CLAIMS ADJUSTER JOB DESCRIPTION

A Claims Adjuster resolves insurance losses by determining what a policy owes, to whom, and when. Each file demands a different combination of skills - one day centers on reading state-specific statute language and reserve math; the next requires a recorded statement and a negotiation with opposing counsel. In US property and casualty lines, adjusters operate under a web of state adjuster licensing requirements, subrogation rights, and Medicare set-aside obligations that make the work legally consequential, not just administrative. Getting a reserve wrong or misreading a coverage endorsement has direct financial consequences for both the insured and the carrier.

As the Claims Adjuster, you investigate losses across personal and commercial property and casualty lines, setting accurate reserves and negotiating settlements within your authority level while keeping policyholders and claimants informed at every stage. You work within a structured claims unit, handling a rotating caseload that spans first-party coverage disputes, liability assessments, subrogation identification, and total-loss determinations, all governed by department best practices and applicable state regulations.

Career Impact: Adjusters who manage both coverage interpretation and litigation oversight across multiple state jurisdictions build a technical profile that qualifies them for senior examiner, team lead, or claims supervisor roles within three to five years.

Business Impact: Reserve accuracy and settlement timing on your caseload directly affect the carrier's loss ratio and the speed at which policyholders receive funds after a covered loss.

Growth Opportunity: Handling litigated files, subrogation recovery, and SIU referrals alongside standard adjusting develops the litigation management and fraud-recognition skills that open pathways into specialty lines and major-loss units.

• Investigate assigned claims by obtaining recorded statements, coordinating field inspections, and collecting photographic and documentary evidence to establish liability and damages.
• Interpret policy language, endorsements, coverage limits, and applicable state statutes to make accurate coverage determinations on property and casualty claims.
• Set and adjust indemnity and expense reserves throughout the life of each file, escalating to a supervisor when exposure exceeds personal authority.
• Negotiate settlements directly with policyholders, claimants, and opposing attorneys within approved payment authority and in compliance with Fair Claims Practices standards.
• Assess vehicle and property damage estimates for accuracy relative to the reported loss facts, approving or rejecting repair supplements based on industry estimating guidelines.
• Identify subrogation and salvage opportunities on settled claims and prepare recovery referrals in accordance with applicable state statutes of limitation.
• Recognize fraud indicators on assigned files and refer SIU-eligible claims to the appropriate unit using defined department criteria.
• Maintain complete and current electronic claim files documenting all contacts, decisions, payments, and reserve changes throughout the claim lifecycle.

• Bachelor's degree in business administration, finance, or a related field, or equivalent work experience.
• 2 or more years of property and casualty claims adjusting experience, with demonstrated proficiency in coverage analysis, reserve-setting, and settlement negotiation.
• Active state adjuster license in the primary jurisdiction of assignment, or ability to obtain within 90 days of hire as a condition of continued employment.
• Working knowledge of state insurance regulations, Fair Claims Practices statutes, and the legal frameworks governing liability and subrogation recovery.
• Demonstrated analytical and investigative skills, including the ability to evaluate damage estimates, interpret legal documents, and identify coverage gaps.
• Strong verbal and written communication skills, with the ability to conduct recorded statements and correspond with attorneys, vendors, and policyholders under pressure.
• Proven ability to manage a rotating caseload, prioritize competing deadlines, and maintain file accuracy with minimal supervision.

• 4 or more years of claims experience handling litigated files, bodily injury exposures, or commercial auto and property lines.
• Industry designation or coursework from a recognized insurance education body, such as CPCU, AIC, or INS.
• Familiarity with Medicare set-aside requirements and Federal Medicare compliance obligations applicable to bodily injury settlements.
• Experience handling total-loss determinations, salvage disposal, and rental coordination under department best practices.

• Reserve adequacy rate, measuring how often initial reserves require significant upward revision at file closure.
• Average days to first contact, reflecting timely outreach to policyholders and claimants following claim assignment.
• Settlement authority utilization rate, tracking the proportion of files closed within personal authority without supervisor escalation.
• Subrogation recovery yield, measured as a percentage of identified recovery opportunities converted to actual collections.
• SIU referral accuracy, reflecting the proportion of referred files confirmed as fraud-eligible by the special investigations unit.
• Typical tools: Claims management platforms (commonly Guidewire, Duck Creek); estimating software (commonly Xactimate, CCC ONE).

• Base Salary Range: $52,000 to $78,000 annually, depending on seniority and state of assignment
• Bonus: Performance-based bonus, typically 5 to 10 percent of base salary
• Equity: Not standard at this level in insurance carriers
• Health Benefits: Medical, dental, and vision coverage; employer contribution standard across the industry
• PTO: 15 to 20 days annually, plus paid holidays and catastrophe-event overtime provisions
• Common Perks: Licensing fee reimbursement, continuing education allowance, and remote or hybrid scheduling on non-field days

Figures are estimates based on general US market benchmarks and may be outdated. Adjust based on location, company size, and seniority level.

Candidates for this position must be legally authorized to work in the United States without sponsorship. Employment in this role is contingent upon successful completion of a background check, which may include a review of prior claims handling history and applicable financial records. Reasonable accommodations will be provided to qualified individuals with disabilities throughout the application and employment process upon request. All applicants are evaluated without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected under applicable federal, state, or local law.

The Claims Adjuster owns a full caseload of property and casualty claims, conducting investigations, damage assessments using estimating software, and settlements in accordance with best claims practices and industry standards. Working alongside less experienced staff as a mentor and trainer, this role supports business production goals and contributes to catastrophe response operations within a regulated insurance environment.

Key Responsibilities

• Model ethical behavior and execute job responsibilities in accordance with core values, ethics, and information protection policies.
• Negotiate and settle claims in accordance with best claims practices, estimating guidelines, and industry standards.
• Conduct investigations and damage assessments using estimating software.
• Research, analyze, and interpret policy contracts and state statutes as they apply to submitted claims.
• Document all relevant information in the electronic claims management system.
• Contribute to business production goals and objectives.
• Train, mentor, and guide less experienced staff as needed.
• Participate in workload surges and catastrophe response, including mandated overtime during catastrophic events.

Required Qualifications

• Bachelor's degree in business administration or a field with skills transferable to insurance, or equivalent experience.
• Active Florida Adjuster license (620 or 644) required, or must obtain within 90 days of employment.
• 2 or more years of experience handling claims, with 4 or more years preferred.
• Working knowledge of laws, rules, regulations, policies, procedures, and department operational guidelines.
• Proficient in Microsoft Windows environment and Xactimate.
• Strong analytical, organizational, negotiation, communication, and customer service skills.
• Ability to recognize problematic situations, implement creative solutions, and work independently.
• Adapt to frequent priority changes.

Embedded within the auto claims team, the Claims Adjuster evaluates and investigates policy coverage, liability, and damages following claim and statutory guidelines, managing assigned inventory and negotiating settlements with claimants, insureds, and attorneys within approved payment authority. Working closely with internal and external customers, this role identifies subrogation and salvage recovery opportunities that support accurate and economical claims resolution.

Core Functions

• Evaluate and investigate policy coverage, liability, and damages following claim and statutory guidelines.
• Establish and adjust initial reserves for all potential exposures throughout the claim.
• Manage assigned inventory in accordance with company guidelines.
• Recognize excess exposures and communicate implications verbally and in writing to customers.
• Recognize and resolve minor injury exposures.
• Conduct thorough investigations, obtain necessary documents, and take recorded statements.
• Ensure timely completion of appraisals and determine accident-related damages.
• Negotiate appropriate settlements with claimants, insureds, and attorneys within approved payment authority.
• Recognize subrogation and salvage recovery opportunities.
• Assist internal and external customers with claims questions by phone or written correspondence.

Qualifications & Experience

• High school diploma or equivalent required, undergraduate degree or equivalent experience preferred.
• INS or other insurance-related courses preferred.
• 2 or more years of auto claims adjusting experience or similar work experience.
• Experience in non-standard auto is a plus.
• Proficient in PC and Windows skills.
• Strong verbal and written communication, critical thinking, time management, negotiation, organization, investigative, and customer service skills.
• Ability to perform basic math calculations including averages and percentages.

Reporting to claims leadership, the Claims Adjuster shapes coverage and liability outcomes on complex claims by analyzing and interpreting policies, overseeing independent adjusters and appraisers, and managing investigation steps through to equitable settlement. Partnering with adjusters, insureds, claimants, attorneys, vendors, and agents through daily contact, this role enables consistent, cost-effective resolution across property and casualty claims.

Primary Duties

• Analyze, review, and interpret policies to assess coverage and liability.
• Establish and maintain proper loss and expense reserves on claims.
• Determine necessary investigation steps on complex claims to reach equitable conclusions for all parties.
• Control and oversee work performed by independent adjusters and appraisers.
• Document, verify, and review damages, evaluate and settle claims, investigate subrogation, handle total losses, and process salvage returns.
• Maintain daily contact with adjusters, insureds, claimants, attorneys, vendors, and agents.

Skills & Qualifications

• Bachelor's degree from an accredited institution or equivalent experience.
• State adjuster's license where domiciled, and non-resident adjuster's license where required.
• 5 or more years of claims handling experience, including coverage, investigation, litigation, negotiation, damage and injury evaluation, salvage, and subrogation.
• Knowledge of and adherence to state laws and regulations governing general liability claims handling.
• Basic understanding of claims, mathematics, construction, auto physical damage, medical terms, and legal issues.

Sitting at the intersection of technical claims expertise and customer service delivery, the Claims Adjuster manages a dedicated caseload of casualty claims, including personal injury, liability disputes, and accidental damage, applying knowledge of personal injury claims, MOJ, CPR, and CRU to ensure adequate reserving and fair settlement. Operating across a large, multi-location claims team handling over 200,000 claims annually, this role produces ad-hoc reports for stakeholders and upholds market-leading service standards.

Duties

• Triage and manage claim files through to settlement, prioritizing new and existing work appropriately.
• Establish liability and indemnity on all claims.
• Understand and apply knowledge of personal injury claims, MOJ, CPR, and CRU.
• Handle all claims competently to ensure adequate reserving and fair, economical settlement.
• Develop and maintain in-depth knowledge of legal and regulatory matters.
• Produce ad-hoc claims reports for stakeholders as required.
• Deliver high-quality customer service as part of a market-leading claims team.

Requirements

• Experience handling casualty claims involving liability disputes and personal injury claims.
• Northern Ireland claims handling experience desirable.
• Strong investigation, negotiation, communication, and organizational skills.
• Ability to develop and maintain solid working relationships with internal and external stakeholders.
• Comfortable manipulating data and producing reports under pressure and tight deadlines.
• Ability to work on your own initiative and organize workload effectively.

A key member of the claims administration team, the Claims Adjuster reports new claims to appropriate insurance carriers, monitors correspondence, and maintains ongoing communication with insurers and adjusters to obtain status updates, reserves, and payments. Collaborating across insured client teams and executive groups, this role ensures accurate claims file management and timely delivery of loss run histories, claims bordereaux, and presentations that support client service objectives.

Functions

• Report new claims to appropriate insurance carriers and create electronic claims files.
• Initiate follow-ups with insurers to confirm receipt of claims, adjuster contact information, and file numbers.
• Communicate with insured clients and client executive teams to confirm reporting and initial adjuster contact.
• Confirm timely assignment of defense counsel when required.
• Maintain ongoing communication with insurers and adjusters to obtain status updates, reserves, and payments.
• Monitor after-hours emergency claims correspondence and route to the appropriate claims team.
• Prepare loss run history, claims bordereaux, monthly meeting minutes, and claims presentations as required.
• Receive and process payments and deliver correspondence on appropriate claims.

Technical Qualifications

• Level 1 insurance license an asset.
• Minimum 1 year of claims experience.
• Knowledge of EPIC internal database system an asset.
• Excellent knowledge of Microsoft Word, Excel, and PowerPoint.
• Strong oral and written communication, time management, organizational, and customer service skills.
• Attention to detail with the ability to work independently and as part of a team.
• Proven ability to work under pressure.

Delivering prompt, accurate resolution of low-complexity property and casualty claims depends on the Claims Adjuster, who investigates loss facts, writes and reviews vehicle and property damage estimates using appropriate estimating guidelines, and negotiates directly with body shops, claimants, and insurance carriers. Based within a multi-line claims environment, this role identifies fraud potential, manages subrogation referrals, and builds rapport with policyholders, agents, and vendors to enable efficient claim closure.

Accountabilities

• Provide ethical, responsive, personal, and efficient claim service while resolving low-complexity property and casualty claims.
• Investigate loss facts promptly by gathering photographic and physical evidence to make accurate and timely claim decisions.
• Interpret and apply coverage on multiple insurance policy types using regulatory and compliance knowledge.
• Establish indemnity and expense reserves and evaluate and execute release forms when necessary.
• Write and review vehicle and property damage estimates applying appropriate estimating guidelines.
• Negotiate directly with body shops, claimants, and insurance carriers.
• Manage rental, vendor, and other claim expenses.
• Recognize fraud potential and prepare claims for subrogation referral and recovery.
• Identify and monitor first-party medical and injury exposures.
• Build rapport with policyholders, agents, carriers, attorneys, and vendors to facilitate prompt claim resolution.

Position Requirements

• Bachelor's degree or associate's degree plus equivalent business experience preferred.
• Insurance industry designation or certification preferred.
• 3 or more years of claims adjusting experience preferred, with 2 or more years of Med/PIP or subrogation experience preferred.
• Working knowledge of insurance policies and regulatory environments, including commercial and auto estimating.
• Proficient with Microsoft Office products and claims-related software programs.
• Experience in conflict resolution and problem-solving.
• Strong verbal and written communication skills.

As the Claims Adjuster, this role assesses large exposures, drafts reservations of rights and coverage denials, and manages defense counsel and independent adjusters on litigated files within a professional liability and claims litigation environment serving insureds in complex legal and regulatory settings. The claims team relies on this work to maintain Fair Claims Practices compliance, deliver timely status updates to insureds and sponsoring companies, and ensure claims are resolved within established authority levels.

Activities

• Assess large exposures and draft reports to carriers.
• Exercise judgment in applying legal liability to assigned claims.
• Research applicable coverage, document coverage dates, limits, and restrictions, and resolve coverage questions.
• Draft reservation of rights and coverage denials for review and approval by senior adjusters.
• Conduct claims investigations and secure supporting documentation.
• Handle claims within Fair Claims Practices guidelines (790.03).
• Assign, monitor, and direct defense counsel, independent adjusters, and experts on litigated files.
• Identify claims exceeding authority and advise the Claims Supervisor or Team Lead.
• Provide regular status updates to insureds, claimants, and sponsoring companies, and deliver presentations to client groups.

Knowledge, Skills & Abilities

• Bachelor's degree or equivalent professional liability and claims litigation management experience.
• Qualified Claims Manager license in the State of California required.
• 5 or more years of adjusting experience.
• Litigation management experience.
• Property and casualty and professional liability claims knowledge, including ability to assess large exposures.
• Proficient in Microsoft Office including Outlook, Word, and Excel.
• Strong analytical, problem-solving, organizational, written, and verbal communication skills.

Claims Adjuster delivers end-to-end handling of commercial and personal vehicle claims, reviewing repair estimates for accuracy, negotiating settlements with claimants and attorneys, and applying Rights of Recovery and Statute of Limitations laws across multiple states to achieve optimal outcomes. The work directly supports corporate policy compliance, accurate bodily injury settlement under Medicare regulations, and timely diary management across an assigned caseload in the transportation sector.

Operational Focus

• Review repair estimates submitted by claimants for accuracy relative to the described accident and send for third-party review as needed.
• Negotiate and settle claims with claimants and their attorneys.
• Utilize and maintain a diary system to ensure timely claims handling.
• Review aged claims and close out as appropriate.
• Apply Rights of Recovery and Statute of Limitations laws across various states to obtain the best outcome.
• Research and collect pictures, invoices, and estimates for accident expenses.
• Follow Medicare regulations to ensure correct settlement of all bodily injury claims.
• Adhere to all corporate policies and procedures and encourage others to do the same.

Professional Experience

• Three or more years of property and casualty claims experience.
• Transportation industry and maintenance experience preferred.
• Extensive knowledge of industry standards, Federal Medicare regulations, and state insurance rules.
• Working knowledge of Microsoft Office Suite.
• Experience in AS400, BMI, Synergize, TMT, and RM Client preferred.
• Strong analytical, problem-solving, and decision-making skills.
• Strong organizational, communication, leadership, interpersonal, and time management skills.
• Ability to work with minimal supervision.

The Life Claims Adjuster produces accurate and timely adjudication of life insurance claims by evaluating submissions, comparing them against policy benefits, and requesting additional information from policyholders, providers, and agents across phone, email, and web service channels. Reporting to claims leadership and collaborating with team members to resolve customer needs, this role advances continuous improvement initiatives that enhance process efficiency and claims workflow.

Key Deliverables

• Adjudicate claims under Life Insurance coverage efficiently and accurately in accordance with policy, guidelines, and regulations.
• Conduct eligibility claim reviews by evaluating submissions and comparing them to policy benefits.
• Request additional information from policyholders, providers, and others as necessary to finalize claims.
• Manage inventory and ongoing claim adjudication actively.
• Communicate with customers using empathy and professionalism via phone and written correspondence.
• Interface with policyholders and agents across multiple service channels including phone, email, and web.
• Collaborate with team members and leadership to ensure effective resolution of customer needs and workflow.
• Engage in continuous improvement initiatives and identify process and efficiency enhancements.

Education & Experience

• Bachelor's degree in business or a related field from an accredited four-year institution.
• Industry courses from organizations such as ICA, AHIP, or LOMA preferred.
• 2 or more years of life claim adjudication experience in life insurance preferred.
• Medical terminology knowledge.
• Broad understanding of life insurance products and systems.
• Proficient in MS Office including Outlook, Word, and Excel.
• Ability to navigate multiple system applications confidently.
• Exceptional written and verbal communication, organizational, analytical, and decision-making skills.
• Bilingual in English and Spanish strongly preferred.

Embedded within a London Market claims team, the Claims Adjuster owns multiple claim files within agreed handling authority, conducting technical checks on insurance documentation and liaising with customers and brokers to resolve queries and support settlements using IT-based systems. Working closely with team members and recruits through training and process improvement contributions, this role maintains accurate reporting and advances innovation across claims operations.

Areas of Ownership

• Conduct technical checks on insurance documentation to ensure accuracy using IT-based systems with supervision or referral where applicable.
• Liaise with customers and brokers to resolve queries and issues related to claims being adjusted.
• Own multiple claim files within an agreed handling authority.
• Input details into the database to initiate settlements and updates.
• Complete accurate reporting associated with claims being adjusted.
• Support team members and customers with complex technical issues.
• Provide training to team members and recruits.
• Support and contribute to innovation and process improvement projects.

Background & Experience

• CII qualified.
• Knowledge of Lloyd's Claims Principles and Minimum Standards and London Market Claims systems.
• Strong adjusting, negotiation, customer service, communication, and influencing skills.
• Competent in MS Excel and Word.
• Organized with good time management, positive attitude, and ability to work calmly under pressure.
• Able to work as part of a team, represent the company professionally, and identify process improvements.

Reporting to claims management, the Home Claims Adjuster refines the settlement of residential property claims by conducting field and desk assessments, providing repair estimations using claims scoping software, and identifying fraud and recovery opportunities in line with policy cover and established standards. Partnering with internal teams and external service providers, this role supports major incident response and delivers effective cost management across an active claims portfolio.

Role Responsibilities

• Investigate, validate, manage, and settle residential property claims in line with policy cover, philosophies, and standards.
• Refer cases outside of agreed financial or competency matrix to appropriate authority.
• Undertake field and desk assessments to maximize efficiencies and outcomes.
• Update customers regularly to ensure optimum service and claim experience.
• Manage work in progress and demonstrate effective cost management on all claims.
• Identify and capture fraud and recovery opportunities.
• Provide repair estimations using claims scoping software.
• Work out of area to support major incidents as required.

Minimum Qualifications

• Knowledge of the insurance industry related to residential home property.
• Technical building knowledge, including current best practice methodology and building pathology.
• Awareness of flood, escape of water, and fire damage management best practices, including health and safety regulations and relevant legislation.
• Claims scoping and management software experience, including Symbility and Exactaware.
• Commercial awareness and appreciation of the economic environment.

Sitting at the intersection of customer service delivery and claims settlement operations, the Claims Adjuster manages verbal and written correspondence with customers, interprets and applies policy terms and conditions, and resolves claims independently under a predetermined value while presenting higher-value files to the Claims Manager for decision. Operating within established systems and regulatory requirements, this role coordinates repair firms, administers supplier invoices, and produces management information on claims performance that supports efficient portfolio oversight.

Job Functions

• Handle all verbal and written correspondence with customers and coordinate with service partners.
• Enter information into internal and claims databases and administer supplier invoices for payment.
• Settle claims in the database, coordinate repair firms, and determine if repair options are available.
• Collate information required to adjust any claim and adhere to all systems and procedures in the settlement process.
• Interpret and apply policy terms and conditions and ensure customer understanding during settlement.
• Resolve claims independently under a pre-determined value and present higher-value files to the Claims Manager for decision.
• Provide regular reports and management information on claims performance to the Claims Manager.
• Retain essential documents for auditing purposes and adhere to all regulatory requirements in claims settlement.

Experience & Qualifications

• 1 or more years of insurance claims handling experience preferred.
• Proven customer service experience required.
• Proficiency in English and French.
• Good standard of IT literacy including Word and Excel.
• Attention to detail, structured approach to work, commercial acumen.
• Ability to leverage relationships effectively.
• Ability to work as part of a team, remain calm under pressure, and adapt to changing business priorities.

A key member of the claims investigation team, the Claims Adjuster leads end-to-end handling of general liability claims by interviewing policyholders and witnesses, reviewing documentation, and negotiating fair settlements directly or through retained counsel, in accordance with applicable Insurance Act requirements. Collaborating with managers and legal representatives on authority escalations and subrogation assessments, this role enables cost-effective claims resolution and consistent compliance with departmental standards.

What You'll Do

• Advise insureds of their rights and obligations in accordance with policy terms and the applicable Insurance Act.
• Investigate claims to determine if the policy will respond to the loss and assess the legitimacy of the claim.
• Interview and take statements from policyholders, claimants, and witnesses.
• Review estimates, photos, videos, hospital records, and other documentation to substantiate claims.
• Set and maintain appropriate reserves up to maximum authority level and inform manager when claims exceed authority limits.
• Negotiate fair and cost-effective settlements with insureds, claimants, or legal representatives directly or through retained counsel.
• Validate invoices and receipts, process payments, and arrange salvage disposal in accordance with departmental standards.
• Assess subrogation feasibility and proceed where appropriate, and participate in claims dispute resolution as required.

Qualifications & Experience

• Post-secondary diploma in business, insurance-related programs, or equivalent work experience.
• CIP designation.
• Minimum 4 years of experience in a claims environment.
• Knowledge of claims performance standards, insurance industry practices, and applicable Insurance Act requirements.
• Proficient in MS Office.
• Strong analytical, troubleshooting, organizational, multitasking, oral and written communication, and listening skills.
• Demonstrated ability to meet deadlines and adapt to changing business needs.

Efficient resolution of low- to mid-range complexity auto claims depends on the Claims Adjuster, who investigates facts of loss, conducts recorded statements, determines total loss status on vehicles, and manages vehicle repairs through timely shop coordination and approval of additional repairs per industry standards. Serving as a key contact for policyholders, claimants, and witnesses, this role maintains accurate electronic records and identifies SIU-eligible claims for referral, enabling sound liability and coverage outcomes across an assigned portfolio.

Day-to-Day Responsibilities

• Investigate facts of loss for low- to mid-range complexity claims, including coverage evaluation, liability, damages, and negotiation to conclusion.
• Determine policy status, coverage, limits, and deductibles, and notify manager of claims outside assigned scope or authority.
• Conduct investigations including recorded statements and coordination of field inspections or experts per department best practices.
• Make prompt contact with policyholders, claimants, and witnesses to set expectations and perform initial exposure assessments.
• Maintain electronic records documenting all file handling activity accurately and thoroughly.
• Determine total loss or probable total loss status for vehicles and resolve on an actual cash value basis.
• Manage vehicle repairs by ensuring timely shop completion and approving or rejecting additional repairs per industry standards.
• Identify and refer SIU-eligible claims per department criteria and transfer injury claims to the appropriate handler.

Technical Qualifications

• High school diploma or equivalent required, with post-secondary education preferred.
• Current adjuster licensure or ability to obtain within 90 days of hire.
• 3 or more years of auto claims handling or insurance-related experience preferred, with 1 or more years of commercial auto experience.
• Comprehensive knowledge of insurance policies, endorsements, and complex legal and contract documents.
• Basic computer skills with proficiency in Microsoft and Google applications preferred.
• Strong oral and written communication, customer service, collaboration, and relationship-building skills.

As the Major Loss Energy Claims Adjuster, this role oversees major loss claims handling across coverage determination, quantum analysis, and legal liability assessment in the energy sector, authorizing case strategies and reserves proposed by colleagues while serving as a senior technical referral point. The major loss claims team relies on this work to deliver technical training to internal and external contacts, represent claims expertise on industry forums, and present major loss management information to senior business stakeholders during quarterly estimate meetings.

Strategic Responsibilities

• Manage major loss claims handling including coverage determination, quantum analysis, and legal liability assessment.
• Prepare and evaluate investigation strategies identifying critical issues affecting liability, causation, and damages.
• Analyze exposures and tradeoffs between defense costs and settlement costs as new information becomes available.
• Ensure effective vendor and litigation management on major loss claims to reduce reliance on outside vendors.
• Authorize case strategies and reserves proposed by major loss colleagues as a senior technical referral.
• Deliver technical training to major loss colleagues and external contacts and support quality assurance and regional audit processes.
• Represent claims expertise on external technical panels and industry forums.
• Coordinate and present major loss management information to senior business stakeholders during quarterly estimate meetings.

Knowledge Skills & Abilities

• Extensive knowledge of claims-related actuarial issues, policy language interpretation, and legal and regulatory requirements.
• Experience in negotiation, mediation, arbitration, and ADR.
• Technical claims audit experience and catastrophe management experience.
• Ability to manage claims outside local jurisdiction, including knowledge of local laws and regulations.
• Expert policy wording interpretation skills and market-leading specialty knowledge in major loss technical claims topics.
• Strong communication, presentation, and time management skills.
• Ability to lead teams, deliver technical training, influence claims strategy, and manage senior internal and external stakeholders.