Senior Claims Representative I - P&C

AF Group • Kalamazoo, MI • 2d ago

SUMMARY: To provide prompt, cost effective and efficient examination, investigation and settlement or denial of insurance claims up to the highest and most severe exposure with minimal supervision, by exercising independent decision- making skills and judgment. RESPONSIBILITIES/TASKS: Adjust a caseload of assigned files, including more severe and/or complex claims, in accordance with Ameritrust Group's policies and procedures. Maintain an active diary on 100% of caseload files, with a current plan of action. Adhere to assigned authority limits for reserving and payments (including settlements). Exercise independent decision-making skills with minimal to moderate supervision and direction on claims assigned, using knowledge of local codes, laws, standards and case-law. Verify coverage, investigate the loss by gathering all pertinent information, evaluate the claim, set reserves, negotiate settlements or deny payments where no coverage, liability or compensability exists. Record statements, obtain documentation such as police reports, medical reports, appraisals, estimates, photographs, etc. to process claims in accordance with Company Best Practices. Evaluate loss, assess reserve and settlement value where applicable and settle cases with claimants, insureds and attorneys autonomously. Decide on denial of coverage, liability or compensability. Identify and thoroughly investigate all possible recovery and subrogation opportunities revealed in the claims handled. File all state and/or federal forms, filings and reports in accordance with statutory Guidelines. Return all telephone calls within one (1) business day, when possible. All messages are to be returned by the end of the same business day in which the call was received. Reports all service complaints to Claims Supervisor or Claims Manager immediately upon receipt. Maintain personal compliance with all continuing education requirements as mandated by statute or by office policy. Manually or electronically document files in a timely fashion with all appropriate information, in a legally accepted, factual manner. Understand coverage issues, including more severe and/or complex claims, with good knowledge of exclusions, endorsements on standard ISO forms. Provide training to other Claims personnel when required by Claim Management. Recognize settlement or exposure value and be able to use tools to assist in settling cases, such as structured settlements, arbitration, mediation, etc. Must adhere to the company code of ethics. Professional and timely communication with all internal and external vendors. Performs related duties as assigned Attendance This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. EMPLOYMENT QUALIFICATIONS EDUCATION Bachelor's degree in a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged. EXPERIENCE Seven years of progressively more responsible experience in a claims environment that provides the necessary skills, knowledge and abilities. Experience handling claims in multiple jurisdictions preferred. Bilingual skills preferred. A concentration in property and casualty would be preferred; orTwo years of AF Group Claims Representative III experience that includes independent handling of the most complex claims and/or the most complex, high touch or labor-intensive customers. QUALIFICATIONS Ability and proficiency in the use of computers and company standard software specific to position. Effective oral and written communication skills. Effective customer service skills. Ability to negotiate, build consensus and resolve conflict. * Ability to act as a representative

Similar Jobs

BONE AUDITOR

JBS USA • Plainwell, MI • 5h ago

Finance, Accounting & Banking

Description Position Title: Bone Auditor Purpose & Scope: The focus of this role is to perform bone yield tests to assess the proper boning techniques of our fabrication processes. This person will be responsible for...

5h ago

Go to Apply

Accounting Manager

Robert Half • Kalamazoo, MI • 5d ago

Finance, Accounting & Banking

Description We are looking for an experienced Accounting Manager to join our team in Kalamazoo, Michigan. This long-term contract position offers an exciting opportunity to oversee financial operations within the healthc...

5d ago

Go to Apply

Billing Specialist

GFL Industries • Kalamazoo, MI • 1w ago

Finance, Accounting & Banking

This position is responsible for ensuring that all customers are billed for services and the timeliness & accuracy of charges on customer bills. The Billing Analyst I will serve as a liaison between Branch Locations,...

1w ago

Go to Apply

Deputy Treasurer, Corporate Finance and Strategy

Stryker • Portage, MI • 1w ago

Finance, Accounting & Banking

The Deputy Treasurer, Corporate Finance and Strategy is a key partner to the VP, Finance and Treasury, with responsibility for Treasury finance, controllership, compliance, reporting, systems, and strategy. This person w...

1w ago

Go to Apply

Director, Division Finance Leader Endo GQO

Stryker • Kalamazoo, MI • 1w ago

Finance, Accounting & Banking

This position is the Divisional Finance Leader for the Endo GQO franchise. This role will directly lead the consolidation of all financials and report the group results for the Endo franchise including any future acquisi...

1w ago

Go to Apply

Senior ASC Finance Specialist (Remote)

Stryker • Portage, MI • 1w ago

Finance, Accounting & Banking

What y ou will do As an ASC Finance Specialist, you will be the main point of contact for Flex Financial, Stryker's equipment finance group, and will support ASC Regional Managers in your assigned regions of the United S...

1w ago

Go to Apply

2025 Summer Finance Intern

Stryker • Portage, MI • 1w ago

Finance, Accounting & Banking

TBD: Megan Dubois to provide Stryker is a global leader in medical technologies and, together with its customers, is driven to make healthcare better. The company offers innovative products and services in MedSurg, Neuro...

1w ago

Go to Apply

2025 Summer Finance Intern

Stryker • Portage, MI • 1w ago

Finance, Accounting & Banking

TBD: UR please see Meghan Dubois Stryker is a global leader in medical technologies and, together with its customers, is driven to make healthcare better. The company offers innovative products and services in MedSurg, N...

1w ago

Go to Apply

Summer Internship 2024 - Finance

Stryker • Portage, MI • 1w ago

Finance, Accounting & Banking

Who we want Innovators. People who seek out hard projects and work to find just the right solutions. Teammates. Partners who listen to ideas, share thoughts and work together to move the business forward. Charismatic net...

1w ago

Go to Apply

Senior Manager, Finance

Stryker • Portage, MI • 1w ago

Finance, Accounting & Banking

*This role will be on a hybrid schedule with the expectation to be at our Portage office 3x/week. The Senior Manager, Finance, appraises and manages operating results and leads decision support activities in pursuit of g...

1w ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.