Claims Adjuster

Claims Adjuster Position Summary VGM Insurance Services provides specialty insurance programs for a variety of niche industries. A division of the VGM Group, VGM Insurance has grown into one of the nation’s leading providers of liability insurance and Medicare/Medicaid Surety bonds for the Home Medical Equipment industry.

As a Claims Adjuster for VGM Insurance, you will be responsible for investigating, evaluating and resolving liability claims on losses of varying value and complexity. In this role, you must provide quality claim handling throughout the claim life cycle all while maintaining full compliance with internal and external standards and state specific regulations.

Reporting Accountability: Director of Claims Working Location: East Coast A day in the life of the Claims Adjuster might include:

• Establishing and maintaining interpersonal relationships with clients
• Interviewing and corresponding with agents and claimants to correct errors or omissions and to investigate questionable claims
• Verifying proper policy coverage and applies best claims practices to conclude assigned cases in accordance with company guidelines
• Investigating each claim by gathering information to determine extent of liability/establishment of negligence
• Report findings on various claims as well as recommendations on the outcome
• Determining settlement amounts by negotiating and conveying claim settlements within authority limits to insureds and claimants – write denials letters when appropriate
• Delivering consistent high-quality service through the claim lifecycle
• Maintaining current knowledge of policy changes and modifications, including possible attendance at various seminars and/or training sessions Position Qualifications:
• Liability insurance claims experience required
• Expert Excel knowledge
• Strong skills in research, coverage evaluations, claim resolution, claims payments and cases
• Knowledge of insurance coverages, contracts, claims handling guidelines, legal and medical terminology
• Experience handling claims from receipt to resolution including coverage verification, investigation through resolution
• Hard work, honesty, integrity and unwavering business ethics
• Detail-oriented organizational skills in a multi-tasking environment Physical Requirements Claims Adjuster VGM Insurance last reviewed: 1/5/2021
• Sitting for long amounts of time
• Using technology efficiently such as computers, phones, misc. office equipment
• Standing This job description reflects the general duties of the job but is not a detailed description of all duties which may be inherent to the position. Reasonably related additional duties may be assigned to the individual Associate. VGM Group, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, nation al origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.