Senior Claims Representative
The primary responsibilities will include the investigation, evaluation, negotiation and resolution of assigned property claims having moderate to high complexity and value, working within delegated reserve and settlement authority. With high degree of independence, handles property claims with additional complexities related to unique coverage and/or exposure issues. Individual may be asked to participate and be deployed to a CAT site to assist our customers.
Essential Duties and Responsibilities:
Investigates, evaluates, negotiates and resolves assigned property claims of moderate to high complexity.
Determines the facts of the loss, coverage compensability and the degree of exposure by unit of coverage.
Reviews, analyses, and applies policy conditions, provisions, exclusions and endorsements pertinent to a variety of losses.
Establishes timely and accurate property claim and expense reserves.
Communicates clearly and professionally with the customer, or their representative, by telephone and/or write correspondence regarding all aspects of the claims process.
Serves as a trainer.
Participates in special routine projects assigned.
Determines settlement amounts based on independent judgment, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles.
Negotiates and conveys property claim settlements within authority limits to insureds.
Controls damage exposures through proper usage of cost containment tools.
Maintains an effective diary system to ensure timely resolution and document claim file activities in accordance with established procedures and state regulations.
Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers.
Performs other duties as required.
This job description has been prepared to indicate the general nature and level of the work that the employees perform within their classification. This description is not to be interpreted as an inventory of all the duties, tasks, responsibilities and qualifications required for the employees assigned to this job.
Education and / or Experience:
Bachelor's Degree or equivalent business experience.
Minimum of five (5) years of progressive experience in the adjusting of residential and commercial claims or a combination of experience and education.
Strong verbal and written communications skills.
Must be able to work in a collaborative atmosphere.
Must be proficient with Microsoft Office, including Word, Excel and PowerPoint.
Customer service orientation; empathy.
Demonstrate ownership attitude and customer centric response to all assigned tasks.
Solid analytical and decision making skills.
Bilingual a plus.
AIC a plus.
Professional designation specific to claims a plus.
Licenses and / or Certifications:
Adjuster's license(s) (where applicable) required or successfully acquired within 60 days of hiring.