[Hiring] Claims Adjuster @The Carlisle Group

Role Description

Do you live near State College Pennsylvania or would you like to relocate to the area? Than this position may be right for you.

Senior Claims Representative- Multi-Line

The Carlisle Group has been Retained to conduct a search for a Senior Claims Representative (Multi Line).

Our client is an A rated Mutual Insurance company and they are looking for a Senior Claims Rep to investigate, evaluate, and settle multi-line claims within established authority level, including those of complexity and high exposure.

Essential Functions:

• Determines coverage and investigates claims:
• Makes personal, written, or telephone contact with general public, reporting agencies, and suppliers of services/goods.
• Reviews and interprets policies to determine coverage.
• Reviews records and documentation.
• Takes telephone-recorded statements from insureds, claimants, and witnesses involved.
• Determines liability.
• Determines amount of loss/damage.
• Makes assignments to appraisers or independent adjusters as needed.
• Orders police reports.
• Indexes injured insured and claimants; follows Medicare reporting requirements and files PLR.
• Assigns independent adjusters; independent appraisers; and experts to assist in the investigation and evaluation of the claim.
• Utilizes counsel to assist in coverage and/or investigation of claims.
• Determines settlement values:
• Utilizes information gained from claim investigations, applicable regulations, and policy provisions or limits.
• Reviews reserves:
• Reviews reserves on a 30-day basis.
• Modifies as necessary, within established authority, or seeks appropriate approvals.
• Develops and documents claims files.
• Establishes and maintains a 30-day diary to update file handling.
• Negotiates with insureds, claimants, or legal representatives; settles claims promptly, fairly, and within established authority.
• Issues claim and expense payments.
• Secures appropriate approvals for check requisition on claims exceeding authority.
• Pursues other carriers for subrogation and determines percent of liability (non-auto claims).
• Handles non-auto salvage.
• Ensures compliance with the Unfair Claim Practices Act and Good Faith Claim Handling regulation.
• Participates in claim orientation for Underwriting personnel, helping with analysis of coverage and/or claim situations.
• Performs other miscellaneous duties as assigned or directed.

Qualifications

• Bachelor’s degree or equivalent education and experience combination.
• Proficient interpersonal relations and communications skills (both written and verbal).
• Thorough knowledge of claims law.
• Proficient analytical and problem solving skills.
• Capacity to work well independently.
• Moderate computer knowledge.
• Demonstrated organizational and time management abilities.
• Demonstrated abilities to deal with a variety of personalities.
• Minimum of five years’ experience with investigation, management, and negotiation of liability and property claims in states of operation.