Claims Representative Job Description Template
Our company is looking for a Claims Representative to join our team.
Responsibilities:
- Consistently meet established productivity, schedule adherence, and quality standards;
- Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims;
- Analyze and identify trends and provide reports as necessary;
- Assists Claim Manager in the identification of exposures and recommends solutions;
- Manages indemnity and expense costs properly;
- Alerts Claim Manager to changes and proposed changes in laws that could impact Ryder’s liability program;
- Manages litigation to ensure claims are handled appropriately, according to the applicable jurisdiction;
- Investigates and adjusts claims, as well as directs independent adjusters, experts, and other vendors in the claim handling processes;
- Interacts with primary and excess insurance carriers, and re-insurers on files meeting reporting thresholds;
- Recommends and sets reserves to ensure the reserves represent the probable ultimate payout based on documented file developments;
- Supervises outside vendors and experts retained to assist in the investigation;
- Investigating and evaluating disability claims that get sent in;
- Examining the claim and evaluating the different elements of it (medical, occupational, financial);
- Reaching out to policyholders, client companies and legal and medical professionals until the issues with the claim are resolved;
- Documenting all findings so that a proper assessment of the claim can be determined.
Requirements:
- Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications;
- An education level of at least a high school diploma or GED OR equivalent years of work experience;
- Self-starting, self-motivating and capable of making decisions independently;
- Bachelor’s degree preferred;
- May participate in development of improvements and help implement change;
- Handle moderate to high complexity on Property Damage & Bodily Injury Liability within settlement authority and instruction;
- Occasional travel on short notice for field work as required (i.e., scene investigations, meeting witnesses, etc.);
- Utilize knowledge, experience and available resources to resolve claims;
- Insurance related designation (INS, AIC, SCLA and/or CPCU) preferred;
- Have, or ability to obtain adjuster license in required states;
- Provide direction to outside vendors and partners;
- Excellent analytical and problem solving skills;
- Investigate and review policy forms, facts and documents related to claims to make appropriate decisions on claims resolution;
- Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills;
- Deal with moderately complex problems that must be broken down into manageable pieces.