The Claims Adjuster II is responsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process. This position reports to the Chicago, Illinois Office.
- Responsible for handling moderate-to-high complexity workers compensation losses, including litigated claims.
- Makes timely and appropriate contacts with interested parties, including, but not limited to the insured, claimant/attorney, witnesses, producers and medical providers.
- Determines, reviews and analyzes coverages that may or may not apply to the claim; Plans, executes and reviews investigations-coverage, liability and/or exposures - including the securing of a signed or recorded statement of the claimant, insured and/or witnesses.
- Discusses possible coverage issues with supervisor and drafts coverage positions as applicable.
- Obtains medical records and reports; police ambulance and agency reports; photographs and measurements; and, expert assistance/testimony.
- Applies facts, as determined by contacts and investigation, to the law of a particular jurisdiction to properly evaluate exposure.
- Maintains appropriate financial accountabilities (reserving) and controls loss adjustment expenses.
- Works with and actively monitors/manages assigned defense counsel.
- Minimizes losses through identification of subrogation and prompt disposition.
- Identifies issues (coverage, liability, damages, handling), seeks appropriate guidance, and communicates pursuant to authority structure.
- Prepares large loss reporting and maintains ongoing claim updates.
- Document all correspondence, reports, discussions and decisions.
- Fulfill state licensing agreements/requirements (if applicable) and apply knowledge of state laws and regulations pertaining to the insurance industry.
- Provides quality service to all customers.
- Mentor less experienced staff members.
- Assist Supervisors and Claim Department with requested tasks or special projects.
- Ability to manage relationships in a fast paced environment, while demonstrating persistence along with problem solving and decision making skills to work with customers through a variety of challenging situations.
- Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions.
- Good knowledge of WC claim procedures, policies, technology, state and federal laws and insurance regulations.
- Ability to communicate effectively and clearly, both orally and in writing.
- Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense.
- Ability to work independently with self-initiative.
- Time management skills, organizational skills and ability to prioritize issues and multi-task.
- Ability to effectively operate computer equipment and applications.
Degree of Supervision Required
- College degree is not a prerequisite for this position; however employee should possess such skills and knowledge as are normally gained in the successful completion of a four-year college program.
- Maintain valid adjusters' license(s) in states assigned or an ability to obtain same.
- Minimum of 3 years' experience in job-related functions or equivalent.
- Insurance coursework (e.g. IIA, CPCU, SCLA and AEI) is beneficial.
- Good knowledge of insurance theory and practices; insurance contracts and their application.
- Minimal degree of supervision needed in processing moderate severity claims during the normal course of business. Some direction and technical supervision may be required as employee begins handling more complex cases.
This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust has the right to revise this job description at any time.
What We Offer
AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.
AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.
AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.