SENIOR MULTI LINE CLAIMS REPRESENTATIVE

Senior Claims Representative- Multi-Line

The Carlisle Group has been Retained to conduct a search for a Senior Claims Representative (Multi Line). This position investigates, evaluates, and settles multi-line claims within established authority level, including those of complexity and high exposure. The ideal candidate would live in the greater State College Pennsylvania area.

Essential Functions

• Determines coverage and investigates claims:
• Makes personal, written, or telephone contact with general public, reporting agencies, and suppliers of services/goods.
• Reviews and interprets policies to determine coverage.
• Reviews records and documentation.
• Takes telephone-recorded statements from insureds, claimants, and witnesses involved.
• Determines liability.
• Determines amount of loss/damage.
• Makes assignments to appraisers or independent adjusters as needed.
• Indexes injured insured and claimants; follows Medicare reporting requirements and files PLR.
• Assigns independent adjusters; independent appraisers; and experts to assist in the investigation and evaluation of the claim.
• Utilizes counsel to assist in coverage and / or investigation of claims.
• Determines settlement values:
• Utilizes information gained from claim investigations, applicable regulations, and policy provisions or limits.
• Reviews reserves:
• Reviews reserves on a 30-day basis.
• Modifies as necessary, within established authority, or seeks appropriate approvals.
• Develops and documents claims files.
• Establishes and maintains a 30-day diary to updated file handling.
• Negotiates with insureds, claimants, or legal representatives; settles claims promptly, fairly, and within established authority.
• Issues claim and expense payments.
• Secures appropriate approvals for check requisition on claims exceeding authority.
• Pursues other carriers for subrogation and determines percent of liability (non-auto claims).
• Handles non-auto salvage
• Ensures compliance with the Unfair Claim Practices Act and Good Faith Claim Handling regulation.
• Participates in claim orientation for Underwriting personnel, helping with analysis of coverage and/or claim situations.
• Performs other miscellaneous duties as assigned or directed.

Qualifications / Basic Job Requirements

• Bachelor's degree or equivalent education and experience combination
• Proficient interpersonal relations and communications skills (both written and verbal)
• Thorough knowledge of claims law
• Proficient analytical and problem solving skills
• Capacity to work well independently
• Moderate computer knowledge
• Demonstrated organizational and time management abilities
• Demonstrated abilities to deal with a variety of personalities
• Minimum of five years' experience with investigation, management, and negotiation of liability and property claims in states of operation