Claims Investigator

3 weeks ago


Sheboygan, Wisconsin, United States Accuity Full time
Job Summary

Accuity is seeking a highly motivated and detail-oriented Claims Intern to join our team. As a Claims Intern, you will be responsible for investigating assigned claims to determine specifics surrounding a loss. This includes providing exceptional customer service to all involved parties, as well as obtaining information from various sources to support the claims investigation and evaluation process.

Key Responsibilities
  • Claims Investigation and Evaluation: Proactively investigate, evaluate, and resolve assigned auto physical damage and basic liability losses.
  • Customer Service: Demonstrate superior communication and customer service skills in all aspects of the position, with a focus on meaningful correspondence and timely initial contact with parties involved in the claim.
  • Policy Coverage Evaluation: Accurately evaluate policy coverage by applying claims facts to the policy contract terms.
  • Reserving and Forecasting: Understand basic reserving concepts and consistently forecast and monitor reserves, while adhering to Acuity's reserve philosophy.
  • Claim File Management: Thoroughly investigate assigned claims to determine coverage, subrogation, and fraud by conducting phone interviews, obtaining recorded statements, securing photos, and obtaining written reports and/or documents.
  • Fraud Detection: Identify potentially fraudulent claims and promptly refer suspect claims to the Special Investigations Unit (SIU).
  • File Documentation: Provide consistent and accurate file documentation with use of activity log entries, claims system screen updates, imaged documentation, the queue, and calendar system.
  • Legal and Statutory Knowledge: Learn basic legal and statutory concepts of the applicable jurisdictions.
  • Settlement Authority: Utilize sound judgment and discretion with settlement authority to properly and effectively resolve claims through negotiation, settlement, or denial.
Requirements
  • Education: Currently enrolled in college, pursuing a four-year degree, preferably in a business-related major.
  • Experience: Entry-level position with customer service experience preferred.
  • Skills: Ability and willingness to provide quality customer service, excellent written and verbal communication skills, organizational and time management skills, thorough understanding of personal computing, typing skills, and technology, strong analytical and creative problem-solving abilities, and ability to work both independently and in collaboration with others.

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