Job Purpose:

• The Senior Claims Adjuster is responsible for the investigation, evaluation, and resolution of complex insurance claims.
• This role ensures that all claims are handled efficiently and within established authority limits, in alignment with company policies, procedures, and industry regulations. The adjuster will assess losses, validate documentation, identify inconsistencies, and make recommendations for process improvements while maintaining comprehensive records and reports.

Pay Range: $25 - $27 an hr 

Key Responsibilities:

• Claim Investigation and Adjustment – 70%

• Proactively investigate and evaluate complex insurance claims.

• Perform adjustments in accordance with company standards and within authority limits.

• Ensure accurate claim resolution and compliance with regulatory and internal guidelines.

• Documentation and Evaluation – 15%

• Review reports and supporting documentation to establish insurance losses.

• Maintain detailed and accurate claim records by completing logs, summaries, and formal reports.

• Highlight irregularities and recommend process improvements when needed.

• Claim Settlement – 10%

• Approve or deny claims based on thorough evaluation.

• Collaborate with supervisors and stakeholders to facilitate timely and appropriate claim settlements.

• Professional Development – 5%

• Participate in training sessions to enhance claims handling expertise and stay updated on industry trends.

Education:

• High School Diploma or GED required.

Experience:

• Minimum of 5 years of experience in claims adjustment.

• Deep understanding of relevant systems, procedures, and policies.

Knowledge, Skill, and Abilities (KSAs):

• Strong analytical and investigative skills.

• Excellent verbal and written communication abilities.

• Ability to assess and resolve complex problems effectively.

• High attention to detail and accuracy in documentation.

• Ability to work independently and manage multiple priorities.