Claims Adjuster Level 2 - (Maternity Contract)

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Claims
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51485 Requisition #
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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.