Claim Representative Resume Samples
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Claim Representative Resume Samples
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Yoshiko
Dicki
34587 Grant Curve
Chicago
IL
+1 (555) 868 5743
34587 Grant Curve
Chicago
IL
Phone
p
+1 (555) 868 5743
Experience
Experience
New York, NY
Claim Representative
New York, NY
Padberg-Hilll
New York, NY
Claim Representative
- Interacting with customers via telephone and correspondence to determine the source of the issues and correcting errors. Claim Representatives can expect to be on the telephone for up to 10% of the day on average
- Interacting with customers via correspondence and sometimes telephone to determine the source of the claim. Claim Representatives can expect to be on the telephone for up to 10% of the day on average
- Providing high quality customer service by responding to and researching and resolving problems and errors, telephone inquiries, customer requests related to credit products
- Support QBE values in personal work behaviors, decision-making, contributions and interpersonal interactions; manage own career development by soliciting feedback and valuing other perspectives
- Meet established performance metrics by setting work related goals, communicating with management to report progress and assisting with assigned special projects to support the achievement of department objectives
- Support claims workflow efficiency by accurately documenting portfolio progress, referring high risk exposures outside authority levels and seeking opportunities that enhance operational
- Provides effective and timely communication to all internal and external stakeholders regarding claim status and other inquiries such as fraud, subrogation recovery, reserve adequacy and underwriting risks
New York, NY
Claim Representative APD
New York, NY
Volkman, Schmeler and Walker
New York, NY
Claim Representative APD
- Providing clear explanation of claims process and coverage to all customers
- Referring all files above settlement authority, with recommendations for resolution, to Unit Manager and follows up through closure
- Documenting claims files in accordance with Best Practices
- Reviewing and analyzing policy conditions, provisions, exclusions and endorsements pertinent to a variety of APD losses
- Managing pending and settles claims within company averages based on type of claim, complexity of claim and geographical area
- Maintaining diary follow up on all files to ensure prompt disposition
- Establishing accurate scope of damages and utilize as a basis for written estimates and/or computer assisted estimates: Working diary system to be proactive on files
present
New York, NY
Senior Claim Representative
New York, NY
Green, Mueller and Grant
present
New York, NY
Senior Claim Representative
present
- Working knowledge of insurance coverages, commonly used insurance concepts, practices, and procedures
- Performs other duties as assigned
- Successfully completes all coursework/education as assigned
- Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions or trials as necessary. Responsible for providing input on settlements / reserves
- Affects settlements and reserves within prescribed time limits and submits recommendations to management on cases exceeding personal authority
- Works toward the resolution of claims, and may attend arbitrations, mediations, depositions, or trails as necessary
- Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, records or other documents) in the investigation of claims
Education
Education
Bachelor’s Degree in Initiative
Bachelor’s Degree in Initiative
University of South Florida
Bachelor’s Degree in Initiative
Skills
Skills
- Demonstrated knowledge of applicable bank, Federal Regulations, Mastercard/Visa regulations and internal procedures
- Demonstrated knowledge of applicable bank, Federal Regulations, MasterCard/Visa regulations and internal procedures
- Good time management skills to maximize the number of clients that can be assisted while maintaining a high level of customer service
- Strong verbal and written communication skills
- Ability to identify and resolve/escalate complex problems with minimal guidance
- Strong problem-solving and decision-making skills
- Proficient computer skills, especially Microsoft Office applications
- In-depth knowledge of products, services, terminology, procedures and systems related to assigned
- Strong customer service skills
- Ability to manage multiple projects and deadlines simultaneously while maintaining a high level of
15 Claim Representative resume templates
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1
Subrogation Claim Representative Auto Resume Examples & Samples
- A Bachelor’s degree or equivalent relevant experience
- Minimum of 1+ year(s) of personal lines claims experience
- Ability to work with a high degree of accuracy
- Strong negotiation skills and attention to detail
- Ability to obtain state specific property casualty claims licensing as required
- Previous insurance subrogation and arbitration experience in a Property Casualty environment is particularly advantageous
- Certifications in Associate in Claims Designation-American Institute of Chartered Property Casualty Underwriters
2
Senior Field Claim Representative Resume Examples & Samples
- Catastrophe claims handling, consisting of an average of 100 claims per month during periods of Catastrophe events, providing support in a timely fashion to all regions. During periods of non-Catastrophe, provide assistance with property personal line claim losses as needed. Inspects and evaluates home claims. Conducts physical inspections of damaged homes within a designated territory. Prepares estimates to repair damages and secures an agreed-upon repair price with the contractor when required, including supplements and re-inspections. Scope claims utilizing technical expertise and information gathered to accurately determine physical claim value using company recognized resources and estimating/evaluating software. Expert on repair practices
- Conducts re-inspections of homes following inspection by other resources or associates. Provides training to other associates within the organization. Responsible for handling the company's high dollar home inspections
- Bachelors degree or equivalent
- 1-3 years of experience in field claims
- Experience in training others
3
Senior Auto Claim, Representative Resume Examples & Samples
- Adjust claims by evaluating and negotiating claims settlement. This is handled using investigative and negotiating skills with clients, claimants, attorneys and medical professionals
- Also determine reserves needed and ensures they are applied
- Problem solving and negotiation skills
- Risk Management, Insurance or Business Management majors preferred
4
Claim Representative Resume Examples & Samples
- Providing high quality customer service when researching and resolving customer inquiries related to fraud claims
- Managing a large caseload by researching, investigating, and resolving disputed credit/debit card charges
- Interacting with customers via correspondence and sometimes telephone to determine the source of the claim. Claim Representatives can expect to be on the telephone for up to 10% of the day on average
- Proven commitment to high quality customer service
5
Claim Representative Resume Examples & Samples
- Managing a large caseload by researching, investigating and resolving disputed credit card charges
- Interacting with customers via telephone and correspondence to determine the source of the issues and correcting errors. Claim Representatives can expect to be on the telephone for up to 10% of the day on average
- Three to four years of experience in clerical and customer service activities
- In-depth knowledge of products, services, terminology, procedures and systems related to assigned
6
Denials / Appeals Claim Representative Resume Examples & Samples
- Analyze and resolve moderately complex insurance denials including coding review to prevent errors within appeals process
- Analyze weekly denial reports to spot trends; assess opportunities to improve internal workflows
- Maintain internal logs (Excel format)
- Others may be assigned
- 2-4 years’ experience in healthcare collections and/or healthcare related field
7
Claim Representative Resume Examples & Samples
- Receive initial claim reports; counsel clients on the claim process and procedural steps in processing and settling the claim
- Prepare instructions and advise clients on action to be taken in event of a claim. i.e. OSHA, Environmental Area, Products Liability, Professional Liability, etc
- Extends full courtesy and assistance to third parties reporting claims or providing claims information
- Maintain full electronic file information by documenting all claims reports, activity, payments, and conversations
- Report claims on the same business day to appropriate carrier(s) via fax/telephone or electronic communication
- Maintain draft register as required by carrier(s)
- Send notice of potential changes to the Client Managers on all changes relating to claims (ex. deletion of vehicle on total loss)
- Handle loss runs process for Commercial Lines Department for claim reviews as requested by consultants
- Develop and maintain claim interface capabilities with companies
- Respond to inquiries as soon as practical and no later than 24 hours to any request
- Meet with carriers to promote good will and to learn their procedures and build a good working partnership that promotes the best claim resolutions for our client's
- Maintain a cordial and effective relationship with clients, co-workers, carriers, vendors, and other business contacts
- Maintain current claim technical reference material and understand how to perform technical tasks to expedite client service
- Support the mission statement, business goals, service standards, and business practices of the company
- Support the financial goals of the company
- Must adhere to pertinent laws, regulations, First Niagara's Compliance Policy and external compliance requirements
- 1-2 years Claims experience is strongly preferred
- Must have Property and Casualty License or ability to obtain within one year. Must comply with all continuing education requirements including pictorials, INS, CISR or CPCU courses
8
Associate Claim Representative Resume Examples & Samples
- Establish and maintain strong relationships with customers, build credibility and gain trust while operating with integrity at all times
- Responsible for the investigation and file management of claims as well as assisting other claim professionals and our policy holders with multiple facets of the claims process
- Serve as “the face of The Hartford” as we deliver on the insurance promise and make a difference in our customers’ lives
- Achieve targeted performance goals to manage costs and support The Hartford’s industry-leading operational claims standards
- Aggressively expand technical acumen to facilitate career advancement to high level positions within Claims upon paid training program completion
- Comfort in making decisions after seeking out information
- Desire to advance your career and the willingness to do what it takes to achieve your goals
- Willingness to learn, lead, be led, support your teammates, have fun and work hard in our Workers’ Compensation department
- No Claims experience required
9
Claim Representative Auto Bodily Injury Resume Examples & Samples
- Policy Interpretation-Coverage analysis
- Investigation of ABI claims to determine liability exposures and subrogation
- Accurate reserve analysis for loss, to include excess exposure recognition
- Handling of Injury exposures with attorneys as well as unrepresented parties
- Effective handling for first and third party claims according to The Hartford claim standards
- Proficient in a claim software platform and Word, Excel, Outlook
- Successful handling of Property Damages to included: estimates, rental and total losses of vehicles
- Subrogation recognition
- Strong customer service and teamwork, answering claim calls in a prompt and professional manner, while backing up other team member calls. Taking ownership of all calls to resolution
- Desire to work as a member of a High Performing Team!
- Good organizational and time management skills and practices
- Analytical Thinking Capability
- Bachelor degree or equivalent claims experience preferred
- Minimum of 2 year’s experience adjusting personal lines
- Excellent telephone and interpersonal skills with a focus on the customer
- Strong time management, organization and attention to detail
- Strong computer skills and accurate keyboarding
- Excellent oral and written communication
- License(s) if required by state/jurisdiction
- Ability to breakdown explanations of complex process and rules into manageable information
- IIA, AIC, CPCU, SCLA preferred
10
Claim Representative Resume Examples & Samples
- Have a passion for customer service
- Desire to advance their career and continuously improve
- Be willing to learn, lead, be led, support others, have fun and work hard
- Have obtained a Bachelor’s Degree prior to their start date
- Reside in the state of Maryland. A remote work option is available, but this candidate must live in the state of Maryland based on state requirements
11
Associate Claim Representative Resume Examples & Samples
- Understand and effectively analyze personal and/or commercial coverage forms
- Strong numerical reasoning skills
- Extensive knowledge of customer service drivers and the ability to resolve customer issues, needs and concerns independently
- Must successfully pass required assessment test
- Must successfully pass state required certification exams and complete continuing education to maintain adjusting licenses
12
Virtual Property Claim Representative Resume Examples & Samples
- At least three years relevant experience handling inside and/or outside property claims
- Strong water and mitigation experience (IICRC Certification) preferred
- Technical expertise in managing property claims of increasing complexity
- Excellent communication skills, oral, written, collaboration and negotiation
- Strong computer proficiency in utilizing estimating and software programs
- College degree or 5+ years relevant work experience required
- Consistent high level of performance and achievement over career span
- State required certification exams and adjusting licenses must be obtained while employed during first year
- Experience writing structural damage estimates using computerized software applications preferred, Xactimate is a plus
- Ability to be available for catastrophe (CAT) deployment, oftentimes on short or limited notice, as a condition of employment
13
Claim Representative Resume Examples & Samples
- Assists Claim Manager in the identification of exposures and recommends solutions
- Investigates and adjusts claims, as well as directs independent adjusters, experts, and other vendors in the claim handling processes
- Alerts Claim Manager to changes and proposed changes in laws that could impact Ryder's liability program
- Interacts, on an on-going basis, with field and operations management, legal counsel, safety managers, customers, insurance carriers, and third party claimants
- Updates field operations personnel on claim status
- Supervises outside vendors and experts retained to assist in the investigation
- Manages litigation to ensure claims are handled appropriately, according to the applicable jurisdiction
- Manages indemnity and expense costs properly
- Interacts with primary and excess insurance carriers, and re-insurers on files meeting reporting thresholds
- Recommends and sets reserves to ensure the reserves represent the probable ultimate payout based on documented file developments
14
Vehicle Inventory Claim Representative Resume Examples & Samples
- Handle initial report of loss, explains claim process, coverage, and follows up for necessary documents to conclusion of the claim
- Investigate and maintain a complete and thoroughly documented claim file
- Handle inquiries from retail customers, financial institutions, and dealers
- Review finance documents and ancillary products/refund amounts to determine outstanding balance owed on the date of loss
- Review insurance company valuation (CCC, Mitchell, Audatex, NADA, Market Research, etc.), settlement breakdown, and declaration page to confirm or ensure that the primary insurance carrier paid/pays their liability
- May handle special projects
- Computer literate with experience with Microsoft products (Outlook, Word and Excel)
- Strong data entry/typing skills
- Must be able to handle up to 20-30 calls per day
- Insurance license preferred
- Call Center, Auto Finance, or Insurance experience preferred
- Must be able to successfully pass a pre-employment drug screen and a comprehensive background check
- HS diploma or equivalent required. Associate / Bachelor's degree in business related discipline preferred
15
Claim Representative APD Resume Examples & Samples
- Handling 1st and 3rd party PI and BI APD claims of low to moderate severity and complexity as assigned: Making contact with insured within Best Practice guidelines
- Returning all phone calls and emails within Best Practice guidelines
- Providing clear explanation of claims process and coverage to all customers
- Acting as primary contact for customer and as intermediary between customer and other parties
- Participating in extended hours duties as required
- Advises underwriting of any information gathered which may affect risk assessment. Investigating and evaluating all relevant facts to determine coverage, damages and liability of first-party APD claims under a variety of policies
- Conducting prompt investigation of coverage and liability
- Documenting claims files in accordance with Best Practices
- Managing pending and settles claims within company averages based on type of claim, complexity of claim and geographical area
- Establishing accurate scope of damages and utilize as a basis for written estimates and/or computer assisted estimates: Working diary system to be proactive on files
- Reviewing and analyzing policy conditions, provisions, exclusions and endorsements pertinent to a variety of APD losses
- Reviewing amounts on all invoices and all documentation supporting payments
- Maintaining diary follow up on all files to ensure prompt disposition
- Ensuring that all claims files and company information are kept confidential. Identifying and following up on all salvage and subrogation opportunities promptly
- Completing a level of investigation that is commensurate with the financial exposure on each loss handled. Managing files in accordance with established Best Practices
- Obtaining and analyzing leases, contracts, by-laws and other relevant documents which may have an impact on the adjustment of losses. Establishing timely and accurate claim and expense reserves
- Posts all reserves in system within Best Practice guidelines and updates system promptly as new information received: Posting all reserves in system within file standards guidelines and updates system promptly as new information received
- Determining appropriate settlement amount based on independent judgment, computer assisted estimates, estimation of actual cash value and replacement value, appraisals, application of applicable limits and deductibles. Explaining payment amounts to all customers by email or letter
- Referring all files above settlement authority, with recommendations for resolution, to Unit Manager and follows up through closure
- Negotiating and conveying claim settlements within authority limits to insureds
- Writing denial letters, Reservation of Rights and other complex correspondence to insureds
- Controlling damages through proper usage of cost containment tools. Meeting all quality standards and expectations per file standard guidelines
- University Degree/College Diploma or equivalent business experience. Enrolment in the CIP program is an asset
- High proficiency with Windows-based programs including spreadsheet and word-processing applications
- Ability to deal with people and communicate effectively by telephone
- Ability to understand and apply policies and procedures
- Proficiency in typing
- Excellent organizational skills with ability to work independently. Solid analytical and decision making skills. Adjusters license as required, based on business needs
- Customer service orientation; empathy
- Demonstrated ownership attitude and customer centric response to all assigned tasks. Math skills. Excellent negotiation skills
- Hardware and software skills to utilize and leverage claim and estimating technology
16
Associate Claim Representative Resume Examples & Samples
- Degree (Bachelor’s or Associates) preferred
- 1-3 years of experience in a fast-paced customer centric environment strongly preferred
- Must have a record of high achievement, self-motivation, ability to multi-task competing priorities as evidenced through work and extra-curricular activities
- Strong communication, presentation, interpersonal, analytical and research skills
- Ability to analyze/reason through complex problems and make sound recommendations while consistently demonstrating honesty, integrity, courtesy and respect when interacting with others
- Ability to obtain and maintain licensing to handle claims in required states
17
Liability Claim Representative Resume Examples & Samples
- Demonstrated ability to maintain positive group and vendor relations
- Demonstration of basic investigation skills
- Ability to adhere to company policies, procedures and guidelines
- Ability to read and interpret documents such as medical reports, bodyshop repair estimates, and legal forms
- Ability to organize and present information, views and concepts in a concise and understandable format for a variety of audiences
- Must have a minimum of 6 months of work experience
18
Claim Representative Resume Examples & Samples
- Organization/coordination
- Open-minded/forward thinker
- Must be eligible to work in the United States without employer sponsorship
19
Claim Representative Resume Examples & Samples
- 1+ years of casualty claims handling experience
- Fluent in English/Spanish a plus
- BI experience a plus
20
Claim Representative Resume Examples & Samples
- 3+ year’s casualty claims handling experience
- 2+ years PD experience preferred
- Experience handling NV, AZ, WA, CA and TX claims is preferred
- Must have claims related computer systems experience. Guidewire claims system experience a plus
- Ability to work Monday - Friday, 10:00 am - 7:00 pm CST or Tuesday - Saturday, 9:00 am - 6:00 pm CST
21
Claim Representative Resume Examples & Samples
- Candidates with total loss claims handling experience, including making coverage decisions, customer contact, and rental managements experience is preferred
- College degree a plus or equivalent experience
- Available to work occasional Saturdays
- Ability to work 8:00 am – 5:00pm PST in Chatsworth or Phoenix, or 10:00 am - 7:00 pm CST for Dallas required
- Knowledge of medical, legal and auto repair/construction terminology is an asset
- California adjusting experience is a plus
- Fire and Theft experience is a plus
- Interpersonal skills must be adequate to effectively coordinate a prompt, fair, and equitable resolution of all assigned claims
22
Senior Flood Claim Representative Resume Examples & Samples
- Responsible for the full examination of assigned flood claims (which can be complex in nature), including but not limited to RCBAP (Residential Condominium Building Association Policy), Examination includes the verification of coverage, and that the loss is paid per the NFIP guidelines. Adherence to NFIP time standards is a requirement. Responsible for the issuance of payment once the loss is determined to be eligible for payment per the assigned authority levels. Desk adjustment and the drafting of denial letters per Legal and FEMA requirements are also required. All NFIP guidelines must be adhered to at all times
- Processes claims which includes the following activities: set up file in Selectiveflood.com, assigns adjuster, makes 24 hour insured contact, confirms NFIP certified adjuster adheres to NFIP rules and regulations, examines claim to confirm policy provisions adhered to, contacts adjusters, insured’s, agents and NFIP personnel for further claim information. notifies underwriting regarding underwriting issues, request NFIP general assist when appropriate, settles non-litigated claims, process expenses/losses incurred, prepares check requisitions, issues payments to insured and vendors per NFIP guidelines, explore salvage/subrogation potential, closes claims and secures appropriate proof of losses, seeks FEMA proof waivers
- Documents claims files and maintain control of work through documentation via flood system claim queues and log notes
- Responsible for ICC claims including the assignment to outside adjusters, full examination and payment issuance. Examination is performed per the NFIP guidelines. Assigns ICC claims to adjusters when documentation supports the same and reviews ICC claims for payment adhering to NFIP rules and regulations. Payments are made per authority guidelines
- Issue checks, proof of loss forms or letters of denial and complete reporting forms for file. Gather appeal and/or litigation files when applicable and provide written synopsis to FEMA
- Manage the process for vendor assignment specific to engineers, CPA’s, salvors, etc. as needed per guidelines. Manage these vendors to ensure they meet FEMA guidelines
- Prepare for and participate in claims round table reviews. Take lead roles during various audits to facilitate auditor questions and provide necessary backup to document that standards were complied with
- Ensures compliance with company and FEMA rules and regulations. Responsible for internal auditing to ensure all compliance measures are being met
- Attends claims seminars and workshops. Provide training to agents as well as internal personnel with webinars and on-site agency training if needed
- Handles incoming calls and correspondence from insured’s, agents, mortgage companies and public adjusters regarding questions or problems associated with claims as well as internal staff
- 2+ years of flood claim experience
- Knowledge of litigation and FEMA appeal process
- Excellent interpersonal skills with the commitment to work successfully in a team environment and foster teamwork
- Strong communication skills, verbal and written
- Exceptional customer relations skills to support strong customer service focus
- Ability to manage multiple tasks and maintain the necessary attention to detail
- Organizational and planning skills
- Problem solving and decision-making skills
- Excellent PC skills Preferred
- Office automation/keyboarding
- High school diploma or equivalent preferred
23
Senior Service Center Property Claim Representative Resume Examples & Samples
- Receives assigned Homeowner and Commercial Property claims and independently reviews/analyzes the policy forms and endorsements to determine applicable coverages, limits, deductibles and settlement calculations
- Gathers appropriate documentation to support the claimed damages through phone/email contact with customers, vendors, and police departments (includes estimates, proof of ownership/value, required company forms, reports, invoices, etc)
- Reviews damage documentation to determine loss amount. Negotiates settlements based on documentation presented, vendor contact/discussions, personal knowledge and experience, customer discussions and policy language
- Documents claim files, establishes and updates reserves throughout the life of the claim, maintains suspense system, processes expenses, prepares checks, updates MCS, and sends appropriate letters based on state regulations and company directives
- Explores salvage and subrogation potential
- Continuously reviews and analyzes investigative information to determine if file is eligible for fraud/SIU handling
- Enlists the assistance of vendors to help with remediation services, verification of loss facts, contents replacement, estimating and cost analysis of the claimed damages
- Reviews all claims continuously to determine whether loss/claim is best served in the Service Center or eligible for transfer to the field for further handling based on complexity of the loss, dollar amount involved, coverages that apply, and issues that surface throughout the investigation
- Actively participates in the triaging and/or handling of large storm and CAT events for the company
- Required to write small estimates using Xactimate (estimating software)
- Understanding of Commercial and Homeowner property policy language and endorsements
- Adjuster licenses in states requiring same (obtain within 3 months of hire)
- Damage evaluation and negotiation skills (review and writing of estimates, contents replacement, etc)
- 1-5 years of Commercial and Homeowner property experience preferred
24
Catastrophe Claim Representative Resume Examples & Samples
- Travel is required upon short notice to location catastrophe which could most likely be out-of-state
- Can meet the physical demands required for this position
- Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses
- Familiar with insurance coverage by studying insurance policies, endorsements and forms
- Works towards the resolution of claims, and may attend arbitrations, mediations, depositions, or trials as necessary
- Minimum of 2 years claims handling experience but not required
- Field claims experience with multi-line property and casualty claims and wind/hail is required
- Proficient with Xactimate software
- Above average communication skills (written and verbal)
- Ability to resolve complex issues
- Organize and interpret data
- Ability to handle multiple assignments
- Possess a valid driver’s license
25
Claim Representative BI Casualty Adjuster Resume Examples & Samples
- 3+ years of casualty/BI claims handling experience preferred
- California claims handling experience a plus
- Non-standard auto experience a plus
- Proficiency with typing and computer skills required
- Must have claim related computer systems experience; Guidewire a plus
26
Claim Representative Resume Examples & Samples
- 3+ years casualty claims handling experience
- 2+ years BI experience preferred
- Must have claims related computer systems experience; Guidewire experience is a plus
27
Material Damage Telephone Claim Representative Resume Examples & Samples
- Evaluate settlement alternatives by reviewing regulatory compliance and fair claims practices; make decisions on best option
- Make appropriate contacts to discuss a settlement; extend an offer to appropriate party; document all file activity and payment/settlement information in file notes clearly outlining basis for settlement
- May handle more complex files with appropriate supervision to develop skills
- Has a basic command of the claims policies and procedures; exhibit basic interpretation of policies & procedures in resolving claims, but may still need some assistance from supervisor
- For claims involving material damage, comply with the company material damage guidelines
- Organization and time management skills are critical for this position
- Demonstrate an understanding of insurance law as it relates to claims
28
Material Damage Telephone Claim Representative Resume Examples & Samples
- Receive claim assignments and verify/investigate coverage and document all appropriate information with very limited Supervisory involvement
- Establish an investigative plan; initiate investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary; may inspect damaged property, and review loss reserves and adjust or opens hidden exposures as necessary
- Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submits to manager for approval
- Determine subrogation or fraud potential and refer to Unit when potential exists or handles to conclusion
- If handling PIP may participate in investigations of medical providers and attend EUOs
- May work with attorneys in resolving serious and complex lawsuits which may mean: conduct negotiations and settlements within authority level, track and document the quality of service provided by defense counsel and manage litigation and recovery costs, and assist manager with research of complex issues and development of defense strategies on litigated files
- May assist in training and development of Claim Representatives or serve as a mentor for claims representatives
- May assist with file reviews and audits
- Is proficient and able to train others in using all systems and technology used within the company
- May be required to make personal appearances on behalf of the company when requested
- May also assist manager with preparing reports and completing projects
29
Long Term Disability Claim Representative Paid Training No Experience Required Resume Examples & Samples
- Plan, recommend, and execute the investigation and disposition of claims consistent with corporate claim standards policies and procedures, and statutory, regulatory and ethics requirements
- Manage caseload/claims within established performance standards
- Establish and maintain effective relationships with customers, gaining their trust and respect
- A passion for customer service
- Demonstrated ability to effectively communicate
- Desire to advance your career and continuously improve
- Willingness to learn, lead, be led, support others, have fun and work hard
30
Liability Claim Representative Resume Examples & Samples
- O In lieu of work experience, will consider involvement in organizations/clubs, volunteer work/community service, athletics or military
- Prior work experience in an office or administrative setting preferred
- Previous insurance or claims related experience a plus
- Must have a valid driver’s license with no more than 2 moving violations and/or at-fault accidents on driving record within the last 3 years
- No drug or alcohol related conviction on driving record in the past 5 years (i.e., DUI/DWI)
- Must be able to work full-time
- Must currently live in driving distance of Weldon Springs, MO
31
Field Claim Representative Resume Examples & Samples
- College degree or equivalent required; 1-2 years of relevant experience preferred
- Strong computer skills are required in order to quickly learn our multiple systems
- A foundation in agricultural and construction is preferred
- Must have valid driver’s license and the ability to travel extensively, (approx. 50% or more during storm season) including overnight. A company vehicle is provided
- Must be able to work under all kinds of weather conditions and fully appraise all physical aspects of the property and buildings, which includes climbing on ladders
32
Material Damage Telephone Claim Representative Trainee Resume Examples & Samples
- Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to manager for approval
- Determine subrogation or fraud potential and refer to Unit when potential exists or handle to conclusion
- Develop a working knowledge of systems and technology used within the company
- Identify customer needs and work to meet those needs using appropriate customer service skills
- Bachelor's Degree or in-lieu of degree equivalent education, training and work-related experience
- Demonstrate the capability of consistently handling aggregate file exposures of at least $2,500
- Demonstrate proficiency in file audits to agreed standard of efficient claims quality
- Demonstrate the ability to interpret and apply written coverage accurately to establish claim and determine an action plan, and often requires assistance on more complex files
- Demonstrate professional oral and written communication skills
- Demonstrate a thorough understanding of the NGIC Insurance brand and ability to exhibit the behaviors
33
Strategic Claim Management Senior Claim Representative Resume Examples & Samples
- Ability to review multiple complex policies and coverage parts, write and articulate clear coverage positions
- Litigation management and trial/mediation analysis and reporting
- Working with and coordinating a number of vendor services, including defense counsel
- Executing financial transactions and financial forecasting; and
34
Total Loss APD Claim Representative Resume Examples & Samples
- Bachelor's degree or equivalent training
- Strong Auto Physical Damage experiences
- Proven negotiation \ dispute resolution skills
- Ability to efficiently manage the rental process
- Proven track record of providing excellent customer service
- Please Note: At this time the role is open to only CAS & Eastern Auto (PDO & ABI) employees
35
Claim Representative Resume Examples & Samples
- A minimum of 3 year’s BI experience handling large exposure claims required
- Experience TX, OK, NM, CO and UT is preferred
- Must have claims related computer systems experience; Guide wire claims system experience a plus
- Ability to work Monday - Friday, 8:00 am - 5:00 pm, 9:00 am – 6:00 pm CST or 10:00 am - 7:00 pm CST
36
Claim Representative Resume Examples & Samples
- Investigates and resolves claims made against a variety of surety bonds
- Secures necessary information (i.e., reports, bonds, credit or financial reports, bond forms, agreements, releases, statements or other documents) to assist in the investigation of claims
- Retains and directs approved consultants and outside counsel. Responsible for maintaining cost controls and overseeing the work of outside counsel
- Determines available avenues of recovery and their cost-effectiveness; coordinates approved recovery efforts
- Establishes and maintains proper loss reserves and expense budgets
- Prepares periodic claims reports as required
- Effects settlements / reserves within prescribed limits and submits recommendations to supervisor on cases exceeding personal authority
- Ensures compliance of claims handling pursuant to all state, legal, statutory and regulatory bodies to comply with all company procedures and requirements
- Maintains organized and appropriately documented claim files
- May attend mediations, arbitrations or settlement conferences as requested
- 3-7 years of claims handling experience, either in Property or Casualty lines
- Experience handling commercial surety claims is a plus
- Bachelor’s degree in Business Administration or equivalent work experience
- Must be detail oriented, organized and possess strong analytical skills
- Strong negotiation and mediation skills are required
- Strong verbal and written communication skills are necessary for this position
- Must be proficient in MS Office
- Ability to work well in a fast-paced environment
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Senior Claim Representative Resume Examples & Samples
- Investigates and handles casualty claims. Reviews and evaluates coverage and damages. Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, records or other documents) in the investigation of claims. Demonstrates excellent judgment in the evaluation and handling of claims
- Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions or trials as necessary. Responsible for providing input on settlements / reserves
- Conveys complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations
- Ensures that claims payments are issued in a timely and accurate manner
- Ensures that claims handling is conducted in compliance with applicable statutes, regulations and other legal requirements, and that all applicable company procedures and policies are followed
- Bachelor's degree or equivalent work experience and/or training
- Minimum of 3-5 years of related claims handling experience. Strong casualty handling experience is required with a strength in coverage analysis. Farm claims experience is a plus. Multi-line adjusters are encouraged to apply
- Demonstrates written, verbal and effective listening communication skills
- Detail oriented and strong organizational skills
- Ability to build and maintain productive relationships with co-workers
- Strong computer skills including experience with Microsoft Excel & Word
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Senior Claim Representative Resume Examples & Samples
- Reviews and evaluates coverage and / or liability
- Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, reports or other documents) in the investigation of claims
- Conveys moderately complex information (coverage, decisions, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations
- May provide guidance and assistance to lower level positions and other functional areas
- Inside position to be located in our Gainesville, GA office. This is not a work from home position
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Workers Compensation Claim Representative Trainee Resume Examples & Samples
- Investigates and maintains claims
- Works toward the resolution of claims files, and may attend arbitrations, mediations, dispositions or trials as necessary
- May affect settlements / reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority
- Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations
- Bachelor’s Degree or equivalent experience
- Part of a formal training program. Previous office experience preferred
- This is an entry level, inside position to be located in our Gainesville, GA office. This is not a work from home position
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Claim Representative Resume Examples & Samples
- Bachelor's degree or equivalent business/work experience
- 3-5 years of crop claims adjusting experience
- Thorough knowledge of coverages, claim practices, procedures and systems
- Excellent communication, organizational, interpersonal and managerial skills
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Claim Representative BI Casualty Adjuster Resume Examples & Samples
- 3+ years of casualty claims handling experience
- 2+ years of BI experience preferred
- Past coverage, liability, and property damage handling experience required
- Must have claims related computer systems experience
- California auto claims handling experience is a plus
- Non-standard auto experience is a plus
- Guide wire experience is a plus
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Senior Claim Representative Resume Examples & Samples
- Investigates and maintains truck and trailer physical damage claims. Reviews and evaluates coverage
- Negotiates and settles towing and recovery charges
- Works toward the resolution of physical damage claims files
- Monitors, controls and negotiates claim settlements with insureds, claimants and attorneys
- Investigates and evaluates recovery potential. Performs all necessary recovery activities
- Documents and maintains all systems and records necessary for proper claim handling
- Services the claim needs of our customers, including insureds, claimants, agents and other Great American personnel
- Must have a minimum of 3 years of commercial auto claims experience. Experience in handling physical damage trucking claims is a plus
- Must have thorough knowledge of insurance coverages, investigative techniques, and commonly used insurance concepts, practices, and procedures
- Must have strong working knowledge of PCs and computer software
- We will rely on your skills in planning and organizing, and your strong verbal and written communication skills
- Continued professional development is required. AIC (Associates in Claims) designation is highly regarded
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Auto Claim Representative Resume Examples & Samples
- Verbal and written communication skills. Interpersonal skills
- Associate (2-year) degree or equivalent
- Bilingual skills
- Prior experience in a call center environment
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Claim Representative Resume Examples & Samples
- 1-5 years of crop claims adjusting experience
- Basic knowledge of coverages, claim practices, procedures and systems
- Excellent communication, organizational, and interpersonal skills
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Senior Claim Representative Resume Examples & Samples
- Confirms and evaluates coverage and/or liability on medium to complex exposure cases. Secures and analyzes necessary information (i.e. expert reports, policies, appraisals, releases, statement, and other necessary documentation) in the investigation of claims
- Works toward the resolution of claims, and may attend arbitrations, mediations, depositions, or trials as necessary
- Affects settlements and reserves within prescribed time limits and submits recommendations to management on cases exceeding personal authority
- Conveys moderately complex information (coverage, decisions, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor
- Ensures that claim payments are issued in a timely and accurate manner
- Must have a minimum of 3-6 years of experience handling property claims. Commercial property claims experience is preferred. Inland Marine experience is a plus. Restoration and/or construction experience will be strongly considered
- Working knowledge of insurance coverages, commonly used insurance concepts, practices, and procedures
- Thorough knowledge and skilled at investigative techniques
- Must have a strong working knowledge of PCs, and computer software
- Bachelor's degree and/or AIC, CPCU, SCLA, and other insurance related designations are highly regarded
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Claim Representative Resume Examples & Samples
- Investigates and maintains Residential/Commercial Property Claims
- Bachelor's Degree or equivalent experience
- Must have a minimum 6 months to 5 years of related experience. Property experience preferred, field adjusting experience a plus
- Familiarity with commercial property forms preferred
- Must have a strong working knowledge of PCs, computer software and commonly used insurance concepts, practices, and procedures
- This position requires a high skill level in planning and organization, as well as written and verbal communications
- Continued professional development and licensing are required. The AIC, CPCU, SCLA, and other insurance related designations are highly regarded
- Ability to manage and control independent adjusters, experts and outside counsel as necessary
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Field Claim Representative Home / Property Resume Examples & Samples
- Maintain Proper file documentation
- Maintains current knowledge of insurance and applicable product/services
- Bachelors degree or 3 years of relevant work experience
- Training in building damage estimating
- Develops basic knowledge of claims process. Successfully completes claim representative trainee program, or equivalent business experience
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Field Claim Representative Resume Examples & Samples
- Prompt and courteous servicing of Property Claims, including insured and agency contact and follow through
- Adheres to high standards of professional conduct consistent with the delivery of superior service
- Timely identification, analysis and resolution of coverage issues arising in claims investigation
- Factual investigation of cause of loss
- Preparation and submission detailed estimates of damaged property
- Performs other duties as directed
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Liability Claim Representative Resume Examples & Samples
- Must have obtained a Bachelor’s degree OR have at least 1 year of liability claims handling experience
- O Involvement in organizations/clubs, volunteer work, and military experience will be considered in lieu of work experience
- Must be willing to work full-time
- Must currently live in the Atlanta area
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Senior Claim Representative Resume Examples & Samples
- Reviews and evaluates coverage
- Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, records or other documents) in the investigation of claims
- Works toward the resolution of claims, and may attend arbitrations, mediations, depositions, or trails as necessary
- May affect settlements and reserves within prescribed limits and submits recommendations to management on cases exceeding personal authority
- Conveys simple to moderately complex information (coverage, decisions, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations
- Ensures that claims handling is conducted in compliance with applicable statues, regulations and other legal requirements, and that all applicable company procedures and policies are followed
- Successfully completes all coursework/education as assigned
- Already licensed or become licensed within 30 days of hire
- Minimum of 2 years or more of claims handling experience preferred
- Familiarity with commercial property forms preferred. Liability and Mortgage property claims experience a plus
- Thorough knowledge of insurance coverages, investigative techniques, and claim adjustment procedures is necessary
- Must have a strong working knowledge of PCs and computer software, including MS Office
- Continued professional development is required. The AIC, CPCU, SCLA, and other insurance related designations are highly regarded
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Liability Claim Representative Resume Examples & Samples
- Must currently live in the Rockville metro area
- Must have satisfactory background check inclusive of driving (no more than 2 moving violations and/or at fault accidents in the past 3 years, and no drug or alcohol related conviction on driving record in the last 5 years) criminal, employment reference, education, and social security. A conviction will not necessarily disqualify you for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered
- # In accordance with Washington, DC law, applicants will not be asked about their criminal record, and no criminal background checks will be conducted, unless and until a contingent offer of employment has been extended
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Claim Representative Resume Examples & Samples
- Identify and refer claims to subject matter experts in a timely manner to maximize claim outcomes
- Knowledge of claims administration best practices and procedures
- Knowledge of insurance products and services
- Use multiple resources to gather and analyze significant data
- Implement planning to organize, prioritize and measure individual work
- Establish and maintain effective and respectful relationships with customers
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Senior Claim Representative Resume Examples & Samples
- 5+ years of handling claims experience
- Education equivalent to a college degree, or the equivalent in related work experience
- Knowledge of laws, statutes, and claims handling practices in multiple states and passed applicable state licensing requirements preferred (NC, SC, W. VA, FL, KY, LA)
- Proficient with interpreting coverage on standard ISO personal auto and homeowner’s policies
- Demonstrates effective and diplomatic oral and written communication skills
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Senior WC Claim Representative Resume Examples & Samples
- Coverage/Investigation/Liability - Determines whether or not proper coverage/compensability exists for the type of claim assigned. Investigates thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage/compensability, liability, legal climate, potential exposure, and damages, and makes decisions, where appropriate, on claim resolution. Monitors ongoing case development for appropriateness
- Damages - Determines the value of the physical damage of property, automobiles, or injuries through inspections and use of appropriate tools. Obtains all necessary documentation to support claim evaluation. Recognizes claim file exposures and escalates appropriately
- Communication - Maintains effective and ongoing communications with insureds, claimants, agents, attorneys, other insurance companies, representatives, vendors, and company personnel
- Customer Service - Ensures customer service excellence. Responsible for the customer and agent experience associated with assigned claims
- Reserving/Reporting - In accordance with Westfield’s reserving philosophy, establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience. Completes appropriate reports so that the current status of the claim is clearly documented at all times
- Negotiation/Settlement - Within decision making authority, negotiates timely and appropriate settlements with insureds, claimants, vendors, attorneys, and other insurance companies. Refers claims exceeding authority to appropriate leader or complex claims specialist with recommendations
- Leader Assistance - May assist and direct office staff at Unit Leader direction
- Coach/Mentor - May provide technical guidance and assistance to lower level associates and other functional areas
- Travel - Travels occasionally in order to participate in special assignments, training, storm duty and/or travel between office locations
- Five or more years worker’s compensation claims adjusting/industry related experience
- Previous experience handling worker’s compensation claims with exposure up to $75,000
- Proficient use of various core systems, office and computer equipment and software packages
- Strong oral, written, and interpersonal communication skills
- Strong organizational and negotiation skills; ability to handle conflict
- Insurance industry designation such as AIC, SCLA, CPCU, etc
- Valid driver’s license and a driving record that conforms to company standards
- Bachelor’s Degree or commensurate experience
- Ability to work effectively in an office environment for 40+ hours per week (including sitting, standing and working on a computer for extended periods of time)
- Ability to communicate effectively in a collaborative work environment utilizing various technologies such as: telephone, computer, web, voice, teleconferencing, e-mail etc
- Ability to operate an automobile within the parameters of the driving policy
