A Claims Adjuster or Specialist investigates and evaluates insurance claims. Specializes in a particular type of insurance. Inspects property damage, including damage to homes, buildings and cars; reviews claims after they are submitted; may authorize or deny payment for claims. May work directly for insurers or on behalf of claimants.
Our personal injury law firm is seeking an experienced Personal Injury Claims Adjuster / Settlement Specialist to assist with the evaluation, negotiation, and resolution of personal injury claims. The ideal candidate has substantial experience handling bodily injury claims , preferably as an insurance adjuster, senior claims representative, claims examiner, litigation adjuster, or casualty claims specialist. This position is particularly well suited for a former insurance adjuster who understands how insurance companies evaluate claims, establish reserves, analyze liability and damages, negotiate settlements, and document claim files. The successful candidate will work closely with the firm's attorneys, paralegals, medical coordinators, and settlement team to evaluate cases, identify coverage and liability issues, prepare claims for settlement, communicate with insurance carriers, and maximize recoveries for injured clients. This is a plaintiff-side position. The candidate must be comfortable transitioning from evaluating claims on behalf of an insurance company to advocating for injured individuals. PRIMARY RESPONSIBILITIESClaims Evaluation and Strategy Review personal injury files and evaluate liability, causation, damages, insurance coverage, and settlement value. Analyze police reports, photographs, videos, witness statements, medical records, medical bills, wage-loss documentation, and other evidence. Identify strengths, weaknesses, and potential issues affecting settlement value. Assist attorneys in developing negotiation and settlement strategies. Evaluate claims from the perspective of an experienced insurance adjuster and identify arguments or issues likely to be raised by the carrier. Identify additional information or documentation needed to strengthen claims before demand or negotiation. Assist with evaluation of automobile, commercial vehicle, trucking, premises liability, and other serious-injury claims. Insurance Coverage Review declarations pages, insurance policies, coverage correspondence, reservation-of-rights letters, and coverage disclosures. Identify applicable liability limits, UM/UIM coverage, PIP, MedPay, excess coverage, umbrella policies, and potential additional insurance. Communicate with insurance carriers regarding coverage and claim status. Assist with obtaining written confirmation of policy limits and other available coverage. Identify potential coverage issues requiring attorney review. Demand and Settlement Preparation Review medical treatment and damages before preparation of settlement demands. Assist in determining appropriate demand and settlement values. Review demand packages for completeness and persuasive presentation. Confirm that significant medical records, bills, diagnostic studies, surgical recommendations, wage-loss documentation, photographs, and supporting evidence are included. Assist attorneys with responses to low settlement offers and unreasonable claim evaluations. Prepare detailed claim evaluations and settlement recommendations. Settlement Negotiations Communicate professionally and effectively with insurance adjusters and claims representatives. Conduct settlement negotiations under attorney supervision and within authority provided by the attorney and client. Analyze offers and provide recommendations regarding negotiation strategy. Maintain detailed documentation of all offers, counteroffers, demands, deadlines, and carrier communications. Recognize common insurance-company negotiation strategies and assist attorneys in responding effectively. Escalate claims when an adjuster's evaluation fails to adequately account for liability, objective injuries, medical treatment, future damages, or other material evidence. Medical and Damages Review Review medical records and bills to understand the client's injuries and course of treatment. Identify gaps in treatment, prior similar conditions, causation issues, or missing medical documentation requiring attention. Track surgeries, injections, diagnostic imaging, specialist recommendations, future medical treatment, and permanent impairment. Review lost wages, loss of earning capacity, household services, and other economic damages. Work with attorneys and staff to ensure claims are not prematurely presented before damages are sufficiently developed. Case Management Maintain organized and accurate claim notes. Monitor insurance-company response deadlines. Follow up aggressively and professionally regarding outstanding evaluations and settlement offers. Participate in regular case-review meetings with attorneys and staff. Identify cases appropriate for early settlement or mediation. Identify claims that should move promptly into litigation when reasonable settlement efforts have been exhausted. Assist with preparing settlement and mediation summaries when requested.
PREFERRED EXPERIENCE
The strongest candidates will have 5+ years of bodily injury or casualty claims experience , particularly experience involving: Automobile bodily injury claims; Commercial automobile or trucking claims; Serious bodily injury claims; High-value or policy-limits claims; UM/UIM claims; Premises liability claims; Litigation claims; Coverage investigations; Negotiation and settlement authority; Medical-record and medical-bill evaluation; and Attorney-represented bodily injury claims. Experience working for an insurance carrier, third-party administrator, or independent adjusting company is strongly preferred. Former Senior Bodily Injury Adjusters, Casualty Adjusters, Litigation Adjusters, Claims Examiners, Claims Supervisors, and Claims Managers are encouraged to apply.
QUALIFICATIONS
Strong knowledge of bodily injury claims handling and insurance practices. Excellent negotiation skills. Ability to analyze complex medical and liability information. Strong written and verbal communication skills. Ability to manage a significant caseload and competing deadlines. Highly organized and detail-oriented. Comfortable working in a fast-paced litigation environment. Strong judgment regarding claim valuation and negotiation strategy. Ability to work collaboratively with attorneys, paralegals, medical coordinators, and other staff. Professional demeanor when dealing with insurance companies, opposing counsel, clients, and medical providers. Bilingual English/Spanish is strongly preferred but not required.
IDEAL CANDIDATE
We are particularly interested in an experienced insurance professional who understands how insurance companies actually evaluate and negotiate personal injury claims .
The ideal candidate understands:
How adjusters evaluate liability and comparative fault; How bodily injury reserves and settlement authority work; How carriers evaluate medical treatment and causation; How claims are documented internally; What causes a claim to receive additional settlement authority; How supervisors and claims committees evaluate significant exposures; How litigation affects claim valuation; How policy-limits demands and serious-injury claims are evaluated; and How to distinguish a properly developed claim from one that requires additional evidence before meaningful negotiations. The position requires someone who can use that insurance-side experience to help our attorneys and clients obtain fair and appropriate compensation.
WHAT WE ARE LOOKING FOR
We are looking for someone who is experienced, analytical, organized, persistent, and comfortable negotiating significant personal injury claims . This is not an entry-level claims position. We are seeking someone who can review a file, understand the liability and medical evidence, identify what is missing, anticipate the insurance company's arguments, and help develop a strategy for resolving the claim. The right candidate will play an important role in moving cases efficiently from treatment and demand through negotiation, mediation, and settlement while ensuring that serious claims receive the attention and valuation they deserve. I can also turn this into a shorter, more aggressive Indeed/LinkedIn job posting designed specifically to attract former State Farm, Allstate, Progressive, GEICO, Farmers, Fred Loya, USAA, and commercial/trucking bodily-injury adjusters.
Pay:
$55,000.00 - $75,000.00 per year
Benefits:
401(k) Dental insurance Health insurance Paid time off Vision insurance
