Insurance Claims Adjuster

Position Overview
Loyalty MGA is seeking a highly skilled and experienced Metal Adjuster to oversee complex claims, provide expert analysis, and serve as a mentor within the claims department. This role requires strong technical knowledge, sound judgment, and exceptional communication skills to ensure accurate claim resolutions while maintaining high standards of compliance and client service.

Key Responsibilities:

·         Manage complex, high-value, disputed, and escalated metal claims with accuracy and professionalism.

·         Conduct comprehensive claim investigations, including document review, stakeholder interviews, and evidence analysis.

·         Evaluate damages and determine appropriate settlements in accordance with policy coverage, state regulations, and company guidelines.

·         Serve as a subject matter expert and mentor to junior adjusters, offering coaching, training, and guidance.

·         Negotiate settlements with claimants, attorneys, vendors, and third parties when required.

·         Prepare detailed reports and present claim findings to management.

·         Remain informed on industry trends, regulatory changes, and best practices to ensure claims are processed efficiently and accurately.

·         Collaborate with appraisers, legal counsel, and third-party vendors to support timely claims resolution.

·         Identify potential fraud indicators and escalate cases when appropriate.

·         Ensure all claims are handled in full compliance with state laws, internal policies, and departmental standards.

Qualifications:

• High School Diploma or GED required.
• Minimum 6 months of claims handling or intake experience.
• Active 6-20 All-Lines Adjuster License required (or ability to obtain and maintain immediately upon hire).
• Bilingual proficiency in English and Spanish is required.
• Strong customer service, communication, and negotiation skills.
• Proficiency in Microsoft Office and basic computer applications.