Claims Representative
MMC

Claims Representative

Reports to: Director of Claims - Operations

Summary/Objective

Claims Representatives provide a high standard of professional conduct in the claims service to customers. They work independently in their overall management of the claims process and act with discretion with customers, claimants, insurance carriers and vendors on effective claim resolution.

Essential Functions

• Take initial first report of claim, verify policy coverages/limits and explain thoroughly the claims process and expected timeframes to the policyholder
• Input claim detail and proper documentation in the agency management system as required by our agency procedures. Ensure procedures are followed to ensure customer confidentiality.
• Report claim to the insurance carrier. Utilize automation tools and real-time processes for all carriers with real-time capabilities
• Submit proper documentation to all parties involved, including customers, carriers, police departments, etc.
• Follow up and follow through with customers and companies on outstanding claims as outlined in the agency procedures. Keep in frequent contact with policyholders on large property loss situations, ensuring they are effectively communicating with the claims adjustor
• Provide open claim reports to the account executive so they are aware of current status of open claims
• Be responsible for all customer communications, conflict resolution, and compliance on customer deliverables. Ensure customer or carrier conflicts are handled in an effective manner by identifying and implementing solutions as issues arise. Keep the account executive and management apprised of conflicts
• Manage daily claim load. During heavy call volume communicate with VP to distribute work to others.
• Process the daily retrieval of claim status notices from carrier websites.
• Communicate large losses and significant reserve changes to account executive and management
• Close out claim in the agency management system when final notice of payment is received
• Be available as needed for afterhours claim support for claim emergencies
• Continue to update job knowledge by participating in educational opportunities

Competencies

• Exceptional communication, organization and time management skills
• Results driven with a positive, professional attitude and exceptional customer service focus
• Strong working knowledge of all lines of property & casualty insurance coverages
• Extremely detail oriented
• Strong technical capacity with knowledge of Microsoft Office software products
• High level of initiative and able to work well in a team environment
• Motivated, goal-oriented, persistent and skilled negotiator
• Handles stressful situations and deadline pressures well
• Plans and executes responsibilities independently and with discretion

Preferred Experience & Education & Licensing

• 3-5 years of claims service experience
• Undergraduate degree or combination of industry education and experience
• Claims Adjustor license

Position Type

This is a full-time position. Office Hours are 8:00-4:30.

Travel

Generally, no travel is required; however, an occasional visit to a claim site or customer's location may be necessary.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job.

AAP/EEO Statement

Clark Insurance provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, sexual orientation, disability, genetics, and any other protected class. In addition to federal law requirements, Clark Insurance complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

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