Multi-line Claims Adjuster

Nebraska Risk Management Association

POSITION TITLE

: Property/Liability Claims Adjuster

DEPARTMENT

:

Claims_______________________

REPORTS TO

:

Property / Liability Claims Manager

PURPOSE OF POSITION

Responsible for adjusting all losses and claims, except workers' compensation. Essential Functions ▪ Exercises discretion and independent judgment in making claim recommendations, recommendations in litigation, and in settling claims up to established limit ▪ Although the Company Claims Manual is used for reference, the Manual is only a guide and experience and good common sense judgment is necessary when managing claims and carrying out job duties ▪

Handling of Losses and Claims:

Handles all losses assigned according to the Claims Manual ▪

Investigations:

Conduct investigation and analyze findings to determine coverage, liability, and damages, develop claim strategy, and negotiate and make recommendations regarding adjustment or litigation of claim; obtains recorded statements of claimants and/or witnesses as necessary. Obtains diagrams and photographs of accident scenes, vehicles and other damage where appropriate; prepares status reports, diary entries and subsequent reviews according to the Claims Manual ▪

Reserves:

Reviews documentation submitted and conducts interviews and/or investigations as necessary to determine the appropriate reserve(s) to be set for each claimant; obtains necessary approval from appropriate parties prior to inputting reserves in excess of designated authority level. ▪

Settlement and Check Authority:

Approves settlement of claims and inputting and issuance of checks up to designated authority levels, seeking approval of those necessary if in excess of that authority level. ▪

Reporting:

Responsible for the record keeping of assigned claim files and claim reports per the Claims Manual ▪

Litigation:

Upon receiving input of the Executive Director and Claims Manager, assigns legal counsel and monitors the defense provided by such legal counsel, effectively makes recommendations with respect to litigation and with respect to the engagement of outside investigators and other professionals ▪ Responsible for attending settlement/mediation conferences and trials as required ▪ Report claims to excess/reinsurance carriers per established requirements ▪

Salvage and Subrogation:

Identifies and initiates pursuit of subrogation; obtains subrogation recoveries from tort feasors when appropriate▪ Updates within

NRMA:

Keeps the Claims Manager, Risk Manager and Executive Director informed about changes and updates on all losses and claims ▪

Meetings and Conferences:

Attends meetings or conferences as requested by the Claims Manager, Risk Manager and/or Executive Director ▪

Handling of Losses and Claims:

Handles all losses assigned according to the Claims Manual. ▪

Investigations:

Obtains recorded statements of claimants and/or witnesses as necessary. Obtains diagrams and photographs of accident scenes, vehicles and other damage where appropriate depending on claim type assigned. Prepares status reports, diary entry updates and subsequent reviews in line with the Claims Manual. ▪

Reserves:

Reviews documentation submitted and conducts interviews and/or investigations as necessary to determine the appropriate reserve(s) to be set for each claim and/or claimant. Obtains necessary approval at appropriate levels prior to input of reserves in excess of designated authority level. ▪

Settlement and Check Authority:

Approves the settlement of claims and inputs and sees that checks are issued up to designated level of authority. Seeks approval on all checks in authority of individual authority level. ▪

Reporting:

Responsible for see that all notes, diaries, tasks and reports are kept current in Origami and that all are in line with the requirements set forth in the Claims Manual. ▪

Litigation:

Submits request for approval to assign counsel for defense when lawsuits on claims being handled are received. Upon approval from the Claims Manager and Executive Director assigns approved legal counsel to the claim. Monitors the defense by legal counsel to be sure that reporting parameters are met and that legal invoices are in line with Legal Defense Budget. Assigns outside investigators or experts with approval of Executive Director. ▪ Responsible for attending mediation or settlement conferences and trials as required. ▪ Reports on claims to excess/reinsurance carriers per the established requirements for those carriers per the carrier instructions or per the Claims Manual. ▪ Reviews the files handled by the claims adjuster(s) for adequacy of reserves; approves reserves to levels of authority and with those beyond authority level gives input for review and approval by Underwriting and Risk Manager or Executive Director as needed. ▪

Salvage and Subrogation:

Identifies and initiates pursuit of subrogation where appropriate. Works to secure the best return possible for all salvage recovery potential. ▪ Updates within

NRMA:

Keeps the Claims Manager, Risk Manager and Executive Director informed as needed on all changes and updates on claims and losses.

Other Job Functions:

▪ Perform other duties as periodically assigned. Essential Knowledge, Experience and Abilities ▪ Must have intermediate level computer skills; knowledge of and ability to use Microsoft operating systems and related programs is required ▪ Ability to read, write and speak English is required; ability to communicate in other foreign languages may be helpful ▪ Must be organized, detail oriented, able to work under multiple deadlines and be flexible; must be able to work with and communicate with other people ▪Minimum 3 years of successful claims adjudication experience▪ Maintain a current knowledge of legislation, court cases and general developments related to liability, insurance and related areas ▪Demonstrated ability to conduct and account for financial transactions▪ Demonstrated ability to compile and analyze statistical data ▪Demonstrated effective use of automated claims system ▪Demonstrated ability to communicate in a professional manner both orally and in writing ▪Demonstrated organizational skills and commitment to follow through on tasks ▪Demonstrated ability to work effectively with people ▪Demonstrated knowledge of property and liability laws and regulations ▪Demonstrated knowledge of medical and legal terminology ▪Demonstrated knowledge and skills to provide assistance to other members of the claims staff ▪ Successful experience in adjusting claims in a self-insured environment Essential Education, Certification and/or Licenses ▪ College degree in business, insurance or related field; sufficient expertise and claims experience may be substituted for a degree; a minimum of three years of claims experience; Associate in Claims (AIC) designation or other similar designation is desirable ▪ Must have a valid Nebraska operator's license and be insurable under NRMA's liability coverages Essential Physical Demands and Typical Working Conditions ▪ Work is generally performed indoors in an office setting and requires a considerable amount of sitting, standing or walking. Work may include climbing ladders, work on roof areas and also in confined spaces. ▪ Work duties require periodically lifting or carrying up to 50 pounds for a minimal distance ▪ Work may be stressful when dealing with irate clients/claimants and/or meeting deadlines Essential Attendance and Availability Requirements ▪ Must maintain an acceptable level of attendance, punctuality, and availability as determined by NRMA; must work such regularly scheduled hours as are determined by NRMA; must work any required overtime, weekends and holidays when necessary. ▪ Must work at the assigned work site ▪ In state travel is required, including occasional overnight stays The specific statements show in each section of this description are not intended to be all inclusive. They represent typical elements and criteria considered necessary to perform the job successfully. NRMA recognizes that an individual with a disability may require an accommodation to enable him or her to successfully perform a job function. Consideration will be given to reasonable accommodations for such disability.

Job Type:

Full-time Pay:

From $60,000.00 per year

Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Flexible schedule Flexible spending account Health insurance Health savings account Life insurance Paid time off Parental leave Professional development assistance Relocation assistance Tuition reimbursement Vision insurance

Experience:

Claims Handling:

3 years (Preferred)

Work Location:

In person