What are the responsibilities and job description for the Claims Representative II - Auto & Casualty Lines, 1st Party Medical position at Goodville Mutual Casualty Company?
Summary :
This position is responsible for adjusting and settling claims for all lines of business written by the company with settlement authority up to $20,000.
Functions :
Handle claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
Verify policy coverage on assigned claims.
Investigate and evaluate claims; negotiate for proper settlement.
Assign independent adjusters, appraisers, and staff Field Claims Representative when necessary.
Pursue subrogation, salvage, and third-party liability contribution.
Notify Claims Supervisor or Manager of all claims that exceed settlement authority of $20,000.
Establish proper reserves on assigned claims.
Report claim complaints, questionable claim submissions and possible fraud to Casualty Claims and SIU Supervisor or Manager.
Attend claim seminars and participate in claim associations.
Perform other duties as assigned by Casualty Claims and SIU Supervisor and Supervisor.
Requirements
High School education required.
One to two years' Property and Casualty claims experience required.
Knowledge of Property and Casualty insurance coverages and terms preferred.
Ability to learn the coverages of all insurance policies written by the company required.
Effective communication and negotiation skills required.
Ability to work effectively with company computer systems required.
Willingness to participate in insurance related study courses with specific goal of attaining AIC designation preferred.
Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required.
Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required.
Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required.
Ability to perform the essential functions of the job with or without reasonable accommodation required.
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