SENIOR CLAIMS REPRESENTATIVE

General Description:

The primary responsibilities will include the investigation, evaluation, negotiation, and resolution of assigned property claims having moderate to high complexity and value, working within delegated reserve and settlement authority. With high degree of independence, handles property claims with additional complexities related to unique coverage and/or exposure issues. Individual may be asked to participate and be deployed to a CAT site to assist our customers.


Essential Duties and Responsibilities:

Investigate, evaluate, negotiate, and resolve assigned property claims of moderate to high complexity.

Determine the facts of the loss, coverage compensability and the degree of exposure by unit of coverage.

Review, analyze, and apply policy conditions, provisions, exclusions and endorsements pertinent to a variety of losses.

Establish timely and accurate property claim and expense reserves.


Communicate clearly and professionally with the customer, or their representative, by telephone and/or write correspondence regarding all aspects of the claims process.

Serve as a trainer.

Participate in special routine projects assigned.


Determine settlement amounts based on independent judgment, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles.


Negotiate and convey property claim settlements within authority limits to insureds.


Control damage exposures through proper usage of cost containment tools.


Maintain an effective diary system to ensure timely resolution and document claim file activities in accordance with established procedures and state regulations.

Provide excellent customer service to meet the needs of the insured, agent and all other internal and external customers.


Perform other duties as required.

Supplementary Information:

This job description has been prepared to indicate the general nature and level of the work that the employees perform within their classification. This description is not to be interpreted as an inventory of all the duties, tasks, responsibilities and qualifications required for the employees assigned to this job.

Education and / or Experience:

Bachelor's Degree or equivalent business experience.

Minimum of five (5) years of progressive experience in the adjusting of residential and commercial claims or a combination of experience and education.

Strong verbal and written communications skills.


Must be able to work in a collaborative atmosphere.

Must be proficient with Microsoft Office, including Word, Excel and PowerPoint.

Customer service orientation; empathy.


Demonstrate ownership attitude and customer centric response to all assigned tasks.


Solid analytical and decision making skills.

Bilingual a plus.

AIC a plus.

Professional designation specific to claims a plus.

Licenses and / or Certifications:

Adjuster's license(s) (where applicable) required or successfully acquired within 60 days of hiring.