Claim Representative II - Casualty

Vermont Mutual • Montpelier, VT • 6d ago

This job was posted by https://www.vermontjoblink.com : For more information, please see: https://www.vermontjoblink.com/jobs/1308730

We welcome both local and remote applicants to apply: While there is a preference for candidates who can work in a hybrid capacity from our Montpelier, VT office, remote candidates located throughout the Northeast will also be fully considered.

JOB SUMMARY

Directly handle a technical claims caseload of a general liability claims. Caseload typically comprised of files arising from a broad range of coverage or perils and possessing a wide range of financial exposure and complexity. Such claims occasionally involve coverage issues or litigation. Employee should possess demonstrated expertise in handling bodily injury claims which involve both comparative negligence theories and defenses and be able to conclude claims promptly and equitably within the provisions of the policy contract and in accordance with known damages and legal requirements. Litigated files should constitute a minority of pending. All files handled must comply with claim file handling guidelines and all other job expectations, regulations and requirements.

DUTIES & RESPONSIBILITIES

Conduct and coordinate loss investigations on all assigned claims.

Negotiate the settlement of claims within authorized amounts or

specific file authority.

Maintain accountability for all assigned claims until disposition is

reached.

Recommend further action to supervisor on claims exceeding authority

limits.

Document all substantive activity on assigned claims and assist in

the control of independent vendors.

Review new losses and open files on diary to ensure reserve adequacy

while keeping management informed of adverse developments.

Monitor loss adjustment expense and take steps to mitigate file

expenses.

Utilize vendors judiciously to maximize value added.

Recognize coverage issues and work with supervisor and claim

management for manner of redress/resolution.

Refer appropriate coverage matters to the Claim Supervisor or Claim

Manager.

Ensure appropriate file handling, documentation, reporting and

expense control of all files handled inclusive of legal bill review/vendor performance/bill review/MSP compliance

Provide accurate, courteous and timely information to all eligible

external and internal customers concerning claim status and other claim inquiries.

Attend meetings with policyholders and agencies as needed.

Draft coverage correspondence in collaboration with Supervisor,

including reservation of rights and coverage disclaimer along with composing detailed correspondence to insureds, claimants, attorneys, etc.

Attend trials, depositions, EUOs, appraisals and mediations where

deemed beneficial or required.

Participate in various forms of Litigation training and as a mentee

with an assigned Examiner Mentor for litigation and coverage advancement

Improve processes within the department to increase the level and

quality of service provided to internal and external customers, i.e. workflow changes, systems implementation, etc.

Participate in setting file direction and recommend appropriate

reserves on claim files within specific authority and on files requiring mandatory reporting to management.\ \

This position handles an assigned claim pending.

Performs other duties or special projects as required or as

assigned.

SUPERVISION RECEIVED

The Claim Supervisor provides direct minimal supervision.

SUPERVISION EXERCISED

Primarily no supervisory duties; however limited supervision of independent adjusters and vendors may occur.

QUALIFICATIONS

Bachelors degree in business, insurance or a related field, or its equivalent

Three or more years of relevant claimtechnical experience; or a combination of education and experience from which comparable knowledge and skills are acquired.

Appropriate state adjusters license(s) where required by law.

Demonstrated commitment to professional development through continuing education related to the job such as AIC, AEI, INS, SCLA CPCU, etc.

Established and improving skills in specialized technical disciplines; including working knowledge of relevant insurance, contract and tort law. Participation in training courses and mentorship program

Knowledgeable about the insurance industry and company operations.

Sound analytical, and negotiations skills.

Very good verbal and written communication skills.

Ability to exercise sound judgment in dealing with p

Similar Jobs

Associate Principal Scientist, Biomarker Operations / Inventory and Data Management

Merck • Montpelier, VT • 14min ago

Management & Administrative

Job Description We are seeking an Associate Principal Scientist to contribute to a pivotal role in our Inventory and Data Management team in our company Biomarker Operations group within Translational Medicine. The missi...

14min ago

Go to Apply

Customer Service Representative I-Mid Shift/Evening

ASM Research, An Accenture Federal Services Company • Montpelier, VT • 40min ago

Management & Administrative

Do you want to make a difference? ASM Research employees are passionate about improving people's lives. With an innovative mindset and an unwavering commitment to those we serve, we partner with healthcare, civilian and...

40min ago

Go to Apply

National Sales Manager - Head Start

Nelnet • Montpelier, VT • 46min ago

Management & Administrative

Nelnet Business Services (NBS), a division of Nelnet, Inc., provides payment technology, education services, and learning management solutions to education and faith-based organizations, serving more than 1,300 higher ed...

46min ago

Go to Apply

Customer Service Representative I- Day Shift

ASM Research, An Accenture Federal Services Company • Montpelier, VT • 46min ago

Management & Administrative

46min ago

Go to Apply

Principal Software Engineer

Oracle • Montpelier, VT • 1h ago

IT & Engineering

Job Description At Oracle Cloud Infrastructure, we believe the future of CI/CD is effortless automation powering innovation at a global scale. As a Principal Software Engineer, you'll help shape a platform where complexi...

1h ago

Go to Apply

Senior Consultant, Blood Bank Validation

Oracle • Montpelier, VT • 5h ago

Finance, Accounting & Banking

Job Description As a Senior Consultant on Oracle Health's Blood Bank Validation team, you will play a key role in ensuring the accuracy and quality of our client's Blood Bank solution. Your primary responsibilities will...

5h ago

Go to Apply

Account Executive, Acquisition Sales

Confluent • Montpelier, VT • 12h ago

Sales & Marketing

Location: Remote, Colorado Employment Type: FullTime Location Type: Remote Department Sales, Global Sales Compensation: $82.2K - $94.5K - Offers Equity - Offers Commission At Confluent, we are committed to providing comp...

12h ago

Go to Apply

Account Executive, Surgery Ultrasound (CO, AZ, UT, NM Region)

Fujifilm • Montpelier, VT • 12h ago

Hospital & Medical

Position Overview This position is intended to sell Ultrasound imaging systems, options, and service contracts to prospective and existing customers in their assigned territory. Company Overview At FUJIFILM Healthcare Am...

12h ago

Go to Apply

Actuary

Public Consulting Group • Montpelier, VT • 12h ago

Finance, Accounting & Banking

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, P...

12h ago

Go to Apply

Connectivity Engineer, Leased - Data Center Design, Engineering, & Construction

Meta • Montpelier, VT • 13h ago

Trucking & Construction

Summary: Meta is seeking a Connectivity Engineer to join the Design Engineering and Construction (DEC) team. Our data centers are the foundation upon which our innovative services are delivered, and our rapidly scaling i...

13h 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.