Inside Property Claim Representative

Ohio Farmers Insurance Company; Westfield Center (OH); Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a Claims Representative to join their dynamic team. In this role, you will independently manage property claims, ensuring thorough investigations and effective negotiations. You will play a crucial part in delivering exceptional customer service while navigating complex claims processes. This position offers an opportunity to work remotely, providing flexibility in your work environment. If you are passionate about claims management and customer relations, this role offers a chance to make a significant impact in a reputable company dedicated to excellence in the insurance sector.

Qualifications

• 2+ years of Claims Handling experience required.
• Bachelor's degree in relevant field or equivalent experience.

Responsibilities

• Investigates claims to determine coverage and establish damages.
• Negotiates claim resolutions with insureds and attorneys.
• Maintains communication with all parties involved in claims.

Skills

Claims Handling

Customer Service

Negotiation

Investigation

Communication

Education

Bachelor's degree in Business Administration

Commensurate Work Experience

Tools

Customer Relationship Management

Claims Case Management

Data Analysis and Reporting

Job description

Job Summary

Westfield Property Claims resolves first party personal, commercial, and agriculture property claims, which includes but is not limited to structural damage, business and personal property, and business income.The Claims Representative works independently under moderate supervision to determine coverage, investigate claim details, establishes damages, negotiates, and settle claims. The role prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties, facilitates and supports the execution of action plans and delivers quality customer services in a moderate complex work environment.

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, potential exposure, damages, legal climate, and makes decisions on claim resolution.


• Determines the value of physical damage of property, through appropriate tools and vendors, recognizes claim file exposures and escalates claims appropriately based on claim severity and complexity.


• Negotiates claim resolution as needed with insureds, 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.


• Establishes proper reserves for each claim based upon thorough investigation, evaluation, and experience.


• Ensures timely & accurate reserve practices are being followed to cultivate favorable reserve adequacy results.


• Sets reserves within authority limits and recommends reserve changes to team leader, processes financial transactions such as stop pays, reissues, payment transfers, etc. within guidelines.


• Refers claims exceeding authority to appropriate manager or complex claims specialist with recommendations.


• 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.


• Formulates sound recommendations for claims file handling.


• Requests additional information from an agent or other parties to assist in the claim investigation


• Maintains effective and ongoing communication with insureds, 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, participates in professional industry groups staying abreast of industry changes and advancements and incorporates best practices.


• Establishes and maintains positive relationships with internal and external customers resolving conflict around disputed benefits and providing excellent customer service.

Job Qualifications

• 2+ years of Claims Handling experience.


• Bachelor's degree in business administration, finance, or any other 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

Behavioral Competencies

• Certified Professional Claims Management (CPCM)


• Adjuster License


• Collaborates


• Customer focus


• Communicates effectively


• Decision quality


• Nimble learning

Technical Skills

• Claims Investigation


• Customer Relationship Management


• Auditing


• Claims Adjustment


• Claims Case Management


• Account Management


• Financial Controls


• Business Process Improvement


• 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.

Founded in 1848, Westfield is a global leader in property and casualty insurance, delivering superior risk insights and innovative solutions to customers through a diverse portfolio of insurance products. Westfield underwrites commercial, personal, surety, and specialty lines of coverage through a network of leading independent agents and brokers in the United States and specialty products through Lloyd's of London Syndicate 1200. As a mutual insurance company with more than 3,000 employees, Westfield has revenues in excess of $4 billion and more than $10 billion in assets.