Claims Representative II - Auto & Casualty Lines, 1st Party Medical - Goodville Mutual Casualty Company : Job Details

Claims Representative II - Auto & Casualty Lines, 1st Party Medical

Goodville Mutual Casualty Company

Job Location : Napoleon,OH, USA

Posted on : 2025-01-26T19:21:42Z

Job Description :
Summary:This position is responsible for adjusting and settling claims for all lines of business written by the company with settlement authority up to $20,000.Functions:
  • Handle claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
  • Verify policy coverage on assigned claims.
  • Investigate and evaluate claims; negotiate for proper settlement.
  • Assign independent adjusters, appraisers, and staff Field Claims Representative when necessary.
  • Pursue subrogation, salvage, and third-party liability contribution.
  • Notify Claims Supervisor or Manager of all claims that exceed settlement authority of $20,000.
  • Establish proper reserves on assigned claims.
  • Report claim complaints, questionable claim submissions and possible fraud to Casualty Claims and SIU Supervisor or Manager.
  • Attend claim seminars and participate in claim associations.
  • Perform other duties as assigned by Casualty Claims and SIU Supervisor and Supervisor.
Requirements
  • High School education required.
  • One to two years' Property and Casualty claims experience required.
  • Knowledge of Property and Casualty insurance coverages and terms preferred.
  • Ability to learn the coverages of all insurance policies written by the company required.
  • Effective communication and negotiation skills required.
  • Ability to work effectively with company computer systems required.
  • Willingness to participate in insurance related study courses with specific goal of attaining AIC designation preferred.
  • Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required.
  • Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required.
  • Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required.
  • Ability to perform the essential functions of the job with or without reasonable accommodation required.
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