Claims Specialist Job Description Template
Our company is looking for a Claims Specialist to join our team.
Responsibilities:
- Communicate with customers to resolve claims;
- Identify issues that may require the use of independent experts or vendors;
- May serve as a resource for complex/non-routine claim issues;
- Help develop and continuously improve standard claim;
- Retains and manages vendors on products and mechanics E&O claims;
- Receives assignments, reviews claim and policy information, and evaluates coverage issues, draft coverage letters;
- Hone technical expertise for the auto aftermarket industry;
- Recognizes claims trends and provides analysis to claims management;
- Recognize coverage issues and issue reservation of rights and declination letters as appropriate;
- Perform special projects as assigned including, but not limited to, tracking company incident statistics, incident investigation file management, etc;
- Work with local management to provide claim status updates;
- Handle claims with injury diagnoses which may be inconsistent with the vehicle damage or loss characteristics;
- Additional responsibilities as assigned;
- Establish claims with third party administrator and/or at fault party;
- Works with minimal supervision to recognize, investigate, and resolve complex coverage, liability, injury, and damage issues.
Requirements:
- Set and revise case reserves in accordance with the reserving policy;
- Effective communication, presentation, negotiation and persuasion skills;
- Meet detailed quality assurance standards and meet set goals of performance;
- Ability to multi-task varied and significant matters;
- Employee must work well in a team environment, be reliable, creative, trustworthy. Strong ethical and compliance requirement;
- Bachelor of Science or Arts Degree preferred;
- Ability to document work in progress;
- Claims handling experience in all lines of property and casualty commercial insurance;
- High school diploma required. Associate/Bachelor’s degree or NC Adjuster’s License preferred;
- Conflict resolution and/or mediation skills;
- Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills;
- Ability to train / give instruction to large groups of people;
- Proficient with modern Microsoft Windows Office software such as Word, Excel, PowerPoint, and Outlook email;
- Have, or ability to obtain adjuster license in required states;
- Physical demands: Ability to sit, stand, walk for lengthy periods of time.