We are seeking a Claim Specialist to handle complex technical issues and claims. The role will involve reviewing assigned claims, contacting insureds and other affected parties, and initiating documentation in the claim handling system. The position requires a high level of approval authority and involves negotiating settlements, securing and evaluating evidence, and preparing manual and electronic estimates.
Requirements
- Claim handling responsibilities include reviewing assigned claims, contacting insureds and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system.
- Complete complex coverage analysis.
- Ensure all possible policyholder benefits are identified.
- Create additional sub-claims if needed.
- Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential.
- Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
- Evaluate the financial value of the loss.
- Approve payments for the appropriate parties accordingly.
- Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
- Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
- Utilize strong negotiating skills.
Benefits
- Medical, dental and vision benefits
- 401k Match
- Paid parental leave and adoption assistance
- Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
- Paid volunteer day annually
- Tuition assistance program, professional certification reimbursement program and other professional development opportunities
- AAA Membership
- Discounts, perks, rewards, and much more
