Claims Processing Manager Jobs in Virginia (NOW HIRING)

Our Claims team is currently seeking an Auto PD Adjuster – Service Claims.

This is a full-time, exempt role with a hybrid work schedule (two days in the office) at one of our Hanover offices: 

• Worcester, MA
• Richmond, VA
• Syracuse, NY 
• Itasca, IL
• Howell, MI 

POSITION OVERVIEW:

The Adjuster Service Claims is responsible for managing a caseload of moderately complex claims from initiation to resolution. This includes determining coverage, conducting thorough investigations, evaluating damages, and negotiating settlements in accordance with policy terms, best practices, and jurisdictional requirements. The role involves direct communication with insureds and third parties, as well as accurate input and management of claim data.

IN THIS ROLE, YOU WILL: 

• Manage a caseload of moderately complex service claims from intake through resolution.
• Conduct thorough investigations, assess liability, and evaluate damages using established procedures.
• Engage underwriting, legal, and stakeholders for comprehensive investigation and evaluation. 
• Identify and refer suspicious claims to the Special Investigation Unit. 
• Transfer risk to appropriate parties.
• Maintain appropriate adjuster licenses and continuing education credits. 
• Handle claims within specific limits and authority; use discretion and independent judgment. 
• Set reserves and authorize payments within scope of authority.
• Review and validate intake claims; conduct investigations and document findings. 
• Coordinate with stakeholders to resolve issues; adhere to claims processing procedures. 
• Utilize technology and data tools to enhance claims processing efficiency and accuracy.
• Resolve claims with empathy and customer-centricity; prepare documentation and evidence. 
• Maintain detailed and compliant documentation of claim activities and communications.
• May represent the company in mediations, arbitrations, and trials. 
• Participate in problem-solving discussions, and cross-functional coordination.
• Handle sensitive communications professionally and translate complex information for diverse audiences.
• Mentor entry-level adjusters and share best practices learned through training and experience.
• Provide exceptional customer service; educate policyholders and ensure satisfaction. 
• Ensures Compliance with all licensing requirements.
• Identify and assign subrogation potential appropriately; set up files to support successful recovery efforts

WHAT YOU NEED TO APPLY:

• Associate degree required; bachelor's degree preferred or combination of education and experience.
• Typically has 3-4 years of relevant Auto claim-handling experience.
• Guidewire experience is a plus.
• Proficient with basic computer navigation; ability to use basic software. systems/applications (Suite of MS Office Products) and use of the internet.  
• Knowledge of insurance products, processes, and relevant laws. 
• Learn and handle negotiations independently within authority, understand common tactics for moderately complex claim resolution.  
• Communicate clearly and empathetically across various channels.
• Operate with decision-making latitude; adapt to changing situations. 
• Deliver difficult messages with clarity and professionalism.
• Collaborate with team members and maintain constructive relationships.
• Manage multiple tasks and deadlines with strong organizational skills.
• Negotiate claims independently within authority limits.
• Understand insurance principles, policies, procedures, and terminology. 
• Possess investigative skills and follow procedures and guidelines. 

Core Capabilities:

• Analytical Reasoning: The ability to identify problems, understand your impact, gather input and data, and develop an effective solution.
• Customer Centricity: Makes customers/clients and their needs a primary focus of one’s actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meets or exceeds customer expectations.
• Digital Fluency: Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes.
• Persuasion and Influence: Uses appropriate interpersonal skills and techniques to gain acceptance for ideas or solutions; uses influencing strategies to gain genuine agreements; seeks to persuade rather than force solutions or impose decisions or regulations.
• Professional Insurance Acumen: Demonstrates a deepening understanding of the insurance industry and the ability to apply specialized technical skills to address complex challenges, adapt to industry trends, and drive value for the organization.
• Planning and Execution: Plans, prioritizes and manages resources and time effectively to achieve specific goals or deadlines.

This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.