Casualty Field Claims Representative

Position Summary

The focus of this position centers around producing timely claim adjustments that are high quality and accurate.

ESSENTIAL FUNCTIONS

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statement(s)

• Manage, investigate, and resolve claims.
• Review insurance policy to determine coverage and limits.
• Communicate and take statements from policyholders, witnesses, and claimants in order to gather information regarding claims.
• Investigate and evaluate injury and/or liability.
• Negotiate and settle bodily injury claims within prescribed authority levels.
• Set and maintain reserves.
• Prepare insurance claim forms and related documents and review them for completeness.
• Provide customer service, such as instructions on proceeding with claims.
• Organize and work with detailed office records, using computers to enter, access, search and retrieve data.
• Post or attach information to claim file.
• Identify potential suspicious claims and refer to SIU.
• Identify opportunities for subrogation.
• Perform other responsibilities as assigned.

POSITION QUALIFICATIONS

Competency Statement(s)

• Accounting and Financial Acumen – Knowledge of accounting principles, financial reporting, and internal control concepts.
• Analytical Thinking – Ability to evaluate complex information, identify patterns, and reach well-supported conclusions.
• Business Acumen – Ability to understand insurance operations, strategic objectives, and associated risks.
• Communication – Ability to communicate clearly and effectively in writing and verbally with employees, management, executive leadership, regulators, external auditors, and the Audit Committee.
• Confidentiality – Ability to protect sensitive information and exercise appropriate discretion.
• Decision Making and Judgment – Ability to formulate sound, objective decisions using available information.
• Ethics and Integrity – Ability to demonstrate conduct consistent with professional standards and Company values.
• Independence and Objectivity – Ability to evaluate matters impartially and communicate concerns candidly.
• Leadership – Ability to influence outcomes through expertise, collaboration, coaching, and professional credibility.
• Organizational Skills – Ability to manage multiple projects, priorities, records, and deadlines using a systematic approach.
• Problem Solving – Ability to identify root causes and recommend practical, risk-based solutions.
• Project Management – Ability to organize and direct audit and risk management initiatives through completion.
• Regulatory Knowledge – Ability to understand and apply insurance regulatory and compliance requirements.
• Risk Assessment – Ability to identify, measure, evaluate, monitor, and communicate enterprise risks.
• Strategic Thinking – Ability to align audit and risk management activities with organizational objectives.
• Working Under Pressure – Ability to complete assigned tasks and handle challenging situations professionally.
• Professionalism – Avoid business or personal activities that present a conflict of interest. Display conduct favorable to oneself, the department, and the company.

SKILLS & ABILITIES

Education: Bachelor’s Degree or comparable experience. Preferred experience: Four years comparable experience in auto, construction, or other areas pertinent to insurance claims.

Computer Skills: Proficient in Microsoft Office Suite.

Licenses: Must have a standard Driver’s License.

Other Requirements: Participate in industry courses such as AIC and/or CPCU.