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Claims Representative-Casualty

Department: 2104 Claims- Liability 1
Location:

Please note, employment offered to residents in the following states only: Connecticut, Delaware, Massachusetts, Maryland, Maine, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont.

At Preferred, we understand the importance of holistic health. To meet the diverse needs of our employees, we offer a comprehensive set of benefits:

Financial

  • Short-term disability, long-term disability, and life insurance coverage are provided at no cost
  • Optional benefits include enhanced life insurance and critical illness plans
  • 401k plan with an employer contribution that you will receive regardless of your own contribution to the plan
  • A cash-balance pension plan
  • Student Loan Repayment Assistance
  • A short-term incentive plan for all employees

Social

  • Generous paid time off, offering of 25 days at hire (prorated based on start date for the first year)
  • 7 days of paid sick leave
  • 10 paid company holidays
  • Personalized paid time off after 3 years!

Emotional

  • Access to 26 sessions with a BetterHelp therapist each year for you and up to 5 dependents, as well as access to all of BetterHelp’s group and digital resources
  • Access to Family First, a team of care experts who can provide you and your loved ones 1:1 assistance with a variety of caregiving solutions, from elder care to legal and financial challenges, insurance and Medicare navigation, and more!

Physical

  • Medical, dental, and vision coverage options begin on the first day of employment
  • Health Savings Accounts (with a generous employer contribution!     

 

YOUR PURPOSE AND FUNCTION IN OUR COMPANY:

Alleviate the impact of adversity on our insureds during challenging life events by promptly investigating and resolving casualty claims. Support and contribute to the Casualty Claims Department and Company’s missions, visions, values, and goals.

QUALIFICATIONS:

  •  High School Diploma or Equivalent
  •  Bachelor's degree preferred
  • 2 or more years of experience handling P&C claims
  • Progress toward attaining one professional designation preferred (i.e., AIC, CPCU, SCLA).
  • Candidate must be inquisitive, analytical and able to convey and defend a determination, sometimes under pressure and scrutiny.
  • Exceptional active listening skills paired with effective oral and written communication skills.
  • Make timely, definitive, and fact driven decisions.
  •  Strong time and project management skills that support continued process improvement.
  •  Skilled at collaboration, group decision making, problem solving and negotiation.
  •   Pursues duties and interactions with integrity.
  •   Proficient in technology platforms utilized by Preferred Mutual (including but not limited to Windows, Microsoft Office Suite, Outlook, and Internet-based applications).

 

KEY CAPABILITIES FOR SUCCESS:

  • Accurate and timely reserve development.
  • Appropriately manage indemnity and loss expenses.
  • Conduct thorough and timely investigation to determine liability and claim valuation.
  • Treat customers in a proactive and responsible manner.
  • Adjust schedule as needed to accommodate customer needs and/or fluctuations in work volume.
  • Leverage technology as a critical component in achieving efficiencies and delivering superior customer service.
  • Handle claims of moderate severity and complexity.
  • Display an understanding of risk transfer opportunities: common and contractual indemnity, contribution, and subrogation, and take appropriate action when necessary.
  • Resolve claims promptly and fairly in a manner that is reflective of coverage, liability, and damages.
  • Demonstrate an understanding of claim procedures and file administration for proper file documentation and claim reporting.
  • Demonstrate an understanding of products and coverages associated with PPA, PCA, PHO, BOP, and CGL policies.
  • Meet file quality standards as determined by internal and external audits.
  • Maintain workload in accordance with Key Performance Driver (KPD) standards.
  • Develop an understanding of fraud indicators.
  • Recognize Key data points within the claim management and other systems and utilizes the data to make informed decisions and reach better claim resolutions.

 

FUNCTIONAL AREA RESPONSIBILITIES:

  • Responsible for investigating, analyzing, and resolving 3rd party casualty claims of low-to-moderate complexity, whether pre-suit or in litigation.
  • Proactively develop coverage, liability, bodily injury and property damage determinations and resolution strategies.
  • Evaluate files for the accurate and timely reserving of claims in accordance with the Preferred Mutual reserving philosophy.
  • Research, understand and adhere to the respective insurance laws and regulations that govern claims handling processes across varying jurisdictions.
  • Research and apply the laws and statutes governing tort negligence against the facts of each claim.
  • Have a basic understanding of litigation phases.
  • Research, then seek help, when a situation is new or complex.
  • Demonstrate independent and effective analysis and decision making when a scenario is not new.
  • Demonstrate willingness to lead and direct their files with less oversight needed.
  • Prioritize effective expense management.
  • Works with management oversight on a regular basis to learn claims handling techniques, negotiation strategies, workload management, and coverage reviews.
  • Be willing, with guidance, to inspect local loss scenes and meet with witnesses, insureds and claimants.
  • Be willing, on occasion, to travel to attend depositions, evidence examinations, mediations and trials in person.
  • Identify, investigate and resolve low to moderately complex coverage issues with assistance from manager.
  • Draft thorough and timely coverage letters, with manager assistance and final review.

 

ABOUT US: As a mutual company, we are independent by nature, so we think about insurance solutions a little differently. Through listening, problem solving, examining your challenges and collaborating on the right solutions for you, Preferred Mutual independent agents provide flexible solutions and adapt to your evolving needs. We do the same for our employees. We are process and domain experts, focused on the solutions that deliver results for our clients and our company. We offer a great work environment, professional development, challenging careers, and competitive compensation. With Preferred, there are no surprises. You can count on us to deliver on our promises and be there when you need us, as your insurance provider and your employer. Preferred Mutual is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law.

DISCLAIMER: This role (job) description indicates in general terms, the type and level of work performed as well as the typical responsibilities of employees in this classification. The duties described are not to be interpreted as being all-inclusive to any specific employee. Management reserves the right to add, modify, change or rescind the work assignments of different positions and to make reasonable accommodations so that qualified employees can perform the essential functions of the job. Nothing in this position description changes the at-will employment relationship existing between Preferred Mutual Insurance Company and its employees.

The salary range for the role is $62,500 to $85,000 per year paid on a salaried basis. The rate offered to any candidate will be reflective of the candidate’s experience and any relevant education, certification, or qualifications related to their ability to perform the responsibilities of this position as permitted by law.

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