Claims Examiner I

Job Title: Claims Examiner I Department: Insurance Country: United States of America State/Province: Arkansas City: Lowell Full/Part Time: Full time Job Summary: Under general supervision, this position is responsible for the investigation and resolution of moderately complex claims. This incumbent will work closely with internal and external contacts to investigate claims, negotiate settlements, and prepare reports to ensure accurate and timely processing of casualty claims. Job Description: Key Responsibilities: Utilize independent knowledge and experience to conduct claims investigations to determine liability exposure of each assigned claim. This investigation includes analysis of state and federal laws, retaining services of field investigators, outside legal counsel to obtain a full picture of exposure and documentation of all findings for each claim within the claims matter management system for management review as well as internal and external audit processes. Manage moderately complex claims involving alleged property damage and bodily injury through the interview of key witnesses, securing evidence, reviewing applicable statutes and laws, and analysis of estimates of repair, analyzing medical reports Handle all monetary aspects of assigned claims through the calculation of financial exposure analysis leading to the establishment of reserves at proper levels within assigned approval levels. And, by keeping management aware of claims with exposures above approved levels for continuous timely and efficient resolutions of assigned claims. Manage negotiations with claimants, claimant's legal representatives or third parties by utilizing strong communication and negotiation skills in sharing investigative results and rationale, listening to claimant perspective and arguments, and influencing claimant perspective to achieve consensus on appropriate and final resolution of assigned claims Utilize strong communication skills to keep all stakeholders aware of findings, decisions, and resolutions to support plans and initiatives to meet business unit needs while establishing accountability in achieving results and identifying and addressing improvement opportunities Prioritize and manage assigned claims workload to keep all involved parties informed and provide timely claims status updates Initiate prompt contact with claimants to obtain information and establish the claims process; process incoming calls, emails, and notifications to support workload surges and/or extenuating situations including the creation of accident reports from the accident hotline Collect and analyze data from internal departments and third-parties to create repair estimates for company equipment to subrogate against adverse parties; present collected data to adverse party for collection or reimbursement of damages Ensure compliance with company and departmental policies and procedures that support the mission, values, and standards of ethics and integrity of the company Pursue continual education in the practice of transportation claims management through internal training, seminars, and other educational materials to stay abreast of the changing claims and legal environment Qualifications: Minimum Qualifications: High School Diploma/GED with 1-2 years of experience in Auto/General Liability Claims, Insurance, or related field, or suitable combination of education, experience, and training AND/OR Demonstration of the following skills and abilities through education, certifications, military, or other experiences Ability to uphold a professional demeanor in all customer interactions, demonstrating empathy and patience in the face of challenging situations Ability to accurately analyze situations and reach productive decisions based on informed judgment Ability to adapt to a dynamic work environment and shifting priorities and directives Ability to effectively transmit, receive, and accurately interpret ideas through various mediums Ability to work with a variety of individuals and groups in a constructive and collaborative manner Ability to capture and document relevant business information in an auditable, organized, and easily retrievable manner Ability to process information with high levels of accuracy Preferred Qualifications: Bachelor's Degree with 1 year of experience in Auto/General Liability Claims, Insurance, or related field Experience in a call center, particularly within the Insurance industry Ability to maintain composure under pressure Ability to type at least 30 words-per-minute Knowledge of claim investigation procedures Knowledge of approaches and techniques for recognizing, anticipating, and resolving problems Proficiency in documenting case details accurately and assessing payment eligibility Compensation: Factors which may affect starting pay within this range may include skills, education, experience, geography, and other qualifications of the #J-18808-Ljbffr