Senior Casualty Claims Representative

This is a fully remote position, open to applicants in California, +1 more state.

📋 Description

• Conduct investigations and resolve claims (90%): Leverage your knowledge and expertise in coverage concepts, policy interpretation, exposure recognition, damage analysis, and liability assessment to analyze and advance claims towards resolution using best practices.

• Comprehend and accurately apply various laws and regulations related to claims handling across multiple states.

• Ability to assess different variables, including medical records, billing, and legal documentation.

• Demonstrated negotiation and settlement capabilities.

• Investigate all facets of claims.

• Create and adjust case reserves in accordance with company policy.

• Process and pay claims within the designated authority level.

• Manage the inventory of pending open claims.

• Serve as the primary point of contact for policyholders throughout the claims process.

• Ensure organization and documentation of claims files (both hardcopy and electronic).

• Engage in extensive phone communication with customers.

• Collaborate with vendors, experts, and other insurance carriers.

• Conduct detailed analyses of records, photographs, damage reports, and policies.

• Complete daily written correspondence to individuals and businesses.

• Occasionally manage litigation files (5%).

• Participate in meetings and contribute to workplace initiatives (5%).

⛳️ Requirements

• Bachelor’s degree or equivalent preferred.

• Bilingual skills, particularly in Spanish, are advantageous but not mandatory.

• A minimum of 7 years’ experience in handling California auto liability claims.

• Friendly, positive, and professional attitude.

• Excellent written and verbal communication abilities.

• Comfortable navigating a fast-paced environment with limited managerial oversight.

• Strong planning and organizational skills are essential.

• Previous experience with moderate complexity bodily injury and property damage insurance claims is required.

• Prior experience in customer service is necessary.

• Strong investigative and analytical abilities.

• Exceptional organization and time management skills.

• Capacity to make prompt and accurate decisions.

• Proven negotiation skills.

• Strong skills in policy interpretation.

🏝️ Benefits

• Health insurance

• Dental insurance

• Vision insurance

• Life insurance

• Disability insurance

• Retirement plans

• Paid time off