Claims Representative

Position Summary

The Claims Representative is responsible for the timely and accurate processing of automobile claim assignments in compliance with company standards and state insurance regulations. This role requires strong analytical skills to assess coverage, document evaluations, and negotiate settlements while ensuring proper payment disbursement.

Principal Accountabilities

Planning and Delivery

· Process claim assignments efficiently, ensuring compliance with company policies and state regulations.

· Manage claims from initial investigation to settlement, maintaining accuracy and timeliness.

· Maintain and update case reserves appropriately based on ongoing assessments.

· Identify subrogation opportunities and refer cases for recovery when applicable.

Business Insight and Analytics

· Evaluate coverage and assess cases with a solid understanding of comparative negligence laws and safety regulations.

· Detect potential fraud and escalate suspicious cases to Claims Management.

· Make informed claim settlement decisions within authorized limits and company guidelines.

Communication and Relationship Building

· Engage professionally with claimants, insured parties, and other stakeholders.

· Handle complex interactions with empathy and a customer-first mindset.

· Draft and issue denial or reservation of rights letters in compliance with legal and company policies.

Leadership

· Apply a proactive and solution-driven approach to claims handling.

· Continuously seek opportunities for professional growth and process improvement.

· Foster a collaborative and values-driven work environment that aligns with Quincy Mutual Group’s commitment to integrity and responsible business practices.

Job Requirements

Experience

· Minimum of 2 years of experience handling automobile physical damage or property claims with a strong track record in claim resolution.

Education

· A relevant 4-year degree is preferred.

· Insurance coursework (AIC preferred) and state licensing (Maine Adjuster’s License preferred) are advantageous.

Skills

· Strong knowledge of comparative negligence laws and auto claims regulations.

· Proficient in PC applications and diary systems for task management.

· Excellent analytical and decision-making skills based on company policies and claim details.

· Exceptional verbal and written communication skills with a focus on professionalism and customer service.

Values

· Embodies Quincy Mutual’s mission of financial security, risk management, and integrity-driven service.

· Demonstrates adaptability, professionalism, and a commitment to continuous improvement.

Additional Details

Supervisory Responsibilities

· None

Equipment to be Used

· Standard office equipment, including computer, email, telephone, and recording tools.

Typical Physical and Mental Demands

· Ability to remain seated or standing for extended periods.

· Capable of handling high claim volumes and maintaining composure under pressure.

Working Conditions

· Primarily office-based, with remote work options based on departmental needs.