Claims Adjuster II - Workers' Compensation

Job Title: Claims Adjuster II - Workers' Compensation

FLSA Status: Exempt

Job Family: Claims

Department: Work Comp Claims

Location: Corporate Office (Fort Wayne, IN)

JOB SUMMARY
Responsible for effectively analyzing and resolving assigned claims consistent with Claims Department standards and company objectives.

POSITION ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Resolve all assigned claims (including the occasional serious/complex claim, which could include but not be limited to unusual damage or coverage issues, or that need the involvement of expert analysis or require early recognition of policyholder concerns) within established settlement authority in a prompt, fair and equitable manner. Identify and investigate coverage, damage, and reserve adequacy on assigned claims.
• Apply statutes, common law, and other applicable legal and regulatory concepts for the effective, efficient and equitable resolution of assigned claims.
• Achieve established claim file audit objectives.
• Communicate with policyholders, agents, claimants, attorneys, medical providers and other persons as needed and direct independent adjusters, appraisers and other support service providers to ensure effective, efficient, and equitable claims resolution.
• Acquire, record and maintain all essential file documentation in accordance with established guidelines.
• Provide timely status reports regarding assigned claims to claims department management and others.
• Identify and pursue appropriate cost containment, loss mitigation and subrogation recovery opportunities.
• Participate and provide input in departmental meetings or interdepartmental meetings, projects or processes that relate to the claims function.
• Travel as needed to attend training programs, conferences, mediation/other legal proceedings, and to conduct investigation relating to claims resolution.
• Further the attainment of overall department objectives by assisting other claims personnel as needed.
• Participate as needed in the orientation or training of new department personnel.
• Complete other projects as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES
The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to effectively communicate with others (both oral and written). Must demonstrate the ability to present a reasoned position in both an oral and written format.
• Must be able to make independent decisions.
• Must have good interpersonal skills. Must have the ability to handle confrontational situations in a productive manner. Must demonstrate the ability to employ sound negotiation techniques in the resolution of assigned claims.
• Must have good organizational skills.
• Must have a good understanding of basic issues related to claims. Must have a good understanding of coverage issues.
• Must be able to access, input and retrieve information from a computer.
• Must have a good understanding of all automated claims department processing systems and workflows.
• Should be able to sit for prolonged periods of time.
• Possess the ability to inspect losses by walking, lifting, climbing or bending.
• Effectively interface with external contacts, Brotherhood employees, managers, and department staff members.

EDUCATION AND/OR EXPERIENCE

• Bachelor’s degree or completed AIC or completed 3 parts of CPCU, is required.
• Must be able to take and pass mandatory adjuster licensing requirements.
• Must have 3 years or more of claim technical experience.
• AIC/CPCU or other insurance-related course work is desired.
• 5 years or more of Brotherhood Mutual claims technical experience is desired.

Terms and Conditions

This description is intended to describe the general content of and requirements for the performance of this position. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements.

Because the company’s niche is the church and related ministries market, and because effective service requires a thorough understanding of this market, persons in this position must be familiar with church operations and must conduct themselves in a manner that will neither alienate nor offend persons within this target niche.

Brotherhood Mutual Insurance Company reserves the right to modify, interpret, or apply this position description in any way the company desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. This position description is not an employment contract, implied or otherwise. The employment relationship remains “at-will”.

Equal Opportunity Employer


This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.