Commercial Specialty Adjuster, Casualty

Department: Claims Job Description: As the Specialty Adjuster, Casualty you will be responsible for investigating, evaluating, and settling first and third-party bodily injury and liability claims. The majority of the claims you will handle will involve Large Losses, Construction Defect, NY Labor Law, Sexual Misconduct, Environmental, Trucking, E&S and Professional Liability. You will generally have settlement authority up to $175,000 for liability claims. Supervisor direction should only be required for high-valued, unique, or multi-faceted claims over settlement authority. You will work out of your home office and require limited supervision. To be successful in this position, you must be familiar with complex claims concepts, practices, and procedures; possess creativity and latitude, and excellent communication and presentation skills. You will rely on experience and judgment to plan and accomplish complex goals. Work Arrangement: Employees who live within 30 miles of the TMG home office are expected to follow a hybrid or in-office schedule. The initial training period may require additional in‑office days. Accountabilities: Handles claims ranging from moderate to complex with considerable latitude for action and decision. Makes coverage recommendations and total claim value determinations. Investigates coverage and cause of loss on routine to complicated claims, which includes but is not limited to policy review, evaluating current and prior medical history/problems. Interviewing all parties associated with the loss and gathering and analyzing all necessary investigative documentation. Reviews, evaluates and negotiates bodily injury claims with unrepresented and represented insureds/claimants including litigation management. Evaluating injury claims and property damage claims will be primary focus. Review medical records and bills to validate accuracy of services provided. Completes bodily injury evaluation summary including liability, damages, causation, diagnosis, treatment, reserves, and general damages. Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage, the language of the policy of insurance, pertinent regulatory and statutory considerations and within granted authority. Prepares written communication, including but not limited to settlement letters, disclaimers of coverage and reservation of rights letters Maintains effective claim file documentation and diary system. Monitor diary to achieve timely development of file and timely disposition of the claim Recognizes and prepares submissions to SIU when indicated. Assigns and supervises vendor resources, including but not limited to independent adjusters, engineers and other experts as needed Helps to identify problems that affect team effectiveness or efficiency and recommend changes in procedures. Travels and attends mediations or training as needed. Qualifications: Bachelor's degree preferred Professional designations are preferred 10+ years in the handling of Claims. Understands concepts of coverage, policy interpretation, exposure recognition and liability determination. State licensing or certification where required. Ability to take responsibility and work independently in a home-based environment. Strong communication and analytical skills. Ability to negotiate skillfully in difficult situations. Must have strong organizational and time management skills. Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations and presenting them effectively. Basic computer skills including Microsoft applications Word, Excel, Outlook and the Internet. Perform work related simple and advanced mathematical problems and calculations. Compose written correspondence and factual reports which are well-organized and concise, utilizing proper English, grammar, punctuation and spelling. Demonstrates the ability to use commonly-used claims concepts, practices and procedures. Must meet or exceed the ability to demonstrate the 5 core and common competencies outlined below. Convey clear, concise information to others, using verbal or other appropriate communication techniques. Complete formal training plan and assignments as required. Follow safe practices in all work activities to avoid injuries and accidents. Pay Range: Anticipated Hiring Range: $82,500 - $130,000 annual base salary depending on experience, qualifications, and geographic location Benefits: We are proud to offer our full-time regular employees a robust benefits suite that includes: Competitive base salary plus incentive plans for eligible team members 401(K) retirement plan that includes a company match of up to 6% of your eligible salary Free basic life and AD&D, long-term disability and short-term disability insurance Medical, dental and vision plans to meet your unique healthcare needs Wellness incentives Generous time off program that includes personal, holiday and volunteer paid time off Flexible work schedules and hybrid/remote options for eligible positions Educational assistance Equal Opportunity Employer The Mutual Group is an Equal Opportunity Employer. It is our policy to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law. Know Your Rights: Workplace Discrimination is Illegal Your Rights Under USERRA Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact [email protected] . Employment Verification The Mutual Group participates in the E-Verify program and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. You are protected from employment discrimination based on your citizenship status and national origin. E-Verify Program Overview E-Verify Participation Poster All offers of employment are contingent upon the successful completion of a background check. #TMG