Claims Examiner - Liability

Location
San Diego, California (Mission Valley)
Salary
Open
Posted
Aug 11, 2017
Closes
Oct 10, 2017
Category
Claims
Job Type
Full Time

SUMMARY

To investigate, evaluate and negotiate to conclusion bodily injury claims and property damage claims.  Investigation and negotiation completed by telephone and correspondence within company guidelines.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Workflow

  • Makes contact with insured and claimant within 24 hours of receipt of file.
  • Determines type of claim line to be opened, establishes reserves and maintains reserves thru-out
  • Takes recorded statements of all parties as needed.
  • Handles liability determination and assessment of any comparative liability.
  • Investigates and resolves coverage questions.
  • Coordinates via outside appraisal services for inspection & determines third party damages.
  • With approval, assigns field investigation tasks to independent vendors and manages their file.
  • Evaluates, negotiates and settles assigned claims within settlement authority.
  • Send all necessary releases, checks, correspondence, proof of loss, etc. to claim resolution
  • Maintains control of file and workflow through proper documentation and diary system.
  • Represents company and insured on files where claimant attorney representation is involved.
  • Handles calls and correspondences on the claim file to conclusion.
  • Develops subrogation and salvage recovery issues and follows recovery procedures.
  • Performs other duties as assigned.

Communicate

  • Acts as a liaison between the company and insured, and between the company and 3rd parties. .
  • Discusses appropriate follow-up with independent appraisers and field adjusters.
  • Stays current on DOI requirements pertaining to all claims handling.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Excellent verbal, written and organizational skills.
  • Typing minimum 30 words per minute.
  • Computer literate in Word and Excel
  • Self-motivated team player. Ability to follow and execute directions.
  • Punctual and conscientious about work hours.
  • Accepts constructive feedback and makes sincere efforts to improve.
  • Effective listener.

Education / Experience

College degree preferred.  Commensurate professional experience will be considered as well.

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