Remote Senior Claims Adjuster - Specialist

Our client, a leading insurance provider, is seeking an experienced and highly skilled Senior Claims Adjuster to join their fully remote claims department. This pivotal role demands a meticulous approach to claims investigation, assessment, and resolution, with a strong emphasis on delivering exceptional customer service in a virtual environment. The ideal candidate will possess a deep understanding of insurance policies, regulatory compliance, and advanced claims handling techniques. You will be responsible for managing complex claims from inception to closure, ensuring fairness and accuracy throughout the process.

Responsibilities:

• Investigate, evaluate, and negotiate complex insurance claims, including liability, coverage, and damages.
• Interpret policy provisions and determine coverage for claims submitted.
• Conduct thorough fact-finding by interviewing claimants, witnesses, and relevant parties.
• Gather and review necessary documentation, such as police reports, medical records, and repair estimates.
• Assess the extent of damages and determine fair settlement values.
• Communicate effectively with policyholders, legal counsel, and other stakeholders throughout the claims process.
• Ensure compliance with all state and federal regulations and company policies.
• Maintain accurate and detailed claims files and documentation within the claims management system.
• Identify potential fraud indicators and escalate suspicious claims for further investigation.
• Contribute to the continuous improvement of claims handling processes and procedures.
• Mentor and guide less experienced claims adjusters in a remote team setting.

Qualifications:

• Proven experience as a Claims Adjuster, with a significant portion handling complex claims.
• In-depth knowledge of insurance policies, claims investigation techniques, and legal/regulatory requirements.
• Excellent negotiation, communication, and interpersonal skills, vital for remote client interaction.
• Strong analytical and problem-solving abilities.
• Proficiency in claims management software and standard office applications.
• Ability to work independently, manage a caseload effectively, and prioritize tasks in a remote work environment.
• Relevant industry certifications (e.g., AIC, CPCU) are highly desirable.
• Bachelor's degree in Business Administration, Finance, or a related field, or equivalent work experience.
• Must be licensed as required by state regulations where applicable, or willing to obtain licenses.
• Dedicated home office setup with reliable high-speed internet for consistent remote performance.

This is a fantastic opportunity to leverage your expertise in a fully remote capacity, supporting a reputable insurance company based in Des Moines, Iowa, US . You will be an integral part of a team dedicated to upholding the highest standards of claims service.