SENIOR MULTI LINE CLAIMS REPRESENTATIVE

About the role

This position investigates, evaluates, and settles multi-line claims within established authority level, including those of complexity and high exposure. The ideal candidate would live in the greater State College Pennsylvania area; however, for the right candidate it can be 100% remote.

Essential Functions

• Determines coverage and investigates claims: Makes personal, written, or telephone contact with general public, reporting agencies, and suppliers of services/goods
• Reviews and interprets policies to determine coverage
• Reviews records and documentation
• Takes telephone-recorded statements from insureds, claimants, and witnesses involved
• Determines liability
• Determines amount of loss/damage
• Makes assignments to appraisers or independent adjusters as needed
• Orders police reports
• Indexes injured insured and claimants; follows Medicare reporting requirements and files PLR
• Assigns independent adjusters; independent appraisers; and experts to assist in the investigation and evaluation of the claim
• Utilizes counsel to assist in coverage and / or investigation of claims
• Determines settlement values: Utilizes information gained from claim investigations, applicable regulations, and policy provisions or limits
• Reviews reserves: Reviews reserves on a 30-day basis. Modifies as necessary, within established authority, or seeks appropriate approvals
• Develops and documents claims files
• Establishes and maintains a 30-day diary to updated file handling
• Negotiates with insureds, claimants, or legal representatives; settles claims promptly, fairly, and within established authority
• Issues claim and expense payments
• Secures appropriate approvals for check requisition on claims exceeding authority
• Pursues other carriers for subrogation and determines percent of liability (non-auto claims)
• Handles non-auto salvage
• Ensures compliance with the Unfair Claim Practices Act and Good Faith Claim Handling regulation
• Participates in claim orientation for Underwriting personnel, helping with analysis of coverage and/or claim situations
• Performs other miscellaneous duties as assigned or directed

Qualifications

• Bachelor's degree or equivalent education and experience combination
• Proficient interpersonal relations and communications skills (both written and verbal)
• Thorough knowledge of claims law
• Proficient analytical and problem solving skills
• Capacity to work well independently
• Moderate computer knowledge
• Demonstrated organizational and time management abilities
• Demonstrated abilities to deal with a variety of personalities
• Minimum of five years' experience with investigation, management, and negotiation of liability and property claims in states of operation