What are the responsibilities and job description for the COMPLEX CLAIMS ADJUSTER position at VYRD?
Job Title: Complex Claims Adjuster
Reports To: Complex Claims Supervisor
FLSA Status: 1099
Department: Claims
Location: Remote
Summary of Position
The Complex Claims Adjuster is responsible for investigating, evaluating, negotiating and settling complex property claims in a timely and efficient manner. This position requires strong knowledge of Florida claims handling, excellent communication skills, and the ability to collaborate effectively with policyholders, vendors, attorneys, and other departments. The Complex Claims Adjuster works under the guidance and direction of the Complex Claims Supervisor to ensure compliance with company and state mandated claims handling requirements.
Duties and Responsibilities: The Complex Claims Adjuster performs the following duties and responsibilities:
1. Obtain necessary documents, investigate, evaluate, and determine coverage on complex claims according to company policies and procedures.
2. Review policy information, documentation, and reported damages to assess coverage and damages.
3. Meticulously maintain thorough and accurate records of all claims activities and updates in the claims management system.
4. Timely preparation and issuance of reservation of rights and denial letters, settlement offers, releases and other necessary claim correspondence.
5. Proactively and professionally communicate with policyholders, vendors, attorneys, public adjusters, internal and external stakeholders to facilitate the claim resolution process.
6. Work collaboratively with the Complex Claims Supervisor and Manager to meet performance standards and goals. Collaborate across all internal departments.
7. Provide excellent customer service by maintaining a professional and positive demeanor in all interactions. Responding to inquiries and concerns from policyholders and claimants in a timely and courteous manner.
8. Ensure compliance with all company policies, regulatory requirements, and industry standards in claims handling.
9. Participate in ongoing training as needed, to stay current with industry developments, claims handling techniques, and relevant laws.
10. Establish and effectively monitor claim reserves based on exposure. Evaluate claims for payment within authority level and ensure accurate claims settlements.
11. Resolves claim disputes through negotiation, and other alternative dispute resolution methods.
12. Participate in projects and assist as needed when requested by management.
Skills
Strong Oral and Written Communication Skills
Ability to negotiate and resolve conflicts in a professional manner
Ability to work both independently and as part of a team
Detail-oriented with strong analytical and problem-solving abilities
Exemplary Customer Service Skills
Organization and Time Management
Job Responsibilities and Qualifications:
- Bachelor’s degree in insurance, business or related field preferred. Insurance designation coursework a plus.
- Five years of Florida related claims experience with increased authority and complexity.
- Two years of complex claims experience preferred including resolving disputed claims and handling of DFS mediation.
- Valid 620 Florida Adjusters license is required
- Strong knowledge of the claims discipline and evaluation of claims performance based on quantitative and qualitative results.
- Strong problem solving and staff development skills.
- Ability to negotiate and establish a personal rapport with opposing parties, and to resolve conflicts in a professional manner
- Basic understanding of residential construction and repair/replace techniques and strong familiarity with Xactimate estimating.
- Skill in effectively negotiating and settling homeowner claims in accordance with policies and procedures.
- Litigation experience is a plus.
- Industry technical designations (i.e. CPCU, AIC ect.) a plus.
- Competent in using Microsoft Word and Excel.
- Sets high personal standards and consistently achieves set goals.
- Must have access to a personal computer and necessary equipment to perform job duties effectively.
Physical Demands and Work Environment
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is regularly required to sit for long hours (via working remotely), stand; walk with hands and arms and stoop, kneel, or crouch. Specific vision abilities required by this job include close vision and ability to adjust focus. The noise level in the work environment is usually quiet. The employee may be required to use any or all of the following daily: PC, telephone, cell phone, scanner, fax, printer and other office equipment.