Claim Representative - Accident and Health (Hybrid)
About The Position
The Claim Representative provides efficient and effective disposition of assigned Accident and Health claims through timely investigation, evaluation, and negotiation. The role is based in Plymouth, Minnesota; New York City, New York; Chicago, Illinois; Alpharetta, Georgia; Mt. Juliet, Tennessee; Farmington, Connecticut; or Denver, Colorado, and follows a hybrid schedule. The representative investigates claims, determines coverage, assesses liability and damages, sets and adjusts reserves, coordinates internal and external resources, evaluates settlement values, and negotiates settlements within their authority. They provide recommendations to management for claims exceeding their authority and document claim activity and recommended follow-up. The role also requires staying current with state licensing requirements and participating in education as required.
Requirements
- 1–3 years of claims experience.
- UM/UIM experience.
- PIP experience.
- Bachelor’s degree preferred, or equivalent claims technical experience required.
Nice To Haves
- Bachelor’s degree.
Responsibilities
- Make timely and appropriate contacts and conduct the investigation needed to determine coverage, assess liability, and determine damages.
- Take recorded statements from all parties involved in a claim.
- Independently determine claim exposure, establish adequate initial reserves, and adjust reserves as needed.
- Assign and direct internal and external resources, including independent adjusters and appraisers.
- Determine whether additional evidence is required, such as accident reports, scene reconstructions, witness statements, police reports, or expert opinions.
- Independently determine settlement value and negotiate appropriate settlements within authority.
- Recommend settlement and disposition of claims exceeding authority to management.
- Clearly and concisely document relevant activity on assigned files and recommend additional activity as appropriate.
- Stay current with state licensing requirements and participate in education as required.
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.
- Bonus potential for full-time employees.
- Mental health support programs.
- Life and disability insurance.
- Paid parental leave.
- Additional voluntary benefits.
- Flexible work arrangement options.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
