Field Claims Representative

Texas Farm Bureau and Affiliated Companies•College Station, TX

105d

About The Position

The Field Claims Representative investigates and resolves claims fairly, promptly, and efficiently in accordance with company and Claims department policies and procedures. The role involves evaluating coverage and claim validity, settling claims within designated authority, maintaining claim documentation and reserves, and coordinating with managers, agents, specialists, and other company units. The position also includes field investigations, travel as required, participation in training and claim committee discussions, and care and maintenance of company equipment.

Requirements

Four-year degree from an accredited college or university.
All Lines Adjuster license from the Texas Department of Insurance, maintained according to Texas licensing requirements, or ability to obtain the license.
Acceptable credit rating.
Effective knowledge of basic computer applications, especially Microsoft Office Suite.
Effective interpersonal verbal skills, both face-to-face and over the phone.
Ability to plan, organize, and complete detailed work independently or in a team environment.
Valid Texas driver’s license at hire and a driving record that would not place the employee on probation or disqualify the employee from Certified Fleet Operator Status under the company Driving and Safety Policy.

Responsibilities

Confirm policy status and coverage.
Investigate, evaluate, and settle claims using technical knowledge and interpersonal skills to reach fair and prompt resolutions.
Respond promptly to calls and complaints.
Investigate coverage questions and Agents’ error and omission claims and submit them to the District Claims Manager.
Submit required reports on assigned claims to the District Claims Manager in a timely manner.
Identify when expert assistance is needed and report the need to the District Claims Manager.
Advise the District Claims Manager of new lawsuits, counsel with insureds, explore settlement possibilities, and assist with case preparation for defense as needed.
Identify and thoroughly investigate subrogation claims and refer them to the Subrogation unit.
Identify potentially fraudulent claims and report them to the District Claims Manager and Special Investigations Unit under company guidelines.
Evaluate, set, and recommend reserves consistent with company policies.
Investigate and report accidental death claims, property protection claims, and payments to fire departments according to established procedures.
Assist in other areas as needed due to business necessity.
Pay and process claims within the designated authority level.
Enter claim payments, reserves, and new claims into the computer system and maintain concise, sufficient file documentation.
Resolve complex claims involving severe exposure through high service-oriented file handling.
Complete and forward Claims department reports to Underwriting.
Present cases and participate in their discussion at claim committee meetings.
Recommend and use structured settlement programs where appropriate.
Verify and analyze claim data to ensure claims are valid and settlements comply with company practices and procedures.
Submit monthly expense reports, monthly telephone bills, and other requested reports.
Contact or interview claimants, doctors, medical specialists, or employees to gather additional claim information.
Participate in the Texas Claims Representative Training Process and follow the recommended schedule unless the assigned District Claims Manager requests changes.
Properly care for and maintain company equipment, including a car, cell phone, and computer.
Achieve and maintain company standards and procedures.
Comply with Certified Fleet Operator requirements under the Company Driving and Safety Policy.
Perform other duties as assigned.