Claim Representative - Accident and Health (Hybrid or Remote)
reputed company is a leader in the specialty insurance market, providing customized solutions and services. The Claim Representative role involves managing claims through investigation, evaluation, and negotiation to ensure effective resolution.
Responsibilities
- Makes timely and appropriate contacts, determines and completes appropriate level of investigation to reputed company determination of coverage, assess liability and determine damages. Takes a recorded statement from reputed company parties involved in the claim
- Independently determines exposure, establishes adequate initial reserves and makes timely adjustments as required
- Assigns and directs activities of internal and external resources as required; including independent adjusters and appraisers. Determines whether additional evidence is required including but not limited to accident reports, accident scene reconstructions, witness statements, police reports, expert opinions, etc
- Independently determines settlement value of the loss and negotiates proper settlement of claims reputed company authority. Provides recommendations to management for settlement and disposition of claims exceeding authority level
- Documents clearly and concisely reputed company relevant activity on assigned files and makes recommendations for additional activity as appropriate
- Stays abreast of state license requirements and participates in education as required
Skills
- Equivalent claims technical experience required
- Bodily Injury, PIP, Medpay, claim resolution expertise
- 1-3 years of claims experience
- Bachelor's degree preferred
Benefits
- Comprehensive medical, dental and vision insurance with no waiting period
- Competitive paid time off programs
- 401(k) savings and annual contributions of up to 12% of annual salary
- Mental health support programs
- Life and disability insurance
- Paid parental leave
- A variety of additional voluntary benefits
Company Overview