What are the responsibilities and job description for the Casualty Claims Representative position at EMC Insurance Companies?
At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees.
This position is eligible to work from home anywhere in the United States
Essential Functions :
Investigates and evaluates routine commercial casualty claims :
Reviews reported facts, confirms that date of loss falls within policy period, determines applicable deductibles and claim payees
Initiates contact with customers to obtain information on the claim and explain the claim process
Documents handling activity including Medicare (MSP) modules in the claims system
Resolves questions of coverage, liability and the value of claims
Takes statements from insureds, claimants and / or witnesses and documents summaries within the claims system
Sets timely, adequate reserves in compliance with the company reserving philosophy and methodology
Assigns vehicle / property damage appraisals and vehicle rentals
Requests and reviews police and fire department reports
Secures medical and wage authorization forms and obtains medical bills, reports and wage information
Reviews bills, invoices and receipts for accuracy
Identifies, investigates, and proactively pursues opportunities for recovery
Notifies people leader of claims which require assignment to higher level Claims team members
With guidance from people leader, negotiates, settles and / or resolves routine commercial casualty claims :
Provides prompt, detailed responses to agents, insureds and claimants on the status of claims
Prepares damage evaluations and handles lower complexity bodily injury
Drafts and sends reservation of rights and denial letters with manager approval
Negotiates settlement amounts for damages claimed within assigned authority limits. Makes recommendations to management for settlement amounts outside of authority limits, and follows case to conclusion for training purposes as appropriate
Issues settlement documents and verifies that they are properly executed
Issues payments within check authority limit
Collaborates with impacted departments :
Submits referrals to the Estimatics Review, Special Investigation, Property Review, Subrogation and Medical Review Units, when necessary
Prepares risk reports for Underwriting
Participates in roundtables where unique cases are discussed to learn and offer input
Assists claims team members with basic claims and other departments as needed
Assists other team members as needed. Participates in department and branch projects.
Education & Experience :
Associate degree or equivalent relevant experience
One year of insurance or claims handling experience
Bachelor’s degree may be considered in lieu of the claim handling or insurance experience requirement
Knowledge, Skills and Abilities :
Ability to adhere to high standards of professional conduct and code of ethics
Ability to obtain all applicable state licenses
Good knowledge of computers
Strong organizational and written and verbal communication skills
Excellent customer service skills
Good problem-solving abilities
Per the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $49,331.48 - $63,345.05. The hiring range for other locations may vary.
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