identify subrogation opportunities, SIU referrals, and other issues requiring escalation.

KNOWLEDGE, SKILLS, AND ABILITIES• The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform• each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with• disabilities to perform the essential functions.

• Must be able to effectively communicate with others (both oral and written). Must demonstrate theability to present a reasoned position in both an oral and written format.
• Must be able to make independent decisions.
• Must have good interpersonal skills. Must have the ability to handle confrontational situations in aproductive manner. Must demonstrate the ability to employ sound negotiation techniques in theresolution of assigned claims.
• Must have good organizational skills.
• Must have a good understanding of basic issues related to claims. Must have a goodunderstanding of coverage issues.
• Must be able to access, input and retrieve information from a computer.
• Must have a good understanding of all automated claims department processing systems andworkflows.
• Should be able to sit for prolonged periods of time.
• Possess the ability to inspect losses by walking, lifting, climbing or bending.
• Effectively interface with external contacts, Brotherhood employees, managers, and departmentstaff members.

EDUCATION AND/OR EXPERIENCEList Degree Requirement, Years' Experience, and Certifications

• Bachelor’s degree or completed AIC or completed 3 parts of CPCU, is required.
• Must be able to take and pass mandatory adjuster licensing requirements.
• Must have 3 years or more of claim technical experience.
• AIC/CPCU or other insurance-related course work is desired.
• 5 years or more of Brotherhood Mutual claims technical experience is desired.

Terms and Conditions

This description is intended to describe the general content of and requirements for the performance of this position. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements.

Because the company’s niche is the church and related ministries market, and because effective service requires a thorough understanding of this market, persons in this position must be familiar with church operations and must conduct themselves in a manner that will neither alienate nor offend persons within this target niche.

Brotherhood Mutual Insurance Company reserves the right to modify, interpret, or apply this position description in any way the company desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. This position description is not an employment contract, implied or otherwise. Theemployment relationship remains “at-will”.