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Claims Examiner for Auto Liability Bodily Injury
2 months ago
Bodily Injury Claims Specialist - Auto Liability
PRIMARY OBJECTIVE: To evaluate and manage intricate auto and commercial transportation bodily injury claims by examining coverage, conducting investigations, establishing liability, and assessing the extent of damages.
KEY FUNCTIONS and RESPONSIBILITIES
Handles intricate auto commercial and personal line claims, including bodily injury, ensuring that claim files are thoroughly documented and accurately coded.Oversees the litigation process for claims that are in dispute.Manages vendor relationships, including the engagement of independent adjusters to aid in the claims investigation.Reports significant claims to excess insurance carriers.Creates and maintains action plans to meet state-mandated contact deadlines and to facilitate timely and appropriate claim resolutions.Identifies and seeks subrogation and risk transfer opportunities; manages salvage processes.Communicates claim status and processing updates with insured parties, clients, and agents or brokers as necessary.ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other assigned duties as needed.Contributes to the organization's quality assurance programs.Travels as necessary.QUALIFICATIONS
Education & Licensing
A bachelor's degree from an accredited institution is preferred. Professional certification relevant to the line of business is also preferred. Must secure and maintain state adjusting licenses as required for the role.
Experience
A minimum of five (5) years of experience in claims management or a comparable combination of education and experience is required, including comprehensive knowledge of personal and commercial auto policies, coverages, principles, and regulations.
Skills & Knowledge
Thorough understanding of personal and commercial auto policies, coverages, principles, and regulations.Familiarity with medical terminology relevant to claim evaluation and Medicare compliance.Knowledge of the application of deductibles, sub-limits, self-insured retentions, and large deductible programs.Excellent oral and written communication skills, including presentation abilities.Proficient in PC usage, including Microsoft Office applications.Strong organizational capabilities.Exceptional interpersonal skills.Effective negotiation skills.Able to collaborate effectively within a team environment.Capable of meeting or exceeding service expectations.WORK ENVIRONMENT
When applicable and appropriate, reasonable accommodations will be considered.
Mental: Requires clear and conceptual thinking abilities; sound judgment, troubleshooting, problem-solving, analytical skills, and discretion; capacity to manage work-related stress; ability to juggle multiple priorities simultaneously; and ability to meet deadlines.
Physical: Involves computer keyboarding and travel as necessary.
Auditory/Visual: Requires hearing, vision, and verbal communication.
