Field Claims Representative

Texas Farm Bureau; Robstown, Northern (TX, KY); Hybrid; USD 52,000 - 78,000; Full time

Job summary

Texas Farm Bureau Casualty Insurance Company in the Claims department seeks an experienced representative to investigate and resolve claims fairly and promptly in accordance with policy provisions and department guidelines.

You will confirm coverage, evaluate and settle claims, communicate with claimants, coordinate with experts, maintain documentation, and participate in claim committee discussions.

Qualifications

• Four-year degree from an accredited college or university.
• All Lines Adjuster license from the Texas Department of Insurance, maintained according to the licensing requirements set forth by the state of Texas or the ability to obtain.
• Acceptable credit rating.
• Effective knowledge of basic computer applications, especially Microsoft Office Suite.
• Effective interpersonal verbal skills, both face-to-face and over the phone.
• Ability to plan, organize, and complete detailed work independently or in a team environment.
• Valid Texas driver’s license and driving record at the time of hire which would not place the employee on probation, or disqualify the employee from Certified Fleet Operator Status, under the company Driving and Safety Policy.

Responsibilities

• Confirm status of policy and coverage.
• Investigate, evaluate, and settle claims while applying technical knowledge and human relations skills to effect fair and prompt settlement of claims.
• Answer calls and complaints promptly.
• Investigate and submit coverage questions and Agents’ error and omission claims to the District Claims Manager.
• Submit required reports on each assigned claim to the District Claims Manager in a timely manner.
• Recognize the need for experts, including those from within or outside the company, and report that to the District Claims Manager.
• Advise the District Claims Manager of new lawsuits, counseling with the insured, exploring the possibility of settlement, and assist in the preparation of each case for defense as necessary.
• Recognize and thoroughly investigate Subrogation claims and make referrals to the Subrogation unit.
• Recognize potentially fraudulent claims and report to District Claims Manager and Special Investigations Unit in accordance with company guidelines.
• Evaluate, set, and recommend reserves consistent with company policies.
• Investigate and report accidental death claims, property protection claims, and payment to fire departments within established procedures.
• Assist in other areas as needed due to business necessity.
• Pay and process claims within designated authority level.
• Enter claim payments, reserves, and new claims into the computer system, using concise yet sufficient file documentation.
• Resolve complex, severe exposure claims using high service-oriented file handling.
• Complete and forward Claims department report to Underwriting.
• Present cases and participate in their discussion at claim committee meetings.
• Recommend and use structured settlement programs where appropriate.
• Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
• Submit monthly expense reports, monthly telephone bills, and other reports as requested.
• Contact or interview claimants, doctors, medical specialists, or employees to get additional information regarding claims.
• Participate in the training process as given in the Texas Claims Representative Training Process, so that the recommended schedule is followed, except when changes are made specifically at the request of the assigned District Claims Manager.
• Properly care for and maintain company equipment including car, cell phone, computer, etc.
• Achieve and maintain company standards and procedures.
• Comply with the Certified Fleet Operator requirements of the Company Driving and Safety Policy.
• Other duties as assigned.

Skills

Interpersonal verbal skills

Education

Four-year degree from an accredited college or university

All Lines Adjuster license from the Texas Department of Insurance

Tools

Microsoft Office Suite

Job description

Company Name: Texas Farm Bureau Casualty Insurance Company | Department: Claims

This position is responsible for investigating and resolving claims in a fair, prompt, and efficient manner, according to company and Claims department policies and procedures.

MAJOR RESPONSIBILITIES AND AUTHORITY

Confirm status of policy and coverage.

Investigate, evaluate, and settle claims while applying technical knowledge and human relations skills to effect fair and prompt settlement of claims.

Answer calls and complaints promptly.

Investigate and submit coverage questions and Agents’ error and omission claims to the District Claims Manager.

Submit required reports on each assigned claim to the District Claims Manager in a timely manner.

Recognize the need for experts, including those from within or outside the company, and report that to the District Claims Manager.

Advise the District Claims Manager of new lawsuits, counseling with the insured, exploring the possibility of settlement, and assist in the preparation of each case for defense as necessary.

Recognize and thoroughly investigate Subrogation claims and make referrals to the Subrogation unit.

Recognize potentially fraudulent claims and report to District Claims Manager and Special Investigations Unit in accordance with company guidelines.

Evaluate, set, and recommend reserves consistent with company policies.

Investigate and report accidental death claims, property protection claims, and payment to fire departments within established procedures.

Assist in other areas as needed due to business necessity.

Pay and process claims within designated authority level.

Enter claim payments, reserves, and new claims into the computer system, using concise yet sufficient file documentation.

Resolve complex, severe exposure claims using high service-oriented file handling.

Complete and forward Claims department report to Underwriting.

Present cases and participate in their discussion at claim committee meetings.

Recommend and use structured settlement programs where appropriate.

Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.

Submit monthly expense reports, monthly telephone bills, and other reports as requested.

Contact or interview claimants, doctors, medical specialists, or employees to get additional information regarding claims.

Participate in the training process as given in the Texas Claims Representative Training Process, so that the recommended schedule is followed, except when changes are made specifically at the request of the assigned District Claims Manager.

Properly care for and maintain company equipment including car, cell phone, computer, etc.

Achieve and maintain company standards and procedures.

Comply with the Certified Fleet Operator requirements of the Company Driving and Safety Policy.

Other duties as assigned.

MINIMUM POSITION QUALIFICATIONS

Four-year degree from an accredited college or university.

All Lines Adjuster license from the Texas Department of Insurance, maintained according to the licensing requirements set forth by the state of Texas or the ability to obtain.

Acceptable credit rating.

Effective knowledge of basic computer applications, especially Microsoft Office Suite.

Effective interpersonal verbal skills, both face-to-face and over the phone.

Ability to plan, organize, and complete detailed work independently or in a team environment.

Valid Texas driver’s license and driving record at the time of hire which would not place the employee on probation, or disqualify the employee from Certified Fleet Operator Status, under the company Driving and Safety Policy.

PHYSICAL REQUIREMENTS

Use of PC, telephone, copy machine, fax, and other office equipment over six (6) hours per day.

Extended periods of sitting and concentrating.

Regular bending, twisting, crouching, pulling, pushing, and reaching in an office or field environment.

Regular physical activities, including lifting, carrying, and using a 35-pound ladder, as well as climbing on roofs.

WORKING CONDITIONS

Subject to relocation.

Occasional long, irregular work hours.

Travel, including overnight travel, as required.

Work to be conducted in an office environment owned or leased by company.