Injury Examiner
- Colorado Springs, CO
- $85,040-162,550 per year
- Permanent
- Full-time
- Adjusts complex auto and homeowner bodily injury claims with significant injuries (e.g. traumatic brain injury, disfigurement, fatality) and UM/UIM, and small business claims, as well as some auto physical damage associated with those claims. Identifies, confirms, and makes coverage decisions on complex claims.
- Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes.
- Prioritizes and manages assigned claims workload to keep members and other involved parties informed and provides timely claims status updates.
- Collaborates and supports team members to resolve issues and identifies appropriate matters for escalation.
- Partners and/or directs vendors and internal business partners to facilitate timely claims resolution.
- Serves as a resource for team members on complex claims.
- Delivers a best-in-class member service experience by setting appropriate expectations and providing proactive communication.
- Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
- May be assigned CAT deployment travel with minimal notice during designated CATs.
- Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
- High School Diploma or General Equivalency Diploma.
- 4 years auto claims and injury adjusting experience.
- Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations.
- Advanced negotiation, investigation, communication, and conflict resolution skills.
- Demonstrated strong time-management and decision-making skills.
- Proven investigatory, prioritizing, multi-tasking, and problem-solving skills.
- Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims.
- Ability to exercise sound financial judgment and discretion in handling insurance claims.
- Advanced knowledge of coverage evaluation, loss assessment, and loss reserving.
- Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
- 2 or more years of catastrophic injury experience (e.g. traumatic brain injury, disfigurement, fatality)
- Experience handling UM/UIM injury claims
- College Degree (Bachelor’s or higher).
- Insurance Designation.
- US military experience through military service or a military spouse/domestic partner