Full-Time Senior Claims Adjuster

Background:

As the result of increasing workloads, we are currently seeking candidates to expand our team as (Senior) Claims Adjuster to handle complex latent liability claims (asbestos, environmental, molestation, etc.). Past experience in managing these types of claims is essential. Our office locations are Philadelphia, PA and Quincy, MA. We support remote/flexible working. Compensation is competitive and will be commensurate with the candidate’s qualifications and experience.

Key Objectives: 

This will be a full time/permanent position to work on a portfolio of business which includes asbestos, environmental pollution, molestation and other product related liabilities. The role will specifically involve working on a large liquidation in support of the PA Insurance Department’s assigned liquidator. You will be responsible for reviewing and resolving technical and complex claims, frequently emanating from risks with high potential exposures. This includes determining case strategy, analyzing liabilities and setting appropriate reserves, negotiating settlements, dealing with counterparties effectively, ensuring payments are timely processed and providing management reporting on claims.

Role and Responsibilities:

• Provide claims review on complex/latent claims in compliance with defined claims procedures, client SLA and within agreed authority levels, including accurately capturing and updating claims data/information in compliance with best practices.
• Apply knowledge and judgement to determine liability by gathering and analyzing relevant facts; utilizing applicable law, determining existence of coverage and the applicability of such coverage to claims presented
• Work to reach a timely resolution to claims by developing case strategy, including developing a case evaluation and escalating issues as appropriate
• Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims.
• Negotiate settlement of claims by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits; knowing when to escalate due to severity and complexity.
• Deal effectively with litigation by liaising with internal and external legal counsel; establishing litigation plan and budget; coordinating defense activities; reviewing litigation expenses and authorizing payments.
• Gain familiarity with the requirements and procedures for managing a complex insurance liquidation and perform associated claim tasks in support of agreed objectives.
• Apply knowledge and judgement to determine appropriate reserve levels to set in respect of identified liabilities.
• Liaise with State Guarantee Association representatives to provide them with required information and seek from them reciprocal data to ensure accurate assessment of liabilities.
• Assist with review and evaluation of Proofs of Claim and issuance of Notices of Determination. Assist with queries and disputes arising from Notices of Determination, including support for any legal proceedings which may ensue.

Key technical skills, knowledge, professional qualifications required:

• Minimum of 5 years’ experience in a similar claims management role gained within the insurance industry.
• Appropriate state adjuster licensing may be required.
• Degree educated ideally with insurance or legal qualifications.
• Knowledge and experience gained managing long-tail latent liabilities.
• Accurate, reliable, with excellent attention to detail and an analytical approach.
• Production of high-quality written work product essential.

Key Personal Skills:

• Resilient and flexible, with the ability to adapt to work to short/changing deadlines.
• Effective and confident communicator and able to effectively and confidently manage multi-party relationship and complex claim negations
• Self-motivated and able to motivate others
• Maintains professional and technical knowledge through training, networks and professional qualifications.

Special Requirements:

Occasional travel within US for meetings when necessary.