Copy of Claims Processor OR Claims Representative I OR Claims Representative II

Goodville Mutual Casualty Company•Napoleon, OH

38d•Onsite

About The Position

Summary: This position is responsible for processing Super Service claims according to company guidelines with settlement authority up to $3,500, as well as providing claims customer service to agents, policyholders, and claimants. Functions: Process first party auto claims according to company guidelines and in compliance with the Unfair Claims Practices Act. Receive incoming loss reports, verify policy coverages, and document for review by CSR and Subro Claims Supervisor. Verify policy coverage of assigned losses. Investigate and evaluate assigned Super Service claims for proper settlement. Assign independent adjusters and appraisers when necessary. Pursue subrogation, salvage, and third-party liability contribution. Notify CSR and Subro Claims Supervisor of all claims that exceed settlement authority of $3,500. Establish proper reserves on assigned claims. Issue payments to vendors with prior management/Claims Representative approval. Assist CSRs with end of day, month-end, and quarterly reports. Report claim complaints, questionable claim submissions and possible fraud to CSR and Subro Claims Supervisor. Perform other duties as assigned by CSR and Subro Claims Supervisor.

Requirements

High school or equivalent education required.
Ability to learn basic knowledge of insurance coverages written by the company required.
Effective communication skills required.
Ability to understand basic insurance terms and law required.
Ability to learn through on-the-job training required.
Ability to work effectively with company computer systems 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.

Nice To Haves

Willingness to participate in insurance related study courses preferred.

Responsibilities

Process first party auto claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
Receive incoming loss reports, verify policy coverages, and document for review by CSR and Subro Claims Supervisor.
Verify policy coverage of assigned losses.
Investigate and evaluate assigned Super Service claims for proper settlement.
Assign independent adjusters and appraisers when necessary.
Pursue subrogation, salvage, and third-party liability contribution.
Notify CSR and Subro Claims Supervisor of all claims that exceed settlement authority of $3,500.
Establish proper reserves on assigned claims.
Issue payments to vendors with prior management/Claims Representative approval.
Assist CSRs with end of day, month-end, and quarterly reports.
Report claim complaints, questionable claim submissions and possible fraud to CSR and Subro Claims Supervisor.
Perform other duties as assigned by CSR and Subro Claims Supervisor.