Claims Consultant (Claims Adjuster) (Sandy, UT)

Claims Adjuster

Position Overview

The Claims Adjuster is responsible for investigating, evaluating, and resolving insurance claims involving property damage, personal injury, casualty losses, and other general liability matters. This role assesses the extent of an insurer’s potential liability, gathers and analyzes relevant evidence, negotiates settlements, and recommends appropriate courses of action to achieve fair and timely claim resolutions.

Working closely with insureds, claimants, insurance agents, investigators, legal counsel, medical professionals, and internal management, the Claims Adjuster ensures claims are handled accurately, efficiently, and in accordance with applicable policies, regulations, and legal requirements.

The ideal candidate is a detail-oriented and analytical professional with strong communication, negotiation, and organizational skills. Experience in excess and surplus (E&S) insurance is preferred. The successful candidate demonstrates sound judgment, professionalism, effective time management, and the ability to manage multiple claims while maintaining thorough documentation and consistent follow-through.

Key Responsibilities

Claims Investigation & Evaluation

• Investigate insurance claims involving property damage, personal injury, casualty losses, and general liability matters.
• Gather, review, and analyze relevant information to determine the facts, circumstances, and potential liability associated with each claim.
• Interview insureds, claimants, witnesses, insurance agents, medical specialists, and other relevant parties to obtain accurate and complete information.
• Review police reports, medical records, photographs, statements, repair estimates, and other supporting documentation.
• Evaluate the extent of damages, applicable policy coverage, liability exposure, and potential claim value.
• Identify inconsistencies, missing information, and other issues requiring additional investigation.
• Prepare detailed claim evaluations, findings, and recommendations to support appropriate resolution strategies.
• Maintain accurate and complete claim files, including investigation notes, correspondence, supporting documentation, and settlement evaluations.

Liability Assessment & Settlement Negotiation

• Analyze policy provisions, available evidence, applicable laws, and relevant facts to assess the insurer's potential liability.
• Determine appropriate claim values based on damages, liability considerations, coverage terms, and supporting evidence.
• Negotiate settlements with claimants, attorneys, and other parties within established authority limits.
• Recommend settlement strategies that balance fair claim resolution with appropriate management of financial exposure.
• Identify claims that may require escalation, additional investigation, or legal intervention.
• Recommend litigation when a negotiated settlement cannot be reached or when legal action is otherwise warranted.
• Communicate settlement positions and supporting rationale clearly to internal stakeholders and external parties.
• Ensure claim decisions are properly documented and supported by the available evidence.

Claims Management & Follow-Up

• Manage an assigned caseload and prioritize activities based on complexity, urgency, exposure, and established service expectations.
• Follow up consistently with insureds, claimants, investigators, other adjusters, managers, and legal counsel to move claims toward resolution.
• Monitor outstanding information requests, investigation activities, settlement negotiations, and litigation developments.
• Coordinate with internal teams and external partners to resolve outstanding issues and prevent unnecessary delays.
• Escalate complex claims, significant exposures, and potential coverage or liability concerns to the appropriate management personnel.
• Maintain timely and professional communication throughout the claims process.
• Ensure claims progress in accordance with internal procedures, applicable regulations, and relevant deadlines.

Communication & Customer Service

• Serve as a professional point of contact for insureds and other parties involved in the claims process.
• Request and obtain the information necessary to evaluate claims accurately and efficiently.
• Explain claim requirements, investigation findings, settlement considerations, and next steps in a clear and professional manner.
• Respond promptly to inquiries and provide updates regarding claim status and outstanding requirements.
• Manage difficult conversations and disputed claims with professionalism, objectivity, and sound judgment.
• Maintain positive working relationships with insurance agents, claimants, attorneys, investigators, and other stakeholders.
• Protect confidential information and handle sensitive claim details appropriately.

Legal & Regulatory Compliance

• Maintain current knowledge of relevant insurance regulations, applicable laws, litigation trends, and court decisions affecting claims handling.
• Monitor legal developments that may influence liability assessments, settlement strategies, and claim outcomes.
• Apply policy language and relevant legal principles when evaluating coverage, liability, and damages.
• Coordinate with legal counsel on claims involving litigation, disputed liability, or complex legal issues.
• Maintain complete documentation to support claim decisions, settlement negotiations, and litigation preparation.
• Follow established claims handling procedures, documentation standards, and applicable compliance requirements.

Reporting & Professional Development

• Prepare claim summaries, investigation reports, reserve recommendations, and settlement evaluations as required.
• Communicate significant developments, potential risks, and recommended actions to claims management.
• Maintain organized records of claim activity, outstanding items, and resolution progress.
• Participate in internal training, professional development, and continuing education activities.
• Apply feedback and updated claims practices to improve accuracy, efficiency, and decision-making.
• Perform additional duties and responsibilities as assigned.

Qualifications

• College degree in Business, Finance, Insurance, Criminal Justice, or a related field is preferred but not required.
• Experience in insurance claims adjusting, claims investigation, liability assessment, or a related insurance function is preferred.
• Strong analytical skills and the ability to evaluate evidence, assess damages, and make sound liability determinations.
• Excellent written and verbal communication skills, including the ability to conduct interviews and prepare clear, accurate claim documentation.
• Demonstrated negotiation and problem-solving skills, with the ability to work toward appropriate claim resolutions.
• Strong organizational and time management skills, with the ability to manage multiple claims and competing deadlines.
• High attention to detail and the ability to maintain accurate, complete, and well-organized claim files.
• Professional judgment and the ability to handle sensitive information and challenging conversations.
• Ability to work independently while collaborating effectively with internal teams and external stakeholders.
• Proficiency in Microsoft Office and familiarity with claims management systems or related insurance technology.
• Willingness and ability to obtain a Property and Casualty Adjuster License within six months of hire, if not already licensed.

Preferred Qualifications

• Experience in excess and surplus (E&S) insurance.
• Active Property and Casualty Adjuster License.
• Experience handling casualty, property damage, personal injury, or general liability claims.
• Familiarity with insurance policy interpretation, liability evaluation, settlement negotiations, and litigation management.
• Experience reviewing medical records, police reports, investigative findings, and other claim-related evidence.
• Knowledge of applicable insurance regulations, court decisions, and claims handling practices.
• Experience coordinating with defense counsel, independent adjusters, investigators, and other claims professionals.
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