Claims Resolution Specialist, Auto Claims
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Under moderate supervision, responsible for obtaining and maintaining essential information in order to handle liability no injury auto claims. Responsible for investigating, evaluating, negotiating and settling personal lines claims. Completes review of policy, accident details and determines coverage and damages owed. Handles the most complex auto liability no injury claims including but not limited to coverage issues, multiple car accidents (4+), specialty vehicles, service issues, high profile claims and litigation. May assist with the training, onboarding, and mentoring of new hires.
- Manages claims handling and resolves the most complex claims including but not limited to coverage issues, multiple car accidents (4+), specialty vehicles, service issues, high profile claims and litigation. Evaluates liability, coverage and settles claims within prescribed procedures and authority.
- Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims. Responds to various written and telephone inquiries including status reports.
- Requires frequent coverage research and analysis resulting in final coverage decision.
- Evaluates loss details for additional parties to be notified or involved in the claim, such as Total Loss, PIP/Med Pay, Subro, Rental, SIU, Legal. Split the file as needed
- Reports coverage denials to manager.
- Negotiates coverage and liability decisions with insured, claimant, claimant carrier.
- Ensures payments processed as needed, or releases payment once liability decided.
- Special assignments or projects as assigned.
- In larger claims locations where significant hiring occurs, in addition to complex claims handling, role will also be responsible for the following:
- Delivers formal training to assigned client groups (predominately new hires). Formal training is typically delivered one-on-one.
- Confers with managers to identify training needs and to ensure training content and materials meet those needs.
- Answers questions and provides sound guidance to assigned client groups (predominately new hires) related to Inside Auto Physical Damage (APD) claim handling.
- Prior auto claims adjusting experience is required with Total loss auto claims experience highly preferred.
- General knowledge of contract language, including regulatory and policy differences, legal liability and general insurance policy coverage.
- Excellent oral, written and interpersonal communication skills, and the capacity to multi-task in a structured work environment, are required
- Associates degree or equivalent training plus generally two or more year's auto non-injury claims handling experience
- Customer Service experience preferred
- Licensing as required.