Associate Claim Representative
3 months ago
Directly handle tasks and functions, and/or a claim caseload comprised mostly of high volume, lower financial cost & lower complexity cases. The primary emphasis is on producing quick, courteous and accurate claims adjustments for our policyholders and claimants. Reasonably conclude claims promptly and equitably within the provisions of the insurance policy and in accordance with known damages and legal requirements. All files handled must comply with claim file handling guidelines and all other job expectations, regulations and requirements.
DUTIES & RESPONSIBILITIES
- Conduct and coordinate investigations on all assigned claims.
- Negotiate the settlement of claims within authorized authority limit.
- Maintain accountability for all assigned claims until disposition is reached.
- Recommend further action on claims exceeding authority limits.
- Document all substantive activity on assigned claims using notepad.
- Review new losses and open files on diary to ensure reserve adequacy and keeping superiors informed of adverse developments.
- Monitor loss adjustment expense and take steps to contain expenses while maintaining quality.
- Identify coverage issues and work with supervisor or claim management for assistance and approval.
- Ensure appropriate file handling, documentation, reporting and expense control over all files handled.
- Provide accurate and timely information to all external and internal customers concerning claim status and other claim inquiries.
- This position handles a claim pending which may vary in size and complexity based on internal and external demands.
- Performs other duties or special projects as required or as assigned.
SUPERVISION RECEIVED
Moderate supervision is received from the Claim Supervisor or Team Leader.
SUPERVISION EXERCISED
This job has no supervisory duties; however limited supervision of independent adjusters, appraisers or vendors may occur.
QUALIFICATIONS
- Associates or Bachelor's degree in business, insurance or a related field, or its equivalent; zero to one or more years of relevant claim processing experience; or a combination of education and experience from which comparable knowledge and skills were acquired.
- Willingness and ability to obtain the appropriate state Adjuster’s License(s) where required by law.
- Familiarity with property and/or casualty claims handling desired, but not required.
- Demonstrated commitment to professional development through willingness to take courses/continuing education related to the job such as AIC, INS, AEI or CPCU certification coursework, etc.
- Good analytical and negotiating skills.
- Good phone, verbal and written communication skills.
- Ability to exercise sound judgment in dealing with professional situations and confidential information.
- Ability to work effectively with a wide range of outside firms and organizations.
- Ability to collaborate effectively with company management, peers and support staff.
- Strong Customer service inclination.
- Proficiency with PC applications including Microsoft Office (Word, Excel & Outlook), imaging and estimating software programs preferred.
- Ability to perform job duties effectively while under pressure.
PHYSICAL DEMANDS/WORKING CONDITIONS
- Predominately sedentary office position with high frequency of keyboarding/computer work required.
- The physical demands are minimal and typical of similar jobs in comparable organizations.
- The work environment is representative and typical of similar jobs in comparable organizations.
- Rare overnight travel.
- Potentially subject to stressful situations with respect to claim dispute.
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