• Handling caseload and adjusting claims within authority and in accordance with the company’s claims philosophy and reserving protocol, ensuring claims are adjusted proactively and efficiently.
• Triaging and managing claims through to resolution.
• Supplying a high professional standard of service to clients, brokers and other stakeholders.
• Ensuring performance within the company’s KPIs and service standards.
• Overseeing the management of certain TPA relationships on accounts, including claim audits.
• Work in conjunction with the underwriting department to assist with risk management and other areas.
• Support the analysis of claims performance to identify trends and exceptions.
• Develop and maintain legal knowledge of the class of business handled.
• Assisting with miscellaneous claims-related projects
• Interaction with other areas of the business, to include internal reporting, drafting and presentation to other areas of the business.

Skills: Claims Handling, Claims Triaging, Client Service, Performance Monitoring, TPA Oversight, Risk Management, Claims Analysis, Legal Knowledge

• Maintains active diaries and a plan of action
• Promptly responds to all inquiries and prepares and presents file summary updates to clients
• Conduct the necessary investigation, either by phone or through independent adjusters, to determine coverage, liability and damages
• Evaluate, negotiate, and settle assigned property damage or severe GL and/or complex bodily injury claims within the authority granted
• Process new claims or modify existing claims according to the appropriate and applicable action
• Analyze claims to determine appropriate action to approve or deny a claim for payment
• Determines accurate payment criteria for clearing pending claims based on defined policies and procedures
• Research claims to determine the appropriate benefit application utilizing established criteria
• Applies physician contract pricing for entry-level claims
• Review and address provider inquiries regarding claim adjudication
• Maintain quality standards and evaluate claims for resolution

Skills: Diary Management, Client Communication, Claims Investigation, Claims Evaluation, Claims Processing, Claims Analysis, Payment Determination, Quality Assurance

• Responds to questions from clients, agents, claimants, lawyers or coworkers
• Gathers information and serves as a resource for claim lawsuits, mediations and arbitrations
• Manage desk- and caseload of at least 125 – 135 claims in an efficient and professional manner
• Investigate claims thoroughly, including coverage, liability and exposure
• Evaluate exposures and maintain accurate and timely reserves on all files
• Control and manage litigation issues
• Evaluate claims for settlement and negotiate with claimants and attorneys to resolve claims in an appropriate and timely manner
• Control and manage medical issues
• Keep claim files documented and updated at all times
• Ensure that all payments are appropriate, timely and accurate
• Establish and maintain positive working relationships within the automotive industry.
• Build positive working relationships with service advisors within the network of auto

Skills: Client Communication, Claims Investigation, Caseload Management, Exposure Evaluation, Litigation Management, Medical Management, Claims Negotiation, Relationship Building

• Adjust moderately to complex Multi-Line Property & Casualty claims
• Plan and implement timely methods of investigating claims and accidents that involve the City and engage experts
• Interview appropriate parties, secure oral and written statements, investigate the root cause of loss and present assessments of corporate liability and recovery avenues
• Mediate claims disputes and obtain accurate estimates on the value of damaged property
• Provide oversight of property damage appraisal services and scope assessment
• Examine medical reports on injured parties, establish appropriate quantum, negotiate settlements with claimants or legal representatives and obtain releases from the concerned parties
• Propose claim settlement proposals and large loss reporting for approval to those with delegated authority pursuant to the City Administration Bylaw
• Maintain accurate and complete files in contemplation of litigation and support the litigation process
• Collaborate with risk analysts for coverage determination and risk identification in order to support risk control practices
• Manage relationships within a diverse line of business and a complex environment
• Work effectively with internal & external stakeholders. 
• Support and contribute to the department's quality assurance program
• Embrace change and advocate for innovative process improvements and lean efficiencies

Skills: Claims Adjustment, Investigation Planning, Liability Assessment, Dispute Mediation, Settlement Negotiation, Litigation Support, Risk Collaboration, Process Improvement

• Provide customers with a high level of service to meet expectations
• Work with Extended Claims Unit Representatives on dedicated accounts
• Review new loss claims with low to moderate complexity and determine appropriate action for resolution
• Conduct phone interviews and take recorded statements from all parties possessing facts regarding the claim
• Review, investigate and determine fault in losses and accidents
• Write reports for the claim file to document all activity related to the loss
• Evaluate, negotiate and adjust the loss and damages through complete resolution of all damages
• Keep a diary system to manage the file in a timely manner
• Document key activities in a timely, clear and concise manner
• Promote a positive team and work environment

Skills: Customer Service, Claims Review, Phone Interviews, Fault Determination, Report Writing, Loss Evaluation, File Management, Team Collaboration

• Uses specific IT-based systems to support the technical checking process.
• Completes accurate reporting associated with the role.
• Open to processing multiple work types to support the business.
• Takes personal responsibility for maintaining skills and knowledge including attending relevant training/seminars.
• Identifies questionable and/or potentially non-compliant data and can initiate prompt actions to resolve.
• Understands and appreciates the need to meet productivity targets
• Maintains quality & compliance standards
• Understands and appreciates the need for high quality.
• Takes personal quality failures seriously and actively addresses them.
• Adheres to compliance requirements by monitoring work against relevant controls.
• Supports quality improvement/compliance initiatives in the team.
• Takes personal ownership for delivering excellent customer service.
• Responds to customer requests in a timely and thorough manner, taking the appropriate action to ensure customer satisfaction.
• Resolves customer problems whilst maintaining the ongoing working relationship.
• Negotiates effectively when responding to customer needs - maintains relationship whilst saying “no”.
• Instills customers' confidence in DXC through relationship building.

Skills: Technical Checking, Report Accuracy, Workflow Flexibility, Continuous Learning, Data Compliance, Productivity Awareness, Customer Service, Relationship Building

• Maximises DXC reputations and Displays commercial awareness
• Recognises commercial opportunities and progresses them through the correct channels
• Displays cost awareness appreciation in decision making
• Identifies new ways of doing things
• Challenges the status quo and encourages the team and peers to do likewise
• Supports local change and innovation initiatives through to implementation
• Validate and obtain information and correct inaccuracies.
• Analyse, investigate & interpret data and information and draw out conclusions.
• Uses appropriate analytical and statistical tools and techniques.
• Backs up conclusions with logical analysis and presents at a level that is appropriate to the audience.
• Reads, analyses and interprets claim documentation to resolve problems using a high degree of professionalism and independent judgement.
• Bring together information from a number of different sources when forming a decision.
• Makes decisions on the best course of action based on available data.
• Clarifies key issues and weighs up the pros and cons of alternative solutions before reaching a decision
• Takes personal responsibility for decisions and can effectively articulate them.

Skills: Commercial Awareness, Innovation Support, Data Validation, Analytical Thinking, Statistical Analysis, Decision Making, Problem Solving, Independent Judgement

• Managing and adjusting claims from first notification to settlement within pre-authorised authority limits
• Claims adjusting on behalf of current clients
• Day-to-day management of the claims component of the Binding Authority accounts. 
• Bordereau processing and reconciliation. 
• Provision of technical support for the adjustment of various COB claims
• Ensuring each client's claim service standards are maintained or enhanced
• Managing and enhancing client relationships
• Monitoring performance against contract SLAs and KPIs
• Delivering and presenting reports to clients on specific claims issues
• Contacts customers within 24 hours, such as clients and claimants for general liability and provides 3-point contact to employees, clients and medical providers for workers’ compensation
• Completes a thorough investigation by determining the facts of the loss and taking statements from the client, claimants, injured workers, and/or witnesses

Skills: Claims Management, Claims Adjusting, Bordereau Reconciliation, Technical Support, Service Standards, Client Relationships, Performance Monitoring, Claims Investigation

• Pursue excellence in service when dealing with all customers. 
• Keep all customers and relevant representatives informed of the claims process and claim status using professional verbal communications and professionally drafted correspondence.
• Obtain and analyze loss details and develop a comprehensive strategy to efficiently and accurately reach a resolution on claims presented for coverage.
• Examine insurance policy provisions, endorsements, state statutory provisions and other records to verify applicable coverage. 
• Research and resolve coverage issues identified during the coverage investigation.
• Conduct detailed liability investigations utilizing investigative tools and processes to include obtaining recorded statements from involved parties, interpreting and decoding police reports, analyzing scene investigations and expert reports and interpreting state negligence laws, statutory provisions and case law to make accurate liability decisions.
• Request appropriate inspections and appraisals
• Maintain oversight of the repair process to ensure appropriate expense handling
• Prepare timely letters and maintain the appropriate diary to ensure compliance with state and federal laws
• Draft and deliver denial letters, reservation of rights letters and other
• correspondence to claimants and insureds
• Determine settlement amounts and negotiate and convey claims settlement within authority limits to insureds and claimants
• Follow proper escalation procedures based on the severity of the claim
• Make reserve recommendations based on the nature of the damages
• Ensure service levels within the team and department are met or exceeded on a daily basis
• Communicate with underwriting on variances within the policy file and claims trends

Skills: Customer Service, Claims Communication, Coverage Analysis, Liability Investigation, Repair Oversight, Settlement Negotiation, Reserve Management, Policy Collaboration

• Analyzes loss details and develops a plan of action to efficiently and accurately reach a resolution on claims presented
• Sets timely, adequate reserves to cover client exposure in accordance with specific client claim handling procedures
• Document all activity in a timely and effective manner
• Resolve issues and make decisions
• Successfully negotiate the settlement and disposition of claims
• Investigate loss events promptly and advise on any policy coverage issues
• Prepare client reports in an accurate & timely manner
• Update the claims management system
• Respond to queries from insurer clients, intermediaries, insured policyholders and third parties promptly
• Effectively manage external experts, outsourced service providers, contractors, etc

Skills: Loss Analysis, Reserve Setting, Activity Documentation, Issue Resolution, Claims Negotiation, Coverage Investigation, Report Preparation, Stakeholder Communication

• Effective reasoning, analysis and decision-making skills.
• Effective influence, organization, negotiation, and hospitality skills.
• Ability to prioritize work.
• Ability to meet deadlines and follow up in a timely manner.
• Good communication skills (verbal, listening, writing), including the ability to deliver difficult messages to customers and/or claimants.
• Good investigation, computer skills.
• Basic knowledge of the claims process.
• Ability to work well in a team, providing assistance to fellow associates and representing the mission of the unit, department or region.
• Ability to communicate often with supervisor, keeping informed.
• Knowledge of insurance policies and regulatory environments

Qualifications: BA in Insurance and Risk Management with 4 years of Experience

• Excellent oral and written communication skills
• Ability to read veterinary medical records
• Ability to maintain composure and approachability when dealing with the fast pace, constant interruptions and stressful conditions
• Excellent telephone and email etiquette
• Problem-solving, independent judgment and critical thinking aptitude
• Able to work in a fast-paced environment and adaptable
• Strong written and oral communication skills with internal and external audiences
• Ability to build relationships with clients/carriers/brokers through active listening and close adherence to priorities, style and Service Instructions.
• Experience in conflict resolution and problem-solving
• Ability to communicate in a complete, concise and logical manner on adjuster-level files
• Ability to prepare and present adjuster-level claims while showing confidence and poise.

Qualifications: BS in Business Administration with 3 years of Experience

• Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint)
• Ability to obtain/Maintain appropriate licensing or educational requirements
• Proficiency in file audits to the agreed standard of efficient claims quality
• Ability to interpret and apply written coverage accurately to establish a claim and determine an action plan, and often requires assistance on more complex files
• Ability to comply with the company's material damage guidelines
• Ability to resolve conflicts and empathize with customers is critical
• Demonstrate professional oral and written communication skills
• Organization and time management skills are critical for this position
• Understanding of insurance law as it relates to claims
• Proficiency with basic computer skills with word processing, spreadsheets, email and internet

Qualifications: BA in Finance with 4 years of Experience

• Proven track record of adjusting to a combination of multiple classes of business
• Experience in handling Claims in accordance with the Lloyd's Claims Scheme
• Experience in respect of the London Market process including Broker CLASS @ Lloyd's and ECF Systems
• Extensive knowledge of the current Lloyd's Claims Scheme including CTP Guidelines
• Ability to widespread relationships with Brokers/Adjusters/Lawyers/Attorneys in the relevant class of business
• Able to work across multiple stringent client SLAs.
• Excellent interpersonal and communication skills in order to interact well within a team and with clients and Brokers
• Able to prioritise work, have good time management skills and able to adapt to the changing demands of the role
• Ability to demonstrate effective time management while prioritizing tasks
• Ability to gather and analyze information in order to evaluate results and choose the best solution to the problem
• Able to interact effectively with personnel at all levels, including attorneys, staff, and clients

Qualifications: BA in Public Administration with 3 years of Experience

• Organizational skills, ability to juggle several projects at the same time
• Able to work independently and take initiative to accomplish objectives in a timely manner
• Strong written and verbal communication skill
• Ability to quickly learn new computer software programs
• Ability to work independently with minimal supervision
• Experience filing with Arbitration Forums
• Excellent writing, analytical, and critical thinking skills
• Experience in a customer service role in industries such as retail, hospitality, logistics, banking, automotive dealerships, vehicle rental, sales or similar fields
• Ability to make confident decisions based on available information

Qualifications: BS in Legal Studies with 2 years of Experience

• Knowledge of insurance contracts, investigative techniques, legal requirements and regulations.
• Ability to work with a wide spectrum of people
• Ability to comprehend and learn new workers' compensation regulations while interpreting complex legal and medical documents
• Experience working within a customer service-oriented environment, with a strong focus on conflict resolution, problem solving, and decision making
• Ability to understand complex situations, research solutions, and make recommendations using sound judgment
• Capable of performing independent investigations using given information to understand root issues
• Excellent verbal and written skills with an aptitude for clear, courteous and concise communication in both English and French languages
• Strong organizational skills and high attention to detail, while able to prioritize a heavy workload in a fast-paced environment
• Superior negotiating skills based on a high degree of common sense and fairness
• Proficient in MS Outlook and Word, and functional knowledge of Excel

Qualifications: BS in Accounting with 4 years of Experience

• Ability to develop and maintain strong business relationships with internal and external customers
• Ability to calculate statutory benefits owed and understand formulaic math
• Ability to work within tight deadlines
• Strong organizational skills to respond to inquiries from a variety of sources
• Excellent written and verbal communication skills
• Customer service orientation and strong analytical and negotiation skills.
• Able to obtain the appropriate level of Adjuster's license.
• Effective analytical skills, including the identification of cause and effect dynamics
• Able to draw valid conclusions and effectively communicate them.
• Ability to interpret complex documents of a legal nature, perform and understand advanced numerical calculations including analysis of comparative information

Qualifications: BA in Criminal Justice with 5 years of Experience

• Effective verbal and written communication skills
• Ability to collaborate with internal staff and external customers
• Ability to use relevant information and individual judgment to comply with organizational and legal regulations
• Ability to establish and maintain effective, trusting and respectful relationships with others
• Ability to complete tasks attentively and thoroughly
• Ability to communicate outside the organization and share information as a positive aid to achieve best practices and objectives
• Experience with agriculture and/or farming
• Applied knowledge of agriculture and crop farming
• Knowledge of crop insurance regulations, policies, procedures and best practices
• Knowledge of investigative techniques and legal research methodologies
• Basic knowledge of Microsoft Office Suite

Qualifications: BS in Economics with 4 years of Experience

• Effective written skills including those of a technical nature
• Effective oral skills, including listening, interviewing, and negotiating, able to flex style appropriate to the audience.
• Organizational skills with the ability to prioritize and manage conflicting priorities in an effective manner.
• Ability to approach customer service, ensuring that all inquiries are effectively dealt with in a timely manner.
• Strong commitment to ongoing education and learning.
• Knowledge of investigation and negotiation techniques, as well as legal and medical terminology, homeowner and comparative negligence concepts, fraud recognition and insurance coverage
• Strong insurance policy and coverage knowledge. 
• Ability to handle claims of the highest complexity and exposure
• Knowledge of a wide range of Property & Casualty industry concepts, practices, and procedures
• Outstanding organizational, time management and follow-up skills
• Able to handle multiple projects at once

Qualifications: BA in Communications with 3 years of Experience

• Excellent verbal and written communication skills
• Ability to prioritize and re-prioritize as situations and needs change throughout the workday
• Ability to multi-task and organize workflow to manage daily responsibilities, meet deadlines and prioritize work
• Excellent Teamwork And Interpersonal Skills
• Excellent attention to detail and follow-through
• Ability to develop and maintain positive working relationships with internal and external customers
• Ability to demonstrate initiative and to work with minimal supervision
• Fluent knowledge of Xactimate/write estimates for commercial & residential customers and submit to insurance for payment
• Knowledge of restoration billing and collections procedures
• Collections experience in the water restoration industry

Qualifications: BS in Psychology with 2 years of Experience