Senior Claims Representative I
Description

Summary:

This position is responsible for adjusting and settling property claims for all property lines of business written by the company with settlement authority up to $40,000.


Functions:

  • Handle claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
  • Verify policy coverage on assigned losses.
  • Investigate and evaluate claims for proper settlement.
  • Negotiate with claimants, insureds, and attorneys when necessary.
  • Assign independent adjusters, appraisers, and staff Field Claims Representative when necessary.
  • Pursue subrogation, salvage, and third-party liability contribution.
  • Communicate with Claims Supervisor or Manager regarding complex claims when assistance is necessary.
  • Manage claims that go to litigation, involving management when necessary.
  • Notify Claims Supervisor or Manager of all claims that exceed settlement authority of $40,000.
  • Establish and maintain proper and adequate reserves on assigned claims.
  • Report claim complaints, questionable claim submissions and possible fraud to Claims Supervisor or Manager.
  • Assist Claims Supervisor and Manager in instructing Claims Representatives.
  • Attend claims seminars and insurance related meetings; participate in claims associations.
  • Perform other duties as assigned by Claims Manager and Supervisor.


Requirements
  • High School education required.
  • Five to eight years of Property and Casualty claims experience required.
  • Professional Property and Casualty claims designations preferred.
  • Thorough knowledge of Property and Casualty insurance coverages, terms and laws governing the jurisdictions in which the company is involved required.
  • Proficiency and knowledge of the Xactimate estimating platform preferred.
  • Ability to learn the coverages of all insurance policies written by the company required.
  • Effective communication and negotiation skills required.
  • Ability to work effectively with company computer systems required.
  • Involvement in insurance related seminars and continuing education required.
  • Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required.
  • Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required.
  • Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required.
  • Ability to perform the essential functions of the job with or without reasonable accommodation required.