Job DescriptionJob SummaryReview, investigate and handle general commercial, professional and auto liability claims as assigned by claims supervisor to determine liability and exposure; to work with high exposure claims involving litigation; to ensure ongoing exceptional claims handling within service expectations; and identify subrogation of claims and negotiate settlements. Communicate directly with clients, brokers, and attorneys to manage claims in a timely and economic manner.
Responsibilities- Receives claim assignments from claim supervisor; examines claim forms and other records to determine insurance coverage.
- Interviews, telephones, and/or correspond with claimant(s) and client within established time frame, document results of these contacts.
- Consults police reports and medical records to determine nature and extent of the accident.
- Reviews medical bills to ensure treatment is reasonable, necessary and related to the injury.
- Ensures that claim file documentation and reserves are current; and keeps client advised on claim status.
- Negotiates settlement with claimant within limits of authority.
- Coordinates and monitors litigation with attorneys.
- Brings claims to conclusion.
- Handles caseload consisting of complex liability.
- Independently prepares for and attends client meetings to discuss claim status, reserve levels and action plans.
- Participates in mentoring programs to assist in the professional development of less experienced adjusters.
- Mentors less experience co-workers to develop their understanding of procedures, state laws, and help others improve their claims handling ability
- Assists with client development, education, and problem solving.
- Completes Excess reports and requests for reimbursement; submits these to carriers; follows up for recovery.
- Handles claims involving subrogation from investigation through recovery.
- On-site investigation of claims when necessary.
- Analyzes and resolves client issues independently.
- Manage healthcare liability claims involving healthcare facilities, and providers, under both primary and excess insurance policies across all 50 states.
- Ensure comprehensive oversight of complex claims, including investigation, evaluation, and resolution, while maintaining compliance with state-specific regulations and industry standards.
- Investigation plans for each claim; evaluating each with respect to standard of care, liability, causation and damages.
- Analyze and process complex or technically difficult medical malpractice lawsuits by investigating and gathering information, determining the exposure on the claim. Overall investigation and management of medical malpractice claims.
- Other duties may be assigned
Requirements- Working knowledge of medical malpractice insurance principles and laws
- Successful history of case management and loss minimization
- Effective analysis of liability, causation and damages
- Successful use of creative settlement tools including structured settlements
- Ability to read and interpret documents such as instructions and procedure manuals.
- Ability to write routine correspondence and effectively present information one-on-one.
- Ability to respond to inquiries and complaints.
- Ability to read, analyze, and interpret general business periodicals, professional journals,
- financial reports, legal documents, and government regulations.
- Ability to effectively present information in group situations.
- Ability to carry out instructions furnished in written or oral form.
- Ability to deal with problems involving several variables.
- Ability to solve practical problems and deal with situations where limited standardization exists.
- Ability to define problems, collect data, establish facts and draw valid conclusions.
- Mathematical Abilities.
- Ability to add, subtract, multiply and divide using whole numbers, common fractions and decimals.
- Ability to compute basic percentages.
- Ability to calculate figures/amounts such as discounts, interest, proportions and complex percentages.
- Communication for this position entails regular contact with both internal and external constituents.
- Good verbal and written communication skills, as well as interpersonal skills.
- Ability to listen well and negotiate with constituents.
- Ability to communicate effectively with people on different educational levels.
- Ability to prepare and present information on an individual basis as well as in a group setting.
- Commercial General Liability insurance policy knowledge preferred.
- Thorough knowledge of liability insurance claims handling, with school/educational
- system or public entity's knowledge preferred.
- Position will be remote
Education and Experience- High school Diploma or equivalent is required.
- 5-7 years prior experience handling professional liability/medical malpractice, auto/general liability claims/personal lines, or an equivalent combination.
- Active multi-state adjuster licenses required.
- Strong organization skills, attention to detail and the ability to multi-task and prioritize work are required.
- Analytical thinking skills are needed to properly evaluate complex claims.
- Attention to detail is necessary as claims adjusters must carefully review documents and policies.
- Strong verbal and written communication skills, as well as interpersonal skills are required, experience with negotiations, knowledge of litigation process is preferred.
- Ability to listen well and negotiate with constituents is needed.
- Basic computer skills or the ability to quickly learn new software are required- Microsoft
- Word, Excel and Outlook experience.
- A strong work ethic and time management skills are needed, to efficiently, and accurately resolve claims.
- Capable of effectively managing an assigned client caseload.
- Ability to establish and maintain good rapport with clients and claimants is needed.
- Ability to calculate figures is required.
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Pay Details:
The base compensation range for this position is $95,000 - $125,000. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.
Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership. 
