2019-33 Property Subrogation Claims Adjuster

Job Description:

This position is responsible for the resolution of Property subrogation recovery claims within given authority with a focus on workers compensation and commercial auto claims. Must be able to evaluate liability, conduct causation and liability analysis, identify all at-fault parties and other sources of recovery and place parties on notice of claim. Ability to identify gaps in investigation and direct the handling adjuster on needed elements. Ability to confirm and document damages, send demands, negotiate settlements and represent the interests of our clients and their insureds. Must possess a general understanding of various state statutes and changes in those laws that pertain specifically to subrogation. Ability to craft clear, concise arbitration contentions. All file handling must be within state statutes, Client Claims Handling Guidelines and NARS Best Practices. Other miscellaneous duties as assigned, which may include travel.

Essential Duties and Responsibilities:

Coverage:

  • Identify, analyze and confirm coverage.

Customer Service/Contact:

  • Contact appropriate parties and providers to determine liability, compensation, 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 as needed.
  • Assist with training/mentoring of Claims Adjusters.
  • Assist management when required with projects or leadership as requested.
  • Handle the various duties/responsibilities of the Assistant Unit Manager/Unit Manager as delegated in their absence.
  • Must be willing and able to attend meetings by Skype or Facetime as requested.

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 no later than 30 days prior to mediation date and negotiate settlement.
  • Evaluate and negotiate lien.
  • Recognize and report potential fraud case.

Litigation Management:

  • Develop and direct a litigation plan with defense attorney (if assigned), utilizing all defenses and tools to bring the file to closure
  • Ensure all filings and state mandated forms are completed timely. Litigated files must be diaried effectively based on current activity, but no greater than every 60 days.
  • Review claim files involving active litigation on a monthly basis at minimum, and document responses to filings, development of defenses, depositions, and timely referral to defense counsel.
  • Direct the actions of defense counsel on litigated files.
  • Attend mediations and trials as required for cost effective litigation management.

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.
  • Pay all known benefits, ensuring they are paid timely on state statute.
  • Verify all provider bills have been appropriately reviewed and paid within standard timeframe.

Reporting Requirements:

  • Report all serious injuries/liability issues and potential large loss claims to the client and/or reinsurer based upon the criteria provided by the client and/or reinsurer.
  • Must pass all internal and external audits, which include those performed by regulatory agencies, carriers, and client.
  • 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 for monitoring and directing medical care, case development, or litigation.
  • Close all files as appropriate in a timely and complete manner.
  • Maintain closing ratio as dictated by management team. 

Qualification Requirements: Education / Licensing:

  • Property claims experience
  • High School Diploma, college degree preferred.
  • Must have 3+ years prior claim adjusting or similar experience, with the majority handling subrogation/commercial auto and litigation.
  • Must have 3 to 5 years of overall claims experience, preferably in the line of business being handled.
  • Must possess a Florida Adjuster’s All Lines license or other required jurisdictional licensing.
  • Must be willing and able to attend meetings by Skype or Facetime as requested.

Technical skills:

  • Advance level of interpersonal skills to handle sensitive and confidential situations and information.
  • Requires advanced ability to negotiate claims and to direct litigation.
  • Must have negotiation and litigation skills for significant work with attorneys and arbitration on first and third party 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 proficient in Microsoft Office applications.
  • Must be able to explain and appropriately respond to auditors, clients, and potential clients during in-person presentations.

Abilities:

  • 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.
  • Requires travel as assigned, which can at times be extensive (5 to 7 days per month). 

General Information:

  • The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. This description reflects management’s assignment of essential functions; it does not prescribe or restrict the tasks that may be assign The incumbent must be able to work in a fast-paced environment with demonstrated ability to handle multiple, competing tasks and demands and to seek supervisory assistance when necessary.
  • Incumbents within this position must abide by basic workplace safety procedures and adhere to the standards of conduct set forth in the North American Risk Services, In Employee Handbook. In addition, you may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization’s services (may include: visitors, employees or others).

If interested, please send resume to esharpe@narisk.com.

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