Inside Claims Representative I

Fully Remote Job.

About the role

The organization operates within the insurance industry, providing casualty claims services across multiple states and the District of Columbia. It supports a large network of employees and independent agencies, addressing challenges related to property and liability claims management. The company emphasizes service and offers a broad geographic reach through field offices and a home office complex.

The INSIDE CLAIMS REPRESENTATIVE I is responsible for handling liability and property claims within designated authority, ensuring compliance with relevant laws and regulations. This role plays a crucial part in resolving coverage and liability issues, contributing to effective claims processing and customer service. The position supports the organization's commitment to timely and accurate claims resolution, impacting overall customer satisfaction.

Responsibilities

• Investigate and adjudicate claims within authority limits, ensuring compliance with statutory laws.
• Verify coverage, establish reserves, and maintain claim documentation.
• Obtain additional information to determine liability and coordinate with other departments.
• Communicate with all parties involved in claims following organizational standards.
• Evaluate and negotiate claims and initiate subrogation actions.
• Process settlements or decline payments within authority.
• Respond to inquiries from policyholders, agents, claimants, and experts.
• Maintain knowledge of liability laws, motor vehicle codes, and relevant state-specific insurance regulations.
• Assist with intercompany arbitration applications under supervision.
• Participate in training to stay current on policy changes and legislation.
• Provide support for property claims during high volume periods.

Requirements

• High school diploma or GED with two years of related claims handling or customer service experience, or equivalent educational experience.
• Bachelor’s or Associate’s degree preferred.
• Successful completion of Introduction to Insurance and Introduction to Claims courses preferred.
• Obtain appropriate state-required licenses within 45 days of employment for external hires and within 90 days for internal hires.

Pay

Salary range: $44,936.00 to $71,781.00, dependent on role level, experience, skills, education, training, credentials, and location. Position may be eligible for an annual bonus payment.

Benefits

• Premier health, prescription, dental, and vision benefits starting first day of work.
• Low contributions to medical and prescription premiums, with the organization covering up to 97% of employee costs.
• Traditional pension plan with vesting after five years of service.
• 401(k) plan with up to 4% contribution match.
• Paid time off including vacation, personal, sick, bereavement, and parental leave.
• Tuition reimbursement and career development programs.
• Additional benefits such as life insurance, disability insurance, orthodontic coverage, adoption assistance, fertility coverage, well-being programs, paid volunteer hours, and charitable gift matching.

Note: TalentHop is a recruitment partner of this role. All employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.