Claim Representative Accident and Health
Overview
You will own the full lifecycle of assigned accident and health claims, from first contact to resolution, managing a caseload that spans multiple states. You will investigate coverage, assess liability, and negotiate settlements, working within a hybrid schedule from one of our regional offices. Your team includes claims adjusters and support staff, all focused on delivering fair outcomes for policyholders. This role stands out with its emphasis on recorded statements and independent settlement authority, and it offers a path to grow within a global specialty lines insurer.
What You'll Do9
- 1Contact parties within required timeframes and document all interactions.
- 2Determine coverage by analyzing policy language and applicable state laws.
- 3Take recorded statements from claimants, witnesses, and insureds to establish facts.
- 4Set initial reserves based on exposure analysis and adjust them as new information emerges.
- 5Direct independent adjusters and appraisers to gather evidence and assess damages.
- 6Evaluate medical records, police reports, and expert opinions to support claim decisions.
- 7Negotiate settlements within your authority and recommend actions for claims above your limit.
- 8Document every file with clear notes and propose next steps for unresolved issues.
- 9Maintain state adjuster licenses and complete required continuing education.
Requirements7
- 11-3 years of claims handling experience, with a focus on UM/UIM and PIP lines.
- 2Bachelor's degree preferred or equivalent technical claims experience.
- 3Proficiency with claims management systems and Microsoft Office.
- 4Strong verbal and written communication skills for recorded statements and negotiation.
- 5Ability to analyze complex policy language and apply state regulations.
- 6Proven track record of managing multiple claims and meeting deadlines.
- 7Valid adjuster license or ability to obtain one within 90 days.
Salary Insight
$62 - $91k per year
Location
Required Skills
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