Claim Rep Sr, SIU - No Fault Litigation (Hybrid or Remote)

 Posted 2 hours ago
     
 $52100 - $82200 per year
  
2-5 years experience
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AI Summary

Manage a diverse caseload of complex No-Fault, Med Pay, and fraud-related claims while overseeing litigation exposure. Collaborate with legal partners and medical professionals to drive fair resolutions and ensure regulatory compliance.

 

Higher level opportunity may be available based on experience and qualifications.

 

 

Come join a team where your investigative expertise and knowledge make a real impact. We are looking for an experienced No Fault claims professional to handle complex  No-Fault, Med Pay, and fraud-related claims while managing litigation exposure and delivering outstanding customer service.

 

This role offers the opportunity to work independently, collaborate with legal and investigative partners, and play a critical role in protecting both our customers and the organization through thoughtful, strategic claim handling.

 

What You'll Do

 

Investigate Complex Claims

  • Manage a diverse caseload of claims, including PIP/No-Fault, Med Pay, and suspected fraud-related matters.
  • Conduct detailed investigations through recorded statements, scene reviews, witness interviews, database research, and collaboration with field investigators.
  • Analyze policy coverage including coordination of benefits, liability exposures, damages, and applicable statutes across multiple jurisdictions.
  • Evaluate medical treatment, wage loss claims, and other damages using a variety of investigative resources.

 

Drive Successful Claim Outcomes

  • Develop effective claim strategies that lead to timely and fair resolutions.
  • Negotiate settlements through phone conferences, mediations, arbitrations, and face-to-face discussions.
  • Maintain accurate reserves and manage claim expenses responsibly.
  • Partner with experts, medical professionals, and vendors to support claim evaluations and investigations.

 

Manage Litigation and Regulatory Matters

  • Direct and oversee defense counsel on litigated claims.
  • Participate in depositions, examinations under oath, mediations, arbitrations, and trial-related activities.
  • Prepare responses to regulatory inquiries, consumer complaints, and Department of Insurance matters.
  • Ensure compliance with state regulations and company claim-handling standards.

 

Make an Impact Beyond Your Desk

  • Serve as a mentor and resource for less experienced adjusters.
  • Share best practices and contribute to training initiatives.
  • Recommend process improvements that enhance efficiency and customer experience.
  • Represent the organization with professionalism in all internal and external interactions.

 

 

What We're Looking For

  • Bachelor's degree or equivalent combination of education and related experience.
  • 3+ years of No Fault claims handling experience.
  • Strong investigative, analytical, and negotiation skills, including coordination of benefits.
  • Experience interpreting insurance policies, coverage provisions, and applicable case law and statutes.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple priorities in a fast-paced environment.
  • Ability to obtain and maintain required state adjuster licenses.

 

 

Preferred Qualifications

  • Experience handling SIU, fraud-related, or highly complex claims.
  • Litigation management experience.
  • Insurance coursework, professional designations, or industry certifications.
  • Bilingual language skills.
  • Experience working with attorneys, medical experts, and law enforcement agencies.

 

Why Mapfre?

 

As a global insurance leader with a strong local presence, we offer more than a job — we provide a purpose-driven career where your growth, well-being, and impact truly matter.

 

Purpose & Culture: Join a company built on trust, collaboration, and inclusion. Our values guide everything we do, creating a workplace where people feel respected and empowered.

 

Comprehensive Benefits: Enjoy competitive health coverage, retirement plans, paid time off, flexible work options, and lifestyle perks like employee discounts.

 

Career Growth: Advance your skills through tuition reimbursement, leadership programs, and internal mobility opportunities. Your development is our priority.

 

Social Responsibility: Contribute to meaningful initiatives through Fundación Mapfre, supporting communities and sustainability worldwide.

Pay Philosophy: The typical starting salary range for this role is determined by several factors including skills, experience, education, certifications, and location. Some roles at Mapfre are eligible for commission and/or bonus earnings, in addition to salary, calculated based upon factors set forth in the compensation plan for the role.

 

 

Salary Range $52,100 - $82,200

 

If you require an accommodation for a disability so that you may participate in the selection process, you are encouraged to contact the Mapfre Insurance Talent Acquisition team at talentacquisition@mapfreusa.com.

 

 

We are proud to be an equal opportunity employer.

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