Job Description

The claims adjuster handles a caseload of approximately 100 pending claims that encompass less complexity. The position requires establishing facts of loss, coverage analysis, investigation, /liability/negligence determination, damage assessment, settlement negotiations, identifying potential fraud and appropriate use of authorized vendors. The adjuster trainee must also complete timely and appropriate reserve analysis. All file handling must be within state statutes, Client Claims Handling Guidelines and NARS Best Practices.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

COVERAGE:

• Identify, analyze, and confirm coverage.

CUSTOMER SERVICE/CONTACT

• Contact appropriate parties and providers to determine liability, compensability, negligence, and subrogation potential.
• Contact appropriate parties to obtain any needed information and explain benefits as appropriate. Continue contact throughout the life of the file as appropriate.
• Answer phones check voice mail regularly and return calls with 8 business hours.
• Assist management when required with projects as requested.

SUBROGATION:

• Timely refer all files identified with subrogation potential to the subrogation department.

INVESTIGATION:

• Verify facts of loss and pertinent claims facts such as employment, wages, or damages and establish disability with treating physicians as appropriate.
• Identify cases for settlement. Evaluate claims and request authority and negotiate settlement.
• Recognize and report potential fraud cases.

RESERVES:

• Establish ultimate reserves (anticipated cost to bring file to close based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.
• Verify all provider bills have been appropriately reviewed and paid within standard timeframes.

REPORTING REQUIREMENTS:

• Must pass all internal and external audits, which include those performed by regulatory agencies, carriers, and clients.
• Follow reporting requests as outlined by client files and NARS guidelines.

RESOLUTION:

• Document plan of action in the claim system and set appropriate diaries.
• Maintain a regular diary and follow up as required
• Close all files as appropriate in a timely and complete manner.
• Maintain 1:1 closing ratio.
• Other jobs duties as assigned.

QUALIFICATION REQUIREMENTS:

EDUCATION / LICENSING:

• High School Diploma, 2-year college degree preferred.
• Must possess a Florida Adjuster’s license or other required jurisdictional licensing. (Or be willing, as a condition of employment, to obtain one within 30 days of start date).
• Complete 5 training classes with 80% score (Commercial Auto, Personal Auto, Commercial GL, Residential Property/ Homeowners; Residential Renters)
• Hold or obtain a New York 17-70 adjuster’s license

TECHNICAL SKILLS:

• Advance level of interpersonal skills to handle sensitive and confidential situations and information.
• Requires advanced ability to negotiate claims.
• Requires advanced ability to work independently.
• Requires an advanced level of organization and time management skills.
• Must possess advanced level written and verbal communication skills.
• Must be able to explain and appropriately respond to auditors, clients, and potential clients during in-person presentations.
• Must be able to pass all training courses within 12 months with a score of 80% or above.

ABILITIES:

• Must be able and agree to work overtime as needed, especially during a catastrophe.
• Requires long periods of sitting.
• Requires working indoors in environmentally controlled conditions.
• Requires lifting of files and boxes up to approximately 20 pounds.
• Repeated use of a keyboard, mouse, and exposure to computer screens.

In the spirit of pay transparency we are excited to share the base salary for the position exclusive of fringe benefits or potential bonuses. This position is also eligible for an annual performance raise if all guidelines are met. Your salary compensation will be determined based on factors such as geographic location, skills, education and or experience. In addition to those factors, we believe in the importance of pay equality and consider the internal equality of our current team members as a final part of any offer. Please keep in mind that the range mentioned above is full base salary range for the role. Hiring at maximum of the range would not be typical to allow future and continued salary growth. We also offer a generous compensation and benefits package.

Company Description

North American Risk Services (NARS) is a premier third-party claims administrator that is dedicated to producing the best possible results for our clients. "Founded in 1996, NARS handles claims for insurers, brokerages, managing general agencies, reinsurers, liquidation bureaus, self-insured funds and entities." For more career opportunities and to learn more about NARS, please visit www.narisk.com.