Claim Representative I

9 hours ago

Westerville, United States Accident Fund Holdings, Inc. Full time
Job Description

SUMMARY:

This is the entry level claim handling position. You will work on Commercial Property Claims and exercise discretion within your given authority.

RESPONSIBILITIES/TASKS:
  • With supervision review claims and evaluate information to determine coverage and scope of damage.
  • Work closely with manager on complex files or files above settlement/reserve authority.
  • On a timely basis obtain all relevant facts and expert input to determine cause and extent of damage.
  • Work with independent adjusters, experts and vendors as appropriate to help facilitate the claim process.
  • Understand commercial property coverage forms including knowledge of exclusions, limitations and amendatory endorsements.
  • Determine scope of damages through the use of Xactimmate and/or vendor and IA estimates.
  • Verify coverage, contribute to the investigation and documentation of the claim file, according to the property file handling guidelines and Department of Insurance requirements by gathering all pertinent information necessary to determine the resolution of the claim.
  • Provide reserve recommendations to claim leadership.
  • Maintain effective communication with all stakeholders including the insured, agents, public adjusters and attorneys.
  • Develop the skills to negotiate settlements with the insured, attorneys or 1st party representatives.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS

EDUCATION OR EQUIVALENT EXPERIENCE:

Bachelor's degree in a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Minimum of one year of relevant experience that provides the necessary skills, knowledge and abilities or completion of claims trainee program. Bilingual skills preferred.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
  • Ability and proficiency in the use of computers and company standard software specific to position.
  • Knowledge of medical and legal terminology related to the work.
  • Effective oral and written communication skills.
  • Effective customer service skills.
  • Ability to negotiate, build consensus and resolve conflict.
  • Ability to manage multiple priorities and meet established deadlines.
  • Attention to detail and analytical skills.
  • Ability to work independently as well as within a team.

WORKING CONDITIONS:

Work is mostly performed in an office setting with no unusual hazards. Minimal travel is required. Must be able to drive an automobile and have valid operator license. Specific vision abilities required by this job includes close vision, distance vision, color vision, and ability to adjust focus. While performing the duties of this job, the employee is frequently required to handle documents, books, manuals; reach with hands and arms; talk; and hear.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

Pay Range - Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $47,000 and $78,800.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.

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