What are the responsibilities and job description for the Claims Processor OR Claims Representative I OR Claims Representative II position at Goodville Mutual Casualty Company?
Description
Summary:
This position is responsible for processing Super Service claims according to company guidelines with settlement authority up to $3,500, as well as providing claims customer service to agents, policyholders, and claimants.
Functions:
- Process first party auto claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
- Receive incoming loss reports, verify policy coverages, and document for review by CSR and Subro Claims Supervisor.
- Verify policy coverage of assigned losses.
- Investigate and evaluate assigned Super Service claims for proper settlement.
- Assign independent adjusters and appraisers when necessary.
- Pursue subrogation, salvage, and third-party liability contribution.
- Notify CSR and Subro Claims Supervisor of all claims that exceed settlement authority of $3,500.
- Establish proper reserves on assigned claims.
- Issue payments to vendors with prior management/Claims Representative approval.
- Assist CSRs with end of day, month-end, and quarterly reports.
- Report claim complaints, questionable claim submissions and possible fraud to CSR and Subro Claims Supervisor.
- Perform other duties as assigned by CSR and Subro Claims Supervisor.
Requirements
- High school or equivalent education required.
- Ability to learn basic knowledge of insurance coverages written by the company required.
- Effective communication skills required.
- Ability to understand basic insurance terms and law required.
- Ability to learn through on-the-job training required.
- Ability to work effectively with company computer systems required.
- Willingness to participate in insurance related study courses preferred.
- Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required.
- Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required.
- Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required.
- Ability to perform the essential functions of the job with or without reasonable accommodation required.