Senior Claims Adjuster-ERS

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.

**Position can sit remotely for candidates who ideally reside in the Midwest region**

Essential Functions:

• Investigates and evaluates multi-line and multi-state claims and losses of moderate to severe complexity

• Completes thorough investigation by determining facts of loss and taking statements from client, claimants, injured workers, and witnesses

• Analyzes loss details and develops a plan of action to efficiently and accurately manage outstanding issues and reach resolution on claims presented

• Completes reserve analysis to identify potential reserve and reporting requirements for large claims

• Sets timely, adequate reserves to cover client probable exposure in accordance with specific client claim handling procedures

• Analyzes collected medical records to evaluate injury as a factor in the determination of compensability and ongoing medical management

• Identifies risk factors and determines if referral for additional handling such as Estimatics Review Unit, Special Investigation Unit, Subrogation, or Medical Review, is necessary (with client approval)

• Identifies subrogation potential on every claim which includes review of police and fire department reports and pursues recovery accordingly

• Identifies complex claims that need escalation and initiates discussion with people leader

• Prepares information for jurisdictional state filings for worker’s compensation claims

• Negotiates, settles and/or resolves moderately complex claims

• Makes recommendations to management for settlement amounts outside of authority limits, and follows case to conclusion for training purposes as appropriate 

• Prepares bodily injury and/or property damage evaluations, negotiation ranges and target settlement numbers

• Gathers information and serves as a resource for claim lawsuits, mediations and arbitration

• Maintains active diaries and a plan of action in line with client handling instructions

• Prepares mandatory reporting for excess carriers according to defined carrier reporting requirements

• Remains current on jurisdictional and industry related developments within the respective line of business through internal and external training opportunities

• Ensures all continuing education units (CEU’s) and professional licenses are kept up-to-date as per requirements of the relevant jurisdictions

Experience & Education:

• Bachelor’s degree or equivalent relevant experience

• Five years of claims adjusting experience or related experience

• Prior experience with a third party administrator (TPA) preferred

• INS, AIC, SCLA, WCLA and CPCU coursework or designation preferred

• Experience handling claims under Minnesota jurisdiction preferred

Knowledge, Skills & Abilities

• Excellent knowledge of the theory and practice of the claim function

• Excellent analytical, investigative and problem-solving abilities with respect to liability and coverage

• Thorough knowledge of insurance contracts, medical terminology and legal aspects of court procedures affecting legal liability for all lines of insurance. 

• Strong computer skills, including claims systems

• Strong organizational, written, and verbal communication skills, including documentation

• Strong ability to advise, partner, and effectively consult with diverse internal and external stakeholders

• Occasional travel required; a valid driver’s license with an acceptable motor vehicle report per company standards

The hiring salary range for this position will vary based on geographic location, falling within either the $77,000-$106,000 range or the $84,000-$117,000 range. A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. 

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