Claim Rep Sr, SIU - Casualty (Hybrid or Remote)

Come join a team where your investigative expertise and knowledge make a real impact. We are looking for an experienced casualty claims professional to handle complex Bodily Injury, No-Fault, Med Pay, UM/UIM, and fraud-related claims while managing litigation exposure and delivering outstanding customer service. This role offers the opportunity to work independently, collaborate with legal and investigative partners, and play a critical role in protecting both our customers and the organization through thoughtful, strategic claim handling.

What You'll Do

Investigate Complex Claims

• Manage a diverse caseload of casualty claims, including Bodily Injury, PIP/No-Fault, Med Pay, UM/UIM, and suspected fraud-related matters.
• Conduct detailed investigations through recorded statements, scene reviews, witness interviews, database research, and collaboration with field investigators.
• Analyze policy coverage, liability exposures, damages, and applicable statutes across multiple jurisdictions.
• Evaluate medical treatment, wage loss claims, and other damages using a variety of investigative resources.

Drive Successful Claim Outcomes

• Develop effective claim strategies that lead to timely and fair resolutions.
• Negotiate settlements through phone conferences, mediations, arbitrations, and face-to-face discussions.
• Maintain accurate reserves and manage claim expenses responsibly.
• Partner with experts, medical professionals, and vendors to support claim evaluations and investigations.

Manage Litigation and Regulatory Matters

• Direct and oversee defense counsel on litigated claims.
• Participate in depositions, examinations under oath, mediations, arbitrations, and trial-related activities.
• Prepare responses to regulatory inquiries, consumer complaints, and Department of Insurance matters.
• Ensure compliance with state regulations and company claim-handling standards.

Make an Impact Beyond Your Desk

• Serve as a mentor and resource for less experienced adjusters.
• Share best practices and contribute to training initiatives.
• Recommend process improvements that enhance efficiency and customer experience.
• Represent the organization with professionalism in all internal and external interactions.

What We're Looking For

• Bachelor's degree or equivalent combination of education and related experience.
• 2 years of casualty claims handling experience, including Bodily Injury and related coverages.
• Strong investigative, analytical, and negotiation skills.
• Experience interpreting insurance policies, coverage provisions, and applicable statutes.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Ability to obtain and maintain required state adjuster licenses.

Preferred Qualifications

• Experience handling SIU, fraud-related, or highly complex casualty claims.
• Litigation management experience.
• Insurance coursework, professional designations, or industry certifications.
• Bilingual language skills.
• Experience working with attorneys, medical experts, and law enforcement agencies.