Title: Claims Adjuster Supervisor: Director of Claims
Location: Cerritos, CA - Office Based
Travel Required: Frequent Day Trips, Occasionally Overnight, Mostly Within California
Level/Salary Range: Position Type: Full-Time Exempt
Job Purpose:
Under the supervision of the Claims Manager, the role of the claims adjuster is to investigate, analyze and determine the extent of ASCIP’s liability concerning casualty and property claims resulting in loss or damages, and attempt to effect settlement with claimants. The process by which this is accomplished is through correspondence or interviews with ASCIP member staff, witnesses, claimants, or others to compile relevant information. This role will be responsible for establishing financial reserves, overseeing litigation, mediation and/or settlements, and maintaining a record of all such activity in an electronic database. Success in this role will be evaluated by member satisfaction, adherence to ASCIP and Industry best claims administration guidelines, and the ability to close claims in a cost-effective manner. Work will be performed under the general supervision of ASCIP’s Claims Manager and will require a high degree of independence and initiative.
Essential Duties:
Investigate Claims
• Investigate the circumstances of property or liability claims or incidents reported by ASCIP members and assigned by the Claims Manager.
• Investigation will be accomplished through direct contact with member staff via phone, email or direct field contact as may be appropriate and given the potential severity of the matter.
• Collect evidence and information regarding the circumstances of the claim will be obtained through interview with knowledgeable parties, inspection of property, examining documents, and/or review of reports to secure relevant facts, circumstances, documents, and materials.
• Investigate and assess damage to property.
• Prepare report of findings of the investigation.
Evaluation and Administration of Claims
• Examine claims information and other records to establish coverage under ASCIP’s Memorandum of Coverage.
• Analyze information gathered by investigation and report findings and recommended actions.
• Assist members with handling claims decisions relative to the Governmental Claims Act.
• Evaluate subrogation potential.
• Strategize the most effective, efficient, and cost-effective approach to processing and resolving the claim.
• Evaluate the claim information for the extent of liability for ASCIP.
• Establish, review, and maintain adequate expense and indemnity reserves within specified authority levels throughout the life of the file.
• Approve payments on any expenses incurred to resolve claims.
• Attempt to resolve claims prior to litigation when possible and seek settlement authority as may be required.
• Attend and contribute to monthly claim management meetings or roundtable meetings.
• Provide direction to defense counsel on litigated claims.
• Attend and participate in mediations, settlement conferences and trials as may be required.
• Compile evidence for litigation proceedings.
Electronic File Documentation
• Input claims data on each claim into ASCIP’s claims system as per established guidelines.
• Maintain all relevant file notes and correspondence in the claims system to support claims activity.
• Maintain a diary on all assigned claims ensuring each claim is managed in a timely, cost-effective manner.
• Ensure that reasonable reserves are maintained based on current claim information.
Other
• Perform other related duties as assigned.
• The CEO may revise the essential duties and reporting relationship of this position at any time.