Full-Time

Casualty Claims Adjuster I

Posted on 11/15/2024

EMC Insurance

EMC Insurance

1,001-5,000 employees

Financial Services

Compensation Overview

$58.6k - $75.3kAnnually

Entry, Junior

Remote in USA

Eligible to work from home anywhere in the United States.

Category
Insurance
Finance & Banking
Requirements
  • Bachelor’s degree or equivalent relevant experience
  • One year of casualty claims adjusting experience or related experience
  • Relevant insurance designations preferred
  • Ability to obtain all applicable state licenses
Responsibilities
  • Exercises independent judgment in the investigation, negotiation, and disposition of auto and casualty claims of moderate complexity within limitations of authority outlined in the Claims Guide.
  • Communicates effectively with insureds, claimants, vendors, and agents, regarding coverage, claims status and other claims questions.
  • Negotiates, settles, and/or resolves claims.
  • Reviews the claim notice, contracts, state statutes and policies to verify the appropriate coverage, deductibles, and payees.
  • Initiates timely contact with insureds and claimants to explain the claim process and initiate the investigation.
  • Obtains statements from insureds, claimants, and witnesses and documents summaries within the claims system.
  • Request and analyze investigative and other relevant reports, claim forms and documents when appropriate.
  • Identifies, investigates, and proactively pursues opportunities for recovery including arranging of evidence preservation in legal compliance that meets custody, control, transfer, analysis, and disposition of physical and/or electronic evidence.
  • Adheres to all state requirements regarding regulatory compliance by sending out letters/forms containing appropriate language according to timelines.
  • Drafts reservation of rights and coverage denial letters with supervisor approval.
  • Assigns vehicle/property damage appraisals and vehicle rentals.
  • Makes recommendations to people leader on the assignment of independent adjusters.
  • Provides prompt, detailed responses to agents, insureds, and claimants on the status of claims.
  • Resolves questions of coverage, liability and the value of the claims and communicates with insureds and claimants to resolve claims in a timely manner.
  • Prepares bodily injury and/or damage evaluations, negotiation ranges and target settlement numbers prior to negotiation. Obtains authority when required.
  • Identifies and protects all liens as appropriate.
  • Investigates Medicare liens and resolves issues in accordance with EMC and Medicare guidelines.
  • Prepares and issues settlement and release documents verifying accuracy and ensuring they are properly executed.
  • Reviews and audits estimates written by independent adjusters for accuracy and to ensure the most cost-effective repair approach.
  • Submits referrals to the Estimatics, Special Investigation, Subrogation, Medical Review Units and Claims Legal teams as appropriate.
  • Prepares claims and participates in claims roundtables to discuss unique cases to evaluate coverage and damage.

Company Stage

IPO

Total Funding

N/A

Headquarters

Des Moines, Iowa

Founded

N/A

Growth & Insights
Headcount

6 month growth

1%

1 year growth

1%

2 year growth

1%
Simplify Jobs

Simplify's Take

What believers are saying

  • EMC Insurance's involvement in funding rounds for InsurTech firms like Betterview indicates a forward-thinking approach, potentially leading to innovative insurance solutions and market leadership.
  • Strategic investments in technology-driven companies could enhance EMC's operational efficiency and customer service, offering employees opportunities to work with cutting-edge technologies.

What critics are saying

  • The insurance industry is highly competitive, and EMC Insurance must continuously innovate to maintain its market position against larger, more established players.
  • Relying heavily on external InsurTech investments for innovation could pose risks if these ventures do not yield the expected technological advancements or financial returns.

What makes EMC Insurance unique

  • EMC Insurance's investment in InsurTech companies like Betterview highlights its commitment to leveraging technology for enhanced property risk intelligence, setting it apart from traditional insurers.
  • The appointment of Matt Spackman as SVP – Chief Human Resources Officer suggests a strategic focus on strengthening human resources, potentially improving organizational culture and employee engagement.

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