Third Party Sr. Claims Representative

Job Summary

Fleet Response is currently seeking qualified candidates to work virtually or at our corporate office, for the following position: Third Party Sr. Claims Representative.

Essential Duties And Responsibilities

• First Notice of Loss (FNOL): Review and send loss notices to clients per client parameters.
• Administrative Support: Performing general administrative tasks such as mailing documents, creating documents, uploading documents, gathering documents, setting up tows & handling a shared inbox.
• Information Gathering: Contacting various parties to obtain missing or additional information required for claim processing & verification.
• Verify Coverage: Review the claim to ensure that the claim is covered.
• Investigate & Determine Liability: Conduct thorough investigations to establish fault, or liability, for an incident. This includes interviewing the client, claimant, witnesses, and other involved parties, and reviewing police reports and other documentation.
• Identify Potential Fraud: Watch for any signs of fraudulent activity, such as staged accidents or overstated claims, and refer suspicious cases to a Special Investigation Unit (SIU).
• Mitigating Cost: Aim to control expenses while ensuring fair and prompt resolution of claims.
• Evaluate the extent of damage, which can include property damage, repairs, total loss, loss of wages, loss of use, rental, towing, diminished value & out-of-pocket expenses.
• Determine Total Loss vs Repair: Evaluate if the cost of repairs exceeds the value of the vehicle or property and handle the claim toward a total loss settlement if necessary.
• Manage Repairs: Monitor the progress of repairs to ensure the repairs are being completed timely and accurately.
• Manage Total Loss Claims: Perform detailed market research to determine the actual cash value (ACV) of a totaled vehicle. This involves analyzing vehicle history, local market comparable, and salvage value.
• Manage Rentals: Verify coverage, explain terms, initiate rental arrangements, advise on non-covered events, rental duration, authorize extensions.
• Review and Authorize Supplements: Review additional repair costs submitted and approve payment while following guidelines.
• Ensure Compliance: Adhere to all federal and state laws and regulations governing the claims process.
• Maintain Licensing: Maintain insurance adjuster licensing as required in all states.
• Communication: Requires clear, professional communication and strong interpersonal skills with all parties involved in the claim, including but not limited to peers & leadership.
• Negotiate Settlements: Determine an appropriate settlement amount based on liability and damage assessment, then negotiate a resolution with the claimant, client or legal counsel.
• Maintain Claim Files: Ensure that all claim activity, notes, and correspondence are thoroughly and accurately documented.
• Set Reserves: Set and maintain appropriate financial reserves for each claim to ensure funds are available for potential settlement payments.
• Process Payments: Process timely & accurate payments for vehicle repairs, total loss settlements, and other covered expenses.
• Workload and Metrics: Effectively manage a high volume of claims and meet key performance indicators (KPIs), such as average claim processing time, closure rates, and customer satisfaction scores.
• Finalize & Close Claims: Ensure all necessary steps are completed, and all paperwork is filed before finalizing and closing the claim.
• Developing: Responsible for actively accepting, acting on, and implementing coaching and feedback to improve professional performance and development.
• Mentor & Train: Responsibilities may include mentoring a team member and assisting in training.

Qualifications

• Education/Experience: Associate degree (A.A.) or equivalent from a two-year college or technical school, or 2–4 years of related experience; combination of education and experience may be considered.
• Industry Experience: Prior experience in automotive, fleet management, claims management, or vehicle re-marketing strongly preferred. Third-party claims handling experience preferred.
• Licensing: Ability to obtain and maintain insurance adjuster licensing as required in all states.

Key Skills & Competencies

• Strong oral and written communication, including the ability to simplify complex information and negotiate effectively with claimants, attorneys, and clients.
• Ability to analyze liability, assess damages, and evaluate complex claims accurately.
• Customer service and empathy, maintaining professionalism in difficult or emotional situations.
• Attention to detail with meticulous documentation and record-keeping.
• Proficiency with claims management systems and Microsoft Office.
• Strong investigative, analytical, and problem-solving skills.
• Ability to multi-task, prioritize, and manage a high volume of claims effectively.
• Knowledge of insurance principles, coverage, and legal/regulatory compliance is a plus.
• Mental/Analytical Skills: Calculate property depreciation, repair/replacement costs, and claimant lost wages. Evaluate multiple bids or vendor quotes to ensure fair settlements.

Physical Requirements

• Primarily sedentary work with occasional light lifting (up to 10 lbs).
• Close visual acuity for computer work, reading, and documentation.
• Able to communicate clearly in person and via phone.

Preferred Traits

• Strong initiative and self-motivation.
• Dependable, punctual, and team-oriented.
• Adaptable to changing regulations, processes, and claim scenarios.

Work Schedule

• A variety of flexible work arrangement schedules are available, with the ability to work from home as part of your schedule, after completion of training.
• This position works Monday through Friday, 8:00 AM until 5:00 PM.

Additional Benefits

• Competitive compensation and PTO.
• 401(k) with employer contribution.
• Medical, dental, vision, life, and disability insurance.
• Several voluntary benefit options.
• A flexible work environment with remote options post-probation.