CASUALTY CLAIMS ADJUSTER I
Emc Insurance Companies
Time: 2 weeks ago
Casualty Claims Adjuster I
Illinois- Work From Home
job requisition id
At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees.
This position can be performed remotely for candidates who reside in IL, MN, WI, IA, MS, LA, MO, or AR.
- Promptly investigates and evaluates claims
- Reviews the claim notice and policy to verify coverage, deductibles, claim payee/mortgagees and compensability
- Initiates contact with customers to obtain information on the claim and explain the claim process
- Takes statements from insureds/claimants/witnesses and documents summaries within the claims system
- Documents claim handling activity including Medicare (MSP) modules in the claims system
- Resolves questions of coverage, liability and the value of claims
- Drafts reservation of rights and denial letters when appropriate
- Sets timely, adequate reserves in compliance with the company reserving philosophy and methodology
- Assigns vehicle/property damage appraisals and vehicle rentals
- Secures all the necessary official reports, claim forms and documents
- Reviews bills, invoices and receipts for accuracy
- Provides prompt, detailed responses to agents, insureds and claimants on the status of claims
- Identifies, investigates, and proactively pursues opportunities for recovery
- Notifies the Claims Manager/Supervisor of the claims which require assignment to higher level Claims team members
- Negotiates, settles and/or resolves claims
- Prepares bodily injury and/or damage evaluations, negotiation ranges and target settlement numbers prior to negotiation
- Communicates with insureds/claimants/attorneys to negotiate the settlement of claims
- Issues settlement documents and verifies that they are properly executed
- Issues timely payments within check authority limit
- Assists own branch claims team members as needed. Assists other branches in handling of claims (due to storms or temporary staffing gaps) through Resource Sharing Program. Participates in branch and department projects.
- Submits referrals to the Estimatics Review, Special Investigation, Property Review, Subrogation and Medical Review Units, when necessary
- Prepares risk reports for Underwriting
- Reviews coverage intent and policy activity with Underwriting
- Reviews account inspection information with Risk Improvement
Education & Experience:
- Bachelor’s degree or equivalent relevant experience
- One year of claims adjusting experience
- Attainment of all applicable state licenses within one year of hire
- Relevant insurance designations preferred
Knowledge, Skills & Abilities:
- Working knowledge of the theory and practice of the claim function
- Good knowledge of insurance contracts, medical terminology and substantive and procedural laws
- Ability to adhere to high standards of professional conduct and code of ethics
- Strong knowledge of computers and claims systems
- Strong organizational and written and verbal communication skills
- Good investigative and problem-solving abilities
- Occasional travel required; a valid driver’s license with an acceptable motor vehicle report per company standards required if traveling
Our employment practices are in accord with the laws which prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.
All of our locations are tobacco free including in company vehicles.
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