高级财产理赔调整员 - Field

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.
**This position is eligible to work remotely in the Minneapolis/St Paul, Minnesota area**
Exercises independent judgment in the investigation, evaluations, negotiation, and disposition of large and moderately complex to complex commercial property claims, including claims in litigation, within limitations of authority outlined in the Claims Guide. Communicates with insureds, agents, and experts regarding coverage and claim status or questions.
Essential Functions:
1. Promptly investigates and evaluates large and moderately complex to complex commercial property claims and reinsured cyber claims as assigned:

• Reviews and evaluates the claim notice, lawsuits, contracts, and policies to verify coverage, deductibles, claim payee/mortgagees and determines compensability

• Performs field inspections on large and moderately complex to complex commercial property claims as applicable

• Initiates timely contact with insureds and claimants to explain the claims process

• Coordinates with appropriate experts to ensure urgent matters are addressed, such as initial remediation, temporary restoration, business continuation either at the damaged location or at a new temporary business site, preserving evidence, securing origin and cause experts, various engineers, general and subcontractors etc., and multi-party reinspection

• Obtains statements from insureds, claimants, witnesses, and all other pertinent parties

• Documents claim activities, reserve analysis, summaries of reports in the claim system

• Sets timely, adequate reserves using reserve worksheets in compliance with the company reserving philosophy and methodology

• Analyzes business records, such as profit and loss statements, tax forms, financial forecasts, and payroll records to estimate the loss of business income

• Secures all necessary official reports, claim forms, and pertinent documents

• Reviews bills, invoices, and receipts, including legal and litigation related expenses, for accuracy and appropriateness

• Notifies all parties involved that legally require appropriate notice

• Notifies the Claims Supervisor of claims exceeding authority level and requiring assignment to more senior level team member

2. Negotiates, settles and/or resolves large and moderately complex to complex commercial property claims:

• Resolves questions of coverage and resolves disputes on repair methods and the value of the claims

• Drafts and sends reservation of rights and denial letters upon manager approval

• Evaluates cause of loss and writes detailed estimates for cost of repairs and value of damaged property, including reviewing discrepancies identified between research and software estimates

• Provides prompt, detailed responses to agents, insureds, and claimants on the status of claims

• Evaluates, analyzes negotiation ranges, and target settlement numbers

• Communicates with insureds/claimants/attorneys to negotiate the settlement of claims

• Performs re-inspection of property files and participates as an adjuster or re-inspector during catastrophic claims operations

• Identifies, investigates, and proactively pursues opportunities for recovery, including arranging of evidence preservation in legal compliance that meets custody, control, transfer, analysis, and disposition of physical and/or electronic evidence

• Recommends appropriate defense counsel to manager and collaborates with assigned attorney on litigation following EMC case handling guidelines

• Identifies potential fraudulent claims and refers cases to Special Investigation Unit (SIU) as necessary, participating in any subsequent subrogation and SIU proceedings

• Drafts and issues settlement documents and timely payments, including statements of loss and proof of loss, and verifies accuracy and compliant documentation

• Assists as needed in the coordination and preparation of cases involved in mediations, appraisals, arbitrations, and lawsuits

3. Collaboration

• Submits referrals to the Estimatics, SIU, Large Loss Claims, Bond, Subrogation, and Coverage Counsel when necessary

• Prepares risk reports for Underwriting and Risk Improvement

• Review coverage intent and policy activity with Underwriting

• Reviews account inspection information with Risk Improvement

• Actively participates in claims roundtables by preparing cases needing group discussion and providing input on cases shared by other claims adjusters

• Handles referrals of property or property damage claims from other units or departments

• Reviews and audits property estimates written by independent adjusters and contractors for accuracy and to ensure the most cost-effective repair approach

• Assists claims team members as needed. Acts as a technical resource for less experienced claims adjusters, providing guidance on claims handling practices

• Participates in large projects as necessary

Education & Experience:

• Bachelor’s degree or equivalent relevant experience

• Five years of property claims adjusting experience or related experience

• Relevant insurance designations preferred

This position is open to being filled at the Property Claims Specialist level with the below requirements:

• Bachelor’s degree or equivalent relevant experience

• Eight years of property claims adjusting experience or related experience

• Relevant insurance designations preferred

Knowledge, Skills & Abilities:

• Excellent knowledge of the theory and practice of the claim function

• Strong knowledge of insurance contracts, medical terminology and substantive and procedural laws

• Strong knowledge of computers and claims systems

• Ability to obtain all applicable state licenses

• Excellent organizational and empathetic interpersonal skills

• Strong written and verbal communication skills

• Excellent customer service skills

• Excellent investigative and problem-solving abilities

• Ability to maintain confidentiality

• Occasional travel required; a valid driver’s license with an acceptable motor vehicle report per company standards required if driving

The hiring salary range for this position will vary based on geographic location, falling within either of the following:
$78,726 - $108,771 or $87,008 - $119,646A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.
For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers.
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.
All of our locations are tobacco free including in company vehicles.
Originally posted on Himalayas