We’re committed to putting people first – if you need an accommodation as you go through the job searching, application, and interviewing process, please click here for more information.
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Evaluation and reserves, financial analyses, insurance regulations, negotiation and settlement of moderate to high complexity claims, other skills required include a focus on customers, decision making, results oriented, spoken communication, and adaptability. An ability to build relationships, listen (i.e., comprehend nuances and acknowledge others' viewpoints). Mentoring and training less experienced team members, write business correspondence, produce accurate work, manage projects and vendors, and use core applications/spreadsheets. As normally acquired through a bachelor's degree or equivalent; successful completion of required internal training programs and AIC (Associate in Claims) modules 33 and 35. Prefer designations such as AIC, SCLA, CPCU, etc,. At least 2-3 year of progressively responsible experience. 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Knowledge of claims investigation techniques, medical terminology and legal aspects of claims preferred. 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Set up claims and update the loss to reflect actual circumstances. Determine the need for independent adjusters or independent medical examiners. Evaluate claim for potential fraud. Assess actual damages associated with claims and conduct negotiations to settle claims. Be involved with litigated claims as necessary. High school diploma plus 1-3 years' of related customer service experience or applicable insurance knowledge. Licensing required in some states. Effective analytical skills required to learn and apply basic policy/contract coverage and recognize questionable coverage/contract situations (which necessitate supervisory involvement) along with effective interpersonal skills to explain the facts and logic used to arrive at decisions in a way that the customer understands. Effective written skills to compose clear, succinct descriptions when posting files and drafting correspondence. Good telephone and typing skills required. 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Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly. Establishes action plans based on case facts, best practices, protocols, jurisdictional issues and available resources. Manages an inventory of property/casualty and disability claims (e.g. workers` compensation, general liability, commercial automobile, property, group benefits), evaluates compensability/liability and losses, and negotiates settlements within prescribed limits. Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols. Confirms or denies coverage based on facts obtained during the investigation and advises policyholders as to proper course of action. Makes effective use of loss management techniques (e.g. Immediate Contact Plan, L9 check, Disability Management, open end release, first call settlements) and other resources. Updates files and provides comprehensive reports as required. 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(max-width:989px){#advanced_menu_toggle[data-av_icon]:before{font-size:30px;font-weight:normal;font-family:'FontAwesome'!important;} #advanced_menu_toggle{border-width:0px;} .container{padding:0 30px;} .responsive .logo{padding-top:10px;} } .main_menu .current_page_item a .avia-menu-text{border-bottom:0!important;} @media screen and (max-width:767px){.rem-arrow a:before{content:' '!important;} .responsive #top #wrap_all .container{width:92%;max-width:92%;} #advanced_menu_toggle{left:0;right:auto;border-width:0px;} .responsive #top .logo{margin:0 auto;width:150px;} .responsive .logo img{max-height:40px;margin:0 auto!important;} #header_main{border-top:0;} } @media screen and (min-width:1024px){li#menu-item-13649 ul.sub-menu{left:207px!important;} li#menu-item-13649.dropdown_ul_available>a::after{font-family:FontAwesome;position:absolute;left:auto;margin:0 5px;font-size:10px;} } #top a:focus{outline-offset:-2px!important;opacity:1!important;} .inner-container 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background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-11981:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-1136:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-1435:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-3937:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-12966:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} .fa-brands{-webkit-font-smoothing: antialiased; font-style: normal; font-variant: normal; line-height: 1; text-rendering: auto;font-family: 'Font Awesome 6 Brands'} .position-details li{list-style-type: disc;} .header-wrapper{display:none!important;}.disability p {text-align:center!important;background-color:#F0F0F0!important; height:45px!important;padding-top:12px!important;} .disability a {color:blue!important;text-decoration:underline!important;} @media only screen and (max-width: 1325px){.disability p {height:67px!important;}} @media only screen and (max-width: 675px){.disability p {height:92px!important;}} @media only screen and (max-width: 480px){.disability p {height:114px!important;}}h4{margin-top: 5px;font-weight: 600;}