Policy Services

Description:

Position Summary

The ideal candidate is an experienced, all-lines adjuster, with at least one year of PIP handling experience for Florida PIP claims, specifically with experience clearing coverage and qualifying claimants for benefits under the policy. The candidate has a strong background in insurance claims processing, excellent communication skills, and the ability to handle complex situations with empathy and professionalism. Adjusters are responsible for assigned files within their department matched to their expertise in claims handling. They must follow protocols set forth by department supervisors/managers and operate within their stated authority and handle claims in accordance with the Florida adjuster code of ethics.

Essential Duties and Functions

The essential functions include, but are not limited to the following:

· Evaluate auto insurance claims promptly and accurately to determine coverage, liability, and settlement options.

· Conduct thorough investigations into the circumstances surrounding each claim, including obtaining statements, collecting evidence, and analyzing policy provisions.

· Maintain detailed and organized claim files, documenting all relevant information, correspondence, and decisions made throughout the claims process.

· Communicate effectively with policyholders, claimants, witnesses, and other involved parties to gather information, explain coverage, and provide updates on claim status.

· Negotiate settlements within authorized limits, considering factors such as liability, damages, and policy coverage.

· Provide exceptional customer service to policyholders and claimants, addressing inquiries, concerns, and complaints in a timely and professional manner.

· Ensure compliance with insurance regulations, company policies, and industry standards in all aspects of claims handling.

· Collaborate with internal teams, including underwriters, legal counsel, and other claims professionals, to resolve complex claims and mitigate risk effectively.

· Identify opportunities for process improvement and contribute to the development of best practices within the claims department.

· Perform quality reviews of claim files to ensure accuracy, consistency, and adherence to company guidelines.

· Ensure timecards are reviewed daily for accurate hours worked.

Requirements:

Minimum Qualifications (Knowledge, Skills, and Responsibilities)

· Strong knowledge of insurance principles, regulations, and industry standards.

· Excellent analytical skills with the ability to assess liability and evaluate damages.

· Exceptional communication and interpersonal skills, both written and verbal.

· Proficiency in insurance claims software, preferably Microsoft Office suite.

· Demonstrated ability to manage multiple priorities and meet deadlines in a fast-paced environment.

· Commitment to providing outstanding customer service and maintaining professionalism in challenging situations.

Required Education and Experience:

· High School Diploma or equivalent experience in auto claims insurance, business administration, or a related field; Bachelor’s or Associates degree preferred.

· Minimum of 1+ years of PIP handling experience for Florida PIP claims

· Florida Adjuster License.