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Fleet Response · 4 hours ago

Third Party Sr. Claims Representative

United States

Full-time

Onsite

Mid, Senior Level

2+ years exp

Fleet Response is a company dedicated to providing innovative and effective service to its clients while maintaining high standards of professionalism. The Third Party Sr. Claims Representative will manage complex claims from initiation to closure, requiring significant independent judgment and exceptional negotiation skills.

Management Consulting

Growth Opportunities

Hiring Manager

Amira C.

Responsibilities

First Notice of Loss (FNOL): Review and send loss notices to clients per client parameters

Administrative Support: Performing general administrative tasks such as mailing documents, creating documents, uploading documents, gathering documents, setting up tows & handling a shared inbox

Information Gathering: Contacting various parties to obtain missing or additional information required for claim processing & verification

Verify Coverage:Review the claim to ensure that the claim is covered

Investigate & Determine Liability: Conduct thorough investigations to establish fault, or liability, for an incident. This includes interviewing the client, claimant, witnesses, and other involved parties, and reviewing police reports and other documentation

Identify Potential Fraud:watch for any signs of fraudulent activity, such as staged accidents or overstated claims, and refer suspicious cases to a Special Investigation Unit (SIU)

Mitigating Cost: It is a fundamental duty aimed at controlling expenses while ensuring fair and prompt resolution of claims

Assess Damages:Evaluate the extent of damage, which can include property damage, repairs, total loss, loss of wages, loss of use, rental, towing, diminished value & out-of-pocket expenses

Determine Total Loss vs Repair:Evaluate if the cost of repairs exceeds the value of the vehicle or property and handle the claim toward a total loss settlement if necessary

Manage Repairs:Monitor the progress of repairs to ensure the repairs are being completed timely and accurately

Manage Total Loss Claims:Perform detailed market research to determine the actual cash value (ACV) of a totaled vehicle. This involves analyzing vehicle history, local market comparable, and salvage value

Manage Rentals:verify coverage, explain terms, initiate rental arrangements, advise on non-covered events, rental duration, authorize extensions

Review and Authorize Supplements:Review additional repair costs submitted and approve payment while following guidelines

Ensure Compliance:Adhere to all federal and state laws and regulations governing the claims process

Maintaining Licensing:Maintain insurance adjuster licensing as required in all states

Communication: This requires clear, professional communication and strong interpersonal skills with all parties involved in the claim, including but not limited to peers & leadership

Negotiate Settlements:Determine an appropriate settlement amount based on liability and damage assessment, then negotiate a resolution with the claimant, client or legal counsel

Maintain Claim Files:Ensure that all claim activity, notes, and correspondence are thoroughly and accurately documented

Set Reserves:Set and maintain appropriate financial reserves for each claim to ensure funds are available for potential settlement payments

Process Payments:Process timely & accurate payments for vehicle repairs, total loss settlements, and other covered expenses

Workload and Metrics:Effectively manage a high volume of claims and meet key performance indicators (KPIs), such as average claim processing time, closure rates, and customer satisfaction scores

Finalize & Close Claims:Ensure all necessary steps are completed, and all paperwork is filed before finalizing and closing the claim

Developing: Responsible for actively accepting, acting on, and implementing coaching and feedback to improve professional performance and development

Mentor & Train: Responsibilities may include mentoring a team member and assisting in training

Qualification

Claims managementInsurance adjuster licensingNegotiation skillsAutomotive industry experienceAnalytical skillsCustomer serviceMulti-taskingMicrosoft OfficeCommunication skillsAttention to detailProblem-solving skills

Required

Associate degree (A.A.) or equivalent from a two-year college or technical school, or 2–4 years of related experience; combination of education and experience may be considered

Ability to obtain and maintain insurance adjuster licensing as required in all states

Strong oral and written communication, including the ability to simplify complex information and negotiate effectively with claimants, attorneys, and clients

Ability to analyze liability, assess damages, and evaluate complex claims accurately

Customer service and empathy, maintaining professionalism in difficult or emotional situations

Attention to detail with meticulous documentation and record-keeping

Proficiency with claims management systems and Microsoft Office

Strong investigative, analytical, and problem-solving skills

Ability to multi-task, prioritize, and manage a high volume of claims effectively

Calculate property depreciation, repair/replacement costs, and claimant lost wages

Evaluate multiple bids or vendor quotes to ensure fair settlements

Primarily sedentary work with occasional light lifting (up to 10 lbs)

Close visual acuity for computer work, reading, and documentation

Ability to communicate clearly in person and via phone