Senior Claims Representative- Multi-Line
The Carlisle Group has been Retained to conduct a search for a Senior Claims Representative (Multi Line). This position investigates, evaluates, and settles multi-line claims within established authority level, including those of complexity and high exposure. The ideal candidate would live in the greater State College Pennsylvania area.
Essential Functions:
- Determines coverage and investigates claims:
- Makes personal, written, or telephone contact with general public, reporting agencies, and suppliers of services/goods.
- Reviews and interprets policies to determine coverage.
- Reviews records and documentation.
- Takes telephone-recorded statements from insureds, claimants, and witnesses involved.
- Determines liability.
- Determines amount of loss/damage.
- Makes assignments to appraisers or independent adjusters as needed.
- Orders police reports.
- Indexes injured insured and claimants; follows Medicare reporting requirements and files PLR.
- Assigns independent adjusters; independent appraisers; and experts to assist in the investigation and evaluation of the claim.
- Utilizes counsel to assist in coverage and / or investigation of claims.
- Determines settlement values:
- Utilizes information gained from claim investigations, applicable regulations, and policy provisions or limits.
- Reviews reserves:
- Reviews reserves on a 30-day basis.
- Modifies as necessary, within established authority, or seeks appropriate approvals.
- Develops and documents claims files.
- Establishes and maintains a 30-day diary to updated file handling.
- Negotiates with insureds, claimants, or legal representatives; settles claims promptly, fairly, and within established authority.
- Issues claim and expense payments.
- Secures appropriate approvals for check requisition on claims exceeding authority.
- Pursues other carriers for subrogation and determines percent of liability (non-auto claims).
- Handles non-auto salvage
- Ensures compliance with the Unfair Claim Practices Act and Good Faith Claim Handling regulation.
- Participates in claim orientation for Underwriting personnel, helping with analysis of coverage and/or claim situations.
- Performs other miscellaneous duties as assigned or directed.
Qualifications/Basic Job Requirements:
- Bachelor’s degree or equivalent education and experience combination
- Proficient interpersonal relations and communications skills (both written and verbal)
- Thorough knowledge of claims law
- Proficient analytical and problem solving skills
- Capacity to work well independently
- Moderate computer knowledge
- Demonstrated organizational and time management abilities
- Demonstrated abilities to deal with a variety of personalities
- Minimum of five years’ experience with investigation, management, and negotiation of liability and property claims in states of operation
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