Claims Representative I or II

Goodville Mutual Casualty Company; Napoleon (OH); On-site; USD 46,000 - 62,000; Full time

Job summary

Goodville Mutual Casualty Company is seeking a Claims Adjuster to handle and settle claims across all lines with settlement authority up to $7,500. The role emphasizes accuracy, timely response, and adherence to Unfair Claims Practices Act.

Responsibilities include verifying policy coverage, investigating claims, establishing reserves, and coordinating with independent adjusters as needed. Travel to multiple offices is expected.

Qualifications

• High school education required.
• Minimum of one year of work experience in a customer service role preferred.
• Ability to learn the coverages of all insurance policies written by the company required.
• Effective communication skills required.
• Ability to work effectively with company computer systems required.
• Willingness to participate in insurance related study courses preferred.
• Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required.
• Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required.
• Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required.
• Ability to perform the essential functions of the job with or without reasonable accommodation required.

Responsibilities

• Handle claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
• Verify policy coverage on assigned claims.
• Investigate and evaluate assigned claims for proper settlement.
• Assign independent adjusters and appraisers when necessary.
• Pursue subrogation, salvage, and third-party liability contribution.
• Notify Claims Supervisor or Manager of all claims that exceed settlement authority of $7,500.
• Establish proper reserves on assigned claims.
• Report claim complaints, questionable claim submissions and possible fraud to Claims Supervisor or Manager.
• Attend claim seminars and participate in claim associations.
• Perform other duties as assigned.

Skills

Customer service

Communication skills

Policy coverage knowledge

Teamwork

Flexibility

Education

High school diploma

Tools

Company computer systems

Job description

Description

Summary

This position is responsible for adjusting and settling claims for all lines of business written by the company with settlement authority up to $7,500.

Functions

• Handle claims according to company guidelines and in compliance with the Unfair Claims Practices Act.
• Verify policy coverage on assigned claims.
• Investigate and evaluate assigned claims for proper settlement.
• Assign independent adjusters and appraisers when necessary.
• Pursue subrogation, salvage, and third-party liability contribution.
• Notify Claims Supervisor or Manager of all claims that exceed settlement authority of $7,500.
• Establish proper reserves on assigned claims.
• Report claim complaints, questionable claim submissions and possible fraud to Claims Supervisor or Manager.
• Attend claim seminars and participate in claim associations.
• Perform other duties as assigned.

Requirements

• High school education required.
• Minimum of one year of work experience in a customer service role preferred.
• Ability to learn the coverages of all insurance policies written by the company required.
• Effective communication skills required.
• Ability to work effectively with company computer systems required.
• Willingness to participate in insurance related study courses preferred.
• Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required.
• Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required.
• Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required.
• Ability to perform the essential functions of the job with or without reasonable accommodation required.