Summary: Investigates, evaluates, negotiates, and settles covered claims within assigned authority. This position plays a key role in delivering prompt, professional claims service while maintaining strong relationships with policyholders, agents, attorneys, and others involved in the claims process. This position will work remotely in northeast North Dakota, preferably in the Devils Lake area.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Conducts thorough and timely investigations by gathering and evaluating relevant information, including statements, reports, records, photographs, estimates, invoices, and expert opinions as needed.
- Analyzes coverage, liability, damages, and claim-related issues by interpreting policy language, applicable laws, regulations, and company guidelines to determine appropriate claim resolution.
- Maintains accurate, organized, and well-documented claim files, including notes, forms, worksheets, reports, and supporting documentation to ensure proper claim handling and file management.
- Reviews bills, estimates, appraisals, medical documentation, repair documentation, and other claim-related materials for accuracy, reasonableness, and compliance with policy provisions and company standards.
- Evaluates claims and negotiates fair, timely, and cost-effective settlements within established authority limits; prepares recommendations for additional authority when necessary.
- Communicates claim decisions, coverage determinations, settlement explanations, and claim status updates clearly and professionally with customers, claimants, attorneys, vendors, repair facilities, medical providers, and other involved parties.
- Coordinates with internal departments, external vendors, independent adjusters, appraisers, attorneys, medical professionals, engineers, or other specialists as needed to support effective and efficient claim resolution.
- Ensures compliance with company policies, regulatory requirements, service standards, and applicable state laws throughout the claim handling process.
- Manages assigned claim inventory effectively by prioritizing workload, maintaining diary follow-up, meeting established deadlines, and achieving quality and productivity expectations.
- Identifies subrogation potential early in the claim process and takes the necessary actions to preserve evidence and protect the company’s subrogation rights.
Essential Competencies and Skills
- Excellent verbal and written communication with the ability to explain complex information and manage sensitive interactions professionally.
- Skilled in computer systems, data entry, and claims-related software with strong organizational and multitasking abilities.
- Able to accurately interpret policy language, legal principles, medical documentation, and supporting materials.
- Strong problem-solving skills and judgement when reviewing contracts and applying company policies.
- Competent in basic math concepts to ensure precise claim calculations.
- Consistent attendance, punctuality, and accountability.
- Background in handling complex or high-value claims.
- Understanding of construction processes and familiarity with property estimating tools.
- Experience with auto damage estimating (CCC preferred) and autobody repair workflows.
Education, Work Experience, and Certifications
- Required: High school diploma or equivalent.
- Preferred: Bachelor's degree or equivalent work experience. Preferred: Professional insurance designations such as Chartered Property Casualty Underwriter (CPCU), Associate in Claims (AIC), Associate in Risk Management (ARM), or other related credentials.
Senior Claim Representative Requirements
- Must have five years of claim handling experience and AIC and/or AINS insurance designation and be in good standing.
Travel Requirements
- Frequent travel within the company’s business footprint is required for field claim work, employee training, and other required tasks as needed. This includes minimal overnight travel.
Physical Demands/Working Conditions
- Prolonged periods of sitting and working at a computer workstation. Occasional standing, walking, bending, reaching, or lifting office materials up to 10-15 pounds. Frequent use of hands and fingers for typing, data entry, and operating standard office equipment. Frequent visual concentration and close attention to detail of electronic claim files.
- Ability to work outdoors in varying weather conditions. Regular standing, walking, bending, kneeling, crouching, climbing, reaching, and navigating uneven terrain during inspections and investigations. Driving and operating a motor vehicle require maintaining a valid driver’s license and an acceptable driving record.
- Nodak Insurance provides reasonable accommodations to qualified individuals with disabilities to support the performance of essential job functions.
Nodak Insurance Company complies fully with all federal, state, and local employment laws and shall provide equal employment and advancement opportunities for all persons regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, the presence of any mental or physical disability, status with regard to public assistance or marriage, or any other category protected by local, state or federal law.
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Parental leave
- Referral program
- Retirement plan
- Vision insurance
Location:
- Devils Lake, ND (Preferred)
Ability to Commute:
- Devils Lake, ND (Preferred)
Work Location: Remote
