Claims Representative 2

Enlyte•Egg Harbor Township, NJ

8d•Hybrid

About The Position

Investigates, evaluates, disposes of and settles the most complex and highest exposure claims with minimal supervision, including the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves in accordance with legal statutes, policy provisions and company guidelines. This is a hybrid position and requires the candidate to live near Egg Harbor Township, NJ. The work schedule is Monday - Friday 8:00 AM - 4:30 AM EST.

Requirements

HS Diploma/GED equivalent
At least 2+ years of experience handling first party property claims preferred; more experience may be required depending upon complexity of claim pending.
Completion of training courses internally and/or externally in all significant areas affecting claims handling and practices.
Proficient with MS Excel and Word.
Computer experience with related claims software.
Excellent verbal and written communication skills.
Excellent negotiation skills.
Superior organizational and decision making skills.
Strong analytical and strategizing skills.
Significant understanding of self-insured retention, excess and reinsurance reporting.

Nice To Haves

Licenses, certifications, awards preferred.

Responsibilities

Understand concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims toward resolution using Best Practices.
Promptly investigate all assigned claims for coverage, liability assessment and damages.
Manage a claim pending of approximately 250 files, the majority of which are in litigation.
Investigate claims by interviewing claimants and witnesses, establish claim reserves, handle evidence, obtain evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings.
Negotiate and settle claims, set reserves and manage litigation within client service parameters and authority levels by obtaining demands and making offers to claimants.
May present evidence at legal proceedings.
Direct appraisal and/or inspection of damaged property.
Dispose of salvage and pursue subrogation when appropriate.
Document plan of action in the claim system and set appropriate diaries.
Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
Close all files as appropriate in a timely and complete manner.
Maintain closing ratio as directed by management team.
Attend/participate at mediation, trials or hearings.
Routinely interact with clients, claimants, attorneys, investigators, experts and other vendors.
Perform other duties as required.