Liability Claims Adjuster Job at SustainableHR PEO & Recruiting, Madison, WI

  • SustainableHR PEO & Recruiting
  • Madison, WI

Job Description

Location: Wisconsin | Hybrid / Primarily Remote Salary: $70,000–$82,000 annually Schedule: Full-Time Position Overview We are seeking an experienced Liability Claims Adjuster to join a collaborative, professional team where your expertise and judgment will play an important role in managing complex claims. This position is primarily focused on four key areas: Litigation, Bodily Injury, Coverage, and Negotiations . The Liability Claims Adjuster will independently manage claims from initial investigation through resolution, working closely with claimants, insured parties, attorneys, legal counsel, and other stakeholders. The ideal candidate brings 5–10 years of liability claims experience and is confident evaluating complex coverage issues, handling bodily injury claims, managing litigated files, and negotiating fair and effective resolutions. Key Areas of Focus Litigation Manage litigated liability claims from initial assignment through resolution. Work closely with defense counsel, claimants' attorneys, insured parties, and other stakeholders. Develop claim strategies and evaluate potential legal and financial exposure. Review legal invoices, releases, settlement documentation, and other litigation-related materials. Maintain accurate documentation and ensure litigated claims progress toward timely resolution. Provide recommendations based on claim exposure, legal considerations, and investigative findings. Bodily Injury Investigate and evaluate bodily injury claims, including liability, damages, and overall exposure. Review medical records, police reports, witness statements, photographs, and supporting documentation. Conduct interviews with claimants, insured parties, witnesses, and other involved individuals. Evaluate damages and determine appropriate reserves and settlement strategies. Manage bodily injury claims through final resolution while maintaining clear and professional communication. Coverage Analyze insurance policies to determine coverage and identify potential coverage issues. Evaluate complex claims based on policy language, exclusions, endorsements, and applicable legal standards. Prepare and review Reservation of Rights and Denial letters . Clearly communicate coverage positions and claim decisions to appropriate parties. Partner with internal resources and legal counsel when additional coverage analysis is required. Ensure coverage decisions are thoroughly documented and supported. Negotiations Lead negotiations with claimants, attorneys, insured parties, and third parties to achieve appropriate claim resolutions. Develop negotiation strategies based on liability, damages, coverage, litigation exposure, and overall claim value. Negotiate settlements on complex Bodily Injury and litigated liability claims . Evaluate settlement demands and prepare well-supported counteroffers and recommendations. Balance effective claim resolution with appropriate risk management and financial considerations. Maintain professional and productive communication throughout challenging or high-stakes negotiations. Additional Responsibilities Manage liability claims throughout the full claim lifecycle, from investigation through resolution. Collect and analyze evidence to determine liability, damages, and exposure. Approve or deny claims based on coverage, investigative findings, and established guidelines. Process settlements and claim payments accurately and efficiently. Maintain detailed and organized claim files and system records. Ensure compliance with applicable state and federal insurance regulations. Manage CMS and ISO reporting requirements. Prepare claim status reports and updates for leadership and stakeholders. Collaborate with internal departments, legal teams, vendors, and external partners. Participate in claims system upgrades, troubleshooting, testing, and process improvement initiatives. Support onboarding, training, and claims system administration as needed. What We're Looking For 5–10 years of liability claims experience , with demonstrated experience in Litigation, Bodily Injury, Coverage, and Negotiations . Experience independently managing complex liability claims from investigation through final resolution. Strong background handling litigated claims and working directly with attorneys and defense counsel. Proven experience investigating and evaluating bodily injury claims. Strong settlement negotiation experience , including negotiating with claimants, attorneys, and third parties. Strong understanding of coverage analysis, policy interpretation, exclusions, endorsements, and Reservation of Rights. Experience with Auto Liability and General Liability claims. Strong knowledge of insurance regulations, legal standards, and claims best practices. Excellent investigative, analytical, negotiation, and decision-making skills. Strong written and verbal communication skills. Ability to independently manage multiple complex claims and competing deadlines. Proficiency with claims management systems and Microsoft Office. Bachelor's degree in Business Administration or a related field, or equivalent relevant professional experience. Preferred Qualifications CPCU, AIC, or another relevant insurance designation. Municipal liability claims experience. Employment Practices Liability experience. Experience with CMS and ISO reporting. Knowledge of Wisconsin municipal law. Claims system administration or user-support experience. Why Consider This Opportunity? Competitive salary of $70,000–$82,000 , based on experience. Primarily remote/hybrid work environment for Wisconsin-based professionals. Opportunity to handle sophisticated Litigation, Bodily Injury, Coverage, and Negotiation matters. Autonomy to manage claims from investigation through resolution. Opportunity to use your negotiation and claims expertise on complex, meaningful cases. Collaborative environment where experience, professional judgment, and new ideas are valued. Opportunity to contribute to process improvements and claims operations beyond your individual caseload. This is a primarily remote/hybrid opportunity requiring residency in Wisconsin within reasonable driving distance for occasional in-person meetings, training, and business needs . Occasional business travel may be required for meetings, training, conferences, or claim-related activities. #J-18808-Ljbffr

Job Tags

Full time, Work at office, Remote work

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