Claims Representative - Auto - #9824450

Qualifications:

EDUCATION and EXPERIENCE:
• Bachelor’s Degree required, except that additional related work experience may be substituted on a year-for-year basis for the formal education requirement.

QUALIFICATIONS:
• Ability to operate a personal computer and standard office equipment
• Ability to learn and operate claims-related software
• Consistently delivers accurate, clear and concise messages orally and/or in writing
• Ability to handle a high volume of detailed work accurately and completely
• Ability to research and compile information and exercise good judgment
• Engages in continuous learning opportunities to further develop skills and capabilities in procedures and principles
• Consistently presents a calm, competent, and professional image to the public and other MOFB employees
• Takes responsibilities seriously and consistently meets MOFB’s expectations for quality, service, and professionalism
• Co-operate with team members to contribute to the achievement of MOFB’s goals and mission
CERTIFICATES, LICENSES, REGISTRATIONS:
• Valid Missouri Driver License required

Salary Info: Exact starting salary determined by prior experience.
Summary: Responsible for the assignment and handling of complex multi-line or discipline-specific insurance claims which include: coverage analysis, investigation, evaluation, negotiation, settlement, salvage, and subrogation. Adjudicates claims within assigned settlement authority and adheres to applicable laws, regulations, and company guidelines. Conducts field investigations to document damage, loss, or determine liability.

ESSENTIAL DUTIES:
• Performs complex claim handling duties as assigned within the property, liability, casualty, or auto discipline
• Conducts on-site assessment of reported claims as needed and assigned
• Documents the claim file in a prompt, clear, and concise manner, with the facts gathered in the investigation
• Evaluates coverage, gathers evidence and documentation, and determines whether coverage is applicable for assigned losses
• Establishes, evaluates, and maintains individual case reserves in accordance with the Claims Department Reserving Philosophy
• Conducts detailed analysis and applies proper legal theory in determining negligence, evaluating medical records and injury valuation, and/or preparing large property loss estimates
• Negotiates fault and damages with insureds, claimants, adverse carriers, attorneys, or other involved parties
• Determines value of covered damages, and adjudicates the claim within authority level, and in compliance with applicable laws, regulations, and company guidelines
• Coordinates with outside vendors and experts for attorney services, fire cause and origin, professional engineering services (structural, mechanical, and electrical), estimate reviews, accident reconstruction, medical bill reviews, appraisal services, and official reports
• Performs and assists with subrogation and salvage recovery efforts, to include identifying recovery potential, and/or pursuing liable tortfeasor or other insurance carriers, as warranted
• Assists in the handling of claims at other claim levels and claim disciplines as necessary and within authority
• Attends and participates in Alternative Dispute Resolution, Examinations Under Oath, or any legal proceedings up to and including trial
• Directly handles and/or assists with storm and catastrophe losses as needed
• Remains on-call for storm/catastrophe claims, or other escalated claims as needed
• Assists in the handling of claims at other claim handling levels as necessary and within authority
• Assists with training personnel as needed
• Provides excellent customer service to all external and internal customers and maintains good working relationships with field and Home Office personnel

Counties: Boone County, Callaway County, Cole County, Cooper County, Moniteau County, Howard County