Inside Claims Representative

Summary: Responsible for investigating, evaluating, negotiating, and settling moderate to complex casualty claims—including auto liability, farm and ranch liability, and homeowners liability—within assigned settlement authority and under general supervision. Delivers prompt, fair, and customer-focused claim service while building and maintaining strong relationships with policyholders, claimants, legal representatives, and internal stakeholders.

Essential Duties and Responsibilities: Other duties may be assigned as needed. 

• Conduct thorough investigations of liability claims involving bodily injury and/or property damage. This includes obtaining recorded statements, medical documentation, police reports, photographs, accident diagrams, witness information, and, when necessary, expert opinions (e.g., accident reconstruction, medical consultants, engineers).
• Assess legal liability by reviewing coverage terms, policy language, and applicable endorsements. Consult legal and regulatory resources to interpret liability exposures, statutes, and precedent relevant to auto, farm/ranch, and homeowners liability claims.
• Determine claim compensability and prepare detailed denial letters or reservation of rights, when applicable, ensuring compliance with state regulations and company standards.
• Evaluate damages by analyzing medical bills, treatment notes, lost wage documentation, and property repair estimates. Apply policy limits, deductibles, depreciation, and comparative negligence principles to arrive at an appropriate settlement value.
• Negotiate settlements with claimants, attorneys, or other parties and ensure compliance with fair claims practices.
• Maintain accurate and timely claim documentation, correspondence, and system notes. Ensure files reflect proper claim strategy, reserve justification, and action plans.
• Collaborate with defense counsel and monitor litigated claims when assigned, assisting with discovery and trial preparation as needed.
• Recommend and secure settlement authority for cases exceeding personal limits, providing clear summaries and justification.
• Close claims efficiently, ensuring timely payments and resolution in accordance with company guidelines and applicable regulations.
• If working remotely, the employee is responsible for maintaining a suitable home workspace and adhering to the Company Telecommuting Agreement.

Authority: This role involves handling claims settlements within a defined personal authorization limit. While adhering to established claim procedures and relevant legal principles is essential, the position also requires independent judgment and proactive initiative to achieve successful outcomes.

Promotional potential and organizational progressions: This position may be offered as Senior Claims Representative, depending on the candidate's experience and qualifications. Compensation will vary accordingly, ranging from $25.00 to $46.15 per hour. 

Education and/or Experience: This role requires a Bachelor's Degree or equivalent professional experience. Preferred Candidates will have prior experience as a claim representative, demonstrating the ability to manage more complex cases with minimal supervision. This level of proficiency is typically gained through approximately three years of relevant experience.

Required Knowledge and Skills:

• Excellent written and verbal communication abilities are essential.
• Proficiency in internet applications, spreadsheet software (such as Microsoft Excel or Google Sheets), and word processing programs (like Microsoft Word or Google Docs) is expected.
• Strong organizational skills are necessary.
• Candidates must be able to accurately and efficiently calculate figures and amounts, including discounts, interest, commissions, and percentages, as well as understand other basic mathematical concepts.
• The ability to readily interpret policy language, liability, and negligence law in more complex cases, and to conduct research when needed, is required. The work involved is diverse and intricate.
• A solid understanding of claim values and the ability to establish the value for most assigned cases is important. Knowledge of claim procedures and the legal requirements for proper claim handling is also necessary. The role involves accessing and accurately entering information into the CRT system.
• Preparing written worksheets, forms, and other documentation to facilitate efficient claim handling is a key responsibility.
• The role includes recording various reports, letters, and file documentation for transcription by the relevant staff.
• Maintaining acceptable attendance in accordance with the company's personnel policy is a requirement.

Professional Expectations: You will have broader personal settlement authority, which will be subject to standard supervisory review. Generally, you can expect to work independently with typical supervision and will be accountable for your outcomes.

This position involves considerable contact, both via telephone and in person, with a diverse group, including claimants, insured parties, agents, attorneys, Company personnel, and the general public. It is essential to always be mindful of representing the Company and to consistently project a positive image. Furthermore, you must possess the ability to communicate effectively with individuals who may be upset or angry to facilitate the resolution of disputes and disagreements.

Physical Requirements: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

While performing the duties of this job, the employee is occasionally required to stand, walk, sit, use hands to finger, handle, or feel, reach with hands and arms, climb or balance; stoop, kneel, crouch, or crawl; and talk or hear.  The employee must occasionally lift and/or move up to 25 pounds.

The noise level in the work environment is usually moderate. 

Nodak Insurance Company complies fully with all federal, state, and local employment laws and shall provide equal employment and advancement opportunities for all persons regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, the presence of any mental or physical disability, status with regard to public assistance or marriage, or any other category protected by local, state or federal law.