Claims Representative II

Penn National Insurance; Harrisburg (Dauphin County); On-site; USD 45,000 - 75,000; Full time

Job summary

An established industry player is seeking a Claims Representative II to join their dynamic team. In this role, you will investigate, evaluate, and resolve claims while ensuring compliance with legal statutes and company standards. You will engage with policyholders and third parties, utilizing strong negotiation skills to achieve optimal settlements. This position offers an excellent opportunity to develop your career in the insurance industry, where your contributions will directly impact customer satisfaction and operational efficiency. Join a forward-thinking company that values communication, accountability, and professional growth.

Qualifications

• 1 year experience in property/casualty claims handling.
• Willingness to obtain an adjuster's license.

Responsibilities

• Investigates and resolves claims in a timely manner.
• Negotiates with policyholders and third parties.

Skills

Effective communication

Negotiation

Organizational skills

Detail orientation

Interpersonal skills

Education

High school diploma or equivalent

Bachelor's degree

Adjuster's license

Tools

Claims management software

PC skills

Job description

PURPOSE

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

AUTHORITY

1. Claims Division:

Dimension: $'s or Numbers

Effective 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, dependent on experience and competency.

Inservco:

Manages approximately 2,400 claims per year, with authority depending on experience and competency.

COMPETENCIES AND ESSENTIAL DUTIES

Business Acumen

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

Negotiation

• Contacts and negotiates with policyholders, claimants, third parties, medical and legal professionals in arbitration, litigation, subrogation, contribution, and salvage processes.
• Achieves best practices settlement, assessing costs and liabilities for auto property damage, workers' compensation, property losses, and bodily injury claims.

Results Oriented

• Identifies and pursues subrogation and salvage opportunities.

Time & Priority Management

• Performs claims duties timely, verifies coverage, handles policyholder and claimant issues, and may perform limited field work on low-exposure claims.

Decision Making

• Analyzes coverage and liability issues, gathers factual information, generates solutions, and sets reserves accordingly.

Performs other duties as assigned by the CSO Team Leader Multi/WC or Claims Service Office Manager II.

CORPORATE CORE COMPETENCIES

Effectively Communicates and Connects

• Communicates and negotiates effectively, influences, provides feedback, listens actively, and builds positive relationships.

Customer Focused

• Identifies customer needs, develops relationships, responds quickly, and owns resolution outcomes.

Talent Development Mindset

• Seeks development opportunities, recognizes peers, and identifies learning opportunities.

Demonstrates Adaptability

• Supports change, proposes new ideas, manages ambiguity, and demonstrates flexibility.

Demonstrates Accountability

• Makes sound decisions, is reliable, seeks feedback, learns from errors, and understands organizational mission.

SPECIAL RELATIONSHIPS

• Reports to 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, policyholders, claimants, third parties, and vendors.

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 property/casualty claims handling.

Technical/Professional Knowledge

• Effective communication, interpersonal, organizational skills, detail orientation, PC skills, understanding of laws and insurance terminology.

JOB REQUIREMENTS (ADA)

• Primarily sedentary; occasional standing/walking.
• Ability to see, operate equipment, access systems, hear, communicate, interpret concepts, maintain attendance, and travel as needed.