Property Claims Adjuster

Property Claims Adjuster

Position Summary

Processes and resolves claims, including coverage analysis, investigation, and thorough development of damage issues; develops detailed resolution plans.

Duties and Responsibilities

• Identifies, analyzes, and resolves coverage issues according to established Company protocol, including thorough policy review and the analysis of its application to the individual claim.    
• Develops and directs investigative plans. Conducts timely and detailed investigations that include scene investigation (e.g., photos, diagrams, blueprints, maps), statements, official reports (e.g., police, fire, weather, hail), and ownership documents (e.g., tax liens, judgments, encumbrances). identifies alleged and actual damages, identifies potential liable parties, recognizes and addresses potential fraud.
• Conducts thorough damage development, leading to timely and adequate evaluations, including appraisals/estimates, business records, invoices, detailed inventory, purchase records, receipts, credit card statements, and ALE documents. Develops appropriate methods of repair/replacement, verifies ownership, and applies any special limitations.
• Performs technical reviews of appraiser and contractor property damage estimates.
• Assures accurate and timely case reserving by evaluating reserves as additional information is developed and revising them accordingly. Confirms that the reserves represent the most likely ultimate cost of the loss, based on known and reasonably foreseeable facts.
• Effectively and efficiently manages independent adjusters, experts, and vendors. Assures that assignments outline specific tasks, that fees and time frames are agreed upon at time of assignment, and that Invoices are checked to confirm that charges are limited to the assigned tasks and are specific to instructions.
• Assures thorough and timely claims reporting. Prepares and distributes SLAs, SLRs, and Underwriting Alerts per accepted protocol.
• Assures appropriate handling of time-sensitive documents.  Brings time sensitive documents to the attention of the supervisor to be addressed within the prescribed time frame.
• Interfaces with others within the Company to analyze and improve program performance. Notifies Underwriting of unusual risks discovered during the investigation of a loss. Identifies and analyzes trends within a specific program or book of business and brings it to the attention of management.
• Keeps management informed of issues that represent a significant risk to the company or that jeopardize the achievement of overall corporate objectives.
• Interacts with customers to assure excellent customer service. Establishes 24-hour, voice to voice communication. Maintains effective communications with the Customer at all times.
• Maintains current knowledge of regulations and issues, industry activity, and trends.

Education and Experience

• Minimum 3-5 years related, applicable experience.  Progressive experience processing claims is preferred.
• Associate degree (A.A. or A.S.) or equivalent from a two-year college, business school, or technical school is preferred.  Bachelor’s degree (B.A. or B.S.) from a four-year college or university preferred.
• Or equivalent combination of education and experience.
• Texas Property/Casualty Adjuster license.

Skills, Knowledge, and Abilities

• Knowledge of standard office equipment and machines, including printers, copiers, and calculators.
• Ability to use software packages including document management estimating programs, and Microsoft Office.
• Experience adjudicating claims.
• Knowledge of residential construction/estimating.
• Knowledge of Fair Claims Practices.
• Knowledge of legal doctrines and principles.
• Understanding of State and county laws, claims investigation processes, and types of insurance policies.
• Outstanding written and verbal communication skills.
• Ability to manage timer effectively.
• Ability to compose letters, outlines, memoranda, and basic reports and to orally communicate technical information.
• Ability to effectively interact with supervisor, peers, claimants, contractors, and vendors.
• Ability to read and interpret documents such as insurance policies, regulations, and reports. 
• Ability to organize and prioritize own work schedule on short-term basis.
• Ability to solve practical problems and deal with variables. Ability to define problems, collect data, establish facts, and draw valid conclusions. 
• Ability to add, subtract, multiply, and divide, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio and percent and to draw and interpret bar graphs.
• Ability to make operating decisions and assist in formulating recommendations.

Working Conditions

• Normal office environment with strict deadlines.  Requires site visits outside the office.
• Requires repetitive movement of wrists, hands, and/or fingers for sustained periods of time.
• Requires standing less than 1/3 of the time.
• Requires repetitive movement of wrists, hands, and/or fingers for sustained periods of time.
• Requires standing less than 1/3 of the time.
• Requires sitting more than 2/3 of the time.
• Requires use of fingers and hands or feeling between 1/3 and 2/3 of the time.
• Requires talking or hearing between 1/3 and 2/3 of the time.
• Requires the ability to lift up to ten pounds between 1/3 and 2/3 of the time.
• Requires close vision, defined as clear vision at 20 inches or less.
• Requires field vision, defined as the ability to observe an area that can be seen up and down or to the left and right while the eyes remain fixed on a given point.
• Requires depth perception, defined as three-dimensional vision and the ability to judge distances and spatial relationships so as to see objects where and as they actually are.
• Valid driver’s license and insurable driving record.

Freedom to Act:  Works consists of somewhat difficult tasks with several choices as to what operations and processes will be followed.  Requires use of moderate judgment in applying policies and adapting standards to fit facts and conditions.  Work is performed with some latitude for independent action or decision within policies and practices.

Disclaimer:  This document describes the minimum essential duties, responsibilities, skills, abilities, effort, and working conditions of the position.  It in no way implies that these are the only functions to be performed by the incumbent and the functions may be modified by the supervisor at any time to meet Company needs.  Workers are required to follow any other job-related instructions and to perform any job-related functions requested by a supervisor or manager.  Unless otherwise indicated, all job-related functions will be performed on-site at the Employer’s facility.  Successful performance requires that the incumbent possess and utilize the abilities and skills described.  All functions are subject to reasonable modification to accommodate individuals with disabilities.  Some functions may exclude individuals who pose a direct threat or significant risk to the health and safety of themselves or others.