SENIOR CLAIMS REPRESENTATIVE
About The Position
The Senior Claims Representative investigates, evaluates, negotiates, and resolves assigned property claims of moderate to high complexity and value, working within delegated reserve and settlement authority. The role handles claims with additional coverage or exposure complexities with a high degree of independence. The representative may also be asked to deploy to a catastrophe (CAT) site to assist customers. The position requires determining loss facts, coverage compensability, and exposure by coverage unit; applying policy terms; establishing reserves; communicating throughout the claims process; and reaching settlements within authority limits. The representative also serves as a trainer, participates in assigned projects, manages claim files and diaries, controls damage exposure through cost-containment tools, and provides customer service to insureds, agents, and other stakeholders.
Requirements
- Bachelor’s degree or equivalent business experience.
- At least five years of progressive experience adjusting residential and commercial claims, or a combination of experience and education.
- Strong verbal and written communication skills.
- Ability to work collaboratively.
- Proficiency with Microsoft Office, including Word, Excel, and PowerPoint.
- Customer-service orientation and empathy.
- Ownership attitude and customer-centric responses to assigned tasks.
- Solid analytical and decision-making skills.
- Adjuster’s license(s) where applicable, or ability to successfully acquire them within 60 days of hiring.
Nice To Haves
- Bilingual ability.
- AIC designation.
- Professional designation specific to claims.
Responsibilities
- Investigate, evaluate, negotiate, and resolve assigned property claims of moderate to high complexity.
- Determine loss facts, coverage compensability, and the degree of exposure by unit of coverage.
- Review, analyze, and apply relevant policy conditions, provisions, exclusions, and endorsements.
- Establish timely and accurate property claim and expense reserves.
- Communicate professionally with customers or their representatives by phone and written correspondence about the claims process.
- Serve as a trainer.
- Participate in assigned special routine projects.
- Determine settlement amounts using independent judgment, actual cash value and replacement value estimates, contractor estimate validation, appraisals, applicable limits, and deductibles.
- Negotiate and convey property claim settlements to insureds within authority limits.
- Control damage exposures through appropriate use of cost-containment tools.
- Maintain an effective diary system to ensure timely resolution and document claim file activities in accordance with procedures and state regulations.
- Provide customer service to insureds, agents, and internal and external customers.
- Perform other duties as required.
- Participate in deployment to a CAT site when asked.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
