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Senior Claim Representative

JOB SUMMARY

Directly handle a diverse claims caseload including multiple coverage feature types and a large percentage of losses of moderate to high complexity and financial severity.  Claims assigned occasionally involve substantive coverage issues.  Employee should possess demonstrated expertise in handling significant property claims and confidently capable of writing sizable detailed building estimates (including commercial) and handling complicated business interruption claims.  Employee should be highly skilled in all coverage’s written with an emphasis on the more difficult losses and exposures, and be capable of seeing more difficult adjustments through final resolution using a wide variety of settlement techniques.  Conclude claims promptly and equitably within the provisions of the policy and in accordance with known damages and legal requirements. All files handled must comply with claim handling guidelines and all other job expectations, regulations and standards.

DUTIES & RESPONSIBILITIES

  • Conduct and coordinate loss investigations on all assigned claims.
  • Negotiate the settlement of claims within authorized amounts or specific file authority.
  • Maintain accountability for all assigned claims until disposition is reached.
  • Recommend further action on claims exceeding authority limits.
  • Document all activity on assigned claims and assist in the control of independent vendors.
  • Review new losses and files on diary to ensure reserve adequacy while keeping management informed of adverse developments.
  • Monitor loss adjustment expenses and take steps to effectively manage costs of third party service providers.
  • Utilize vendors judiciously to ensure maximum value from services.
  • Review coverage questions and suggest interpretations to Claim Staff Supervisor for approval.
  • Refer appropriate coverage matters to the Claim Supervisor and/or Claim Manager.
  • Ensure appropriate file handling, documentation, special reporting and expense control of all files handled.
  • Provide accurate, courteous and timely information to all eligible external and internal customers concerning claim status and other claim inquiries.
  • Presents reports and leads discussion on files requiring roundtable reviews with peers and management
  • Provide service calls to policyholders and agencies as needed.
  • Serve as a technical resource within the Department through mentoring and knowledge sharing.
  • Draft coverage correspondence, including reservation of rights and coverage disclaimer along with composing detailed correspondence to insureds, claimants, attorneys, etc.
  • Attend trials, depositions, EUO’s and mediations where deemed beneficial or required.
  • Suggest improvements to processes within the department to increase the level and quality of service provided to internal and external customers, e.g. workflow changes, systems implementation, etc.
  • Effectively follow direction on complicated or high-exposure matters and recommend appropriate reserves on claim files within specific authority and on files requiring mandatory reporting to management.
  • Deliver technical training for adjusting staff and clerical personnel as needed.
  • This position handles an assigned claim pending.
  • Performs other duties or special projects as required or as assigned.

SUPERVISION RECEIVED

The Claim Supervisor provides minimal direct supervision.

QUALIFICATIONS

  • Bachelor’s degree in business, insurance or a related field, or its equivalent.
  • Five or more years of relevant technical claim handling experience with demonstrated achievement and progressive responsibilities; or a combination of education and experience from which comparable knowledge and skills are acquired.
  • Appropriate state Adjuster’s License(s) where required by law.
  • Advanced knowledge of the technical aspects of property claims.
  • Demonstrated commitment to professional development through the attainment of recognized industry designations such as AIC, AEI, SCLA, CPCU programs, etc.
  • Sound understanding of the insurance industry and company operations.
  • Strong analytical and negotiating skills.
  • Very good oral and written communication skills.
  • Demonstrated ability to exercise sound judgment in dealing with professional issues.
  • Demonstrated ability to work effectively with a wide range of outside firms and organizations.
  • Demonstrated ability to collaborate effectively with company management, peers and claim support staff.
  • Proficiency with PC applications including Microsoft Office (Word, Excel & Outlook); Experience with imaging programs preferred.
  • Ability to perform job responsibilities under stressful situations.

PHYSICAL DEMANDS/WORKING CONDITIONS

  • Employees in this job classification may be based in either a typical office environment or from a remote location or residence as determined by management.
  • For field based positions, regular outside automobile day travel of approximately 50% is expected.
  • For non-field positions, predominately sedentary office position with high frequency of keyboarding/computer work required.
  • Occasional overnight travel.
  • Potentially subject to inclement weather and stressful situations with respect to claim disputes.

How to Apply:

Submit cover letter, salary requirements and resume, in strict confidence.

Apply Online

If you have any questions, please call 800-451-5000


We offer a comprehensive and competitive benefits package for all of our employees.

Competitive Salary
Paid Time Off
401(k) Retirement Plan
Health Insurance
Dental Insurance
Vision Insurance

Life Insurance
Disability Insurance
Professional Development
Wellness Programs
Company-sponsored Events
...and more!

Questions? Please call us at 800-451-5000

We are an Equal Opportunity Employer

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Agent Locations: Connecticut, Maine, Massachusetts, New Hampshire, New York State, Rhode Island and Vermont.