Third Party Sr. Claims Representative

Third Party Sr. Claims Representative

Fleet Response's mission is to provide innovative and effective service to our clients and to maintain a high standard of professionalism and partnership in an environment that fosters opportunity, integrity, and excellence. Our mission would not be possible without an environment that is created from mutual trust and respect, coupled with a commitment to diversity, equity & inclusion.

Our commitment to diversity, equity & inclusion aligns with our corporate values and is supported at the highest levels in the Company. Diversity helps to drive new business, fuel innovation, and attract and retain the best employees. It makes a difference in the workplace, marketplace, and community advancing the way we live and work.

Fleet Response specializes in providing services to corporations who self-insure physical damages to their fleets. Built from an insurance background with an eye for detail, Fleet Response prides itself on offering a variety of customized services to all our clients.

Fleet Response is currently seeking qualified candidates to work virtually or at our corporate office, for the following position: Third Party Sr. Claims Representative. The Third Party Sr. Claims Representative is responsible for the day to day management of client accident claims from assignment through completion. The Third Party Sr. Claims Representative typically manages 3rd party claims, including repair and rental management, claimant communication, and client communication. Confirms coverage and liability are properly in order prior to assisting 3rd party customers with repairs and/or rental and proactively works with client. Provides operational input and guidance as needed to teammate and works with the Claims Supervisor and Claims Manager to ensure client and customer parameters and expectations are consistently met by the team.

Job Summary:

Fleet Response is currently seeking qualified candidates to work virtually or at our corporate office, for the following position: Third Party Sr. Claims Representative. A Third-Party Sr. Claims Representative manages the most complex, high-exposure claims, requiring significant independent judgment, a strategic mindset, advanced technical expertise, and exceptional negotiation skills. They manage claims with complex coverage, liability, damage issues, often involving sensitive customer interactions filed by a third-party claimant against our clients from initiation to closure. This role often involves mentoring the Third Party Claims Specialist.

Essential Duties and Responsibilities Includes, but is not limited to, the following:

• First Notice of Loss (FNOL): Review and send loss notices to clients per client parameters.
• Administrative Support: Performing general administrative tasks such as mailing documents, creating documents, uploading documents, gathering documents, setting up tows & handling a shared inbox.

• Information Gathering: Contacting various parties to obtain missing or additional information required for claim processing & verification.

• Verify Coverage: Review the claim to ensure that the claim is covered.
• Investigate & Determine Liability: Conduct thorough investigations to establish fault, or liability, for an incident. This includes interviewing the client, claimant, witnesses, and other involved parties, and reviewing police reports and other documentation.
• Identify Potential Fraud: Watch for any signs of fraudulent activity, such as staged accidents or overstated claims, and refer suspicious cases to a Special Investigation Unit (SIU).
• Mitigating Cost: It is a fundamental duty aimed at controlling expenses while ensuring fair and prompt resolution of claims.
• Assess Damages: Evaluate the extent of damage, which can include property damage, repairs, total loss, loss of wages, loss of use, rental, towing, diminished value & out-of-pocket expenses.
• Determine Total Loss vs Repair: Evaluate if the cost of repairs exceeds the value of the vehicle or property and handle the claim toward a total loss settlement if necessary.
• Manage Repairs: Monitor the progress of repairs to ensure the repairs are being completed timely and accurately.
• Manage Total Loss Claims: Perform detailed market research to determine the actual cash value (ACV) of a totaled vehicle. This involves analyzing vehicle history, local market comparable, and salvage value.
• Manage Rentals: Verify coverage, explain terms, initiate rental arrangements, advise on non-covered events, rental duration, authorize extensions.
• Review and Authorize Supplements: Review additional repair costs submitted and approve payment while following guidelines.
• Ensure Compliance: Adhere to all federal and state laws and regulations governing the claims process.
• Maintaining Licensing: Maintain insurance adjuster licensing as required in all states.
• Communication: This requires clear, professional communication and strong interpersonal skills with all parties involved in the claim, including but not limited to peers & leadership.
• Negotiate Settlements: Determine an appropriate settlement amount based on liability and damage assessment, then negotiate a resolution with the claimant, client or legal counsel.
• Maintain Claim Files: Ensure that all claim activity, notes, and correspondence are thoroughly and accurately documented.
• Set Reserves: Set and maintain appropriate financial reserves for each claim to ensure funds are available for potential settlement payments.
• Process Payments: Process timely & accurate payments for vehicle repairs, total loss settlements, and other covered expenses.
• Workload and Metrics: Effectively manage a high volume of claims and meet key performance indicators (KPIs), such as average claim processing time, closure rates, and customer satisfaction scores.
• Finalize & Close Claims: Ensure all necessary steps are completed, and all paperwork is filed before finalizing and closing the claim.
• Developing: Responsible for actively accepting, acting on, and implementing coaching and feedback to improve professional performance and development.
• Mentor & Train: Responsibilities may include mentoring a team member and assisting in training.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

• Education/Experience: Associate degree (A.A.) or equivalent from a two-year college or technical school, or 2–4 years of related experience; combination of education and experience may be considered.

• Industry Experience: Prior experience in automotive, fleet management, claims management, or vehicle re-marketing strongly preferred. Third-party claims handling experience preferred.

• Licensing: Ability to obtain and maintain insurance adjuster licensing as required in all states.

Key Skills & Competencies:

• Strong oral and written communication , including the ability to simplify complex information and negotiate effectively with claimants, attorneys, and clients.

• Ability to analyze liability, assess damages, and evaluate complex claims accurately.

• Customer service and empathy , maintaining professionalism in difficult or emotional situations.

• Attention to detail with meticulous documentation and record-keeping.

• Proficiency with claims management systems and Microsoft Office.

• Strong investigative, analytical, and problem-solving skills .

• Ability to multi-task, prioritize, and manage a high volume of claims effectively.

• Knowledge of insurance principles, coverage, and legal/regulatory compliance is a plus.

Mathematical/Analytical Skills:

• Calculate property depreciation, repair/replacement costs, and claimant lost wages.

• Evaluate multiple bids or vendor quotes to ensure fair settlements.

Physical Requirements:

• Primarily sedentary work with occasional light lifting (up to 10 lbs).

• Close visual acuity for computer work, reading, and documentation.

• Ability to communicate clearly in person and via phone.

Preferred Traits: