Claims Clerk, Sr. reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk, Sr. verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk, Sr. processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk, Sr. works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Claims Clerk, Sr. typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
The Sr. Claim Representative qualifies as a hybrid position, after a 90-day review. This position will be required to work out of our Wooster, OH office during the 90-day review period, with the ability to work from home 2 days per week after an acceptable 90-day review. The Sr. Claim Representative is responsible for the investigation, adjustment and resolution of assigned claims and is required to manage a caseload of moderate to complex type losses in accordance with Company standards and IC 27-4-1/ORC 3901-1-54.
Salary Grade (10) 53,357 - 66,697 - 80,036
The Sr. Claim Representative – Auto Physical Damage investigates moderate to complex coverage and liability claims for personal/commercial auto policies for auto physical damage claims. The position also requires reviewing and verifying auto damages via CCC, negotiating total loss settlements, handling salvage, and managing rental use. See also essential duties and responsibilities below.
ESSENTIAL DUTIES AND RESPONSIBILITIES relevant to all openings include the following.
Initiate prompt and effective communication with all parties having legal or contractual interest in the claim presented.
Conduct a prompt and complete investigation of all losses assigned. The scope of investigation should be proportionate to complexity of the claim.
Provide superior customer service, proactively explain the claim process to the customer and update claim status as necessary.
Know and understand personal and commercial policies and endorsements related to assigned position.
Promptly and accurately document all developments in claim file.
Establish accurate and timely reserves. Reserves should adequately reflect exposure presented.
Maintain an active diary to achieve timely file development.
Identify complex issues and seek assistance as needed.
Effectively negotiate and compromise settlements where appropriate.
Recognize and identify potential subrogation.
Effectively control the use of outside vendors.
Handle claims on a good faith basis.
Adhere to the “Unfair Claims Practices Act” and other statutory requirements.
Any other duties deemed necessary by your supervisor or management.
Must maintain a valid driver license in good standing.
SUPERVISORY RESPONSIBILITIES
None
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE
College Degree or Equivalent Experience
Minimum of 2 years’ experience as a Claim Representative
Excellent Written and Verbal Communication Skills
Excellent Interpersonal Skills
Superior Organizational Skills
Efficient Time Management Skills
Demonstrated Negotiation Skills
Demonstrated Experience Providing Customer-driven Solutions, Support or Service.
LANGUAGE SKILLS
Excellent verbal and written communication skills. The individual must be able to effectively and clearly communicate with agents, insureds, departmental and company personnel via telephone, fax, e-mail, one-on-one dialogue and small group presentations in a professional manner.
REASONING ABILITY
The position requires the individual to apply common sense, understanding, reasoning and sound educated judgement coupled with sound Claims training and experience to properly evaluate and analyze claims for recommended action within assigned authority levels.
CERTIFICATES, LICENSES, REGISTRATIONS
AIC or CPCU are highly encouraged.
Obtain state specific property casualty claims staff adjuster licensing as required.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Employees are required to sit at a workstation to perform various PC functions. Additionally, the employee is required to devote substantial time to telephone communication.
While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. Duties may involve accessing roofs/heights, inspections of compromised scenes, where common sense and caution should prevail.
Employees will be required to travel. This may require extended periods of time sitting in a vehicle.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The Sr. Claim Representative is responsible for the proper handling of claims. Each Sr. Claim Representative will be assigned a specific work cubicle station or an office environment in their home conducive to a productive work environment and/or other individual work areas. The workstation may be located adjacent to other similar workstations. The workstation has the necessary equipment to perform the position duties including personal computer, telephone, file space, and needed worktable space.
The environment is reasonably quiet with needed interaction between other team members, immediate supervisor, and other company staff. Moderate noise level from telephone calls is expected.
0 Claims Clerk, Sr. jobs found in Akron, OH area