Claims Specialist

Jewelers Mutual•Neenah, WI

22d•Onsite

About The Position

Responsible for adjudicating PL, CL, Shipping and CarePlan claims as assigned. The claims specialist also assists with administrative duties for the department, helping the team effectively negotiate and resolve claims in a timely manner and in accordance with established good faith handling procedures.

Requirements

High School Diploma or GED
Proficiency in Microsoft suite applications including Word, Excel, Outlook, and PowerPoint.
Ability to obtain/maintain an adjuster’s license (product specific)

Nice To Haves

Property/casualty insurance adjusting experience
Jewelry expertise, including experience working in the jewelry trade
Proficiency in Guidewire software

Responsibilities

Investigates, evaluates, and resolves multi-line claims in accordance with established procedures, good faith practices, and in accordance with the policy.
Examines claim adjustors’ reports or similar claims/precedents to determine extent of coverage and liability.
Pays claimant/insured amount due according to our contractual obligation and in alignment with our company procedures.
Identifies and refers questionable claims to the special investigation unit in accordance with established fraud reporting procedures.
Maintains excellent written and verbal correspondence with all parties involved on the claim.
Evaluates and obtains damage documentation to accurately set reserves and effectively resolve claims.
Maintains current status on claims and reviews claims on diary system.
In rare circumstances, may be required to provide testimony under oath on claims in litigation.
Provides quality customer service along with accurate and timely claim investigations and payments.
Handles monthly bulk payments and applies recoveries as needed.