Settlement (Demand) Negotiator

TITLE:                                  Settlement (Demand) Negotiator

REPORTS:                            Head of Demands, Settlements & Negotiations

LOCATION:                         Beverly Hills Office (In-Office)

GENERAL DESCRIPTION:

Core Mission: To serve as the firm’s negotiating voice with insurance carriers once a demand letter is sent, converting each pre-litigation bodily injury claim (auto, premises, and commercial/truck) into the strongest fair settlement for the client, documenting every offer and counter in Filevine, and moving every file to resolution or litigation without delay.

1. Case Ownership & Communication Protocol

The moment a demand letter is sent by the Demands team, the Settlement Negotiator takes ownership of the file for all negotiation activity with the carrier. To prevent mixed messages and “phone tag,” the Negotiator is the exclusive point of contact for the adjuster on every assigned file.

• Adjuster Communication: Negotiate with adjusters by phone and email, and return all adjuster calls and emails promptly.
• Internal Coordination: Work directly with Case Managers (client updates and treatment status), the Demands team (missing records, supplemental demands), and the Lien team (outstanding medical balances and liens that affect the client’s net recovery).
• Client Communication: Explain offers, counteroffers, and settlement recommendations to clients clearly.

2. Phase I: Demand Review & Case Valuation

Before responding to any carrier offer, the Settlement Negotiator must know the file and establish the firm’s position.

• Demand Package Review: Review the full demand package, including medical records and bills, medical specials, wage loss, liability evidence, photos, and police or incident reports.
• Case Valuation: Evaluate case value based on liability, injuries, treatment, specials, and other damages, and set a target settlement range and opening position. The valuation must be documented in Filevine.
• Coverage & Limits: Confirm and track the at-fault party’s policy limits and identify all available coverage, including UM/UIM and any additional, commercial, or excess policies.
• Deadlines: Calendar and track all demand response deadlines and follow-up dates in Filevine.

3. Phase II: Negotiation with Insurance Adjusters

• Offers & Counters: Evaluate every offer against the case valuation and respond with a well-supported counteroffer backed by the records, bills, and liability facts.
• Follow-up: If a carrier has not responded to a demand or counteroffer in a timely manner, initiate a follow-up with the adjuster.
• Filevine Documentation: Document every offer and counter in Filevine the same day it is made or received, including the date, amount, adjuster name, and basis for the position taken.
• Policy Limits & UM/UIM: When damages meet or exceed the available limits, pursue a policy limits tender and coordinate any UM/UIM claim with the handling attorney.
• Strict Rule: No offer may be accepted, and no settlement confirmed to a carrier, without documented authority from both the client and the handling attorney.

 

4. Phase III: Authority, Resolution & Escalation

A case is considered settled and ready for the Settlement phase only when the Settlement Negotiator confirms:

1. Client Authority: The client has approved the final settlement amount after a full explanation of the offer, and the approval is documented in Filevine.
2. Attorney Authority: The handling attorney has approved the settlement, and the approval is documented in Filevine.
3. Carrier Confirmation: The settlement is confirmed with the carrier in writing, and the file is handed off to the Settlement Assistant.

Litigation Referral: When negotiations stall (for example, liability is denied, the carrier will not make a reasonable offer, or the carrier stops responding), the Negotiator must promptly flag the case for litigation review by the handling attorney, with a written summary of the negotiation history.

5. Qualifications & Requirements

• In-Office: This position works on-site at the Beverly Hills office. Remote work is not available.
• Experience (Preferred): Prior personal injury settlement or negotiation experience is preferred.
• Knowledge & Skills: Strong negotiation, communication, and organizational skills; working knowledge of medical records, billing, and insurance coverage (bodily injury, UM/UIM); ability to manage a high-volume caseload under deadlines.
• Technology: Filevine experience preferred; proficiency with Microsoft Office and email.
• Education: College degree preferred.

Department Success Metric

 

The goal for this role is to turn demands into fair, well-documented settlements as quickly as possible.

• Settlement Volume: Meets monthly settlement volume goals set by management.
• Turnaround: Meets turnaround goals set by management for responding to carrier offers and for resolving each case or flagging it for litigation.
• Documentation: Every offer, counter, and authority is recorded in Filevine.

 

This job description is not intended to be all-inclusive, and employees are expected to perform other reasonably related duties as assigned by the Founder, CAO, or their designee. In the event of staff absence, employees are required to fulfill any tasks requested by their supervisor to ensure seamless operations; however, employees performing a task that falls outside their standard role must proactively request specific approval from their supervisor.