BI Claims Adjuster (Level II)

Gainsco Auto Insurance

(Dallas, Texas)

Full Time Weekends

Job Posting Details

About Gainsco Auto Insurance

GAINSCO Inc., is a property and casualty insurance holding company. Through our insurance brand, GAINSCO Auto Insurance®, we concentrate our efforts on the non-standard personal automobile market, specializing in minimum-limits personal auto insurance. GAINSCO was established in 1978 as a Texas corporation and is based in Dallas, with a regional office in Miami. Our insurance operations are conducted through MGA Insurance Company Inc., a Texas corporation.

Summary

To investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of non-attorney represented injury claims and to contribute to a reduced loss ratio

Responsibilities

**Results Expected and Duties Performed**

* Establishes proof of loss by studying documentation submitted; assembling additional information as required from outside sources such as claimant, witnesses, physician, employer, hospital, and other insurance companies; initiates investigation of claims involving complex coverage claims, complex liability, and/or bodily injury claims (non-attorney represented), as well as questionable claims. (65%)

* Resolves claim by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter. Presents evidence at legal proceedings by testifying and producing reports and other documents as evidence (25%)

* Ensure legal compliance by following guidelines, company policies, and state and federal insurance regulations (10%)

**Required behaviors for all positions:**

* Communicate with co-workers, management customers, vendors, and others in a courteous and professional manner
* Conform with and abide by all Company codes, regulations, policies, values, work procedures and instructions
* Adherence to company attendance policy 
* Established Tenure preferred

Results Expected and Duties Performed

Establishes proof of loss by studying documentation submitted; assembling additional information as required from outside sources such as claimant, witnesses, physician, employer, hospital, and other insurance companies; initiates investigation of claims involving complex coverage claims, complex liability, and/or bodily injury claims (non-attorney represented), as well as questionable claims. (65%)
Resolves claim by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter. Presents evidence at legal proceedings by testifying and producing reports and other documents as evidence (25%)
Ensure legal compliance by following guidelines, company policies, and state and federal insurance regulations (10%)

Required behaviors for all positions:

Communicate with co-workers, management customers, vendors, and others in a courteous and professional manner
Conform with and abide by all Company codes, regulations, policies, values, work procedures and instructions
Adherence to company attendance policy
Established Tenure preferred

Ideal Candidate

**Education**:

* Bachelor’s degree or higher (with two year’s work experience within field of major, is preferred) or equivalent work experience.

**Experience**:

* Previous Claims and/or Customer Service experience within an Insurance environment is required. 
* Prior experience interpreting policy language and state statutes is required. Ideal candidate will have a proven track record of making sound coverage and liability decisions based on facts presented by customers and/or through additional fact gathering and investigations. 
* Experience in handling minor to moderate bodily injury claims is preferred (either attorney represented and/or non-attorney represented).

**Skills and Abilities**

* Excellent verbal and written communications skills; ability to manage own time while prioritizing multiple tasks; ability to remain calm when dealing with difficult customers; effective negotiating skills; ability to gather and analyze information in order to evaluate results and choose the best solution to the problem.

**Other**

*  A valid State Adjuster License where required; Bilingual (English/Spanish) preferred; occasional weekend work may be required.

Education:

Bachelor’s degree or higher (with two year’s work experience within field of major, is preferred) or equivalent work experience.

Experience:

Previous Claims and/or Customer Service experience within an Insurance environment is required.
Prior experience interpreting policy language and state statutes is required. Ideal candidate will have a proven track record of making sound coverage and liability decisions based on facts presented by customers and/or through additional fact gathering and investigations.
Experience in handling minor to moderate bodily injury claims is preferred (either attorney represented and/or non-attorney represented).

Skills and Abilities

Excellent verbal and written communications skills; ability to manage own time while prioritizing multiple tasks; ability to remain calm when dealing with difficult customers; effective negotiating skills; ability to gather and analyze information in order to evaluate results and choose the best solution to the problem.

Other