ESIS Claims Representative, AGL

Key Objective

Under the direction of the Claims Team Leader, investigate and resolve claims promptly, fairly, and in accordance with established best practices and guidelines.

Responsibilities

• Receive assignments and review claim and policy information to support the investigation and determine the extent of the policy's obligation to the insured, depending on the line of business.
• Contact, interview, and obtain statements from insureds, claimants, witnesses, police officers, and others as needed to gather relevant claim information.
• Inspect and appraise damage for property losses, or arrange for such appraisal when appropriate.
• Evaluate facts gathered through investigation to determine the extent of liability, if any, and the company's obligation under the policy contract.
• Prepare reports related to investigations, settlements, claim denials, and evaluations of involved parties.
• Set reserves within authority limits and recommend reserve changes to the Team Leader.
• Review claim progress and status with the Team Leader and discuss issues and recommended corrective actions.
• Submit unusual or potentially adverse exposures to the Team Leader for review.
• Assist the Team Leader in developing process improvements and methods for handling claims.
• Resolve claims promptly and fairly.
• Obtain releases, proofs of loss, or compensation agreements and issue company drafts for claim payments.
• Notify claimants and insureds/customers when a claim is denied, when applicable.

Qualifications

• Minimum of 3 years of claims handling experience in the Auto and General Liability line of business, demonstrating technical claims knowledge and proficiency.
• Experience in a TPA environment is strongly preferred.
• Ability to obtain required state licenses.
• Knowledge of insurance coverages and a solid understanding of applicable legal principles.
• Knowledge of auto liability cost-containment programs and strong account management skills.
• Excellent communication, negotiation, and interpersonal skills, with the ability to interact effectively with internal and external stakeholders at all levels of the organization.
• Strong analytical and problem-solving skills.
• Demonstrated ability to provide consistent, high-quality service to customers.
• An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

Pay

The pay range for the role is $57,000 to $83,000. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program.