Job Details

We are looking for experienced adjusters to handle daily claims for our carriers in West Virginia. A Daily Claims Adjuster determines and communicates the extent of loss or damage associated with commercial/residential claims, assisting the insurer in fulfilling its obligation to policyholders and helping to safeguard the insurers reputation and efficacy.

PRIMARY JOB RESPONSIBILITIES:

• Conduct triage upon receipt of claim to determine best method to scope and adjudicate the loss.
• Through interviewing or other methods, obtains necessary information from the claimant and from experts such as health care practitioners, accountants, and others to fully and accurately assess the extent of the loss.
• Work cooperatively with expert witnesses, attorneys, public adjusters, and carriers examiners as needed to conduct investigations, confirm findings, and support evaluations.
• Apply understanding of insurance policies and policy interpretation, establishing appropriate loss estimates based on all relevant information and findings.
• Establish and recommends the reasonable and proper amount the insurance company should pay on a claim.
• Ensure the accuracy of information collected and reported and guards against fraudulent claims, based on critical issues identified and accurate conclusions drawn.
• Prepare accurate, clear, thorough, and concise reports and letters to insurance carriers on conclusions and recommendations. Follows established policies, procedures, and processes in preparing information, and submits reports and documents in a timely manner and in accordance with insurers standards and expectations. Effectively uses software systems as necessary to produce accurate estimates.
• Maintain accurate, thorough notes, journal entries, and time and expense records as required. Submits reimbursement reports in keeping with organization and client policies, procedures and practices, and accepted industry standards. Applies knowledge of both time-and-expense and fee-for-service procedures, according to the stipulations of the agreement with the insurer.
• Obtain manager guidance as necessary, and in accordance with Eberl policy and practice, in formulating recommendations and completing evaluations and reports.