Claims Representative

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.