Apply on Employer Site

Vermont Mutual Insurance Group · 3 months ago

Claim Representative II - Casualty

Montpelier, VT, US

Full-time

Onsite

Mid Level

$62K/yr - $75K/yr

3+ years exp

Vermont Mutual Insurance Group is seeking a Claim Representative II - Casualty to manage a technical claims caseload of general liability claims. The role involves conducting investigations, negotiating settlements, and ensuring compliance with claims handling guidelines while providing excellent customer service.

Financial ServicesInsurance

Growth Opportunities

Responsibilities

Conduct and coordinate loss investigations on all assigned claims

Negotiate the settlement of claims within authorized amounts or specific file authority

Maintain accountability for all assigned claims until disposition is reached

Recommend further action to supervisor on claims exceeding authority limits

Document all substantive activity on assigned claims and assist in the control of independent vendors

Review new losses and open files on diary to ensure reserve adequacy while keeping management informed of adverse developments

Monitor loss adjustment expense and take steps to mitigate file expenses

Utilize vendors judiciously to maximize value added

Recognize coverage issues and work with supervisor and claim management for manner of redress/resolution

Refer appropriate coverage matters to the Claim Supervisor or Claim Manager

Ensure appropriate file handling, documentation, reporting and expense control of all files handled inclusive of legal bill review/vendor performance/bill review/MSP compliance

Provide accurate, courteous and timely information to all eligible external and internal customers concerning claim status and other claim inquiries

Attend meetings with policyholders and agencies as needed

Draft coverage correspondence in collaboration with Supervisor, including reservation of rights and coverage disclaimer along with composing detailed correspondence to insureds, claimants, attorneys, etc

Attend trials, depositions, EUO’s, appraisals and mediations where deemed beneficial or required

Participate in various forms of Litigation training and as a mentee with an assigned Examiner Mentor for litigation and coverage advancement

Improve processes within the department to increase the level and quality of service provided to internal and external customers, i.e. workflow changes, systems implementation, etc

Participate in setting file direction and recommend appropriate reserves on claim files within specific authority and on files requiring mandatory reporting to management

This position handles an assigned claim pending

Performs other duties or special projects as required or as assigned

Qualification

Claim handling expertiseInsurance knowledgeNegotiation skillsAdjuster's licenseAnalytical skillsCustomer service orientationJudgment skillsPC proficiencyVerbal communicationWritten communicationCollaboration skills

Required

Bachelor's degree in business, insurance or a related field, or its equivalent

Three or more years of relevant claim technical experience; or a combination of education and experience from which comparable knowledge and skills are acquired

Appropriate state adjuster's license(s) where required by law

Demonstrated commitment to professional development through continuing education related to the job such as AIC, AEI, INS, SCLA CPCU, etc

Established and improving skills in specialized technical disciplines; including working knowledge of relevant insurance, contract and tort law. Participation in training courses and mentorship program

Knowledgeable about the insurance industry and company operations

Sound analytical, and negotiations skills

Very good verbal and written communication skills

Ability to exercise sound judgment in dealing with professional and personnel situations

Ability to work effectively with a wide range of outside firms, etc

Ability to collaborate effectively with company management, peers and support staff

Demonstrated customer service orientation

Proficiency with PC applications including Microsoft Office (Word, Excel & Outlook); Experience with imaging and claims handling programs preferred

Ability to perform job duties under stressful situations