Remote Jobs

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Professional Lines Adjuster

reserv

Location
Georgia
Posted

Professional Lines Adjuster at Reserv: Analyze claims, resolve disputes, and provide customer service using AI-driven technology.

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Principal Software Engineer

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Principal Software Engineer - Workforce

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United States of America
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Staff Software Engineer

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United States of America
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Staff Software Engineer

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Professional Lines Adjuster

reserv

Job Location

Job Summary

Reserv is an insurtech company that uses AI and automation to simplify claims processing. They seek a Professional Lines Adjuster to work with customers, analyze claims, and resolve disputes. The ideal candidate has 7+ years of experience handling professional lines claims, a willingness to learn, and excellent communication skills. Reserv offers a generous benefits package, flexible remote work options, and opportunities for growth and development.

Description

About Reserv 

Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.

We have ambitious (but attainable!) goals and need adjusters who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can’t wait to meet you. 

 

About the role 

We are seeking highly organized and customer-focused Professional Lines Adjuster to join our team. The successful candidate will be responsible for speaking to customers on the phone, educating and helping the customer work through their claim to the best possible outcome. Your role will also be responsible for handling an inventory of claims, triaging critical claims, and delivering service to all constituents of the claim. 

The ideal candidate has a willingness to work through and design process that supports the quickest claim resolution with the best outcome. In addition, you will collaborate closely with our product and engineering teams to give feedback and identify technology and process improvements. 

 

Who you are 

  • Highly motivated and growth-oriented. You're excited by the prospect of building a tech-driven claims org.
  • Passionate adjuster who cares about the customer and their experience.
  • Empathetic. You exercise empathy and patience towards everyone you interact with.
  • Sense of urgency - at all times. That does not mean working at all hours.
  • Creative. You can find the right exit ramp (pun intended) for the resolution of the claim that is in the insured’s best interest.
  • Conflict-enjoyer. Conflict does not have to be adversarial, but it HAS to be conversational.
  • Curious. You have to want to know the whole story so you can make the right decisions early and action them to a prompt resolution.
  • Anti-status quo. You don’t just wish things were done differently, you act on it.
  • Communicative. (we'd love to know what this means to you)
  • And did we mention, you have a sense of humor. Claims are hard enough as it is

 

 What we need 

We need you to do all the things typical to the role:

  • Provide prompt, courteous and high-quality customer service to all policyholders and claimants by answering customer calls, filing claims, and resolving customer requests
  • Analyzing and reviewing nursing home professional liability insurance claims to identify areas of dispute, investigating, and gathering all necessary information and documentation related to the claim, evaluating liability and damages related to the claim, and negotiating and settling claims with opposing parties or their insurance providers.
  • Manage an inventory of claims, establish initial reserves for all potential exposures, and adjust as appropriate throughout the claim
  • Analyzing and reviewing nursing home professional liability insurance
  • Managing legal aspects of litigated cases, including evaluation of legal
  • process and expenses.
  • Ensure compliance with specific state regulations, policy provisions, and standard operating procedures
  • Managing litigation cases related to professional liability claim disputes, virtually attending mediations, arbitrations, and court hearings as necessary, and communicating regularly with clients, claims adjusters, attorneys, and other stakeholders.
  • Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to resolve the claim
  • Maintain adjuster licenses and continuing education requirements

Requirements

  • Bachelor's degree (lack of one should not stop you from applying if you possess all the other qualifications)
  • 7+ years experience handling Professional Lines claims including experience with:
    • Nursing home exposures
    • Allied medical losses
  • Having additional Professional Lines experience a plus including:
    • Errors & Omissions
    • Medical Malpractice
    • Directors & Officers
    • Miscellaneous other professional lines a plus
  • Have active adjuster license(s) and be willing to obtain all licenses within 45 days, including completing state required testing
  • Knowledge of state regulations, policy provisions, and standard operating procedures
  • Ability to analyze and evaluate complex data and make sound decisions based on established guidelines, policies, and procedures
  • Curious and motivated by problem solving and questioning the status quo
  • Desire to engage in learning opportunities and continuous professional development
  • Willingness to travel for client and claims needs

Benefits

  • Generous health-insurance package with nationwide coverage, vision, & dental
  • 401(k) retirement plan with employer matching
  • Competitive PTO policy – we want our employees fresh, healthy, happy, and energized!
  • Generous family leave policy
  • Work from anywhere to facilitate your work life balance
  • Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!

At Reserv, we value diversity and believe that a variety of perspectives leads to innovation and success. We are actively seeking candidates who will bring unique perspectives and experiences to our team and welcome applicants from all backgrounds. If you believe you are a good fit for this role, we would love to hear from you!