This position is responsible for conducting the investigation, evaluation and disposition of coverage, liability and damage issues of automobile material damage and bodily injury claims. It requires basic working knowledge of material damage estimating and “red lining”. Files assigned may have greater degree of complexity and handling is accomplished with greater autonomy than files assigned to Trainees. Claims Representatives typically require 50% mentoring and guidance from a manager. Responsibilities & Objectives· Resolve claims according to applicable law and policy provisions. · Conduct investigation including interviews, recorded statements, securing public records, and obtaining documents. · Negotiate and communicate effectively with body shops, attorneys and customers and vendors. · Evaluate and conclude claims consistent with CG (Claims Guidelines) and Department of Insurance Regulations. · Maintain mail, diary and phone calls in a timely manner. · Manage total loss claims. · Recognize possible fraud and perform basic fraud investigation. · Recognize and document subrogation opportunities. · Manage basic litigation. · Demonstrate CUDA compliance. · Perform other duties as assigned. PREREQUISITES- Bachelors degree preferred and/or relevant claims handling experience
Experience & Skills · Minimum 1 – 3 years claims experience · Ability to read, analyze and interpret insurance policies, technical procedures and government regulations · Excellent verbal and written communication skills · Working knowledge of Microsoft Word · Excellent analytical, problem solving and conflict resolution skills · Excellent organizational skills and the ability to work under pressure · Initiation of AEI – Legal Principles claims law course and/or industry recognized coursework
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