Senior Claims Representative II

Summary:

This position is responsible for adjusting and settling claims for all lines of business written by the company with settlement authority up to $60,000.

Functions:

• Handle claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
• Verify policy coverage on assigned losses.
• Investigate and evaluate claims for proper settlement.
• Negotiate with claimants, insureds, and attorneys when necessary.
• Assign independent adjusters, appraisers, and staff Field Claims Representative when necessary.
• Pursue subrogation, salvage, and third-party liability contribution.
• Communicate with Claims Supervisor or Manager regarding complex claims when assistance is necessary.
• Manage claims that go to litigation with limited management involvement.
• Notify Claims Supervisor or Manager of all claims that exceed settlement authority of $60,000.
• Establish and maintain proper and adequate reserves on assigned claims.
• Report claim complaints, questionable claim submissions and possible fraud to Claims Supervisor or Manager.
• Assist Claims Supervisor and Manager in training and instructing Claims Representatives.
• Attend claims seminars and insurance related meetings; participate in claims associations.
• Perform other duties as assigned by Claims Manager and Supervisor.

• College education preferred.
• Eight to ten years’ Property and Casualty claims experience required.
• Professional Property and Casualty claims designations preferred.
• Thorough knowledge of Property and Casualty insurance coverages, terms and laws governing the jurisdictions in which the company is involved required.
• Ability to learn the coverages of all insurance policies written by the company required.
• Proficiency and knowledge of Xactimate estimating platform required, if handling property claims. 
• Effective communication and negotiation skills required.
• Ability to work effectively with company computer systems required.
• Involvement in insurance related seminars and continuing education required.
• Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required.
• Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required.
• Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required.
• Ability to perform the essential functions of the job with or without reasonable accommodation required.