What you'll be doing:
In accordance with application of state and federal laws and company best
practices, handle moderate value claims within an assigned line of coverage,
such as medical only, short to moderate duration indemnity, automobile physical
damage, property damage, business personal property, non-structural building
damage, low to moderate severity bodily injury claims, and subrogation as
applicable. Gather and review claim information, determine coverage, and
conduct investigation. Initiate and maintain customer contact to provide
updates and resolve any issues with the claim. Update information in the claim
system to document claim handling activities. Determine/set reserves and make
payments within level of authority. Investigate and refer identified claims to
Loss Recovery Services as applicable.
On any given day, you'll:
Perform claim tasks timely and document claim files appropriately.
Proactively manage claim activities to ensure fair claim resolution. Handle
all claims in accordance with state and federal laws and ensure accurate and
timely compliance with jurisdictional compliance requirements.
Verify coverage at an intermediate level by gathering adequate information
necessary to make an informed decision in a fair, equitable, and ethical
manner. Evaluate subrogation potential based onthe applicability of policy
language and/or governing state laws and statutes as appropriate.
With limited supervision, perform a thorough investigation based upon the
type, complexity, and severity of the claim. Upon completion of the
investigation, analyze and evaluate the potential exposure and damages,
including potential full or partial liability and compensability denials.
Formulate and document an action plan based on the covered damages and
injuries.
Determine and set reserves based on the most probable outcome of the claim,
within authority level. Evaluate and negotiate directly with insured,
claimant, or claimant's attorney on all cases within authority level. Review
claim facts and exposure with claims management, as appropriate, to guide
claim strategy. Make complete, accurate, and timely payments within authority
for covered losses. Refer claims above authority to appropriate team member
for review and potential reassignment.
Maintain a professional, courteous, and helpful approach when communicating
in-person, on the phone, or through email and other correspondence with
internal and external customers and business partners.
Recognize when vendor partners are required on a claim, including experts,
independent adjustors, nurses, defense attorneys, etc. Assign and direct
vendors, as needed, to aid in the investigation and evaluation of the claim.
Manage claim expense by concluding vendor assignment when vendor is no longer
adding value to the claim.
Investigate and refer identified claims to Loss Recovery Services, as
applicable.
May act as a resource to Claim Representative I to aid in their development.
Completes all other assigned duties, as requested.
Here's what we expect:
Additional training in commercial insurance, medical, and/or building
terminology knowledge is desirable.
Completion of courses in any one or more of the following designations, INS
or AIC is preferred.
A minimum of two years commercial insurance and/or claim handling experience
is ideal.
Ability to obtain and maintain state adjusting license requirements and
complete continuing education requirements.
Evidence of organizational skills, ability to prioritize, and to think
independently.
Strong listening, verbal, and written communication skills.
Knowledge of policy terminology and legal principles involving at least one
or more of the following: commercial insurance, automobile, medical, and
property claims.
Education:
Bachelor's degree preferred. A combination of equivalent education and/or
commercial insurance experience may be considered in lieu of a degree.
Church Mutual is an equal opportunity employer. All qualified applicants will
receive consideration for employment without regard to race, color, religion,
sex, sexual orientation, gender identity, national origin, veteran or disability
status.
Exact compensation will vary based on consideration of a variety of factors
including education, skills, experience, and location.
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