Complex Claims Master Adjuster

Westfield Insurance

. Determine coverage for assigned complex claims and investigate coverage, liability, legal climate, exposure, and damages .

Posted 10/8/2026full-timeRemote • Ohio • United StatesSeniorLeadWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive experience in complex claims handling, including investigation, negotiation, and resolution. Possesses strong knowledge of claims management systems, financial controls, and business process improvement within the insurance industry.

Highest-signal resume keywords

Complex Claims HandlingClaims Management System ExperienceData Analysis And Reporting SkillsChartered Property Casualty Underwriter (CPCU)Associate In Claims (AIC)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjustmentClaims EvaluationClaims InvestigationClaims ManagementCost OptimizationFinancial ControlsBusiness Process ImprovementClaims Case Management

Soft Skills

CommunicationCoachingSupervision

Certifications & Qualifications

Chartered Property Casualty Underwriter (CPCU)Associate In Claims (AIC)

Industry Keywords

Insurance Industry KnowledgeClaims ResolutionClaim ReservesExposure AnalysisSettlement Negotiation

About the role

Key responsibilities & impact

Determine coverage for assigned complex claims and investigate coverage, liability, legal climate, exposure, and damages
Make claim resolution decisions
Select, direct, and supervise internal and external resources and experts
Communicate with claims staff, business partners, insureds, claimants, agents, attorneys, insurers, vendors, contractors, and public adjusters
Establish and review claim reserves and complete claim status reports
Negotiate settlements and refer claims exceeding authority with recommendations
Stay current on industry topics, trends, processes, technology, and best practices
Assist less experienced claims professionals with large or complicated losses
Participate in coaching, development, training, and education of claims professionals
Participate in complex exposure file analysis and strategy development
Travel as needed, including regular use of an assigned fleet vehicle and short-notice or daily driving duties
Serve as a technical consultant and subject matter expert to business partners

Requirements

What you’ll need

10+ years of complex claims handling experience
Bachelor's degree in Business Administration or related field and/or commensurate work experience
Valid driver’s license
Driving record that conforms to company standards
Chartered Property Casualty Underwriter (CPCU) certification preferred
Associate in Claims (AIC) certification preferred
Claims adjustment, evaluation, investigation, and management knowledge
Claims management system experience
Insurance industry knowledge
Business process improvement knowledge
Financial controls knowledge
Claims case management knowledge
Data analysis and reporting skills
Cost optimization knowledge

Benefits

Comp & perks

Remote work arrangement
Assigned fleet vehicle
Travel expenses/vehicle utilization for assigned territory