Primary Purpose: Investigates insurance claims; obtain all necessary information to evaluate claims and expedite settlement. Essential Duties and Responsibilities include the following. Other duties may be assigned. 1. Investigate out of state insurance claims within limits of authority; responsible for the accurate and efficient completion of all phases of claims processing from inception to settlement. 2. Obtain (via telephone or correspondence) loss reports, insured/witness/claimant statements, medical/police reports, appraisals, repair estimates, etc., as required; take photos as indicated. 3. Confirm coverage for new claims and set reserves amounts; follow up on necessary information; and record diaries for scheduled review of files; issue payment & correspondence as needed. 4. Analyze all accumulated data, reports, photos, etc. and evaluate claims; determine coverage and extent of loss/liability; prepare corresponding claims summaries. 5. Settle claim within limits of authority; issue drafts/checks for claim payment and obtain required liability releases; upon settlement, close claims files. 6. Confer with Out of State Claims Manager regarding complex claims or when potential exposure exceeds settlement authority. 7. Periodically review all open out of state claims files; obtain any necessary information and adjust reserve amounts as needed. 8. Make assignments to independent adjusters as necessary; be vigilant in using independent adjusters only for those investigation activities which cannot be done by telephone or by correspondence. Competencies To perform the job successfully, an individual should demonstrate the following competencies: 1. Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data. 2. Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments. 3. Interpersonal Skills- Maintains confidentiality; Keeps emotions under control. 4. Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and obtains clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. 5. Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Reads and interprets written information. 6. Business Acumen - Understands business implications of decisions; Displays orientation to profitability. 7. Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works ethically and with integrity; Upholds organizational values. 8. Organizational Support - Follows policies and procedures; Supports organization’s goals and values. 9. Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions. 10. Planning/Organization - Prioritizes and plans work activities; Uses time efficiently. 11. Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Accepts responsibility for own actions. 12. Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Monitors own work to ensure quality. 13. Quantity - Meets productivity standards; Completes work in timely manner; Works quickly 14. Safety and Security - Observes safety and security procedures. 15. Adaptability - Adapts to changes in the work environment; Deals with frequent change, delays, or unexpected events. 16. Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time. 17. Dependability - Follows instructions, responds to management direction; Commits to long hours of work when necessary to reach goals.
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Job Type
Full-time
Career Level
Entry Level
Number of Employees
101-250 employees