Job Details

Claims Representative I

The Claims Representative I is responsible for investigating, evaluating and disposing of assigned claims in a timely manner in order to achieve best practices type settlements within legal statutes, policy provisions and Company and/or client guidelines.

This is a hybrid role reporting to the Waukesha, WI office.

POSITION COMPETENCIES

• Business Acumen
• Negotiation
• Results Oriented
• Time & Priority Management
• Decision Making

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Establishes and maintains a quality relationship with insureds, claimants, agents, underwriting, medical and legal professionals, appraisers and independent adjusters in order to develop an effective communication channel through which to more efficiently resolve claims.
• Properly identifies and pursues subrogation, contribution and salvage opportunities when available, in order to reduce or recover the amount of payment.
• Uses appropriate, tactful and complete communications, in order to ease negotiations, develop rapport and project a positive corporate and personal image.
• Develops claims files from initial assignment to disposition.
• Prepares claim file documentation accurately and completely in order to justify all actions taken and to provide an effective audit trail.
• Achieves a best practices type settlement in the disposition of claims.
• Completes actions on a timely basis, such as verifying coverages, setting or adjusting reserves, making appropriate contacts.
• Collaborates with Team Leader, Manager and Home Office as necessary to develop case strategy, moving the investigation along and disposing of the claim, in order to keep management, claimants, insureds and other interested parties satisfied that effective efforts are being made toward claim settlement.

ADDITIONAL RESPONSIBILITIES

• Initiates self-development and training, in order to improve upon, maintain or acquire skills prescribed as promoting professional and personal growth in claims handling.
• Performs other duties as may be assigned by the Reporting leaders listed above.
• May require outside personal adjusting, interviewing, inspections, scene investigations, and securing of personnel records from clients (pertains to position in Inservco only).
• May participate as a member of a Claims Catastrophe Team (pertains to position in Penn National Insurance).

SPECIAL RELATIONSHIPS

• Direct contact with branch underwriting and/or claims service office personnel;
• Direct contact with Home Office claims personnel;
• Direct contact with agents, insureds, claimants, medical and legal professionals, appraisers and independent adjusters;

QUALIFICATIONS

Education/Credentials

• Bachelor's degree preferred
• Continuing education in insurance-related courses such as The Institutes Certificate in General Insurance (AINS) and Associate in Claims (AIC) courses preferred.
• Adjuster's license or be willing to obtain one as required.

Experience

• 3 years of progressive experience in a property/casualty claims handling position preferred.

Technical/ Professional Knowledge

• Must have a good understanding of tort and state laws applicable to assigned claims, the Unfair Claims Settlement Act and insurance policy coverages and provisions
• Must have a good understanding of terminology applicable to assigned claims; i.e., medical, legal, automotive and construction terminology
• Good communication skills, both oral and written
• Good inter-personal skills
• Good negotiation skills
• Good customer service skills
• Good analysis and evaluation skills
• Good decision-making skills
• Must have a strong sense of urgency
• Good PC skills, with an emphasis on Microsoft Office Products
• Good planning and organization skills
• Must be able to work independently as well as a member of a team
• The compensation has been carefully determined by considering a variety of important factors, including skill sets, experience, training, and certifications. With these considerations in mind, the estimated hiring range is $64,000 -$90,000. Additionally, you may be able to participate in our annual incentive program, depending on eligibility under the plan.

JOB REQUIREMENTS (as required by ADA – Americans with Disabilities Act)

• This position is primarily a sedentary position that requires occasional standing and walking throughout the office environment.
• Must be able to perform computer-based tasks and access digital information necessary for job duties, including through the use of assistive technologies.
• Must be able to complete computer-based tasks and utilize office equipment as needed to perform essential job functions.
• Must be able to access and enter information accurately using automated systems.
• Must be able to communicate effectively with internal and external clients using telephone, electronic, or other communication systems.
• Must be able to present information to individuals and groups.
• Must be able to interpret and apply concepts that may or may not be based upon established guidelines.
• Must be able to maintain acceptable attendance and adhere to scheduled work hours.