NAELA's CareerCenter

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A Claims Adjuster II is responsible for the timely, good faith adjustment and disposition of self-administered casualty claims in multiple jurisdictions.  Responsibility extends to all aspects and phases of investigations, evaluations, negotiations and settlements/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 casualty claims (the acceptable caseloads vary based on the jurisdiction(s), mix and complexity of Worker's Compensation and General Liability cases as determined by Claims Unit Manager.)

• 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.
• Perform other duties as business demands

CANDIDATE PROFILE

Experience

• At least one year of claims adjusting experience with applicable industry licensing.

Knowledge and Skills

• Ability to grasp and apply technical knowledge, including litigation case management and adjusting skills
• Effective reasoning, analysis and decision making skills
• Effective influence skills
• Strong negotiation skills
• Ability to organize work and other priorities to ensure timely completion of all deliverables/deadlines
• Strong customer oriented/hospitality skills
• Demonstrate strong leadership abilities
• Ability to prioritize work
• Good communication skills (verbal, listening, writing), including the ability to deliver difficult messages to customers and/or claimants
• Good investigation skills
• Basic knowledge of claims process
• Working knowledge of Claims software platforms, Microsoft suite (Excel, Outlook,etc.)
• Ability to work well in a team, providing assistance to fellow associates and representing the mission of the unit
• Possess a willingness to accept and respond positively to constructive criticism
• Present oneself with a positive, professional demeanor
• Communicate often with supervisor keeping him/her informed
• Show dependability

Education or Certification

• High School Diploma or GED
• Associate degree (or higher) in Claims or Associate in Risk Management or related field is desirable
• California Experienced Claims Adjuster Designation and current on education hours.
• California Self-Insured Administrator's Certificate required.