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Grinnell Mutual Reinsurance


Location: Grinnell, Iowa
Experience: 2 - 5 years
Education: Bachelor's Degree
Wage: Salaried
Type: Full Time
Shift: 1st - Day
Open: 06/02/2017
Close: 12/31/2017

 
Telephone Claims Adjuster Specialist
Description:
Investigates claims, negotiates settlements, and authorizes payments to customers for casualty and property losses covered by a Grinnell Mutual policy to reach a fair and equitable settlement. Acts as company representative during the claims process providing service primarily via telephone and e-mail.



Job Duties and Responsibilities
•Provides the highest level of service to all customers who include policy holders, claimants, agents, loss control, underwriting, peers and in-house telephone claims representatives.
•Investigates the facts of assigned property and casualty claims to determine coverages, damages, and negligence in a timely and efficient manner as outlined in GMRC claims procedures.
•Gathers supporting data such as appraisals, interviews, police reports, medical bills, and statements related to the claim, utilizing telephone and written correspondence. In consultation with manager, enlists the assistance of a field adjuster for additional on-the-scene information related to claim when required for the claim, e.g. photos, measurements, etc.
•Evaluates potential financial risk to the company and sets reserves based on current exposure. Updates reserves based on additional data or facts gathered.
•Settles claims in a fair and equitable manner based on policy coverages and the information gathered during the investigation, without exceeding individual authority. Consults with manager proactively if settlement has potential to exceed authority limit.Provides recommendations and requests additional authority as appropriate.
•Ensures that checks/drafts are issued and that liability releases are obtained in a timely manner to assist with efficiently closing claims.
•Maintains a complete and well documented file in order to support the decisions and settlement of the claim.
•Operates in accordance with applicable federal and individual state’s fair claim practices and regulations. Stays current with changing legislation, shares knowledge with co-workers and managers, and applies information as appropriate.
•Performs other duties as assigned.



Knowledge, Skills, and Abilities
•Bachelor's degree (B.A) from four-year accredited college or university and two years property/casualty claims experience; or equivalent combination of education and experience. AIC or SCLA designation preferred.
•Ability to demonstrate good interpersonal, active listening and customer service skills to bring claim to a resolution in a timely manner following GMRC claims procedures. Includes being familiar with facts, patient, resistant to stress, persistent, empathetic, and decisive.
•Ability to professionally present information and respond to questions in one-on-one or group settings. Communication may be via the telephone phone, in person, or in written correspondence.
•Ability to think logically and make decisions regarding claim investigation using personal judgment, experience, and known facts and figures while following claims procedures to determine coverages, negligence, and damages.
•Ability to organize work, determine priorities, and meet deadlines established by claims guidelines while incurring frequent interruptions.
•Ability to read, analyze, interpret, and apply insurance terminology while reading/reviewing contracts, business periodicals, professional journals, technical procedures and governmental regulations to daily work.
•Ability to calculate figures and amounts such as interest, proportions, and percentages.
•Ability to work harmoniously with co-employees including managers and interact with customers and the general public in a tactful and courteous manner.
•Ability to maintain regular and predictable schedule to meet the needs of our customers and provide adequate coverage during our core business hours.
•Ability to operate basic office equipment, including computers, utilizing specialized claims applications and Microsoft Office applications.
•Ability to maintain a valid driver’s license is preferred to allow flexibility to travel on occasion to claim sites or professional development opportunities.



Supervisory Responsibilities
•No supervisory responsibilities are required for this position.



Responsibility & Decision Making Authority
•Responsible for claim file from assignment to settlement following claims procedures, providing strong customer service, and following applicable laws and regulations.
•Determines and authorizes an assist from field representative for additional information regarding claim such as photos, in-person interviews, or measurements.
•Defers to manager for approval if assist recommendation includes retaining the services of an independent adjuster or vendor.If approved, Telephone Claims Adjuster/Specialist has responsibility to manage and direct the work of a third party field claim representative, investigator, crop adjuster or other vendor.



Fiscal Responsibility
•Resolves and negotiates claims within authority level assigned by manager. Sets reserve on files and tracks amount paid against that limit.
•Requests additional authority level from supervisor on a per file basis as required to fairly settle claim.



Contacts
•Frequently works with all levels of employees in the home office including management, in-house counsel, property appraisers, special investigators, underwriters, finance, and support units.
•Frequently works with external customers including insureds, claimants, agents, witnesses, field adjusters, contactors, body shops, counsel, medical professionals, and local authorities.



Working Conditions and Physical Efforts
•To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.
•The position is physically located in a cubicle setting within a typical office environment. The position requires an individual to sit for extensive periods while on the telephone and computer. The work may be stimulating yet demanding. It can also be stressful when experiencing a high volume of claims, when assigned potentially large claims, or when working with many types of individuals facing a loss.
•The individual may occasionally be required to travel to actual claims sites when the volume is particularly high as a result of weather, accident, or other catastrophic situation. On these assignments, the individual may be required to stand, walk, stoop, kneel, crouch, crawl, or climb ladders/roofs and be required to work inside or outside on a claim site. The individual may occasionally lift and/or move up to 25 pounds.




Email your resume to careers@grinnellmutual.com



This job description is not intended to describe, in detail, the multitude of tasks that may be assigned, but rather to give the employee a general sense of the responsibilities and expectations of his/her position. As the nature of the business demands change, so too may the job duties and responsibilities.