Our client, a leading insurance provider, is actively seeking an experienced Remote Senior Claims Adjuster to manage complex claims from their home office. This fully remote position requires a deep understanding of insurance policies, claims investigation, and settlement processes. You will be responsible for handling a portfolio of challenging claims, conducting thorough investigations, determining coverage, negotiating settlements, and ensuring compliance with all regulations. The ideal candidate possesses excellent analytical skills, strong negotiation abilities, and a commitment to providing outstanding customer service while working independently.

Key Responsibilities

Investigate, evaluate, and settle complex insurance claims in accordance with policy provisions and company guidelines. Conduct thorough reviews of claim documentation, accident reports, medical records, and other relevant evidence. Determine coverage liability and calculate appropriate claim settlements. Communicate effectively with policyholders, claimants, attorneys, and other parties involved in the claims process. Negotiate settlements within established authority limits, striving for fair and equitable resolutions. Ensure compliance with all state and federal insurance regulations and company policies. Maintain accurate and detailed claim files, documenting all activities and communications. Identify potential subrogation or salvage opportunities. Provide exceptional customer service throughout the claims handling process. Contribute to process improvement initiatives and mentor junior adjusters.

Qualifications

Bachelor's degree in Business Administration, Finance, or a related field, or equivalent work experience. Minimum of 5 years of experience in handling complex claims, preferably within property and casualty or specific lines of insurance. Proven expertise in claims investigation, evaluation, negotiation, and resolution. Thorough understanding of insurance policies, legal principles, and regulatory requirements. Excellent analytical and critical thinking skills. Strong negotiation and conflict resolution abilities. Exceptional written and verbal communication skills. Proficiency in claims management software and standard office applications. Ability to work independently and manage a caseload effectively in a remote environment. Relevant state adjuster licenses are required; additional lines of authority are a plus. Apply To this Job