What are the responsibilities and job description for the INSIDE CLAIMS REPRESENTATIVE position at Universal Insurance?
General Description :
Throughout the process of investigating, evaluating, negotiating, and ultimately resolving claims, the Inside Claim Representative takes on a multifaceted role. They delve into the intricacies of each assigned property claim, meticulously investigating and assessing the extent of damages or losses.
In collaboration with the Unit Manager, they strategize and implement effective solutions to address the challenges posed by these cases, ensuring that each claim is thoroughly addressed and resolved in a timely manner.
Essential Duties and Responsibilities :
Investigates, evaluates, negotiates, and resolves assigned property claims within designated levels of extended authority.
Determines the facts of the loss, coverage compensability, and the degree of exposure by unit of coverage.
Reviews, analyzes, and applies policy conditions, provisions, exclusions, and endorsements pertinent to a variety of losses.
Establishes timely and accurate property claim and expense reserves.
Communicates clearly and professionally with both internal and external customers, or their representatives, by telephone and / or written correspondence regarding all aspects of the claims process.
Determines settlement amounts based on independent judgment, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits, and deductibles.
Negotiates and conveys property claim settlements within authority limits to insureds.
Controls damage exposures through proper usage of cost containment tools.
Maintains an effective diary system to ensure timely resolution and documents property claim file activities in accordance with established procedures and state regulations.
Provides excellent customer service to meet the needs of the insured, agent, and all other internal, external customers and stakeholders.
Handles files in full compliance with state regulations.
Writes denial letters, Reservation of Rights, and other complex correspondence to insureds.
Identifies property claims that may have value added by an outside field inspection.
Determines cases that may have fraud potential and refers claims to the Special Investigations Unit.
Identifies potential for subrogation and refers appropriate claims to the Subrogation Unit.
Partners with counsel to develop responsive litigation plans, which adhere to applicable guidelines.
Performs other duties as required.
Supplementary Information :
This job description has been prepared to indicate the general nature and level of the work that the employees perform within their classification. This description is not to be interpreted as an inventory of all the duties, tasks, responsibilities, and qualifications required for the employees assigned to this job.
Education and / or Experience :
Bachelor's Degree preferred but not required. Minimum of three (3) years of progressive experience in the adjusting of residential and commercial claims or a combination of education and experience.
Strong verbal and written communications skills.
Must be able to work in a collaborative atmosphere.
Must be proficient with Microsoft Office, including Word, Excel, PowerPoint.
Present a customer-centric approach with a strong emphasis on empathy.
Exhibits a sense of ownership and consistently delivers customer-centric responses to all assigned tasks.
Owns and demonstrates solid analytical and decision making skills.
Spanish speaking is a plus.
Licenses and / or Certifications :
State applicable Adjuster's license(s) required.
AIC a plus.
Professional designation specific to claims a plus.
