Claims Specialist

Job Description

Job Description

POSITION SUMMARY:

The Insurance Claims Specialist receives, investigates, negotiates, reports, and documents personal and commercial insurance claims. This position requires the review and understanding of insurance policies, direct client contact, and diligent follow-up with clients and carriers to assist in the satisfactory resolution of claims. The Claims Specialist is responsible for the documentation and administration of claims within the Agency’s Management System. The successful Claims Specialist is a compassionate, well-spoken, friendly, organized, and detail-oriented person. This position requires knowledge of the claims process for all types of commercial and personal insurance claims and the Claims Specialist must ensure that all claim, health, and financial information of the client, agency, and carrier is held confidentially.

ESSENTIAL FUNCTIONS:

Receives the first report of claim from the client, carrier, producer, account manager, or other related third party.

Upon receipt of claim/loss information, and in consultation with Senior Claims Specialist or Producer/Account Executive, tentatively determine if a client policy(s) will likely respond to the reported claim.

Verify policy, terms, type, carrier, and date of loss.

Report claims applicable carrier(s) and documents the same in the Agency Management System.

Monitor the assigned carrier adjustor’s performance on the claim by setting up regular tasks and follow-ups.

Discuss, explain, and follow up with clients throughout the claims process

Review carrier claim reserves for accuracy.

Responsible for documentation and administration of claim file in the Agency Management System.

Respond to claim-related inquiries from agency personnel, repair shops, producers, etc.

*Other duties may be assigned.

Adirondack Trust is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, sex, transgender status, gender identity, gender dysphoria, sexual orientation, national origin, physical or mental disability, protected veteran status, marital and familial status, domestic violence victim status, known relationship or association with any member of a protected class, or other characteristics protected by applicable law.