Claims Representative

Summary: Investigate, negotiate, and settle claims of a more serious nature within personal settlement authority under general supervision. Render prompt claim service and establish the best possible relationship with all persons involved. 

Essential Duties and Responsibilities include the following.  Other duties may be assigned.

• May be responsible for the set-up of claims, including taking loss reports, establishing a claim file either through automated or manual systems, and obtaining policy information through the use of computer or direct contact with agents or company personnel.
• Performs a thorough investigation of the loss, including securing recorded or signed statements, medical records and reports, proof of loss, police reports, diagrams, photographs, or testimony from technical experts.
• Investigation may be tedious and involve exploring less accessible sources.
• Secure assistance of specialists or outside vendors where personal judgment dictates the cost effectiveness and need for these services.
• Interprets coverage and liability issues on the majority of cases, seeking advice on only the most involved cases or those with dollar values exceeding personal authorization. This includes reviewing policy language and endorsements as well as using reference materials to determine legal precedent. On claims where investigation warrants denial, prepares denial materials including documentation and communicates the decision to the affected parties.
• Evaluates and appraises losses and applies deductibles, betterment, and depreciation principles in arriving at a settlement amount. This may include writing estimates and acquiring agreed prices for property damage as well as assessing bodily injury and related awards for personal injury cases.
• Reviews all bills and estimates prior to making a settlement or seeking settlement authority to determine applicability for payment under policy provisions.
• Prepares drafts, negotiates settlements, and performs all tasks required to close a case and effect efficient and fair settlement of claims. This may include the proper handling of subrogation and disposal of salvage or property owned by the Company to reduce paid loss amounts.
• Prepares all worksheets, forms, documentation, and reporting duties to create a file that is capable of being used by others to monitor progress or continue efficient handling of a claim.
• Responsible for providing an acceptable work space to work out of their home and comply with the Company Telecommuting Agreement.

Authority: Responsible for the settlement of claims within personal authorization. Must follow claim procedures and applicable legal doctrines; however, uses independent judgment and initiative to obtain results.

Education and/or Experience: Bachelor's Degree or equivalent. Experience at the claim representative level with the ability to handle more complex cases with only general supervision. Generally acquired at about 3 years of experience. 

Promotional Potential and Organizational Progressions: Senior Claims Representative

Certificates, Licenses, and Registrations: AIC, Agents Property and Casualty License (by state). 

Required Knowledge and Skills: 

• Highly developed written and verbal communication skills.
• The ideal candidate should possess proficiency in Internet applications, spreadsheet software (e.g., Microsoft Excel or Google Sheets), and word processing programs (e.g., Microsoft Word or Google Docs).
• Strong organizational skills.
• Must have the ability to calculate figures and amounts such as discounts, interest, commissions, percentages, and other basic mathematical concepts with accuracy and efficiency.
• Must be able to readily interpret policy language, liability, and negligence law on more involved cases and perform research when required. Work is varied and complex in nature.
• Must have knowledge of claim values and establish the value of the majority of assigned cases. Must have knowledge of claim procedures and legal requirements for proper claim handling. Access and enter information accurately into the CRT.
• Record numerous reports, letters, and file documentation for transcription by appropriate staff. 
• Maintain acceptable attendance as defined in the company personnel policy. 

Physical Requirements: 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 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

The noise level in the work environment is usually moderate. 

For Outside Claim Representatives Only: 

Visually and physically inspect accident and/or loss scenes. Conduct in-person meetings with claimants, insureds, agents, and the public in a variety of locations away from the home office. Visually and physically inspect the damages claimed. Work outdoors in all types of weather for a limited time period while inspecting damages or a loss scene. Photographically record damages, accidents, and/or loss scenes.

While performing the duties of this job, the employee is occasionally required to stand; walk considerable distances in all types of weather, terrain and conditions; sit; use hands to finger, handle, measure, or feel; reach with hands and arms; transport, setup and climb ladders to inspect roofs including dwellings, barns, bins, grain systems, and other structures, or balance; stoop, kneel, crouch, or crawl in or under structures and equipment. The employee must regularly lift and/or move items weighing at least 50 pounds.

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.