Advanced Insurance Claims Processor

  • location: Scottsdale, AZ
  • type: Temporary
  • salary: $36.72 per hour
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job description

Advanced Insurance Claims Processor

Specializes in E&S personal and commercial property damage claims predominantly of a serious and sometimes complex nature. Adjusts serious exposure E&S personal and commercial property claims requiring investigation, property damage evaluation and negotiations. Oversees the activities of defense counsel. Responsible for the handling of claims in accordance with prescribed authorization.
Responsibilities:
1. Promptly and effectively handles to conclusion assigned claims with little to no direction and oversight that may include complex and catastrophic property losses. Makes decisions within delegated authority, recommends settlement values in the disposition of serious and sometimes complex claims as outlined in company policies and procedures. Adheres to high standards of professional conduct consistent with the delivery of superior service.
2. Utilizes various methods of settlement in those cases where warranted; assigns cases to outside vendors as warranted.
3. Opens, closes and adjusts reserves in accordance with company practices designed to ensure reserve adequacy. Recommends Special Reserves where necessary. In accordance with Corporate Reserving Guidelines. Adheres to file conferencing notification and authority procedures.
4. Maintains current knowledge of: assigned insurance lines; court decisions that may affect the claims function; current guidelines in the claims function; and policy changes and modifications. This may require attendance at various seminars or training session.
5. Serves as a mentor to less experienced claims associates and assists with training/presentations as assigned by claims management.
6. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for suit, trial, or subrogation. (Property/MD/Casualty).
7. Oversees defense counsel in all Alternative Dispute Resolution activities from inception throughout the life of the claim.
8. Delivers a positive On-Your-Side customer service experience to internal, external, current and prospective Nationwide customers.
9. Perform other duties as assigned.
Working hours: 8:00 AM - 5:00 PM
Skills:
Education: Undergraduate studies in business administration or related field preferred and/or relevant experience
Licenses/Designations: Successful completion of required claims certification schools/courses. Professional development such as IIA or CPCU preferred. State licensing where required.
Experience: Five years commercial property claims handling experience preferred.
Qualifications:
Knowledge: Proven knowledge of first party property legal and/or commercial claims terminology, state regulations, claims processes, best practices, and customer relationship management. Advanced knowledge of insurance theory and practices, insurance contracts and their application. Excellent customer focus and proven ability to proactively meet customer needs. Analytical skills necessary to make decisions and resolve conflict in application of coverage, laws of jurisdiction to investigation facts, policy exclusions and exceptions. Proven organizational skills to effectively prioritize increased and more complex workloads. Demonstrates strong but flexible standards and can be seen as balanced based on the conflicting demands of the position. Excellent written and verbal communication skills necessary to effectively communicate and/or negotiate with various audiences. Demonstrated leadership capabilities to effectively train, coach, and provide feedback to less experienced associates. Knowledge of claims systems. Advanced knowledge of claims best claims practices used to resolve serious and/or high exposure/large loss claims.
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.
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