Claims Representative - Multi-Line

Primary Responsibilities

• Investigate, evaluate, negotiate, and resolve assigned claims in compliance with applicable laws, regulations, and internal claims handling standards, with an emphasis on quality and consistency.
• Provide high-quality customer service in a fast-paced environment while serving as a primary contact for members.
• Maintain accurate, timely and well-organized documentation within the claims management system while managing multiple active claims concurrently.
• Deliver clear, accurate, and customer-friendly coverage explanations and written correspondence to help our members understand claim decisions and next steps.
• Negotiate claims within established settlement authority and promptly notify leadership of any claim trending toward or exceeding authority limits.
• Assign, coordinate, and monitor work performed by outside investigators, third-party vendors, law firms, and individual attorneys when assigned.
• Provides oversight of medical, legal damage estimates, and miscellaneous invoices to determine if they are reasonable and related to designated claims.
• Negotiates any disputed bills or invoices for resolution.
• Assigns litigated claims to approved law firms and/or individual attorneys and monitors progress.
• Attends facilitations/mediations as assigned.
• Manages diary system to move losses to conclusion in a timely manner.
• Collaborate closely with internal teams, including risk management, underwriting, and claims leadership to support effective claim outcomes.

Required Qualifications

• Bachelor’s Degree; minimum of two years of claims experience handling multi-line claims or an equivalent combination of education and experience.
• Must have knowledge of coverage, liability, and complex claims handling procedures.
• Ability to handle complex case-related tasks in a fast-paced and changing environment.
• Excellent interpersonal skills and the ability to work in a strong team environment.
• Excellent verbal and written communication skills, with the ability to deliver clear, professional, and customer-focused communication.
• Strong organizational and time-management skills, including the ability to prioritize, multitask, meet deadlines, and independently follow up on open items.
• Dependable, reliable, and able to achieve high levels of professionalism when handling cases and interacting with school district representatives and their employees, attorneys, families of injured and fellow employees.
• Strong cognitive and analytical skills.
• Able to travel and work remotely on a periodic basis.
• Proficiency in Microsoft Office applications, including Excel and Word, with the ability to use technology effectively to document, track and communicate claim activity.
• Commitment to continuous learning including willingness to participate in ongoing education with industry recognized training (IIA, AIC or INS or other relevant claims designations).