Claims Representative, Risk Management

JOB SUMMARY

The Claims Representative inputs, creates, investigates, evaluates, negotiates and settles a variety of claim types. Makes appropriate recommendations to Western National Group (WNG) entities regarding settlement and reports claims to third party administrators and insurance carriers as needed. Monitors incoming correspondence, invoicing and other expenses and investigates for proper charges or recovery. Continuously monitors claim files while working towards resolution and closure in a timely manner by maintaining a current diary on open files. Maintains database of all claims and tracks inquiries on pending claims. Maintains iN.Site system for incident/accident reports, assists with incident/accidents investigations. Maintains constant outside

communications with claims related issues, including and not limited to, litigated and non-litigated claims.

This position is offering $40.80 to $52.89 per hour depending on experience with a discretionary performance-based bonus of up to 5% of the annual base salary.

DUTIES AND ESSENTIAL JOB FUNCTIONS

Inputs and creates claim files on assigned incidents/claims as reported on iN.Site.

Adheres to standard claims handling procedures.

Generates claims reports and maintains notes and correspondence regarding claim file activity and communications on the claims database on iN.Site.

Monitors a variety of claim files (1st and 3rd party property, liability and litigated claims) and maintains a daily running diary.

Investigates insurance claims.

Performs property inspections as needed, which will include traveling to communities and/or jobsites.

Analyzes information gathered by investigation and reports findings and recommendations.

Determines liability.

Files claims as needed with carriers.

Communicates with internal departments, claimants, attorneys and insurance companies over the telephone, in person and in written correspondence.

Makes settlement recommendations.

Negotiates claim settlements to avoid litigation.

Prepares demand/denial letters as needed.

Drafts offer letters and releases.

Creates statements of loss notifications.

Ensures signed releases are received prior to issuing settlement funds.

Creates check requests and requests settlement monies from Accounts Payables.

Follows-up with insurance adjusters and provides information needed to expedite settlement or insurance recovery.

Coordinates agreed scope/estimate of damages with independent insurance adjusters, vendors or contractors on large losses.

Reviews incoming attorney letters and lawsuits.

Travels to and attends mediations, as needed.

Travels to and represents WNG entities at Small Claims court hearings.

REQUIRED KNOWLEDGE SKILLS AND ABILITIES

Critical competencies include, but are not limited to, communication, relationship building, critical thinking, customer service and accountability.

Excellent written, verbal communication and oral presentation skills.

Proficient in Microsoft Office Suite, excellent computer skills and typing ability.

Aptitude to apply general knowledge of contract, property and/or insurance laws.

Ability to read, interpret, apply and explain internal rules, regulations, policies and procedures.

Adhere to policy and procedure, safety practices and customer service philosophies.

Demonstrate an exceptional level of attention to detail and organization, with the ability to multi-task and prioritize work, meet deadlines and manage changing priorities effectively.

Excellent customer service skills, empathize with, actively listens to and deals sensitively and professionally with claimants.

The skill to develop and apply knowledge of injury, property and liability issues to adjust claims.

Maintain quality work product and professionalism, even when work volume is high.

Strong analytical skills.

Construction knowledge preferred.

Some understanding of real estate management.

REQUIRED LICENSES/CERTIFICATION

Must possess a valid driver’s license and proof of auto insurance.

Must maintain an acceptable driving record pursuant to insurance underwriting guidelines established by WNG’s insurance carrier.

EDUCATION/EXPERIENCE

High School diploma, with a 2- or 4-year degree preferred.

Must have 2 to 3 years of claims experience.

This position is offering $40.80 to $52.89 per hour depending on experience with a discretionary performance-based bonus of up to 5% of the annual base salary.

Western National Group is an Equal Opportunity Employer. All applicants will be considered without regard to race, color, ancestry, national origin, religion, creed, age (over 40), disability, mental and physical, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), sexual orientation, gender identity, gender expression, medical condition, genetic information, marital status, and military and veteran status or any other legally protected status.