BI Claims Adjuster (Level II)

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.

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

**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

**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.