Samazon Staffing is seeking a Senior Claims Adjuster to manage a caseload of primarily litigated commercial general liability claims remotely, with a focus on complex cases such as wrongful death, slip and fall, habitability, personal injury, sexual assault, and trip and fall. The role operates within a paperless, RMIS-based environment and requires strong investigative, negotiation, and mentoring skills.
What You'll Do
- Manage caseload of primarily litigated files of approximately 125 claims.
- Direct independent adjusters (when applicable) and defense counsel, as necessary
- Analyzes and processes complex or technically difficult commercial general liability claims by investigating and gathering information to determine the exposure on the claim
- Investigates, analyzes, determines potential liability, and effectively settles with adverse parties.
- Manages claims through well-developed action plans to an appropriate and timely resolution
- Assesses liability, gather investigative information and resolve claims within evaluation
- Negotiates settlement of claims up to designated authority level, request authority timely, as needed
- Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim
- Approve and makes timely claim payments and adjustments, and settles claims within designated authority level
- Assist litigation manager with the litigation process; ensures timely and cost-effective claims resolution
- Uses appropriate cost containment techniques
- Communicate claim activity with the appropriate parties (supervisor, broker, agent, client)
- Cultivate and maintain professional client relationships
- Participate in monthly claim round table and reserve committee
- Audit files to ensure field completion and data integrity
- Prepare Claim Analysis Reports for all claim reviews (internal/external)
- Complete Plan of Action, Status Updates, Reserve Properly
- Request all pertinent documents and audit files for closure, field completion, document gathering, financials, etc.
- Request settlement authority and checks
- Identify tender and subrogation opportunities
- Attend mediations, if merited (rare travel, if any).
- Exercises sufficient and independent judgment to settle cases prior to mediation and/or litigation.
- Obtains all necessary documentation from the appropriate parties within established timelines.
- Remains abreast of new case law and statutes.
- Maintains confidentiality of information processed.
- Ensure the maintenance of the data integrity of our RMIS
- Mentors team members.
- Completes other duties and special projects as requested.
What We're Looking For
- 7-10+ years of experience handling catastrophic level commercial general liability claims
- Litigated claims experience imperative
- Active license is required (multi-state)
- Must share our core values
- Must be reliable and dependable
- Must enjoy finding and proposing solutions to problems
- Must thrive in a fast pace, deadline driven environment
- Must be willing to self-learn in addition to taking direction (work independently and as a team)
- Must be comfortable with working on new and sometimes unfamiliar problems. Ability to problem solve and find solutions/answers
- Must be self-motivated, proactive, and detail oriented
- Must be respectful to all colleagues and clients and contribute to a fun, happy and team building atmosphere
- Typing (min 65 wpm)
- Experience with automated claims handling systems (RMIS) (paperless environment)
- Extensive understanding of General Laws in multi states
Nice to Have
- TPA Carrier experience a plus
- Real estate/multi-family experience claims handling experience highly preferred
- If you are located in Houston, TX, it is a plus but not required
Technical Stack
- RMIS
- automated claims handling systems
Work Mode
- Remote position; Houston, TX location is a plus but not required.
- Rare travel, if any, for mediations.
Samazon Staffing is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.
