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Claims Lead Representative

  • Location

    Egg Harbor, United States

  • Sector:

    Other Area(s)

  • Job type:

    Contract

  • Contact:

    Leric Arcigal

  • Job ref:

    21294

  • Published:

    about 1 year ago

  • Expiry date:

    2020-09-29

POSITION SUMMARY

Investigates, evaluates, disposes of and settles the most complex and highest exposure claims with minimal supervision, including the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves in accordance with legal statutes, policy provisions and company guidelines.

KEY RESPONSIBILITIES: (Duties may include, but are not limited to, all or some of the following)

Understand concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims toward resolution using Best Practices.

Promptly investigate all assigned claims for coverage, liability assessment and damages.

Manage detailed investigation and negotiations.

Investigate claims by interviewing claimants and witnesses, establish claim reserves, handle evidence, obtain evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings.

Negotiate and settle claims, set reserves and manage litigation within client service parameters and authority levels by obtaining demands and making offers to claimants.

May present evidence at legal proceedings.

Direct appraisal and/or inspection of damaged property.

Dispose of salvage and pursue subrogation when appropriate.

Report all serious injuries/liability issues and potential large loss claims to the client and/or reinsurer based upon the criteria provided by the client.

Document plan of action in the claim system and set appropriate diaries.

Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution.

Close all files as appropriate in a timely and complete manner.

Maintain closing ratio as directed by management team.

Attend/participate at mediation, trials or hearings.

Routinely interact with clients, claimants, attorneys, investigators, experts and other vendors.

Perform other duties as required.

COMPENTENCIES

Confidentiality - Possesses high level and regard for confidentiality.

Dependability - Is trustworthy, reliable and accurate.

Detail Oriented - Focuses on details to obtain a quality work product.

Follows Direction - Acts in accordance with instructions.

Judgment - Forms an opinion objectively and with discretion.

Organization - Is able to plan and carry out activities effectively.

Problem Solving - Evaluates information and situations, approaching and resolving in a timely manner.

Teamwork - Promotes cooperation and commitment within a team to achieve goals.

Time Management - Plans and controls time to effectively accomplish goals.

Work Ethic - Is hard working, diligent, reliable, and has initiative.