Field Senior Claims Representative – Nashville

Westfield-Insurance; Westfield Center (OH); Remote; USD 65,000 - 90,000; Full time

Job summary

Westfield-Insurance is seeking a Claims Senior Representative-Property Field to serve as a technical expert in property claims. You will determine coverage, investigate facts, negotiate settlements, and guide a team of adjusters while delivering high-quality customer service in a high-volume environment.

The role handles first-party homeowners and commercial property claims, uses Xactimate, and may require travel for field assignments; remote work option with occasional visits to client sites

Qualifications

• Bachelor's degree in Business, Communication, or a related field or commensurate work experience.
• 4+ years of Claims Handling experience.
• For field roles only: Valid driver’s license and a driving record that conforms to company standards.

Responsibilities

• Determines whether proper coverage exists for the type of claim assigned.
• Investigates thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage, legal climate, potential exposure, and damages, and makes decisions on claim resolution.
• Meets established goals & objectives, arranges for salvage disposition and other recovery proceedings as necessary, participates in claim file reviews and audits with customer and broker.
• Provides support in negotiation of settlements with insureds, claimants, vendors, attorneys, and other insurance companies.
• Maintains effective and ongoing communication with insureds, claimants, agents, attorneys, other insurance companies, representatives, vendors, and company personnel.
• Completes appropriate reports to ensure that the claim status is clearly documented, obtains all necessary documentation to support claim evaluation.

Skills

Collaborates

Communicates Effectively

Customer Focus

Decision Quality

Nimble Learning

Education

Bachelor's degree in Business, Communication, or related field

Tools

Account Management

Claims Investigations

Claims Adjustment

Financial controls

Case Management

Customer Relationship Management

Project Management

Business Process Improvement

Auditing

Data Analysis and Reporting

Job description

Job Summary

The Claims Senior Representative-Property Field serves as a technical expert on claims adjusting. The role determines coverage and investigates, analyzes, negotiates, and settles claims not requiring outside investigation. The role delivers quality customer service in a high volume, moderate complexity work environment and mentors less experienced Adjusters on the team. Westfield Property Claims resolves first party personal, commercial, and agriculture property claims, including structural damage, business and personal property, and business income losses.

Job Responsibilities

• Determines whether proper coverage exists for the type of claim assigned.
• Investigates thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage, legal climate, potential exposure, and damages, and makes decisions on claim resolution.
• Meets established goals & objectives, arranges for salvage disposition and other recovery proceedings as necessary, participates in claim file reviews and audits with customer and broker.
• Provides support in negotiation of settlements with insureds, claimants, vendors, attorneys, and other insurance companies.
• Manages approved vendors and counsel utilized as necessary in the claim process, including approval of investigation plans and budgets. Monitors, reviews, and issues payments to vendors and counsel in accordance with guidelines and standards.
• Supports to review proper reserves for each claim based upon thorough investigation, evaluation, and experience.
• Identifies and refers all claims to management for further handling and assignment instructions.
• Refers claims exceeding authority to appropriate manager or complex claims specialist with recommendations.
• Formulates sound recommendations for claims file handling, subsequent transactions, and renewal processing.
• Requests additional information from an agent, identifies the need for referral to the field based on underwriting guidelines.
• Maintains effective and ongoing communication with insureds, claimants, agents, attorneys, other insurance companies, representatives, vendors, and company personnel.
• Completes appropriate reports to ensure that the claim status is clearly documented, obtains all necessary documentation to support claim evaluation.
• Interprets complex and detailed documents such as contracts, legal documents, insurance regulations and policies as needed.
• Maintains knowledge of related coverage, law, and legislative environment and trends, participants in professional industry groups staying abreast of industry changes and advancements and incorporates best practices.
• Adjusting first party homeowners and commercial property claims.
• Efficient in use of Xactimate to evaluate first party property claims.
• For field roles only: Travels as often as needed including regular utilization of assigned fleet vehicle in order to cover assigned territory. This may involve traveling on short notice or other daily driving duties as assigned. May be required to travel for extended periods to fulfill storm duty responsibilities.

Job Qualifications

• 4+ years of Claims Handling experience.
• Bachelor's degree in Business, Communication, or a related field and/or commensurate work experience.
• For field roles only: Valid driver’s license and a driving record that conforms to company standards.

Location

Remote

Licenses and Certifications

• Certified Professional Claims Management (CPCM) (preferred)

Behavioral Competencies

• Collaborates
• Communicates Effectively
• Customer Focus
• Decision Quality
• Nimble Learning

Technical Skills

• Account Management
• Claims Investigations
• Claims Adjustment
• Financial controls
• Case Management
• Customer Relationship Management
• Project Management
• Business Process Improvement
• Auditing
• Data Analysis and Reporting

This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.