GeoVera Holdings, Inc.

Claim Representative Senior Liability

US-CA-Fairfield
ID
2017-1269
# of Openings
1
Category
Claims - Fairfield

Summary

This position is responsible for the investigation, evaluation and resolution of minor to large claims. Other functions may include providing day-to-day mentoring, technical guidance, and training to other claim handlers. Requires minimal day to day supervision.

Essential Functions

  • Using best claim practices, investigate, evaluate, reserve, and settle claims within scope of authority, workload guidelines, time and service standards.
  • Ability to effectively and accurately analyze complex coverage issues and prepare coverage letters.
  • Responsible for claims in multiple jurisdictions including litigated files. Requires understanding of different jurisdictional laws/issues.
  • Able to effectively evaluate, negotiate and settle medium to large claims of varying complexities and claim types with both with both claimants and attorneys.
  • Timely and accurately set loss reserves and effectively manage loss adjustment expense
  • Recognize problematic claims files and develop appropriate claims strategy with an eye towards litigation avoidance.
  • Effectively manage vendors and expense by utilizing Independent adjusters and experts only for tasks that cannot be performed in-house including management of law firms and enforcing litigation management policy.
  • Prepare injury evaluations.
  • Identify and investigate for possible fraud, contribution, recovery and vendor management opportunities to reduce total claim cost.
  • As necessary, coordinate activities with insured’s and adjusting companies to ensure timely and appropriate resolution of claims.
  • Accurately and appropriately document and diary files as required by the best practices, the claim manager and regulatory agencies
  • May provide day-to-day mentoring/technical guidance, education and training to other claim handlers on an as needed basis.
  • Provide timely quality claim service that meets the needs of customers and business partners.
  • Provide “back up” for Claim Manager or supervisor as needed
  • Actively participate in CAT planning, management and resolution of CAT claims
  • Must possess good technical claims knowledge in area of responsibilities, as demonstrated in above average quality reviews of work product.

 

Additional Responsibilities

 

Performs other related duties as required and assists with special projects.

Minimum Requirements

Education, training, and experience:

  • College graduate and/or equivalent combination of High School Diploma/GED, training and work experience preferred.
  • 3-5 years of previous claim handling experience required, of which at least 2 years must be Personal Lines Property or general liability claim handling experience.  Litigation Management and First Party Property experience preferred
  • Professional insurance designation preferred, (INS, CIC, AIC, CPCU, AEI, etc).
  • Must be able to obtain state adjuster licensing in applicable states within 120 days of employment and maintain licensing requirements as a requirement of continued employment.

Knowledge, skills, and abilities:

  • Demonstrate proficiency using all claim systems including injury evaluation systems, as well as Windows, and related software.
  • Working knowledge of the legal system as it applies to claim handling
  • Demonstrate effective customer service skills (consistently makes customer issues a high priority; consistently models and articulates a strong customer-focus ethic).
  • Self directed and ability to effectively prioritize/organize
  • Strong written and oral communication skills.
  • Ability to handle multiple tasks with accuracy, able to prioritize effectively and meet deadlines
  • Works well with management and co-workers 

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