Claims Senior Representative

Westfield is seeking a highly skilled Claims Senior Representative to join our team. As a technical expert in claims adjusting, you will be responsible for handling injury claims, evaluating and resolving complex issues, and providing exceptional customer service.

• Claims Evaluation and Resolution: Determine whether proper coverage exists for the type of claim assigned, investigating thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage, liability, legal climate, potential exposure, and damages, and make decisions on claim resolution.
• Goal Achievement and Objectives: Meet established goals and objectives, arrange for salvage disposition and other recovery proceedings as necessary, participate in claim file reviews and audits with customers and brokers.
• Damage Assessment and Recovery: Determine the value of physical damage to property, automobiles, or injuries through appropriate tools, recognize claim file exposures, and escalate appropriately.
• Settlement Negotiation and Vendor Management: Provide support in negotiating settlements with insureds, claimants, vendors, attorneys, and other insurance companies, manage approved vendors and counsel utilized as necessary in the claim process, including approval of investigation plans and budgets.
• Payment and Reserve Management: Monitor, review, and issue payments to vendors and counsel in accordance with guidelines and standards, support the review of proper reserves for each claim based on thorough investigation, evaluation, and experience.
• Claim Referral and Management: Identify and refer claims to management for further handling and assignment instructions, refer claims exceeding authority to appropriate managers or complex claims specialists with recommendations.
• Communication and Reporting: Maintain effective and ongoing communication with insureds, claimants, agents, attorneys, other insurance companies, representatives, vendors, and company personnel, complete appropriate reports to ensure that the claim status is clearly documented, obtain all necessary documentation to support claim evaluation.
• Knowledge and Staying Current: Interpret complex and detailed documents, such as contracts, legal documents, medical reports, insurance regulations, and policies as needed, maintain knowledge of related coverage, law, and legislative environment and trends, participate in professional industry groups, staying abreast of industry changes and advancements, and incorporate best practices.

• 4+ years of claims handling experience.
• Bachelor's degree in Business, Communication, or a related field, and/or commensurate work experience.
• Valid driver's license and a driving record that conforms to company standards (for field roles only).