9/29/2023

Claims Representative - Liability

Qualifications:	EDUCATION and EXPERIENCE: Bachelor’s Degree required, except that additional related work experience may be substituted on a year-for-year basis for the formal education requirement. Prior experience in handling complex liability claims is preferred. QUALIFICATIONS: Valid Missouri Driver License required. Ability to operate a personal computer and standard office equipment. Ability to learn and operate claims-related software. Ability to communicate effectively with people in person and on the phone, and in written form. Ability to handle a high volume of detailed work accurately and completely. Ability to research and compile information and exercise good judgment.
Salary Info:	Exact starting salary determined by prior experience.
Summary:	Responsible for the assignment and handling of complex multi-line or discipline-specific insurance claims which include: coverage analysis, investigation, evaluation, negotiation, settlement, salvage, and subrogation. Adjudicates claims within assigned settlement authority and adheres to applicable laws, regulations, and company guidelines. ESSENTIAL DUTIES: Performs claim handling duties as assigned within the liability discipline. Conducts on-site assessment of reported claims as needed and assigned. Documents the claim file in a prompt, clear, and concise manner, with the facts gathered in the investigation. Evaluates coverage, gathers evidence and documentation, and determines whether coverage is applicable for assigned losses. Establishes, evaluates, and maintains individual case reserves in accordance with the Claims Department Reserving Philosophy. Applies proper legal theory in assessing fault, and throughout the claim adjudication process. Determines dollar amount of covered damages, and adjudicates the claim within authority level, and in compliance with applicable laws, regulations, and company guidelines. Coordinates with outside vendors and experts for attorney services, fire cause and origin, professional engineering services (structural, mechanical, and electrical), estimate reviews, accident reconstruction, medical bill reviews, appraisal services, and official reports. Completes periodic review of all assigned open claims. Assists in the handling of claims at other claim levels and claim disciplines as necessary and within authority. Attends and participates in Alternative Dispute Resolution, Examinations Under Oath, or any legal proceedings up to and including trial. Assists with training new agents, customer service representatives, and claims department personnel. Provides excellent customer service to all external and internal customers, and maintains good working relationships with field and Home Office personnel. Performs other duties as assigned.
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