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EMC Insurance

Provides property/casualty insurance and reinsurance

Claims Specialist

Claims AdjudicationUpdated on Nov 12
Full-timeRemote in USA$85.8k - $130.4k

About the Job

Requirements

  • A bachelor's degree or equivalent relevant experience is required.
  • Seven years of claims adjusting or related experience is required.
  • Adjuster experience in Iowa, Arizona, and Utah is required.
  • Advanced knowledge of best claims practices for resolving serious and complex injury, workers’ compensation, general liability, property, and commercial auto claims is required.
  • Excellent knowledge of the claims function is required.
  • Advanced analytical, investigative, and problem-solving abilities involving liability and coverage are required.
  • Excellent knowledge of insurance contracts, medical terminology, and legal aspects of court procedures affecting legal liability across insurance lines is required.
  • Advanced computer skills, including claims systems, are required.
  • Maintain required licenses and continuing education.
  • Strong organizational, written and verbal communication, and documentation skills are required.
  • Thorough investigative and problem-solving abilities are required.
  • Ability to advise, partner, and consult effectively with diverse internal and external stakeholders is required.

Responsibilities

  • Investigate, evaluate, and resolve severe and complex workers’ compensation claims across multiple jurisdictions, determining coverage, compensability, liability, and settlement value.
  • Manage all aspects of claims handling, including investigations, documentation, reserves, benefit calculations, payments, and jurisdiction-specific reporting.
  • Coordinate medical care, return-to-work efforts, and complex cost-containment strategies, including catastrophic claims, Medicare requirements, and lien resolution.
  • Manage litigation in partnership with defense counsel, develop resolution strategies, negotiate settlements, and attend depositions, hearings, trials, and mediations.
  • Direct vendors and experts, monitor expenses, and pursue subrogation and other recovery opportunities.
  • Serve as a technical resource for team members, contribute to claims roundtables, collaborate with specialized units, and communicate emerging risks to underwriting and risk improvement teams.
  • Travel occasionally as required.

Desired Qualifications

  • Adjuster experience in Texas is preferred.
  • Prior experience with a third-party administrator (TPA) is preferred.
  • INS, AIC, SCLA, WCLA, or CPCU designation is preferred.

About the Company

EMC Insurance

Provides property/casualty insurance and reinsurance

EMC Insurance Companies provides property and casualty insurance products for businesses and also offers reinsurance. It underwrites commercial policies and provides loss-control services, bonds, surety, and fidelity coverage, operating in more than 40 states with international risk written on a reinsurance basis. Its EMC Re division supplies facultative and treaty reinsurance to other insurers, helping them manage risk. The goal is to simplify insurance transactions for clients while offering broad risk coverage and supporting other insurers through reinsurance partnerships.

Company size
1,001-5,000
Company stage
IPO
Headquarters
Des Moines, IA
Founded
1911

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