Job Title: Sr Claims Adjuster - Casualty
FLSA Status: Exempt
Job Family: Claims
Department: Casualty Claims
Location: Corporate Office (Fort Wayne, IN)
JOB SUMMARY
Responsible for effectively analyzing and resolving assigned serious/complex claims consistent with
claims department standards 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 primarily serious/complex, (including but not limited to claims involving unusual damage
or coverage issues or need to involve expert analysis or that require early recognition of
policyholder concerns), claims within established settlement authority in a prompt, fair and
equitable manner. Identify and investigate coverage, damage, and reserve 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. - Achieves established claim file audit objectives.
- Communicate with policyholders, agents, claimants, attorneys, medical providers and other
persons as needed and direct independent adjusters, appraisers and other support service
providers to ensure effective, efficient, and equitable claims resolution. - Acquire, record and maintain all essential file documentation in accordance with established
guidelines. - Provide timely status reports regarding assigned claims to department management and others.
- Identify and pursue appropriate cost containment, loss mitigation and subrogation recovery
opportunities. - Participate and provide input in departmental meetings or interdepartmental meetings, projects or
processes that relate to the claims function. - Travel as needed to attend training programs, conferences, mediations/other legal proceedings,
and to conduct investigation relating to claims resolution. - Further the attainment of overall department objectives by assisting other claims personnel as
needed. - Participate as needed in the orientation or training of new department personnel.
- Assist in the setting of initial reserves as needed.
- Complete other projects as assigned.
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 be able to
communicate complex coverage and legal concepts in both an oral and written format. - Must be able to make independent decisions.
- Must have strong organizational and interpersonal skills.
- Must have the ability to handle confrontational situations in a productive manner. Must possess
strong negotiation skills and utilize them in the resolution of serious/complex claims. - Must have a thorough understanding of all issues related to claims. Must have a thorough
understanding of coverage. - Must be able to access, input and retrieve information from a computer. Must have a thorough
understanding of all automated claims department processing systems and workflows. - Must be able to train others on claims department policies, procedures and systems.
- Should be able to sit for prolonged periods of time. Should have the ability to inspect losses by
walking, lifting, climbing or bending. - Effectively interface with external contacts, Brotherhood employees, managers, and department
staff members.
EDUCATION AND/OR EXPERIENCE
List Degree Requirement, Years' Experience, and Certifications
- Bachelor’s degree required.
- Must be able to take and pass mandatory adjuster licensing requirements.
- Must have five or more years of claim technical experience.
- CPCU designation strongly desired.
- Seven 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. The
employment relationship remains “at-will”.