Senior Complex Claims Adjuster

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Complex Claims Adjuster based in the United States.

As a Senior Complex Claims Adjuster, you will take ownership of complex, high-exposure first-party property claims from initial notification through final resolution. You will investigate structure, dwelling, and contents losses while making sound coverage and liability decisions. The role involves managing represented claims, negotiating with attorneys and public adjusters, and delivering fair settlement outcomes. You will apply strong policy interpretation, investigative judgment, and knowledge of multi-state insurance regulations. Customer communication is also central to the role, ensuring policyholders feel informed and supported during challenging circumstances. Working remotely within a collaborative claims environment, you will also serve as a resource and mentor to less experienced team members.

Accountabilities:

• Independently manage a full caseload of complex, high-exposure property claims from first notice of loss through resolution, including attorney- and public adjuster-represented files.
• Examine and interpret insurance policies, applicable forms, records, and other documentation to determine coverage and the extent of liability.
• Handle structure, dwelling, and contents claims, including files with exposure of up to $100,000.
• Investigate claims thoroughly using recorded statements, property inspections, documentation reviews, and information from police, fire departments, vendors, and other relevant sources.
• Prepare, review, and adjust damage estimates and loss valuations using Xactimate and Xactanalysis.
• Draft and manage complex reservation of rights, coverage denial, release, and other claims correspondence.
• Negotiate with attorneys, public adjusters, vendors, and other stakeholders to achieve fair and equitable claim resolutions.
• Apply applicable insurance statutes, regulations, ethical standards, good-faith practices, and claim-handling requirements across multiple states.
• Maintain accurate and well-documented claim files, including diary notes, contacts, payments, investigation findings, and resolution activities.
• Manage vendor relationships and coordinate field assignments to support timely and effective claim resolution.
• Identify potential fraud indicators and recognize opportunities for subrogation within claim files.
• Conduct effective recorded statements and perform detailed analysis to support claim investigations and coverage decisions.
• Monitor claim timeliness, quality, customer satisfaction, and escalation metrics while maintaining appropriate service standards.
• Provide guidance and mentorship to less experienced claims professionals, promoting consistent and high-quality claim-handling practices.
• Contribute to continuous improvement initiatives and help identify opportunities to make claims processes more efficient and effective.
• Remain available for required overtime and weekend work during catastrophic events.

Requirements:

• 3+ years of first-party property claims adjusting experience directly with an insurance carrier, with demonstrated experience handling claims with exposures of up to $100,000.
• Deep knowledge of property insurance policies, coverage interpretation, investigation practices, and end-to-end claims processes.
• Hands-on experience managing claims represented by attorneys and/or public adjusters is strongly preferred, along with strong negotiation and conflict-resolution skills.
• Proven ability to manage vendor relationships and negotiate effectively to achieve favorable and equitable outcomes.
• Experience drafting complex reservation of rights letters, coverage denial letters, release letters, and related claims documentation.
• Strong investigative skills, including the ability to conduct thorough recorded statements and analyze documentation and evidence.
• Ability to recognize potential fraud indicators and identify subrogation opportunities.
• Proficiency with Xactimate and Xactanalysis, along with strong technical skills using tools such as Excel, Snapsheet, Slack, and CRM platforms.
• Working knowledge of insurance laws, good-faith practices, regulatory timelines, and claims requirements across multiple states.
• Familiarity with litigation processes is preferred, including previous deposition and/or mediation experience.
• Exceptional interpersonal and customer-service skills, with the ability to communicate with empathy and professionalism during difficult situations.
• Strong organizational, analytical, decision-making, and problem-solving abilities, with the capacity to manage complex caseloads independently.
• Ability to work effectively in a remote environment while maintaining accountability, responsiveness, and consistent claim-handling quality.
• Demonstrated ability to mentor and support less experienced claims professionals.
• Willingness to work required overtime and weekend shifts when catastrophic events create increased claims demand.
• Ability to live and work full-time in an eligible U.S. state.

Benefits:

• Competitive salary of $80,000-$100,000, with actual compensation based on market conditions, qualifications, experience, and internal pay equity.
• Company equity through Restricted Stock Units (RSUs), included as part of the standard compensation package based on role and level.
• 401(k) plan with company matching contributions of up to 4% of eligible earnings.
• Multiple medical insurance plan options, plus dental and vision coverage.
• Company-funded HSA contributions depending on medical plan selection.
• Company-paid life insurance and short-term disability coverage.
• Supplemental benefits including long-term disability, critical illness, accident, legal, and pet insurance.
• Access to mental health support and confidential counseling resources.
• Flexible PTO for exempt employees, with most employees taking approximately 15-20 days annually.
• 8 company-observed holidays.
• Paid parental leave, including up to 14 weeks at 100% pay for birthing parents and 8 weeks at 100% pay for non-birthing parents.
• Employee referral bonuses.
• Career mobility and internal growth opportunities.
• Professional development budgets for certifications, conferences, and learning, subject to management approval.
• Remote-first working environment with flexibility to work remotely within eligible U.S. states.
• Opportunity to make a meaningful impact in a technology-driven insurance environment while working alongside collaborative and knowledgeable claims professionals.