Third Party Sr. Claims Representative

Fleet Response•Hudson, OH

7d•Hybrid

About The Position

Fleet Response is seeking a Third Party Sr. Claims Representative to manage complex, high-exposure claims from initiation to closure. This role requires significant independent judgment, a strategic mindset, advanced technical expertise, and exceptional negotiation skills. The representative will handle claims with complex coverage, liability, and damage issues, often involving sensitive customer interactions filed by a third-party claimant against our clients. This role also involves mentoring Third Party Claims Specialists and providing operational input to teammates and leadership to ensure client and customer expectations are met.

Requirements

Associate degree (A.A.) or equivalent from a two-year college or technical school, or 2–4 years of related experience; combination of education and experience may be considered.
Ability to obtain and maintain insurance adjuster licensing as required in all states.
Strong oral and written communication, including the ability to simplify complex information and negotiate effectively with claimants, attorneys, and clients.
Ability to analyze liability, assess damages, and evaluate complex claims accurately.
Customer service and empathy, maintaining professionalism in difficult or emotional situations.
Attention to detail with meticulous documentation and record-keeping.
Proficiency with claims management systems and Microsoft Office.
Strong investigative, analytical, and problem-solving skills.
Ability to multi-task, prioritize, and manage a high volume of claims effectively.
Calculate property depreciation, repair/replacement costs, and claimant lost wages.
Evaluate multiple bids or vendor quotes to ensure fair settlements.
Primarily sedentary work with occasional light lifting (up to 10 lbs).
Close visual acuity for computer work, reading, and documentation.
Ability to communicate clearly in person and via phone.

Nice To Haves

Prior experience in automotive, fleet management, claims management, or vehicle re-marketing strongly preferred.
Third-party claims handling experience preferred.
Knowledge of insurance principles, coverage, and legal/regulatory compliance is a plus.
Strong initiative and self-motivation.
Dependable, punctual, and team-oriented.
Adaptable to changing regulations, processes, and claim scenarios.

Responsibilities

Review and send loss notices to clients per client parameters (First Notice of Loss).
Perform general administrative tasks such as mailing, creating, uploading, and gathering documents, setting up tows, and handling a shared inbox.
Contact various parties to obtain missing or additional information required for claim processing and verification.
Review claims to ensure coverage.
Conduct thorough investigations to establish fault or liability, including interviewing parties, reviewing police reports and other documentation.
Identify potential fraudulent activity and refer suspicious cases to a Special Investigation Unit (SIU).
Control expenses while ensuring fair and prompt resolution of claims.
Evaluate the extent of damages, including property damage, repairs, total loss, loss of wages, loss of use, rental, towing, diminished value, and out-of-pocket expenses.
Determine if the cost of repairs exceeds the vehicle or property value and handle the claim towards a total loss settlement if necessary.
Monitor the progress of repairs to ensure timely and accurate completion.
Perform detailed market research to determine the actual cash value (ACV) of a totaled vehicle, analyzing vehicle history, local market comparables, and salvage value.
Verify coverage for rentals, explain terms, initiate rental arrangements, advise on non-covered events, rental duration, and authorize extensions.
Review and authorize additional repair costs submitted, approving payment according to guidelines.
Adhere to all federal and state laws and regulations governing the claims process.
Maintain insurance adjuster licensing as required in all states.
Communicate clearly and professionally with all parties involved in the claim, including peers and leadership.
Determine an appropriate settlement amount based on liability and damage assessment, and negotiate a resolution with the claimant, client, or legal counsel.
Ensure all claim activity, notes, and correspondence are thoroughly and accurately documented.
Set and maintain appropriate financial reserves for each claim.
Process timely and accurate payments for vehicle repairs, total loss settlements, and other covered expenses.
Effectively manage a high volume of claims and meet key performance indicators (KPIs).
Ensure all necessary steps and paperwork are completed before finalizing and closing the claim.
Actively accept, act on, and implement coaching and feedback to improve professional performance and development.
Mentor team members and assist in training.