What are the responsibilities and job description for the Claims Specialist position at Jewelers Mutual?
Summary
Responsible for adjudicating PL, CL, Shipping and CarePlan claims as assigned. The claims specialist also assists with administrative duties for the department, helping the team effectively negotiate and resolve claims in a timely manner and in accordance with established good faith handling procedures.
A secondary responsibility within this role is to provide support to the Jewelry Recovery Specialist with salvage related documentation including salvage-related invoices, payments, and recoveries.
Why Jewelers Mutual
We are a financially secure, exceptionally positioned, and intellectually curious company driven by our core values of Agility, Accountability and Relevancy! We continue to raise the tide of the jewelry industry we’ve served since 1913 through our innovative people, our unyielding customer commitment, and evolution of our products and services to be the most trusted advisor to all we serve.
With a generous benefits package, office locations throughout the United States, and a mantra of “making your mark today”, consider evolving your career and shining bright with Jewelers Mutual Group!
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Investigates, evaluates, and resolves multi-line claims in accordance with established procedures, good faith practices, and in accordance with the policy.
- Examines claim adjustors’ reports or similar claims/precedents to determine extent of coverage and liability.
- Pays claimant/insured amount due according to our contractual obligation and in alignment with our company procedures.
- Identifies and refers questionable claims to the special investigation unit in accordance with established fraud reporting procedures.
- Maintains excellent written and verbal correspondence with all parties involved on the claim.
- Evaluates and obtains damage documentation to accurately set reserves and effectively resolve claims.
- Maintains current status on claims and reviews claims on diary system.
- May be required to provide testimony under oath on claims in litigation.
- Provides quality customer service along with accurate and timely claim investigations and payments.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Leadership Responsibilities
None
Qualifications
- Property/casualty insurance adjusting experience is desired.
- Jewelry expertise, including experience working in the jewelry trade, is desired.
- Proficient in Microsoft suite applications including Word, Excel, Outlook, and PowerPoint.
- Proficiency in Guidewire software desired.
Physical Requirements
- Prolonged periods sitting at a desk and working on a computer.
- Occasionally required to stand; walk; use hands to finger, handle, or touch objects or controls; and talk or hear.
