Complex Claims Representative

📋 Description

• Conduct investigations, analyses, and assessments to establish the extent of liability for first-party homeowner property losses and damages.

• Effectively engage and negotiate with policyholders, agents, public adjusters, attorneys, and service providers through phone, email, and internal systems to ensure precise documentation of claim details.

• Successfully oversee a caseload of pending claims at various stages of the claims process.

• Interpret and apply the specifics of insurance policies to guarantee the accuracy of payments and claims denials.

• Understand and apply computer-generated loss estimates, engineering reports, and construction terminology.

• Update and maintain detailed claim handling records in our electronic claims management system and other relevant applications.

• Provide mentorship to mid-level and associate claims representatives.

⛳️ Requirements

• Over 7 years of experience as a desk adjuster in the homeowner/property sector.

• Proficient in adjusting all perils, including fire, hail, wind, water, theft, lightning, vandalism, and more.

• Knowledge of valued policy states and an understanding of applicable perils and appropriate limit tendering.

• Prior experience collaborating with contractors and vendors for effective claims resolution.

• Skilled in managing complex claims with loss values of $100K and above.

• Experience in evaluating Proof of Loss submissions.

• Familiarity with handling CRN, DTPA, NOI, mediations, and appraisals.

• Capable of conducting recorded statements with insured parties.

• A Bachelor’s degree or equivalent experience is preferred.

• A High School Diploma or its equivalent (GED) is mandatory.

• Proficient in MS Office and other internal insurance-related programs, systems, or applications (Outlook, Word, and Excel).

• Effective communication skills using platforms such as Slack and MS Teams.

• Previous experience with systems like Symbility is an advantage.

🏝️ Benefits

• Medical, Dental, and Vision coverage.

• Short- and Long-Term Disability (Company Paid).

• Voluntary Long-Term Disability options.

• Employee Life & AD&D insurance (Company Paid).

• Voluntary Life & AD&D coverage for employees, spouses, and children.

• Flexible Spending Accounts for Healthcare and Dependent Care, along with a Healthcare Savings Account (HSA).

• 401K plan with a generous matching contribution and no vesting schedule.

• 20 days of Paid Time Off (PTO) annually (prorated based on hire date).

• Company Paid Holidays and 2 “Choose Your Own Holidays.”