Posted in Insurance 30+ days ago.
The Claims Representative I investigates, evaluates and disposes of assigned workers' compensation claims in a timely manner in order to achieve best practices type settlements within legal statutes, policy provisions and Company and/or client guidelines.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Develops claims files from initial assignment to disposition.
Prepares claim file documentation accurately and completely in order to justify all actions taken and to provide an effective audit trail.
Completes actions on a timely basis, such as verifying coverages, setting or adjusting reserves, making appropriate contacts, moving the investigation along and disposing of the claim, in order to keep management, claimants, insureds and other interested parties satisfied that effective efforts are being made toward claim settlement.
Achieves a best practices type settlement in the disposition of claims.
Properly identifies and pursues subrogation, contribution and salvage opportunities when available, in order to reduce or recover the amount of payment.
Uses appropriate, tactful and complete communications, in order to ease negotiations, develop rapport and project a positive corporate and personal image.
Initiates self-development and training, in order to improve upon, maintain or acquire skills prescribed as promoting professional and personal growth in claims handling.
Establishes and maintains a quality relationship with insureds, claimants, agents, underwriting, medical and legal professionals, appraisers and independent adjusters in order to develop an effective communication channel through which to more efficiently resolve claims.
May require outside personal adjusting, interviewing, inspections, scene investigations, and securing of personnel records from clients.
Why Penn National Insurance/Inservco
A career with Penn National Insurance offers a total rewards package that makes us a regional employer of choice. When you are part of the Penn National Insurance/Inservco family, we want you to feel secure in:
Education/Credentials (applies to both positions):
High School Diploma, or GED required; 4-year college degree preferred.
Continuing education in insurance-related courses such as IIA Certificate in General Insurance and Associate in Claims courses and/or Workers’ Compensation courses (PA 10, 11, 12 ,and 13) preferred.
Minimum of 2-years experience in a workers' compensation claims handling position, such as a Claims Representative II.
Must have a good understanding of tort and state laws applicable to assigned claims, the Unfair Claims Settlement Act and insurance policy coverages and provisions.
Must have a good understanding of terminology applicable to assigned claims; i.e., medical, legal, automotive and construction terminology.
Good communication skills, both oral and written.
Good inter-personal skills.
Good negotiation skills.
Good customer service skills.
Good analysis and evaluation skills.
Good decision-making skills.
Must have a strong sense of urgency.
Good PC skills, with an emphasis on Microsoft Office Products.
Good planning and organization skills.
Must be able to work independently as well as a member of a team.
JOB REQUIREMENTS (as required by ADA)
Must be able to see and effectively use a computer monitor.
Must be able to operate a computer keyboard, applicable printers and other
general office equipment.
Must have the ability to communicate effectively, both orally and in written
Must be able to interpret and apply concepts based on established guidelines.
Must be able to access and enter information accurately, using automated
This is primarily a sedentary position that requires occasional standing and
walking throughout the office environment.
Must have the ability to perceive and distinguish emotions during interactions
with people, in person and via the telephone.
Must be able to maintain acceptable attendance and adhere to scheduled work
Designated Claims Representative I and Senior Claims Representative positions
(resident positions) may also require the following:
Specific vision abilities include close vision, distance vision, peripheral vision, depth
perception and the ability to adjust focus.
Requires a combination of sitting, standing, walking, bending over and climbing a
ladder and stairs throughout the day.
Must have a valid driver’s license and be able to operate a motor vehicle.
Requires periodic day and overnight travel within territory.