Address
Form of workHandle a caseload up to 150 pending claims that may include some levels of complexity. Requires establishing facts of loss, coverage analysis, investigation, compensability/liability/negligence determination, coordination of medical care (as appropriate), litigation management, damage assessment, settlement negotiations, identifying potential fraud, vendor management, reserve analysis, and report completion. Ability to attend conferences, client meetings, mentor other adjusters and assist management as needed. Ensure compliance with state statutes, client guidelines and NARS Best Practices. Address claim metrics in a timely and appropriate manner. Perform 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,
Must have New York License and experience handling New York Labor Law exposure.
