Full Time

Other

No

5. Claim representative training program, including the basic building damage school. 6. Possession of or ability to obtain a builder's license within the first six months of employment in position 7. Extensive experience as a claim representative, a public or private investigator or equivalent. Experience in the investigation, evaluation and settlement of one or more of the following: 8. Auto claims including automobile market evaluations and the preparation of auto repair estimates 9. Homeowner property claims, including accurately preparing construction damage estimates and adjusting property damage 10. Inspecting and evaluating auto repairs for quality and compliance with estimates 11. Inspecting and evaluating construction repairs for quality and compliance with repair estimates

1. Associate's degree in business administration, insurance or a related field or equivalent work experience. Bachelor's degree preferred. 2. Successful completion of basic claim representative training program or equivalent or ability to obtain within 9 months. 3. Candidates must be eligible to acquire and maintain a state adjuster's license for appropriate state(s). 4. Possession of a valid state driver's license.

Description: Independently performs detailed and highly complex claim investigations/processing or those of a higher dollar value at both internal and off-site locations regarding the specialized field assigned. Examines policies to determine the status, extent, type of coverage and need for additional information. Obtains necessary accident, legal, expert opinion and police reports to complete files. Determines the type and extent of loss and ensures the claim is consistent with all reported facts. Determines validity of claim and prepares a written summary of findings. Conducts investigations, defines appropriate evidence and obtains supportive documentation. May determine extent of injuries and reserves, evaluate claims for long term exposure, prepare initial and bi-annual reserve projections for re-insurers, evaluate and maintain adequate reserves and advise re-insurers and finance of recommendations. Reviews assigned claim files on diary and checks for progress toward completion of settlements. Determines if there is a need for further investigation. Evaluates, negotiates, responds to inquiries and settles claims. Provides guidance and technical support to staff members regarding specialized discipline. Participates in training claims personnel with respect to specific assigned disciplines. Assists in monitoring claims activity as it relates to expertise. Reviews the status of open and closed reserves and makes adjustments consistent with exposures. Conducts re-inspections as necessary. Performs duties characteristic of a claim representative and in addition assists manager in activities such as internal control reviews, special projects, external fraud investigations, and other related areas specific to claim operations. Assists management in oversight activities of claims operations, such as internal control reviews, limited work product reviews, processing issues and related functions. Assists in the review of excess tolerance reports and check registers to ensure compliance with corporate policies and procedures. Summarizes and communicates results to management. Prepares and/or participates in the preparation of various performance reports in regards to specialized projects or programs within the assigned area. Periodically reviews actual services rendered to ensure customers receive the type and quality of work authorized. May participate in the settlement support council and provide expertise regarding structured settlement candidates. Meets with branches/legal department to assist in structured settlement utilization/litigation as necessary. Works closely with and directs structured settlement companies (vendors) in negotiation/settlement process. Attends court hearings to assist in the approval process. Frequently acts in an advisory capacity. Responsible for production results in assigned geographical territory. Makes independent decisions regarding structured settlement potential on each case referred to the unit. Has skills/authority to accept or reject candidate for structured assignment. Reviews files for potential subrogation and completes subrogation forms as needed. Assists in the recovery of corporate claim expenditures from insureds/applicants, uninsured motorists, businesses, other insurers, etc. In accordance with established procedures. Performs other related duties as assigned. Required: 1. Associate's degree in business administration, insurance or a related field or equivalent work experience. Bachelor's degree preferred. 2. Successful completion of basic claim representative training program or equivalent or ability to obtain within 9 months. 3. Candidates must be eligible to acquire and maintain a state adjuster's license for appropriate state(s). 4. Possession of a valid state driver's license. Completion/possession of one or more of the following: 5. Claim representative training program, including the basic building damage school. 6. Possession of or ability to obtain a builder's license within the first six months of employment in position 7. Extensive experience as a claim representative, a public or private investigator or equivalent. Experience in the investigation, evaluation and settlement of one or more of the following: 8. Auto claims including automobile market evaluations and the preparation of auto repair estimates 9. Homeowner property claims, including accurately preparing construction damage estimates and adjusting property damage 10. Inspecting and evaluating auto repairs for quality and compliance with estimates 11. Inspecting and evaluating construction repairs for quality and compliance with repair estimates Knowledge of one or more of the following: 12. Company claim policies and procedures 13. Negligence law 14. Essential insurance act as it pertains to claim handling 15. The fair trade practices act as related to claims 16. Criminal law 17. Court procedures 18. Homeowners' coverage 19. Property provisions 20. Concepts and principles of property claims 21. Fraud and arson indicators relative to auto property, home property and/or bodily injury claims 22. Vehicle construction, identification, arson cause and origins and/or locking systems 23. Building construction 24. Subrogation procedures 25. Intercompany arbitration Demonstrated skill in: 26. Organization and planning 27. Analyzing and problem solving 28. Decision making Ability to perform one or more of the following: 29. Communicate effectively with others in a work environment and with the public (e.g. police department, vendors, contractors, attorneys) 30. Provide guidance and training to claims personnel in the resolution of claims 31. Investigate claims, define appropriate evidence and obtain supportive documentation 32. Estimate damage and determine settlement value of property damage claims 33. Develop cost reduction and/or cost containment measures with respect to operating expenses and paid claims 34. Evaluate, negotiate, respond to inquiries and settle claims 35. Impart fraud awareness training in a formal or informal setting to other aaa employees, community groups or related professional organizations 36. Function effectively and independently in a personal computer environment utilizing word processing, spreadsheet and external software systems 37. Present effective and persuasive testimony in civil and criminal litigation on a regular basis 38. Coordinate the repair of property at out -state locations 39. Work irregular hours and respond to emergencies on a twenty four per day basis to service customers 40. Prepare and present activity and statistical reports 41. Coordinate and control major projects 42. Safely operate a motor vehicle in order to perform claim inspections/resolutions 43. Research, analysis and interpretation of subrogation laws in various states 44. Process complex, time sensitive data and information from various sources 45. Make decisions based on data presented 46. Complete multiple complex tasks in a timely fashion 47. Written communication skills. (a written sample may be required at time of interview). 48. May require over night or extended travel. Preferred: 49. Completion of iia (insurance institute of america) or other insurance coursework. 50. Subrogation experience in a property/casualty insurance company. 51. Property insurance industry business experience. 52. Strong negotiation and investigation skills. Knowledge of: 53. Ultramate estimate writing programs 54. Xactimate estimate writing programs 55. Completion of one or more of meemic sponsored auto and property physical courses (i.e. vale tech, motors insurance corporation/general motors institute) Ability to: 56. Lift up to 25 pounds 57. Climb ladders 58. Walk on roofs

Independently performs detailed and highly complex claim investigations/processing or those of a higher dollar value at both internal and off-site locations regarding the specialized field assigned. Examines policies to determine the status, extent, type of coverage and need for additional information. Obtains necessary accident, legal, expert opinion and police reports to complete files. Determines the type and extent of loss and ensures the claim is consistent with all reported facts. Determines validity of claim and prepares a written summary of findings. Conducts investigations, defines appropriate evidence and obtains supportive documentation. May determine extent of injuries and reserves, evaluate claims for long term exposure, prepare initial and bi-annual reserve projections for re-insurers, evaluate and maintain adequate reserves and advise re-insurers and finance of recommendations. Reviews assigned claim files on diary and checks for progress toward completion of settlements. Determines if there is a need for further investigation. Evaluates, negotiates, responds to inquiries and settles claims.

Provides guidance and technical support to staff members regarding specialized discipline. Participates in training claims personnel with respect to specific assigned disciplines. Assists in monitoring claims activity as it relates to expertise. Reviews the status of open and closed reserves and makes adjustments consistent with exposures. Conducts re-inspections as necessary. Performs duties characteristic of a claim representative and in addition assists manager in activities such as internal control reviews, special projects, external fraud investigations, and other related areas specific to claim operations.

Assists management in oversight activities of claims operations, such as internal control reviews, limited work product reviews, processing issues and related functions. Assists in the review of excess tolerance reports and check registers to ensure compliance with corporate policies and procedures. Summarizes and communicates results to management. Prepares and/or participates in the preparation of various performance reports in regards to specialized projects or programs within the assigned area. Periodically reviews actual services rendered to ensure customers receive the type and quality of work authorized.

May participate in the settlement support council and provide expertise regarding structured settlement candidates. Meets with branches/legal department to assist in structured settlement utilization/litigation as necessary. Works closely with and directs structured settlement companies (vendors) in negotiation/settlement process. Attends court hearings to assist in the approval process. Frequently acts in an advisory capacity. Responsible for production results in assigned geographical territory. Makes independent decisions regarding structured settlement potential on each case referred to the unit. Has skills/authority to accept or reject candidate for structured assignment.

Reviews files for potential subrogation and completes subrogation forms as needed. Assists in the recovery of corporate claim expenditures from insureds/applicants, uninsured motorists, businesses, other insurers, etc. In accordance with established procedures.

Performs other related duties as assigned.