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Employment Type : Full-Time
Job Responsibilities:
This position is responsible for investigating and resolving claims in a fair, prompt, and efficient manner, according to the Company and Claims department policies and procedures on an as needed basis.
MAJOR RESPONSIBILITIES AND AUTHORITY
Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
Recognize the need for experts, including those from within or outside the Company, and report that to the District Claims Manager, the Claims Representative, or the Senior Claims Representative responsible for working the Claims Representative’s assigned territory.
Investigate and report accidental death claims, property protection claims, and payment to fire departments within established procedures.
Pay and process claims within designated authority level.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with company policies.
Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
Contact or interview claimants, doctors, medical specialists,insureds, agents, employees, and other necessary to get additional information regarding claims.
Participate in the training process as given in the Texas Claims Representative Training Process, so that the recommended schedule is followed, except when changes are made specifically at the request of the assigned District Claims Manager.
Comply with the Certified Fleet Operator requirements of the Company Driving and Safety Policy.
Other duties may be assigned.
Job Qualifications:
MINIMUM POSITION QUALIFICATIONS
Four-year degree from an accredited college or university.
All Lines Adjuster license from the Texas Department of Insurance, maintained according to the licensing requirements set forth by the state of Texas or ability to obtain.
Acceptable credit rating.
Effective knowledge of basic computer applications.
Effective interpersonal verbal skills, both face-to-face and over the phone.
Ability to plan, organize, and complete detailed work independently or in a team environment.
Valid Texas driver’s license and driving record at the time of hire which would not place the employee on probation, or disqualify the employee from Certified Fleet Operator Status under the company Driving and Safety Policy.
Other Job Information (if applicable):
PHYSICAL REQUIREMENTS
Occasional long, irregular work hours.
Travel, including overnight travel, as required.
Repeated use of PC, telephone, and office machines.
Extended periods of sitting and concentrating. Regular bending, twisting, crouching, pulling, pushing, and reaching in an office or field environment.
Physical activities, including lifting, carrying, and using a 40-pound ladder, as well as climbing on roofs.
Ability to climb a ladder and access roofs for visual examination and measurement.