Job Summary:

• Makes and maintains a connection with the customer by understanding and meeting needs
• Serves the customer with empathy and follows up to ensure that the customer's needs have been met
• Manages, researches, and resolves complex and occasionally highly complex customer communications, concerns, conflicts or issues
• Reviews customer satisfaction results
• Recommends, designs, and implements personal and business unit action plans
• Summarizes documents and enters into claim system notes
• Documents a claim file with notes, evaluations and the decision-making process
• May handle first notice of loss of water damage claims
• Investigates, reviews, determines and verifies complex and occasionally highly complex coverage/policy information
• Provides coverage explanation to customer

Skills on Resume: 

• Customer Relationship Management (Soft Skills)
• Conflict Resolution (Soft Skills)
• Research and Investigation (Hard Skills)
• Documentation (Hard Skills)
• Claim Management (Hard Skills)
• Empathy (Soft Skills)
• Coverage Explanation (Hard Skills)
• Customer Satisfaction Analysis (Hard Skills)

Job Summary:

• Reviews files and makes recommendations to refer files to Home Office for escalation
• Acts as a resource to MCO on complex and occasionally highly complex claim/coverage matters
• Prepares/reviews/approves complex and occasionally highly complex damage estimate
• Reinspects loss with repair contractor
• Prepares, reviews, reconciles, triages, and/or approves supplements
• Handles ALE (additional living expense) claims
• Inspects and estimates damage in a dwelling
• Handles and negotiates complex and occasionally highly complex claims that include Public Adjuster involvement
• May handle claims involved in litigation
• Reviews mitigation bills

Skills on Resume: 

• File Review (Hard Skills)
• Claim Escalation (Soft Skills)
• Damage Estimation (Hard Skills)
• Negotiation (Soft Skills)
• Loss Inspection (Hard Skills)
• Supplement Approval (Hard Skills)
• Litigation Management (Hard Skills)
• Mitigation Review (Hard Skills)

Job Summary:

• Adheres to applicable compliance standards
• Negotiation and Settlement Guidance
• Negotiates and settles claims in accordance with business unit best practices
• Participate in one or more complex or occasionally highly complex special assignments
• Serve as a committee team lead for large projects or as a committee team member on very large projects
• Conducts subrogation investigations
• Assist in researching or responding to or resolving complex and occasionally highly complex compliance issues
• Lead roundtable and/or calibration discussions
• Verify coverage on new losses, determine if coverage applies and the amount of the policy
• Contact insured promptly, verify property location and basic facts of loss

Skills on Resume: 

• Compliance Adherence (Hard Skills)
• Negotiation (Soft Skills)
• Claims Settlement (Hard Skills)
• Special Assignment Management (Soft Skills)
• Subrogation Investigation (Hard Skills)
• Compliance Issue Resolution (Hard Skills)
• Leadership (Soft Skills)
• Coverage Verification (Hard Skills)

Job Summary:

• Direct Property Field Adjusters on issues involving fact gathering and evaluation of damages
• Review reports from field adjusters and make decisions regarding coverage and settlement value
• Keep abreast of and comply with Department of Insurance regulations for all states in which the company writes insurance
• Accurately document all decisions, correspondences, reports, and claims files to reflect all current activity
• Report risk deficiencies to the Underwriting Department
• Accepting notice of claims and working with customers and preferred vendors to resolve claims quickly and efficiently
• Managing moderate to complex personal and commercial property claims
• Confirming policy coverage by ensuring the facts of the claim fall within the scope of Economical claims policies
• Maintaining detailed file records by entering pertinent data into the appropriate systems
• Processing claims payments within level of authority after verifying claimants’ entitlements
• Initiating salvage and subrogation procedures on assigned files

Skills on Resume: 

• Claims Management (Hard Skills)
• Report Review (Hard Skills)
• Regulatory Compliance (Hard Skills)
• Documentation (Hard Skills)
• Risk Reporting (Hard Skills)
• Customer Resolution (Soft Skills)
• Policy Coverage Verification (Hard Skills)
• Claims Processing (Hard Skills)

Job Summary:

• Use fact-finding skills to investigate, adjust, and settle claims independently with a high degree of accuracy and handle the more complex and/or challenging activity
• Work independently out of a home office and will spend a significant portion of time on-site investigating, inspecting, and settling claims
• Complete inspection assignments while at the customer’s property
• Utilize technology that provides access to all applications needed to conclude claims on-site, including the coverage analysis, completing the estimate of damage, and initiating payment, including EFT
• Conduct desk investigation, evaluation and disposition of coverage and damage issues while managing an Independent Adjuster for the physical inspection
• Responsible for ongoing communication and for providing status updates to the insured and others associated with the claim activity
• Conduct inspections, provide analysis/reporting information, write estimates, and determine policy
• Interacting with customers
• Listening and communicating to resolve issues and negotiating fair settlements.
• Upholds the Claims Specialists code of Business Conduct at all times
• Maintains company reputation and integrity of insurance products by complying with federal and state regulations and service standards

Skills on Resume: 

• Fact-Finding (Hard Skills)
• Independent Work (Soft Skills)
• Inspection (Hard Skills)
• Technology Utilization (Hard Skills)
• Coverage Evaluation (Hard Skills)
• Communication (Soft Skills)
• Negotiation (Soft Skills)
• Regulatory Compliance (Hard Skills)

Job Summary:

• Identifies and manages existing and emerging risks that stem from business activities and the job role.
• Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.
• Follows written risk and compliance policies and procedures for business activities.
• Adjusts moderately complex to complex structure claims involving moderate to high severity, and Loss of Use claims involving moderate to high dollar value.
• Adjusts Section II liability claims by identifying exposures and coordinating with liability adjuster to handle the claim.
• Makes independent decisions within authority guidelines regarding determining policy status and coverage.
• Coordinates with Property Direct Repair Program (PDRP) vendors, general contractors, public adjusters and Personal Property Field Adjusters to facilitate claims resolution.
• Supports workload surges and/or Catastrophe (CAT) operations to include working significant overtime and deployment travel during designated CATs.
• Serves as a resource to team members and inside adjusters.
• Settlement and reserving authority levels are moderate.

Skills on Resume: 

• Risk Management (Hard Skills)
• Claims Adjustment (Hard Skills)
• Policy Analysis (Hard Skills)
• Vendor Coordination (Hard Skills)
• Decision Making (Soft Skills)
• Team Support (Soft Skills)
• Catastrophe Operations (Hard Skills)
• Settlement Authority (Hard Skills)

Job Summary:

• Make initial contact with the insured within 24 hours of receipt of assignment
• Inspect assignment within 48 hours of receipt of assignment
• Closures and final reports completed and submitted within 72 hours of receipt of assignment
• Investigate claims by interviewing claimants and witnesses, obtaining official reports, by inspecting physical damage, and by comparing claim information with evidence
• Works within specific time & limits and authority
• Uses discretion and independent judgment in claims handling
• Possesses functional knowledge and skills of field adjusting
• Identifies possibly suspicious claims
• Investigates, analyzes, evaluates and negotiates personal and commercial claims ofminimal to moderate complexity.
• Responsible for managing all aspects of each claim and maintaining a high level of productivity, confidentiality and customer service.
• Scoping and estimating repairs and the ability to acquire skills in the use of estimating with Xactimate software.

Skills on Resume: 

• Claims Investigation (Hard Skills)
• Time Management (Soft Skills)
• Independent Judgment (Soft Skills)
• Field Adjusting (Hard Skills)
• Suspicious Claims Identification (Hard Skills)
• Claims Evaluation (Hard Skills)
• Customer Service (Soft Skills)
• Estimating (Hard Skills)