Senior Construction Defect Claims Adjuster

Ready to make an impact? Apply today and join our mission to deliver excellence in claims resolution!
? Claims Adjuster License Required - California preferred
? 100% Work-From Home
? Great Comprehensive Benefit Package beginning on Day 1

Handle a case load of approximately 125 pending multi-jurisdictional construction defect claims that encompass all levels of complexity, from developer, subcontractor and additional insured exposures. Responsibilities include investigating and establishing facts of loss, coverage analysis, determining compensability, liability, negligence, coordinating medical care, managing litigation, assessing damages, negotiating settlements, identifying potential fraud, and appropriate use of authorized vendors. Also includes timely and appropriate reserve analysis and report completion. Ability to attend settlement conferences, client meetings, mentor other adjusters and assist management as requested. 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.

Coverage:
? Identify, analyze and confirm coverage.

Customer Service/Contact:
? Contact appropriate parties and providers to determine liability, compensability, negligence and subrogation potential.
? Contact appropriate parties to obtain any needed information and explain benefits as appropriate.
? Continue contact throughout the life of the file as appropriate.
? 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.
? Handle the 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.

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:
? Develop and direct a litigation plan with defense attorney (if assigned), utilizing all defenses and tools to bring the file to closure. Ensure all filings and state mandated forms are completed timely. Litigated files must be diaried effectively based on current activity, but no greater than every 60 days.
? Review claim files involving active litigation on a monthly basis at minimum, and document responses to filings, development of defenses, depositions, and timely referral to defense counsel.
? Direct the actions of defense counsel on litigated files.
? Attend mediations and trials as required for cost effective litigation management.

Reserves:
? Pay all known benefits, ensuring they are paid timely on 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.

Resolution:
? Document plan of action in the claim system and set appropriate diaries.
? Maintain a regular diary for monitoring and directing medical care, case development, or litigation.
? Close all files as appropriate in a timely and complete manner.
? Maintain closing ratio as dictated by management team.

Work Environment/Requirements: ? This role requires extended periods of computer screen usage for tasks such as data entry, research, and virtual meetings. ? The ability tomaintain focus and productivity while working for long hours in front of a screen is essential.

Qualification Requirements:

Education / Licensing:
? High School Diploma, college degree preferred.
? Must have 7+ years prior in construction defect claim adjusting with the majority handling complex litigation.
? Must have 7+ years heavy litigation experience for all other lines except workers compensation.

Technical skills:
? Advance level of interpersonal skills to handle sensitive and confidential situations and information.
? Requires advanced ability to negotiate claims and to direct litigation.
? Must have strong negotiation and litigation skills for significant work with attorneys and arbitration on first and third party claims.
? Requires advanced ability to work independently.
? Requires an advanced level of organization and time management skills.
? Must possess advanced level written and verbal communication skills.

Abilities:
? Requires long periods of sitting.
? 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, if required.

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 internal equality of our current team members as a final part of any offer. Please keep in mind that range mentioned above is full base salary range for the role. Hiring at maximum of the range would not be typical in order to allow future and continued salary growth. We also offer a generous compensation and benefits package.

Job Type: Full-time

Pay: $88,000.00 - $130,000.00 per year

Benefits:
? 401(k)
? 401(k) matching
? Dental insurance
? Employee assistance program
? Employee discount
? Health insurance
? Life insurance
? Paid time off
? Professional development assistance
? Referral program
? Retirement plan
? Tuition reimbursement
? Vision insurance

Schedule:
? Monday to Friday

Experience:
? CD Claims Adjusting: 7 years (Required)

License/Certification:
? Claims Adjuster License (Required)

Work Location: Remote

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