What are the responsibilities and job description for the Associate AMD Claim Representative position at Ohio Mutual Insurance Group?
General Summary
The Associate AMD Claims Representative is an entry-level role that is designed for continuous career growth into the role of AMD Claim Representative. This position learns to investigate and evaluate claims as well as resolves claims from a minor to moderate value. Formal training on claims handling, coverage investigations, negotiations, settlements, diary management, and overall claims resolution are part of the overall role.
Essential Functions
- Complies with company procedures and the State Fair Claims Practices Act.
- Reviews policies and claim forms, and manages all external communication with insureds, claimants, and other contacts associated with the claim to determine damages.
- Maintains accurate claims and investigative reports.
- Provides optimal service during times of high claim volume, which can be frequent; must be able to manage high call, email, and text volume from various customers.
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Handles administrative responsibilities associated with the processing and payment of claims:
- records and updates status notes,
- documents the results of external information gathering,
- administers correspondence to customers regarding the status of their claims.
- Issues loss and expense payments within stated authority and complies with check security procedures.
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Works in a team environment to:
- promote and support the unit, department and organizational goals,
- communicate effectively,
- get along with team members,
- work with colleagues effective and professionally.
- Performs other duties as assigned.
Working Conditions
- Normal office working conditions.
- Sitting for extended periods of time.
- Eye strain and fatigue.
- Extended computer usage.
- Handling numerous phone and points of contact from customers daily
- Stress associated with high claim volume, upset customers, making difficult decisions and meeting deadlines.
QUALIFICATIONS
Skills and Abilities
- Must be proficient with operating a computer.
- Exceptional customer service skills.
- Experience working in a customer service environment where conflict resolution, time management, workload prioritization and follow-up are key priorities.
- Strong organizational and detail-oriented skills.
- Ability to focus and manage with frequent interruptions while dealing with various tasks.
- Ability to develop and maintain customer relationships.
- Strong verbal and written communication skills.
- Ability to manage conflict resolution.
- Strong analytical and critical thinking skills.
Education Requirements
- High School Graduate/GED.
- College degree preferred or equivalent work experience.
SUPERVISION
Supervision Received
- Periodic supervision since most duties are repetitive and related with standard instruction and procedures as guides.
- Self-reliant with minimal oversight.
- Unusual problems are referred frequently to the Claims Unit Manager with suggestions for correction.
Supervision
Exercised
- None