About this role
- Manages an inventory of claims to evaluate compensability/liability.
- Establishes action plans based on case facts, best practices, protocols, regulatory issues, and available resources.
- Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages.
- Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves as necessary, during the processing of the claims, and refers claims to the subrogation group or Special Investigations Unit as appropriate.
- Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
- Performs other duties as assigned.
Effective interpersonal, analytical and negotiation abilities required Ability to provide information in a clear, concise manner with an appropriate level of detail Demonstrated ability to build and maintain effective relationships Demonstrated success in a professional environment; success in a customer service/retail environment preferred Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory Licensing may be required in some states