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Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management.
Evaluate insurance coverage based on claim report, the insurance policy and applicable statutes and case law to determine if a claim can be accepted as being within coverage.
Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports.
Comply with all statutory and regulatory requirements of all applicable jurisdictions.
Meet detailed quality assurance standards and meet set goals of performance
Strong customer service skills as demonstrated in listening and the ability to show empathy.
Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.
Knowledge of coverage, liability, and claims handling procedures.
Highly organized, able to keep multiple balls in the air, and make progress on all fronts
Strong written and oral communication skills required as well as strong interpersonal, analytical, investigative, and negotiation skills.
PC literate, including Microsoft Office products
The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree and at least 2+ years of related experience.
Candidates must have, or be able to promptly obtain a Texas Independent Adjuster License