Responsible for confirming coverage, investigating, negotiating, setting reserves and settling covered claims of moderate exposure within their personal settlement authority. Perform duties in accordance with the Claim Handling Guidelines and managerial direction.
Essential Duties and Responsibilities:
Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
- Provide the best possible claim service to both internal and external customers
- Promote teamwork and proactively seek opportunities to assist fellow associates with common challenges, i.e. systems use, file quality, etc.
- Perform thorough investigation, confirm and interpret coverage issues, and draft the appropriate reservation of rights or disclaimer letters as needed for manager approval; refer files to SIU when qualifying issues arise
- Assess if an on-site inspection is warranted and assign an Independent Adjusting Firm
- Review Independent Adjuster report packages
- Solicit estimates and photographs on smaller losses utilizing MyClaimPics to desk adjust claims
- Retain cause and origin experts, engineers, building consultants and/or any other necessary experts as warranted with manager approval; obtain police, fire, weather reports, etc., as needed
- Responsible for proper and timely reserving in accordance with our reserving philosophy
- Update the claim database system with proper and adequate coding and documentation
- Utilize and maintain diary on all open claims
- Review all bills, estimates and Proofs of Loss prior to making settlement and payment of claim
- Make recommendations to manager on damages exceeding adjuster's authority
- Review vendors' bills for accuracy and resolve any billing issues and/or inconsistencies with the vendor
- Determine subrogation/salvage potential on all claims; refer claim to subrogation when warranted
- Handle or oversee CAT claims as needed
Required Skills and Competencies:
The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Bachelor's Degree or in-lieu of degree equivalent education, training and work-related experience
- Obtain/Maintain appropriate licensing or educational requirements
- Possess solid knowledge of Homeowners policies, endorsements and state/local regulations
- Ability to analyze and apply coverage on small to medium loss scenarios
- Ability to operate with a proactive claim handling mind set to drive results
- Ability to resolve conflicts, problem solve and empathize with customers, both internally and externally
- Ability to successfully work in a fast paced environment
- Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint)
- Proficient in estimate writing software
- Possess professional oral and written communication skills
- 2+ years of experience in Property claims
- Prior experience in reviewing scope of damages and estimates