Inside Claims Representative

1 month ago

Gainesville, United States Tower Hill Insurance Group Full time

SUMMARY:

Reviews and analyzes first party homeowners' claims to determine extent of insurance carrier's liability, determines the extent of damaged property, and recommends settlement amounts in order to conclude claims with policyholders in accordance with policy provisions and applicable insurance statutes and laws.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Reviews the insurance policy, endorsements, and related information in order to make a coverage determination.
  • Conducts the appropriate claim investigation and directs the investigation of any assigned independent or other vendor. Interviews and consults with involved parties to gather pertinent information. Records statements per company and client guidelines.
  • Obtains any physical evidence, develops third party information and theory of liability, conducts interviews, and secures official records.
  • Provides prompt service to all stakeholders utilizing phone, fax, mail and electronic mail. Communicates with all customers in a professional manner.
  • Reviews other adjusters' reports, damage estimates, expert reports and any other documentation needed to make the appropriate coverage and loss decisions to conclude assigned claims.
  • Able to write/create simple estimates based on customer's information or other pertinent information.
  • Makes recommendations and decisions based on claim documentation and investigation.
  • Maintains file documentation, file notes and investigation documentation on each assigned claim in accordance with client company guidelines.
  • Maintains open claim inventory per company and client company guidelines.
  • Communicates with Claims management consistent with company guidelines.
  • Operates in accordance with applicable State statutes.
  • Maintains state(s) licensing requirement as necessary including Continuing Education requirements.
  • Participates in depositions as needed.
  • Negotiates within authority and per client guidelines to settle claims and/or to present claims to client for consideration.
  • Provides support to other members of the technical claims staff.
  • Participates in CAT Duty as required.
  • Performs other duties as determined by management.
QUALIFICATIONS
  • College degree (four-year college/university) or equivalent professional education and experience combined; Minimum of 1 year related adjusting experience and successful completion of claims training program.
  • Insurance adjusters license(s) as applicable to the position.
Benefits:
  • Health Insurance
  • Health Reimbursement Account
  • Flexible Spending Account
  • Dental Insurance
  • 401K
  • Paid Time Off
  • Paid Holidays
  • Short & Long Term Disability Insurance
  • Life Insurance

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