Claims Representative II

Penn National Insurance•Waukesha, WI

2h•$52,000 - $72,000•Hybrid

About The Position

The Claims Representative II investigates, evaluates, and resolves assigned claims accurately and promptly, aiming for best-practice settlements in accordance with legal statutes, policy provisions, and company performance standards. This is a hybrid role reporting to the Waukesha, Wisconsin office. The position handles basic and intermediate claims, including auto property damage, non-complex workers’ compensation, property losses, and simple bodily injury claims. The representative verifies coverage and policy provisions, evaluates liability and claim value, sets or adjusts reserves, identifies subrogation and salvage opportunities, and addresses policyholder, self-insured, and claimant concerns. The role involves preparing complete claim documentation and communicating with policyholders, claimants, third parties, agents, underwriting personnel, vendors, and medical and legal professionals. At the Team Leader’s direction, the representative may perform limited field work and handle certain low-exposure, low-complexity workers’ compensation lost-time and bodily injury liability claims. The position may also involve generating alternative solutions and performing other assigned duties. The role is primarily sedentary, with occasional standing and walking in the office. It requires computer and office-equipment use, accurate entry and retrieval of information in automated systems, effective communication and presentation, and adherence to scheduled work hours. The estimated hiring range is $52,000–$72,000. Eligible employees may participate in an annual incentive program. Penn National Insurance describes a total rewards package that includes a 401(k) match, graded profit sharing, incentive compensation, flexible scheduling, remote and hybrid work options, employee recognition programs, continuing education support, tuition reimbursement, and professional development opportunities.

Requirements

Successfully complete the Claims Representative II Trainee curriculum or have at least 1 year of experience in a property/casualty claims-handling position.
Hold an adjuster’s license or be willing to obtain one as required.
Have effective oral and written communication skills.
Have effective interpersonal and organizational skills, including the ability to work independently.
Be detail-oriented and able to handle work requiring significant attention to detail.
Have personal computer skills, particularly with Microsoft products.
Be able to work in a team-oriented, fast-paced, customer-focused environment.
Have a basic understanding of tort and state laws applicable to assigned claims.
Have a basic understanding of the Unfair Claims Settlement Practices Act, insurance policy coverages and provisions, and medical, legal, automotive, and construction terminology.
Be able to perform computer-based tasks, use office equipment and automated systems, communicate with internal and external clients, present information, interpret and apply concepts, and adhere to scheduled work hours.

Nice To Haves

Bachelor’s degree.
Experience in a customer-service-oriented position.

Responsibilities

Investigate, evaluate, and resolve assigned claims accurately and in a timely manner within applicable legal statutes, policy provisions, and company standards.
Prepare accurate and complete claim-file documentation, including relevant statements, photographs, facts, and environmental factors at accident scenes.
Contact and negotiate with policyholders, claimants, third parties, medical and legal professionals, and others in connection with arbitration, litigation, subrogation, contribution, and salvage.
Determine appropriate settlements for assigned claims, assessing costs and first- and third-party liabilities for auto property damage, non-complex workers’ compensation, property losses, and simple bodily injury claims.
Identify and pursue subrogation and salvage opportunities when available.
Perform basic and intermediate claims-handling duties on assigned claims.
Verify coverage and policy provisions to determine claim insurability or compensability.
Handle and resolve policyholder, self-insured, and claimant problems or requests.
Analyze and resolve coverage and liability issues or questions.
Gather and evaluate factual information to identify underlying problems or opportunities relating to assigned claims.
Set or adjust reserves according to the degree of liability and claim value.
At the Team Leader’s direction, perform limited field work and limited handling of low-exposure, low-complexity workers’ compensation lost-time or bodily injury liability claims.
Generate alternative solutions to problems or situations involving assigned claims.
Perform other duties as assigned by the CSO Team Leader Multi/WC Claims Service Office Manager II or CSO Team Leader.

Benefits

Generous 401(k) match.
Graded profit sharing.
Incentive compensation and potential participation in an annual incentive program, subject to eligibility.
A range of benefits supporting financial health, physical well-being, and career development.
Remote and hybrid work options.
Flexible scheduling.
Employee recognition programs.
Continuing education support.
100% tuition reimbursement for academic studies.
Professional development opportunities and designation programs, including CPCU, AINS, CPA, and CISSP.