Associate Claims Representative - Workers Compensation

Essential Duties & Responsibilities:

Performs a combination of duties in accordance with departmental guidelines:

• Develops a working knowledge of commercial insurance and learns to manage an inventory of low complexity claims by successfully completing a formal training program, and following company protocols to verify policy coverage, gather necessary information, maintain appropriate file documentation and authorize disbursements within authority limit.

• Develops ability to contribute to customer satisfaction by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. 

• Learns to verify coverage and establish timely and adequate reserves by reviewing and interpreting policy language, estimating potential claim valuation, and following company's claim handling protocols.

• Develops ability to determine liability and compensability by conducting investigations to gather pertinent information, taking statements from insureds, witnesses and working with experts to verify the facts of the claim.

• Learns to work with appropriate internal and external partners, suppliers and experts by identifying and effectively collaborating with necessary resources to facilitate best claim outcomes.

• With manager approval, authorizes claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.

• Develops ability to meet or exceed quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.

• Learns to identify and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.

• Develops ability to achieve quality standards on every file by following all company  guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.

• Learns and maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.

May perform additional duties as assigned.

Reporting Relationship

Typically Supervisor or above

Skills, Knowledge & Abilities

• Strong desire to develop a wide breadth of knowledge and understanding of the commercial insurance industry, products and claims practices. 

• Good verbal and written communication skills with the ability to demonstrate empathy while providing exceptional customer service.

• Ability to develop collaborative business relationships with both internal and external partners.

• Developing ability to exercise independent judgement, solve problems, and make sound business decisions.

• Analytical mindset with critical thinking skills.

• Strong work ethic, with demonstrated time management and organizational skills.

• Ability to work in a fast-paced, collaborative environment at high levels of productivity.

• Knowledge of Microsoft Office Suite and ability to learn business-related software.

• Ability to manage multiple priorities and adapt to a changing environment .

• Ability to value diverse opinions and ideas

Education & Experience:

• Bachelor's degree required. A 3.0 or higher GPA preferred.

• Demonstrated leadership through prior work experience or participation in extra-curricular activities is a plus.

• Prior corporate internship(s) is preferred.

• Ability to obtain and maintain an Insurance Adjuster License, where applicable.