ESIS Senior Claims Representative, AGL

JOB DESCRIPTION

The Senior Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines.


* Under limited supervision, receive assignments and review claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.


* Contact, interview and obtain statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc.

to secure necessary claim information.


* Depending on the line of business, may inspect and appraise damage for property losses or arrange for such appraisal.


* Evaluate facts supplied by investigation to determine the extent of liability of the insured, if any, and extend the company's obligation to the insured under the policy contract.


* Prepare reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.


* Set reserves within authority limits and recommends reserve changes to Team Leader.


* Review progress and status of claims with Team Leader and discusse problems and suggested remedial actions.


* Prepare and submit to Team Leader unusual or possible undesirable exposures.


* Assist Team Leader in developing methods and improvements for handling claims.


* Settle claims promptly and equitably.


* Obtain releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.


* Inform claimants, insureds/customers or attorney of denial of claim when applicable.

QUALIFICATIONS



* Ten or more years of experience handling claims as evidenced by career progression within the company or similar organization.


* Ability to work independently with limited direction from a Team Leader.


* Authoritative technical knowledge of claims handling and claims terminologies.


* Superior negotiation skills.


* Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc.

in a positive manner concerning losses.


* Strong knowledge of the company's products, services, coverages and policy limits, along with a solid understanding of claims best practices.


* Commanding knowledge of applicable state and local laws related to line of business handled.


* Superior customer service skills

An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters.

Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims.

ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

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