Job Duties and Responsibilities:
- Investigate, evaluate, negotiate and determine accurate damage payment of financial institution claims; CPI, VSI and GAP.
- Assign damage claims to appraisers and follow-up as needed to ensure accurate damage estimates and timely inspections
- Customer acknowledgement and establishment of new claims assigned daily including same day to 24 hour contact of 5-10 claims assigned daily.
- Ensure acknowledgement of claim and that needed documents and insurance proofs are supplied by client within 24-72 hours of the claim and that proper 3 day follow-up occurs until they are received.
- Review all required claim documentation including security agreements, loan histories, payment histories, NADA valuations, underlying claim evaluations, collection notes, statements by pertinent parties and request pertinent information from lenders to ensure all information to adjudicate the claim is provided in order to ensure accurate and thorough settlement.
- Determine the appropriate application of coverage and review the Master policy and specific certificates and waiver forms to determine the policy that applies and the damages that may or may not fall within the policy guidelines.
- Adjudicate claims within the guidelines of the appropriate underwriting company. There are approximately 6-8 different underwriting carriers to review and apply correct policy conditions.
- Ability to review and understand loan and payment documents from financial institutions to properly prepare and determine accurate settlement figures.
- Ability to use and understand programs associated with auto valuation including CCC, Auto Appraisal information (AUDATEX), ISO, NADA, Kelley Blue Book and other adjusting tools.
- Handle the total loss automobile valuation process and salvage requirements of each state.
- Meet and exceed all established claim service standards and benchmarks for an adjuster I. This includes 100% production per month, settling claims within a 10-14 day cycle time, ensuring all customer contact is made and communication requirements met, working all claims to conclusion within 72 hours of having all required documents.
- Process and settle claims per policy and procedures put in place within standard company guidelines
- Promptly and effectively answer and respond to borrowers and lenders claim inquiries and correspondence in a professional manner.
- Answer incoming calls to the claims department and handle or direct as necessary
- Answer incoming email correspondence via the live chat queue as necessary
- Other special projects and duties as assigned
- College degree required except in the following circumstances:
- Internal insurance claim experience as a claim processor or specialist with a minimum of 2 years of internal experience
- A HS degree with a minimum of 2 years of insurance claim experience
- P and C administrative insurance experience of 2-5 years is highly preferred
- Preference given to those with claim processor or specialist experience
- Property & Casualty Adjuster License required – Must be obtained within six months of hire.
- Excellent telephone, written and verbal communication skills required
- Strong decision making and organizational skills required
- Strong customer service skills and the ability to explain complex insurance policy language necessary
- Strong drive for results with a proven track record of achievement
- Ability to evaluates claims of up to moderate complexity, which would include using one's intellect to interpret policy provisions and apply the policy language to individual claim losses and issues payments based upon the value of the individual claim loss
- Ability to discern important file facts and documents all pertinent issues associated with individual claim files with some level of supervision.
- Ability to determine coverage and damages owed on moderately complex claims by assessing the merits of individual claim files and applying the facts of the loss and tangible evidence to the representative's past experience and statutory/regulatory case law.
- Ability to analyze a client's issues and communicates effectively within certain levels of the organization, any and all proposed solutions.