Claims Adjuster I

JOB SUMMARY 

A Claims Adjuster I is responsible for the timely, good faith adjustment and disposition of self-administered claims. Responsibility extends to all aspects and phases of investigations, evaluations, negotiations, settlements and denials of the following claims: workers’ compensation, auto liability, no-fault uninsured motorist and general liability. He/she will manage a caseload ranging from 100-150 claims (the acceptable caseloads vary based on the mix and complexity as determined by Claims Unit Manager.) 

CANDIDATE PROFILE  

Education and Experience  

Required 

• High School Diploma or GED. 

• 1 years claims adjusting or equivalent/relevant experience. 

• Knowledge of claims processing.  

Preferred 

• Applicable industry licensing. 

• Associate in Claims (AIC) or Associate in Risk Management (ARM).  

• Two or four year degree from an accredited college/business/technical school. 

CORE WORK ACTIVITIES  

• Manage caseload ranging from 100 – 150 claims.  

• Investigate claims promptly – taking statements as necessary – to determine liability/compensability 

• Evaluate damages and pay benefits as prescribed by law and/or Marriott policies and procedures 

• Secure necessary documentation to facilitate timely loss adjustment and maintain primary responsibility for settlement decisions up to individual authority 

• Complete and monitor timely WC payments/state filings   

• Monitor and actively manage WC medical treatment with the goal of minimizing disability.  Consult Occupational Health Services as necessary 

• Manage litigation cases including controlling/directing outside attorneys, assisting in discovery/trial preparation and strategy 

• Evaluate claims for potential third party or subrogation recovery 

• Participate in the Service Call Program and complete required Service Call reports detailing current case status 

• Actively participate in regularly scheduled unit meetings and department meetings 

• Comply with Marriott Casualty Claims Policy and Procedure Manual requirements 

• Effectively utilize the Valley Oaks System (iVOS) to manage all claims electronically 

• Enter action plan notes/website notes into iVOS 

• Participate in activities that foster teamwork and continuous quality improvement.