Claims Representative II

Penn National Insurance in; Harrisburg (Dauphin County); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a Claims Representative II to join their dynamic team. This role focuses on investigating and resolving claims while ensuring compliance with legal and company standards. You will engage with policyholders and professionals to negotiate settlements and identify subrogation opportunities. The ideal candidate will possess strong communication and negotiation skills, along with a keen understanding of insurance policies and state laws. This position offers a collaborative environment where your contributions will directly impact the efficiency and success of the claims process.

Qualifications

• High school diploma or equivalent; Bachelor's preferred.
• Adjuster's license or willingness to obtain one.

Responsibilities

• Investigates and resolves assigned claims efficiently.
• Contacts policyholders and third parties to negotiate settlements.

Skills

Effective Communication

Negotiation

Time & Priority Management

Decision Making

Business Acumen

Education

High School Diploma

Bachelor's Degree

Job description

Claims Representative II (Administrative)

The Claims Representative II investigates, evaluates, and resolves assigned claims in a timely and accurate manner to achieve best practices settlements within legal statutes, policy provisions, and Company or client standards (Inservco).

Claims Division:

Claims Representative II (Administrative)

The Claims Representative II investigates, evaluates, and resolves assigned claims efficiently to ensure compliance with legal, policy, and company standards.

Claims Division:

Dimension$'s or NumbersEffective Date

Accountable for the timely and accurate resolution of assigned claims.

Claims:

Manages approximately 1,700 claims per year. Per claim authority level up to $15K, depending on experience and competency.

Inservco:

Manages approximately 2,400 claims per year, with an average monetary authority dependent on experience and competency.

2020

COMPETENCIES AND ESSENTIAL DUTIES

CompetencyDescription of Duties

• Business Acumen: Prepares claim file documentation accurately, including statements, photos, facts, and environmental factors.

• Negotiation: Contacts policyholders, claimants, third parties, medical and legal professionals to negotiate settlements and pursue subrogation and salvage opportunities.

• Results Oriented: Identifies and pursues subrogation and salvage opportunities when available.

• Time & Priority Management: Handles claims promptly, verifies coverage, and manages policyholder or claimant requests.

• Decision Making: Analyzes coverage and liability issues, gathers factual information, and sets reserves appropriately.

Additional duties include performing limited field work, handling low-exposure claims, and supporting team leadership.

CORPORATE CORE COMPETENCIES

CompetencyProficiency Description

• Effective Communication: Communicates and negotiates effectively, influences, provides feedback, and builds relationships.

• Customer Focus: Understands customer needs, develops relationships, and responds quickly with high-quality solutions.

• Talent Development Mindset: Engages in professional development, recognizes peers, and seeks learning opportunities.

• Demonstrates Adaptability: Contributes to progressive thinking, supports change initiatives, and manages ambiguity.

• Demonstrates Accountability: Makes sound decisions, reliably produces results, seeks feedback, and understands organizational missions.

SPECIAL RELATIONSHIPS

• The Claims Representative II reports to the CSO Team Leader Multi/WC, Claims Service Office Manager II, or CSO Team Leader.

• Interacts with all levels within the Claims Service Office, occasionally with underwriting, agents, and policyholders/claimants, third parties, and professionals.

QUALIFICATIONS

Education/

Credentials

• High school diploma or equivalent; Bachelor's preferred.
• Adjuster's license or willingness to obtain one.

Experience

• Completion of Claims Representative II Trainee curriculum or at least 1 year in a property/casualty claims role.

Technical/Professional Knowledge

• Strong communication, organizational, and interpersonal skills.
• Ability to work independently and in team settings.
• Knowledge of tort, state laws, insurance policies, and relevant terminology.

JOB REQUIREMENTS (ADA)

• Primarily sedentary; occasional standing, walking, and operating office equipment.
• Able to see, hear, communicate, and interpret information effectively.
• Valid driver's license and ability to travel with overnight stays.