Commercial Auto BI Claims Adjuster #35150
Office Call Center
Lake Mary, FL Contract To Hire Sep 13, 2023
Contemporary Staffing Solutions is seeking an experienced Commercial Auto BI Claims Adjuster to join our client for a work from home opportunity! You will manage a caseload of up to 150 pending claims, which may involve varying levels of complexity. Your primary responsibilities will include establishing facts of loss, coverage analysis, investigation, determinations of compensability/liability/negligence, coordination of medical care, litigation management, damage assessment, settlement negotiations, fraud detection, and effective utilization of authorized vendors. You will also be responsible for timely and accurate reserve analysis and report completion. Additionally, this role entails attending conferences, client meetings, mentoring fellow adjusters, and assisting management as needed. All claims handling must align with state statutes, Client Claims Handling Guidelines, and the client’s Best Practices. Occasional travel and other duties may be assigned as necessary. This Contract-to-Hire opportunity is offering $30-$35/HR!

Responsibilities:
  • Initial Contact: Initiate first contact with involved parties and clients within 8 business hours.
  • Liability Assessment: Contact relevant parties and providers to assess liability, compensability, negligence, and subrogation potential.
  • Ongoing Communication: Maintain regular contact with relevant parties and provide necessary information and benefits explanations throughout the claim's life.
  • Communication Management: Monitor and respond to phone calls and voicemails promptly.
  • Mentorship: Assist in training and mentoring Claims Adjusters.
  • Project Support: Collaborate with management on projects and leadership tasks as required.
  • Unit Management: Assume the responsibilities of the Assistant Unit Manager/Unit Manager when needed.
  • Subrogation: Identify and refer files with subrogation potential to the subrogation department.
  • Closing Ratio: Maintain a closing ratio as determined by the management team.
  • File Closure: Close all files appropriately and in a timely manner.
  • Fact Verification: Verify facts of loss, claims details, employment information, wages, and damages as needed, and establish disability with treating physicians when necessary.
  • Settlements: Identify cases suitable for settlement, request authority at least 30 days prior to mediation date, and negotiate settlements.
  • Lien Management: Evaluate and negotiate liens effectively.
  • Fraud Detection: Recognize and report potential fraud cases.
  • Litigation Planning: Develop and direct litigation plans with defense attorneys, ensuring timely completion of filings and state-mandated forms.
  • Litigation Oversight: Review claim files involving active litigation monthly, document responses, defense development, depositions, and refer to defense counsel when required.
  • Defense Counsel Direction: Direct actions of defense counsel on litigated files.
  • Mediations and Trials: Attend mediations and trials as necessary for cost-effective litigation management.
  • Reserve Establishment: Establish ultimate reserves based on known facts and adjust them when exposure changes.
  • Benefit Payment: Ensure timely payment of all known benefits in accordance with state statutes.
  • Provider Bill Review: Verify that all provider bills are reviewed and paid within standard timeframes.
  • Reporting: Report all serious injuries, liability issues, and potential large loss claims to clients and reinsurers per provided criteria.
  • Compliance: Successfully pass all internal and external audits, including those by regulatory agencies, carriers, and clients.
  • Reporting Compliance: Follow reporting requests as outlined by client files and the client’s guidelines.

Qualification Requirements:
  • High School Diploma or equivalent required; 2-year degree or higher preferred.
  • 7+ years of prior claim adjusting experience, with a focus on the relevant line of business.
  • 7+ years of heavy litigation experience for all lines except Worker's Compensation.
  • 5+ years of experience in Construction Defect or a related field if handling that line of business.
  • Eligibility for reserve/payment authority of $50,000+ when appropriate.
  • Must possess or have the ability to obtain a Florida Adjuster's license or other required jurisdictional licensing.
  • Strong negotiation and litigation skills for extensive work with attorneys and arbitration on first and third-party claims.
  • Ability to work independently with excellent organization, time management, written and verbal communication skills.
  • Proficiency in explaining and responding to auditors, clients, and potential clients during in-person presentations.

Contemporary Staffing Solutions (CSS) has been a leading provider of contract, temporary, temporary-hire & direct hire solutions. We began as a staffing agency and evolved to a national provider of workforce management solutions with a niche recruitment focus in Accounting & Finance, Call Center & Office, Human Resources, Sales & Marketing, & Information Technology. To learn more about CSS, visit our website: www.ContemporaryStaffing.com.