Claims Examiner - Auto
Remote
3 Months – Contract
Manager's Notes
Auto casualty
Experienced in complex liability and coverage.
TPA experience a plus.
Bodily injury/uninsured/underinsured motorist handling experience to include demonstrable(fatality, fractures, traumatic brain injury) injury handling.
(USD) threshold handling up to 1 million.
No fault(Personal Injury Protection) experience.
Licensed in the contiguous 48 states.
**Litigation handling experience pertaining to BI/UM/UIM** Not all candidates will need this but a minimum of 3 will need litigation handling experience.
Auto Physical Damage handling experience preferred.
Experience working in a fast paced environment, participating in and presenting cases to both internal and external stakeholders.
Description:
PRIMARY PURPOSE:
To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
Responsible for litigation process on litigated claims.
Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
Reports large claims to excess carrier(s).
Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
Communicates claim action/processing with insured, client, and agent or broker when appropriate.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
QUALIFICATION
Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.
Experience: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
Skills & Knowledge
Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations