Claims Representative II - Commercial Liability

Sentry; Stevens Point (WI); Hybrid; USD 50,000 - 70,000; Full time

Job summary

A leading mutual insurance company is seeking a Claims Representative II for their Stevens Point office. The role involves assisting customers, investigating claims, and ensuring compliance with insurance policies. Ideal candidates will have a Bachelor's degree and strong analytical and interpersonal skills. The position offers a hybrid work model and competitive rewards including 401(k) matching and career development opportunities.

Benefits

401(k) with match

Flexible work arrangements

Education and career development opportunities

Paid time off

Insurance benefits

Wellness programs

Charitable gift matching

Qualifications

• At least 1 year of related work experience.
• Knowledge of insurance policies and claim procedures preferred.

Responsibilities

• Provide all aspects of customer service by assisting customers through difficult situations.
• Evaluate claims, check for misrepresentation, and collaborate with SIU to investigate potential fraud.
• Document all decisions, correspondence, and reports during investigations.

Skills

Customer Service

Analytical Skills

Interpersonal Skills

Time Management

Education

Bachelor's Degree

Job description

Claims Representative II - Commercial Liability

Apply locations: Stevens Point, WI | Time type: Full time | Posted on: Posted 3 Days Ago | Job requisition id: JR-138951

This position requires a Customer Service Professional with creativity, empathy, interpersonal skills, and a strong desire to assist customers. You will be responsible for prompt claim investigation, evaluation, and settlement or denial of claims with minor to severe exposures. The role involves explaining policy coverages and claims processes to customers, authorizing payments within authority limits, and documenting all pertinent information and dispositions in claim files. You will handle claims involving moderately complex issues such as bodily injury, negligence, and coverage disputes, and may include handling low complexity litigation in some niches.

This role will be filled following our hybrid work model at our Stevens Point office.

What You'll Do

• Provide all aspects of customer service by assisting customers through difficult situations.
• Verify coverages, investigate losses, gather pertinent information, and deny coverage where applicable.
• Support customers with empathy and understanding.
• Take recorded statements, obtain reports, photographs, and evaluate damages and eligibility for benefits.
• Evaluate claims, check for misrepresentation, and collaborate with SIU to investigate potential fraud.

Additional Responsibilities

• Document all decisions, correspondence, and reports during investigations.
• Settle claims within authority limits and complete claims by evaluating losses.
• Identify trends or problems requiring further review and escalate as needed.
• Consult with senior personnel for guidance and ensure proper handling of files.
• Adhere to jurisdiction-specific compliance requirements.
• Coordinate benefits with other insurance carriers and monitor claim files.
• Refer claims exceeding authority limits for settlement recommendations.
• Work with health facilities, repair shops, and contractors to facilitate services.
• Notify Underwriting of adverse findings.
• Code data accurately and participate in fraud control procedures.
• Maintain state adjuster licensing requirements.
• Perform other duties as assigned.

Minimum Qualifications

• Bachelor's Degree or equivalent experience.
• At least 1 year of related work experience.
• Knowledge of insurance policies, claim procedures, and medical terminology preferred.
• Analytical skills to review and evaluate claims.
• Ability to interpret complex documents and communicate effectively.
• Time management and human relations skills.
• Ability to maintain confidentiality and pass required coursework.
• Valid driver's license and acceptable motor vehicle record.

What You'll Receive

At Sentry, your total rewards include competitive compensation, flexible work arrangements, equipment for home office, 401(k) with match, education and career development opportunities, paid time off, insurance benefits, wellness programs, and charitable gift matching.

About Sentry

Founded in 1904, Sentry is a leading mutual insurance company rated A+ by A.M. Best. Our headquarters are in Stevens Point, WI, with offices across the U.S. We offer a rewarding environment with professional growth opportunities.

Talent Acquisition Contact

Donna Paschall

Equal Employment Opportunity

Sentry is an Equal Opportunity Employer. We do not discriminate based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.