Claims Adjuster Level 2 - (Maternity Contract)

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Claims
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51485 Requisition #
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Gallagher Bassett was established in Chicago in 1962 as a Third Party Administrator (TPA) providing claims and risk control services to self-insured clients and now has 125 branches and over 3,600 skilled professionals in the USA, UK, Australia and Canada. Gallagher Bassett UK was founded in 1991 and now has twelve offices across the UK with over 300 claims handling staff.

Gallagher Bassett UK provides claims management and risk management services to corporate, national and local government, insurer and broker clients.
 
We are constantly seeking skilled professionals who are up for a challenge and take exceptional performance to heart. We present opportunities that not only enable our company to remain an industry leader but also provide employees with limitless possibilities for success and personal growth.
 
Essential Duties & Responsibilities:

  • Review and record claims on Risxfacs within product standards, check policy coverage and allocate appropriate codes and reserves.
  • Make liability enquiries, in accordance with Adjuster’s Manual, using most appropriate method (phone, correspondence, field visit).
  • Evaluate quantum by gathering relevant evidence, adjusting reserves in accordance with GB realistic reserving philosophy.
  • Clearly explain decisions on liability, negotiating settlement within authority level where appropriate.
  • Respond to all written and phone enquiries clearly, courteously and promptly.
  • Review claims regularly using diary system to ensure accurate reserves and timely closure.
  • Develop relationships with clients by providing a friendly, efficient service.
  • Liaise with and control own solicitors to ensure cases not abandoned to them.
  • Assist in general office administration (eg post, printing, order supplies, maintaining equipment) to ensure smooth running of office.
  • Comply with all GB and office procedures.
  • Actively participate in GB training programme.

Additional Considerations:

 

Technical Expertise:
  • CII Certificate in Insurance.

Coverage Verification and Analysis

  • Ability to verify and analyse coverage of adjuster level claims with supervisor validation.

Investigation

  • Ability to investigate adjuster level claims, build rapport with involved parties and establish facts of the case sufficient to support claims strategy with close supervisor oversight.  

Liability/Compensability

  • Determining liability/compensability on adjuster level claims. 

Claim Strategy

  • Create and execute a proactive resolution strategy utilizing the facts gathered during the investigation of adjuster level claims.

Reserve Management/Carrier Reporting

  • Establishes ultimate probable reserve as information comes available, reviewing and pro-actively managing on diary as evidenced in Claim Notes, under moderate supervision. 
  • Ability to refer and ensure quality and timely carrier reporting.

Litigation Management

  • General understanding of the litigation process including shadowing litigated files of senior level adjusters.  
  • Managing minimal exposure litigated cases with close supervision.

Resolution

  • Recognise and proactively pursue resolution opportunities of adjuster level claims, including creative alternatives to typical resolutions, at the earliest point to deliver optimal outcome with close supervision.  

Recoveries

  • Recognise and proactively pursue recovery opportunities on adjuster level claims at earliest point. 
Communication Skills

Verbal & Written

  • Demonstrates the ability to communicate in a complete, concise and logical manner on adjuster level files with supervisor oversight.  

Presentation Skills

  • Demonstrates ability to prepare and present adjuster level claims while showing confidence and poise.  

Client Management

  • In conjunction with supervisor involvement, begin to build relationships with clients/carriers/brokers through active listening and close adherence to their priorities, style and Service Instructions. 


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