Job Description

Job Description

Job Description

Are you looking for a company that can provide you long-term stability with the convenience of working-from-home? If so, this could be a great opportunity for you!

• Join a leader in Third Party Administration of Claims Management
• Full Time Position
• Full Benefits Package (Medical, Dental, Vision, 401k and much more - starting on day 1!)
• IT Equipment Provided

As a Homeowners Property Claims Adjuster the average caseload is approximately 100 pending claims that encompass all levels of complexity. This position requires establishing facts of loss, coverage analysis, investigation, litigation management, damage assessment, settlement negotiations, identifying potential fraud and appropriate use of authorized vendors. Also includes timely and appropriate reserve analysis and report completion. 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:

• Make first contact within parties and client within eight (8) business hours.
• Communicate with parties and providers to determine liability, compensability, negligence, and subrogation potential.
• Obtain necessary information and explain benefits as appropriate. Maintain regular contact throughout the life of the claim process.
• 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.
• Support management and handle various duties/responsibilities of the Assistant Unit Manager/Unit Manager as delegated in their absence.

Subrogation:

• Refer all files identified with subrogation potential to the subrogation department.
• Maintain closing ratio as dictated by management team.
• Close all files as appropriate in a timely and complete manner.

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 liens.
• Recognize and report potential fraud cases.

Litigation Management:

• 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 liens.
• Recognize and report potential fraud cases.

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 event.
• Ensure timely payment of all known benefits in accordance with state statute.
• Verify all provider bills have been appropriately reviewed and paid within standard timeframes.

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.
• Must pass all internal and external audits, which include those performed by regulatory agencies, carriers, and clients.
• Follow reporting requests as outlined by client files and NARS guidelines.

Work Environment/Requirements:

• This role requires extended periods of computer screen usage for tasks such as data entry, research, and virtual meetings.
• The ability to maintain focus and productivity while working for long hours in front of a screen is essential.

Qualification Requirements: Education / Licensing:

• High School Diploma or equivalent required, 2-year degree or higher preferred.
• Must have 5+ years of Homeowners Property Claims Adjusting.
• Must have 5+ years heavy litigation experience for all other lines except worker’s compensation.
• Must be eligible for reserve/payment authority level of $50,000+ when appropriate.
• Must possess a Florida Adjuster’s license or other required jurisdictional licensing.

Technical skills:

• Must have demonstrated advanced skills, a deep understanding of the claims process, and a proven ability to handle more complex cases for a significant period of time in the line of business being handled.
• Requires strong negotiation and litigation skills.
• Requires excellent interpersonal skills to handle sensitive and confidential situations and information.
• Requires ability to work independently.
• Requires excellent organization and time management skills.
• Requires exceptional written and verbal communication skills.

Abilities:

• Requires long periods of sitting.
• Must be willing to attend local NARS office meetings, on occasion.
• 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 for mediation, as assigned.

In the spirit of pay transparency we are excited to share the base salary for the position exclusive of fringe benefits or potential bonuses. This position is also eligible for an annual performance raise if all guidelines are met. Your salary compensation will be determined based on factors such as geographic location, skills, education and or experience. In addition to those factors, we believe in the importance of pay equality and consider the internal equality of our current team members as a final part of any offer. Please keep in mind that the range mentioned above is full base salary range for the role. Hiring at maximum of the range would not be typical to allow future and continued salary growth. We also offer a generous compensation and benefits package.

North American Risk Services (NARS) is a premier third-party claims administrator that is dedicated to producing the best possible results for our clients. Founded in 1996, we handle claims for insurers, brokerages, managing general agencies, reinsurers, liquidation bureaus, self-insured funds and entities.

Company Description

North American Risk Services (NARS) is a premier third-party claims administrator that is dedicated to producing the best possible results for our clients. Founded in 1996, we handle claims for insurers, brokerages, managing general agencies, reinsurers, liquidation bureaus, self-insured funds and entities.

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