Claim Representative I - Property

Job Description

Job Description

JOB SUMMARY

Directly handle a technical claims caseload of a specific nature. Caseload typically comprised of files arising from a limited range of coverage’s and possessing up to moderate financial exposure The primary emphasis is on producing thorough, accurate and courteous claims adjustments for our policyholders and claimants. Such claims infrequently involve substantive coverage issues or litigation. Reasonably conclude claims promptly and equitably within the provisions of the insurance policy and in accordance with known damages and legal requirements. All files handled will comply with claim file handling guidelines and all other job expectations, regulations and requirements.

DUTIES & RESPONSIBILITIES

• Conduct and coordinate investigations on all assigned claims.
• Negotiate the settlement of claims within assigned authority.
• Maintain accountability for all assigned claims until disposition is reached.
• Document all activity on assigned claims and assure control of independent vendors.
• Review new losses and files on diary to ensure reserve adequacy while keeping management informed of adverse developments.
• Monitor loss adjustment expense and take steps to contain file expenses.
• Utilize vendors judiciously to maximize value added.
• Review coverage questions and work with supervisor and claim management for approval.
• Refer appropriate coverage matters to the Team Leader, Claim Supervisor or Manager.
• Ensure appropriate file handling, documentation, reporting, and expense control.
• Provide accurate and timely information to all external and internal customers concerning claim status and other claim inquiries.
• Meet with policyholders and agencies as needed.
• Attend trials, depositions, EUO’s, appraisals and mediations where beneficial or required.
• Suggest improvements of processes within the department to increase the level and quality of service provided to internal and external customers, i.e. workflow changes, etc.
• Participate in setting file direction and recommend appropriate reserves on claim files within specific authority and on files requiring mandatory reporting.
• Deliver technical training for agents, peers and clerical personnel upon request.
• This position directly handles an assigned claim caseload.
• Performs other duties or special projects as required or as assigned.

SUPERVISION RECEIVED

The Claim Supervisor or Team Leader provides direct moderate to minimal supervision.

SUPERVISION EXERCISED

This job has no supervisory duties; however limited supervision of independent adjusters, appraisers and vendors may occur.

QUALIFICATIONS

PHYSICAL DEMANDS / WORKING CONDITIONS

The salary range reflected is a good faith estimate of base pay for the position. In addition to base salary, this role is incentive compensation and benefits eligible, and individual salary will ultimately be determined based on individual experience, skills, qualifications and geographic location.