Senior Casualty Claims Adjuster

EMC Insurance Companies

. Review claim notices, lawsuits, contracts and policies to verify coverage, deductibles, claim payees/mortgagees and compensability .

Posted 10/15/2026full-timeRemote • United StatesSenior💰 $72,726 - $109,786 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims adjusting, including thorough knowledge of insurance contracts, legal procedures, and effective negotiation skills. Capable of mentoring team members while maintaining high standards of professional conduct and analytical judgment.

Highest-signal resume keywords

Claims Adjusting ExperienceInsurance Contracts KnowledgeAnalytical AbilityNegotiation SkillsLicensing Attainment

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ReviewCoverage VerificationBodily Injury EvaluationProperty Damage EvaluationClaims System ManagementMedicare Liens InvestigationLegal Document DraftingSettlement NegotiationRisk ReportingClaims Process Explanation

Soft Skills

Organizational SkillsWritten CommunicationVerbal CommunicationProblem-Solving AbilitiesMentoring

Tools & Technologies

Claims SystemsMedicare/MSP Modules

Certifications & Qualifications

State LicensesRelevant Insurance Designations

Industry Keywords

Claims ProcessInsurance IndustryLegal AspectsCourt ProceduresAdjuster Responsibilities

About the role

Key responsibilities & impact

Review claim notices, lawsuits, contracts and policies to verify coverage, deductibles, claim payees/mortgagees and compensability
Contact customers, insureds, claimants and witnesses to obtain claim information and explain the claims process
Take statements and document summaries and handling activity in the claims system, including Medicare/MSP modules
Set timely and adequate reserves according to company reserving philosophy and methodology
Select appropriate defense counsel for litigated claims and handle medium- to lower-complexity lawsuits
Resolve coverage, liability and claim-value questions; draft reservation-of-rights and denial letters when appropriate
Assign independent adjusters when necessary with supervisory approval
Secure official reports, claim forms and other necessary documents
Review bills, invoices, receipts, legal invoices and litigation expenses for accuracy and appropriateness
Respond to agents, insureds and claimants regarding claim status
Investigate and pursue recovery opportunities; investigate and resolve Medicare liens
Prepare bodily injury and/or property damage evaluations, negotiation ranges and target settlement numbers
Negotiate claim settlements with insureds, claimants and attorneys
Assist with suits, mediations, arbitrations and depositions
Participate in claims roundtables and issue properly executed settlement documents and timely payments
Submit referrals to specialist review units when necessary
Prepare risk reports for Underwriting and review coverage intent, policy activity and account inspection information with relevant teams
Mentor and coach less experienced claims team members; assist other branches through the Resource Sharing Program
Participate in branch and department projects

Requirements

What you’ll need

Bachelor’s degree or equivalent relevant experience
Five years of claims adjusting experience
Attainment of all applicable state licenses within six months of hire
Relevant insurance designations preferred
Proven, excellent knowledge of the theory and practice of the claim function
Analytical ability and sound judgment with respect to liability and coverage
Strong knowledge of insurance contracts, medical terminology and legal aspects of court procedures
High standards of professional conduct
Strong knowledge of computers and claims systems
Strong organizational and written and verbal communication skills
Excellent investigative and problem-solving abilities
Travel required; a valid driver’s license with an acceptable motor vehicle report per company standards required if traveling

Benefits

Comp & perks

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