What are the responsibilities and job description for the Claims Examiner - I position at Wellington Insurance Group?
As a Claims Examiner I at Wellington, you would be responsible for processing, evaluating, adjusting, and resolving non-complex, standard claims in accordance with prescribed authority and best claims practices.
**This role requires on-site attendance in Fort Worth, Texas**
Responsibilities
- Responsible for developing relationships with customers via telephone, investigating insurance policy coverage, determining cause of loss, and documenting activity on each claim to come to a resolution quickly and accurately.
- Responsible for identifying, analyzing, and resolving coverage issues according to established Company protocol, including thorough policy review and analysis of application to the individual claim. With supervisor approval, responsible for negotiating with policyholders to settle claims of limited monetary value.
- Responsible for developing and directing investigative plans, as well as conducting timely and detailed investigations that include scene investigation, statements, official reports, and ownership documents. Also responsible for Identifying alleged and actual damages, identify potential liable parties, recognize and address potential fraud.
- Responsible for conducting thorough damage development, leading to timely and adequate evaluations, including appraisals/estimates, business records, invoices, detailed inventory, purchase records, receipts, credit card statements, and ALE documents. Will also develop appropriate methods of repair/replacement, verify ownership, and apply any special limitations.
- Responsible for establishing voice to voice communication within 24-hours, maintaining effective communications with the Customer at all times, and consistently working within specific time limits and authority.
- Responsible for maintaining company reputation and integrity of insurance products by complying with federal and state regulations, Company protocol, and service standards, as well as maintaining current knowledge of regulations and issues, industry activity, and trends
- Responsible for partnering with SIU and Subrogation to identify questionable claims and subrogation opportunities, as well as assisting or preparing files for suit, trial, or subrogation.
Qualifications
- Six month of related, applicable experience, but one year is preferred.
- Associates degree (A.A. or A.S.) or equivalent from a two-year college, business school, or technical school.
- Adjusters License for states in which the Company conducts business.
- Bilingual with the ability to translate documents and verbal messages from English to Spanish (and vice versa) preferred, but not required.
Wellington is an Equal Opportunity Employer and considers all qualified applicants regardless of race, gender, color, religion, national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law.
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work Location: In person
