ESIS Claims Representative, AGL

Auto, General & Liability Claims Representative

ESIS is seeking an experienced Auto, General & Liability (AGL) Claims representative for the Philadelphia, PA office. The person in this role will handle and maintain all AGL claims and file reviews under the general supervision of a supervisor and as part of the ESIS team.

KEY OBJECTIVE : Under the direction of the Claims Team Leader, the Claims Representative investigates and settles claims promptly, equitably, and within established best practices guidelines.

MAJOR DUTIES & RESPONSIBILITIES :

• Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.
• Contacts, interviews and obtains statements (recorded or in-person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
• Depending on the line of business, may inspect and appraise damage for property losses or arranges for such appraisal.
• Evaluates facts supplied by investigation to determine the extent of liability of the insured, if any, and extend the company's obligation to the insured under the policy contract.
• Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties, etc.
• Sets reserves within authority limits and recommends reserve changes to Team Leader.
• Reviews progress and status of claims with Team Leader and discuss problems and suggested remedial actions.
• Prepares and submits to Team Leader unusual or possible undesirable exposures.
• Assists Team Leader in developing methods and improvements for handling claims.
• Settles claims promptly and equitably.
• Obtains releases, proofs of loss, or compensation agreements and issues company drafts in payments for claims.
• Informs claimants, insureds / customers, or attorney of denial of claim when applicable.

Qualifications

High level of technical claims knowledge and competence as evidenced by a minimum of 5 years claims handling experience in a specific line of business (Auto & General Liability). Experience within a TPA environment is strongly preferred. DE, PA, NY licenses preferred.

Thorough knowledge of ESIS products, services, and coverages; along with a good understanding of applicable legal principles.

Ability to plan, organize and implement general business and personnel management practices as evidenced by successful completion of management and technical programs, completion of the college-level curriculum, or equivalent related practical work experience.

Knowledge of auto liability cost containment programs and proven account management skills are a must.

Ability to lead change by addressing points of resistance at the team and / or individual level. The ability to independently evaluate and implement claims management best practices.

Demonstrates an understanding of team building theory and the techniques of continuous quality improvement and how they apply to ongoing activities.

Strong leadership skills including the ability to coach, develop and lead team members towards the successful attainment of goals and objectives.

Excellent communication, negotiation, and interpersonal skills to effectively interact with all levels of an organization both internal and external.

Strong analytical and problem-solving ability.

Demonstrated ability to provide consistently superior service to customers.