Talent.com

Claims representative Jobs in Raleigh nc

Last updated: 7 hours ago
Claims Representative I - Remote

Claims Representative I - Remote

North Carolina Joint Underwriting AssociationRaleigh, North Carolina, United States
Remote
Full-time
Show moreLast updated: 30+ days ago
Call Center and Claims Representative

Call Center and Claims Representative

HumanaRemote, North Carolina
Remote
Full-time
Show moreLast updated: 30+ days ago
  • Promoted
Long Term Disability Claims Specialist I

Long Term Disability Claims Specialist I

MetLifeCary, NC, United States
Full-time
Show moreLast updated: 10 days ago
  • Promoted
Field Claims Representative

Field Claims Representative

Auto-Owners InsuranceNC, United States
Full-time
Show moreLast updated: 20 days ago
Claims Representative-Storage Team

Claims Representative-Storage Team

GAIC Great American Insurance CompanyNorth Carolina, USA
Full-time
Show moreLast updated: 30+ days ago
  • Promoted
Claims Examiner - Workers Compensation (Remote) with CA Claims Experience

Claims Examiner - Workers Compensation (Remote) with CA Claims Experience

SedgwickRaleigh, NC, United States
$75,000.00–$95,000.00 yearly
Remote
Show moreLast updated: 8 days ago
Long Term Care Claims Representative – Payment Servicing

Long Term Care Claims Representative – Payment Servicing

Genworth FinancialNorth Carolina
$66,400.00 yearly
Remote
Full-time
Show moreLast updated: 30+ days ago
Claims / QC Auditor

Claims / QC Auditor

ChubbRaleigh, United States
Show moreLast updated: 30+ days ago
  • Promoted
Claims Representative Associate

Claims Representative Associate

VirtualVocationsRaleigh, North Carolina, United States
Full-time
Show moreLast updated: 1 day ago
  • Promoted
Commercial Claims Adjuster (Casualty)

Commercial Claims Adjuster (Casualty)

Builders MutualRaleigh, NC, United States
Full-time
Show moreLast updated: 1 day ago
Inside Claims Representative

Inside Claims Representative

Erie InsuranceCary, NC, US
$43,190.00–$68,992.00 yearly
Full-time
Show moreLast updated: 1 day ago
Senior Claims Representative - REMOTE

Senior Claims Representative - REMOTE

Ryder System, Inc.Raleigh, NC, United States
$75,000.00–$80,000.00 yearly
Remote
Show moreLast updated: 30+ days ago
  • Promoted
  • New!
Claims Examiner - Claims Specialist

Claims Examiner - Claims Specialist

James River Management CompanyRaleigh, NC, United States
Full-time
Show moreLast updated: 7 hours ago
Property & Casualty Claims Representative - Broker / Retail Agency - REMOTE

Property & Casualty Claims Representative - Broker / Retail Agency - REMOTE

Work At Home Vintage ExpertsRaleigh, NC, US
Remote
Full-time +2
Quick Apply
Show moreLast updated: 11 days ago
Inside Claims Representative

Inside Claims Representative

Erie Insurance GroupCary, North Carolina, United States
Full-time
Show moreLast updated: 2 days ago
Claims Manager

Claims Manager

Concord Hospitality EnterprisesRaleigh, NC
Show moreLast updated: 30+ days ago
  • Promoted
  • New!
Claims Consultant

Claims Consultant

CuriRaleigh, NC, United States
Full-time
Show moreLast updated: 7 hours ago
Mechanical Claims Adjuster

Mechanical Claims Adjuster

DriveTimeRaleigh, NC
Full-time
Show moreLast updated: 30+ days ago
Claims / QC Auditor

Claims / QC Auditor

CHUBBRaleigh, NC, United States
Show moreLast updated: 30+ days ago
  • Promoted
Medical Claims and Revenue Manager - Remote

Medical Claims and Revenue Manager - Remote

UrrlyRaleigh, NC, United States
Remote
Full-time
Show moreLast updated: 3 days ago
Claims Representative I - Remote

Claims Representative I - Remote

North Carolina Joint Underwriting AssociationRaleigh, North Carolina, United States
30+ days ago
Job type
  • Full-time
  • Remote
Job description

POSITION TITLE : Claims Representative I

DEPARTMENT : Claims

REPORTS TO : Claims Manager or Designee

JOB SUMMARY :

With supervision from the Claims Manager or designee, adjust claims by telephone. Authorize settlement of all assigned claims within established limits, in accordance with Association policies and procedures and North Carolina Statutory {58-63-15 (11)} Unfair Claims Settlement Practices.

DUTIES / RESPONSIBILITIES :

  • Receive and review first Notice of Loss, verifying coverage on all claims.
  • Make initial telephone contact with policyholders or claimants within time standards to determine the cause and extent of loss. Review scope of damages and take sufficient information to offer settlement or use a cost estimating system to obtain agreed settlement. When damage estimate requires field loss scoping and adjustment, assign claim, within designated authority or upon approval of supervisor, to an adjuster and define scope of that adjuster's task. (May also recommend involvement of other loss evaluation experts.)
  • Make written denial with an explanation for the reason(s) on claims for which no coverage is afforded.
  • When appropriate, encourage policyholder involvement in obtaining damage estimates from local contractors.
  • Prepare claims for entry into the computer, establish and update reserves.
  • Within authorized limits, review claims handled by independent adjusters prior to final settlement to ensure that the claims have been processed completely and that all opportunities for salvage and subrogation have been identified and or pursued.
  • Review adjusters' and other expert work product for proper reporting, documentation and investigation to ensure that payments for those services are reasonable.
  • Maintain an effective diary system and document claim file activities.
  • May also be required to assist in the handling of liability bodily injury claims.
  • Possess knowledge in all aspects of electronic claims handling processes and effectively utilize available technology.
  • Answer routine questions relative to area of responsibility from adjusters, producers, policyholders, claimants and others. Answer Department of Insurance and other complaint letters on assigned claims.
  • With the assistance of the Claims Director, may represent the Association and or coordinate with Defense counsel in mediated or settlement conferences including the Board's Appeals committee.
  • Accurately prepare and maintain administrative & other reports as required such as production, quality, expense accounts, and attendance reports.
  • Participate in self-development activities to improve technical skills and to develop other business related subjects.
  • Perform other related duties as required

OTHER DUTIES

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

EDUCATION AND EXPERIENCE :

High school education or equivalent required. College degree desirable. Three (3) years to five (5) years in property or liability claims work required. Willingness to pursue AIC and to complete CPCU designation. Field adjusting experience desirable. An equivalent combination of education and experience may be substituted.

REQUIRED SKILLS AND ABILITIES :

  • Must maintain North Carolina Adjuster's License and valid North Carolina Drivers License
  • Ability to communicate information orally and in writing and to deal effectively and diplomatically with a wide variety of people including fellow employees
  • Willingness to mentor or train co-workers
  • The ability to work with others in a team environment
  • The ability to accept direction from superiors
  • The ability to follow work rules and procedures
  • The ability to accept constructive criticism
  • Ability to work flexible hours
  • PHYSICAL REQUIREMENTS

    The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

  • Prolonged periods sitting at a desk and working at a computer
  • Dexterity of hands and fingers to operate a computer keyboard, mouse, and other related devices
  • Physically able to participate in training sessions, presentations, and meetings Travel to outside meetings required, possibly overnight. May be required to travel to storm sites and temporary storm offices.