Claims Adjuster/Recovery Specialist

Company: Lowers Risk Group LLC
Location: San Diego
Posted on: February 1, 2025

Job Description:

Job Location is Remote within the US This role within the TPA team is critical to our client's success and provides Claims file management for desktop and field work. The successful candidate will have a proven track record of exceeding client requirements through timely client communication, outstanding organizational skills and successful claim file management and file closure. ESSENTIAL DUTIES AND RESPONSIBILITIES:-- Successfully contact the insured and claimant within 24 hours of receipt of file. -- All communication received whether by phone or email must be responded to within 24 hours from receipt.-- All claim files must be worked to completion each time the file is worked.-- As a member of the TPA team, this position will have limited authority without underwriting approval, and as necessary, files will be reported to underwriting for their consideration and review. This requires outstanding professional verbal and written communication skills for communication to underwriting for file approval as necessary.-- Determine type of claim line to be opened, establishes reserves and maintains reserves throughout. Able to evaluate all bodily injury claims to determine appropriate settlement. -- Secure recorded statements of all parties as needed.-- Handle liability determination and assessment of any comparative liability. -- Handle non-complex claim investigation as needed. -- Responsible for successfully handling a high inventory of claims.-- Investigate and resolve coverage questions.-- Coordinate via appraisal services for inspection and determines first and third-party damages. -- With approval, assign field investigation tasks to independent vendors and manages their file. -- Under supervision, evaluates, negotiates, and settles assigned claims within settlement authority. -- Maintain control of file and workflow through proper documentation and diary system.-- Under supervision, handle calls and correspondence on the claim file to conclusion. -- Manage subrogation and salvage recovery issues and follows recovery procedures. -- Communicate over the phone to ensure understanding of reports and documents. -- Utilize company processes to obtain claim file information.-- Inform adverse party of policy restrictions, special coverage instructions. -- Interpret statutes and case laws to build a strong case for coverage and liability.-- Contact customers, insureds, claimants, attorneys, or others to obtain or clarify information. -- Send all necessary releases, checks, correspondence, proof of loss to claim resolution.-- Stay current on DOI requirements pertaining to all claims handling. -- Provide prompt, friendly, courteous, accurate and helpful service including information about the claim handling process, claim number, name of adjuster and general questions about existing claims. -- Perform other various duties as assigned. EDUCATION/EXPERIENCE:Education: Minimum: High school diploma or equivalentPreferred: Bachelor's degree or equivalent in related fieldExperience: Minimum: 1+ years of related insurance adjuster or recovery specialist experiencePreferred: 3+ years of related insurance adjuster or recovery specialist experienceQUALIFICATIONS:The requirements listed below are representative of the knowledge, skills, and/or abilities required for this position: -- Excellent verbal, written and organizational skills-- Demonstrated experience in communicating professionally (both in writing and verbally) to underwriting for file approval as necessary.-- Proficient in MS Office suite, including Word and Excel.-- Detail-oriented.-- Self-motivated team player.-- Demonstrated experience and success in negotiating complex claims.-- Demonstrated ability to successfully manage high claims volume.-- Trustworthy - Ability to handle confidential information and able to work with minimal supervision.-- Reliability - Must be at work on time, and work the schedule assigned by their manager. -- Familiarity with claims-handling procedures.-- Ability to assess and negotiate liability and negotiate settlement with third-party adjusters. -- Maintains active licensure per individual state DOI requirements. PHYSICAL REQUIREMENTS: Talking. Expressing or exchanging ideas by means of the spoken word. Those activities in which individual must convey detailed or important spoken instructions to other team members accurately or quickly. Hearing. Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound. Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers. Close visual acuity for preparing and analyzing data and figures; viewing a computer terminal; extensive reading; visual inspection. EQUAL EMPLOYMENT OPPORTUNITY:Lowers Risk Group provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, pregnancy, gender identity, sexual orientation, status as a Vietnam-era, special disabled veteran or other veteran, or any other status or characteristic protected by applicable federal, state and/or local laws. AT WILL EMPLOYMENT:Lowers Risk Group is an At Will employer and nothing within the job posting or description should be construed as an offer or guarantee of employment.Lowers Risk Group reserves the right to modify, interpret or apply the job description in any way the company desires and the job description is not a contract for employment.Any offer of employment is conditional upon the successful completion of a background investigation and drug screen.Compensation details: 50000-62000 Yearly SalaryPIe753a1aaf884-25660-36626980

Keywords: Lowers Risk Group LLC, El Centro , Claims Adjuster/Recovery Specialist, Other , San Diego, California