Apply on Employer Site

Vermont Mutual Insurance Group · 3 hours ago

Senior Claim Representative - Casualty

Vermont, United States

Full-time

Hybrid

Senior Level

5+ years exp

Vermont Mutual Insurance Group is looking for a Senior Claim Representative to handle a diverse caseload of claims, including those of moderate complexity and financial severity. The role involves conducting loss investigations, negotiating settlements, and ensuring compliance with claim handling guidelines.

Financial ServicesInsurance

Growth Opportunities

Hiring Manager

Christina Nichols

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 on claims exceeding authority limits

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

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

Monitor loss adjustment expenses and take steps to effectively manage costs of third party service providers

Utilize vendors judiciously to ensure maximum value from services

Review coverage questions and suggest interpretations to Claim Supervisor for approval

Refer appropriate coverage matters to the Claim Supervisor and/or Claim Manager

Ensure appropriate file handling, documentation, special reporting and expense control of all files handled inclusive of MSP compliance

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

Presents reports and leads discussion on files requiring roundtable Reviews with peers and management

Provide service calls on policyholders and agencies as needed

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

Attend trials, depositions, EUO’s and mediations where deemed beneficial or required by jurisdiction. Suggest improvements to processes within the department to increase the level and quality of service provided to internal and external customers, e.g. workflow changes, systems implementation, etc

Effectively follow direction on complicated or high-exposure matters 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

Adjuster's LicenseCasualty Claims ExpertiseNegotiation SkillsAnalytical SkillsContractTort LawMicrosoft OfficeJudgment SkillsStress ManagementOral CommunicationWritten CommunicationCollaboration Skills

Required

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

Five or more years of relevant technical claim handling experience with demonstrated achievement and progressive responsibilities; 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

Advanced knowledge of the technical aspects of casualty claims

Demonstrated commitment to professional development through the attainment of recognized industry designations such as AIC, AEI, SCLA, CPCU programs, etc

Fully developed skills in specialized technical disciplines; including extensive knowledge of relevant contract and tort law

Sound understanding of the insurance industry and company operations

Strong analytical and negotiating skills

Very good oral and written communication skills

Demonstrated ability to exercise sound judgment in dealing with professional issues

Demonstrated ability to work effectively with a wide range of outside firms and organizations

Demonstrated ability to collaborate effectively with company management, peers and claim support staff

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

Ability to perform job responsibilities under stressful situations