Claims Adjuster - Alternative Dispute Resolution
Job Description:
• Promptly review assigned claims and execute appropriate ADR strategies in compliance with Florida Statutes 627.70152 and 627.7152.
• Verify loss details and policy coverage to ensure accurate application of benefits.
• Manage claims from start to finish, including fact gathering, policy analysis, coverage determination, and payment issuance within authority limits.
• Review all claim materials to assess completed and pending investigations, positioning the file for timely resolution.
• Maintain detailed documentation of claim actions, communications, and decisions.
• Respond daily to emails, calls, and inquiries from insureds, public adjusters, attorneys, and contractors.
• Establish and adjust reserves promptly in response to changing claim exposure.
• Provide clear and timely status updates, explaining settlement decisions and claim outcomes.
• Submit reserve and payment approval requests as needed.
• Identify and draft Reservation of Rights or denial letters for managerial review.
• Evaluate claims for suitability for DFS Mediation or appraisal, initiate the selected ADR process, and manage the claim through resolution.
• Attend mediations and apply technical and negotiation skills to facilitate claim settlements.
• Oversee the appraisal process, ensuring regular communication and timely progress toward resolution.
Requirements:
• A four-year college degree is preferred
• Prior insurance experience with an insurance carrier or agency.
• Minimum 7 years’ experience and/or training in P & C Insurance or equivalent combination of education and experience.
• Minimum of 3 years’ experience in the appraisal process.
• Continuously maintain all licenses required to perform work in the states we currently complete business in within 60 days of employment.
Benefits:
• Company-sponsored Medical, Dental, Vision, Life, and Disability Insurance (Short-Term and Long-Term).
• 401k Retirement Plan with a generous 9% match
• Four weeks of PTO and Pet Insurance for your furry family members.
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