Casualty Claims Specialist

EMC Insurance Companies

. Investigate, evaluate, negotiate, and dispose of highly complex auto and casualty claims, including claims in litigation .

Posted 9/30/2026full-timeRemote • United StatesSeniorLead💰 $78,726 - $119,646 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive expertise in investigating and managing complex auto and casualty claims, including litigation management and negotiation. Proficient in analyzing insurance contracts, medical terminology, and claims systems while maintaining high ethical standards and exceptional communication skills.

Highest-signal resume keywords

Casualty Claims Adjusting ExperienceInsurance Contracts KnowledgeLitigation ManagementClaims Systems ProficiencyInvestigative Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims InvestigationCoverage AnalysisNegotiationClaims DocumentationRisk ReportingReserve SettingLitigation PlanningMedicare Liens InvestigationClaims AuditingLegal Budget Management

Soft Skills

Organizational SkillsInterpersonal SkillsWritten Communication SkillsVerbal Communication SkillsCustomer Service Skills

Tools & Technologies

Claims SystemsComputer Proficiency

Certifications & Qualifications

Relevant Insurance DesignationsState Licenses

Industry Keywords

Auto ClaimsCasualty ClaimsLiability ClaimsSubrogationEthics in Claims

About the role

Key responsibilities & impact

Investigate, evaluate, negotiate, and dispose of highly complex auto and casualty claims, including claims in litigation
Review claim notices, contracts, state statutes, and policies to verify coverage, deductibles, and payees
Investigate complex coverage issues with Coverage Counsel and/or outside counsel
Contact insureds and claimants, obtain statements, and document investigations in claims systems
Analyze reports, claim forms, documents, Medicare modules, reserves, and recovery opportunities
Prepare claims and participate in claims roundtables
Set timely and adequate reserves
Manage litigation, including lawsuits, defense counsel, legal budgets, mediations, arbitrations, and depositions
Prepare coverage analyses, reservation of rights letters, lawsuit analyses, litigation plans, and damage evaluations
Negotiate and settle claims with attorneys, insureds, and claimants
Investigate Medicare liens and protect liens
Prepare settlement and release documents and issue timely payments
Review and audit estimates, invoices, and litigation expenses
Serve as a technical resource and subject matter expert for claims team members
Assist with claims and suits outside the assigned jurisdiction
Lead or participate in casualty claims projects
Submit referrals to Estimatics, Special Investigation, Subrogation, Medical Review Units, and Coverage Counsel
Prepare risk reports and collaborate with Underwriting and Risk Improvement

Requirements

What you’ll need

Bachelor’s degree or equivalent relevant experience
Eight years of casualty claims adjusting experience or related experience
Relevant insurance designations preferred
Superior knowledge of best claims practices for serious and complex liability claims
Advanced knowledge of insurance contracts, medical terminology, and substantive and procedural laws
Excellent knowledge of computers and claims systems
Ability to obtain all applicable state licenses
Ability to adhere to high standards of professional conduct and code of ethics
Exceptional organizational and empathetic interpersonal skills
Thorough written and verbal communication skills
Advanced customer service skills
Ability to maintain confidentiality
Thorough investigative and problem-solving abilities
Occasional travel required
Valid driver’s license with an acceptable motor vehicle report per company standards required if driving

Benefits

Comp & perks

Comprehensive rewards package; benefits details provided at www.emcins.com/careers
Work from home anywhere in the US
Tobacco-free workplaces and company vehicles