EMC is looking for a Casualty Claims Adjuster I to join our team. In this role, you will be responsible for investigating, evaluating, and settling casualty claims, verifying coverage, communicating with insureds and claimants, setting reserves, and negotiating settlements. We’re all about working together to make an impact.
What You'll Do
- Review claim notice, contracts, state statutes, and policies to verify coverage, deductibles, and payees.
- Initiate timely contact with insureds and claimants to explain the claim process and begin investigations.
- Obtain statements from insureds, claimants, and witnesses and document summaries in the claims system.
- Request and analyze investigative reports, claim forms, and other relevant documents.
- Document claim activities, reserve analysis, and summaries including Medicare (MSP) modules.
- Set timely, adequate reserves in compliance with company methodology.
- Identify, investigate, and proactively pursue recovery opportunities, including arranging evidence preservation.
- Adhere to all state regulatory compliance requirements by sending appropriate letters and forms on time.
- Review bills, invoices, and receipts for accuracy and appropriateness.
- Notify your people leader of claims needing escalation or reassignment.
- Draft reservation of rights and coverage denial letters with supervisor approval.
- Assign vehicle and property damage appraisals and vehicle rentals.
- Make recommendations to your people leader on assigning independent adjusters.
- Provide prompt, detailed responses to agents, insureds, and claimants on claim status.
- Resolve questions of coverage, liability, and claim value to settle claims in a timely manner.
- Prepare bodily injury and damage evaluations, negotiation ranges, and target settlement numbers prior to negotiation, obtaining authority when required.
- Identify and protect all appropriate liens.
- Investigate Medicare liens and resolve issues per EMC and Medicare guidelines.
- Communicate with insureds, claimants, and attorneys to negotiate claim settlements.
- Prepare and issue settlement and release documents, verifying accuracy and proper execution.
- Issue timely payments.
- Review and audit estimates from independent adjusters for accuracy and cost-effective repair approaches.
- Submit referrals to Estimatics, Special Investigation, Subrogation, Medical Review Units, and Claims Legal teams as needed.
- Prepare risk reports for Underwriting and Risk Improvement.
- Prepare claims and participate in roundtables to discuss unique cases for coverage and damage evaluation.
What We're Looking For
- A bachelor’s degree or equivalent relevant experience.
- One year of casualty claims adjusting or related experience.
- Ability to obtain all applicable state licenses.
- A valid driver’s license with an acceptable motor vehicle report per company standards if traveling.
Nice to Have
- Relevant insurance designations.
Team & Environment
You will report to a people leader, collaborating closely with team members and other departments to resolve claims effectively.
Benefits & Compensation
- Compensation range: $55,795 - $77,098 or $61,659 - $84,778.
Work Mode
This position is open to candidates across the United States.
Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.
