Claims Adjuster

Headquartered in the heart of San Diego, local franchisor with multiple national brands is seeking a Claims Adjustor to fill the role of the Franchise Reporting Coordinator.

ABOUT COMPANY CULTURE

Adding value to the lives of employees, franchisees, and customers is at the heart of the brand. When it comes time to get work done, team members take pride in their work. When someone needs a helping hand, everyone rolls up their sleeves to tackle the task. While each team member owns their main responsibilities, flexibility and adapting to new tasks is part of everyone’s role. When it comes to small wins, big accomplishments, or milestones, it’s fairly common to raise a glass and celebrate (these days at a safe distance or over Zoom). After multiple decades, this local company has proven the test of time, which is why many employees have been a part of the brand for so long. The company truly values its people which is why benefit packages for full-time employees include full health insurance, dental insurance, and vision insurance coverage. Benefits also include flexible spending account, life insurance, 401(k) plus matching, and paid time off.

ABOUT THE ROLE

While our field partners do their best to keep everything in pristine condition, sometimes accidents happen. This role is primarily responsible for duties related to claims adjustments when accidents do occur. Qualities and traits desired in a team member include:

· Great communicator with strong relationship management skills

· Outgoing and enjoys talking on the phone and communicating over email

· A creative problem solver who is resourceful and enjoys finding solutions to challenges

· A good listener with patience, able to de-escalate and resolve conflict

· Respectfully assertive and comfortable offering suggestions

· Likes consistency and enjoys completing routine duties

· Organized and detailed with great follow through

· Enjoys working in a team environment with peers and cross-functional partners

General role responsibilities include:

· Manage claims for multiple brands (8)

· Review reported claims and gather information

· Evaluate franchisee sales and ADV coverage documents

· Research item repair opportunities, source service providers and gather repair estimates

· Submit amount for payment and ensure payment processed and mailed

· Communicate with key parties through all phases of the claim process using internal communication systems and software

FULL JOB DESCRIPTION & DESIRED QUALIFICATIONS

This entry level Claims Adjustor role, also called the Franchise Reporting Coordinator, is responsible for handling MTC (Master Transit Coverage)/ADV (Alternate Declared Value) Coverage claims filed by franchisees and/or their customers. Plans and schedules work needed to process claim, gather documents and contacts claimant(s), and investigates claims. Organization, follow up, and excellent phone skills will all be needed to keep claims rejected/paid in a timely fashion.

In addition to franchisee MTC/ADV coverage review, this person is a backup for the data entry for the review and audit of all franchise brands. In this role, you will be engaged in conducting sales, cash and royalty reviews, investigate discrepancies and provide guidance to franchisee’s for proper reporting.

This position requires entering data into a proprietary database, using accounting records, internal and external documents. The proprietary database is used throughout the organization to track sales from franchised locations. Workers in this occupation check for incorrect information and formatting to fulfill company quality control policies in addition to correcting any errors introduced during the manual data entry process.

Detailed Job Duties:

1. Contributes to team effort by accomplishing related results as needed.

2. Creating and maintaining operations by following policies and procedures; reporting needed changes.

3. Enters data by inputting alphabetic and numeric information using an established procedure.

4. Maintains data entry requirements by following data program techniques.

5. Investigate and process MTC/ADV Coverage claims filed by franchisees.

6. Request MTC/ADV Coverage compliance documents directly from customer or broker/carrier.

7. Verifies entered data by reviewing, correcting, deleting, or reentering data; combining data from multiple systems when information is incomplete.

8. Make decisions, maintain records, reports, or files.

9. Contact insured or other involved persons to obtain missing information.

10. Examine photographs and statements. Inspect property damage to determine extent of damages.

11. Prepare and review MTC/ADV Coverage-claim forms and related documents for completeness.

12. Verify that coverage applies through the MTC/ADV Coverage policy, jobs were reported and paid.

13. Evaluate damages to ascertain compensation amount. Recommend claim action. Evaluate all information to determine how claim should be handled.

14. Calculate amount of claim. Negotiate with claimant to settle claim.

15. Issue payout amounts. Post or attach information to claim file

16. Prepare and present claims to insurance company if over the self-insured amount(s).

17. Provide customer service.

18. Maintains customer confidence and protects operations by keeping information confidential.

Desired Qualifications:

Education: High School graduate required with some college preferred.

Work History: Entry level role with 1-3 years experience preferred. Specific industry experience not required.

Technical Skills/Qualifications: Experience using Excel, Access, Word, Sage 100 (formally MAS90). Organized and detail oriented. Proficient with typing and data entry. Capable of maintaining high level of confidentiality. Strong decision making skills. An independent self-starter who is inquisitive and able to analyze information. A team player who takes accountability and works well with a range of personality types.

Location: This is not a remote position—it is a full-time role on-site at the San Diego office. Compliance with Covid-19 workplace protocols is mandatory for all employees.

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Application Question(s):

• Are you able to contact customers with follow up questions?

Education:

• High school or equivalent (Required)

Experience:

• Microsoft Excel: 2 years (Required)
• Customer service: 1 year (Required)
• Claims: 1 year (Required)

Work Location: In person

Salary : $20 - $22