Claims Serv Specialist III

Key Responsibilities

• Timely completion of all case activities, maximizing customer service and minimizing net loss payout. 

• Contacts all insureds, claimants and witnesses that may have information relating to the loss, either in person, by 

• telephone or in writing. This may include visiting the accident location to examine, photograph and diagram 

• physical facts and conduct neighborhood canvasses. 

• Inputs and retrieves information using the automated claims system, requests checks, form letters and other 

• correspondence through the automated claim system. 

• Evaluates case facts determining coverage, liability and reserves, and reports on settlement; maintains a reminder system. 

• Interprets and evaluates medical reports to determine if they are applicable to the claim; monitors legal and medical billings and investigates for proper charges and pays accordingly. 

• Negotiates settlements with individuals, attorneys, and other insurance carriers within their granted settlement 

• authority level. 

• Pursues subrogation and may arrange for salvage to obtain the maximum recovery. 

• Prepares detailed scope of damages on property losses and brings to conclusion. 

• Assists, when requested, in the selection and evaluation of experts as needed. 

• Manages litigation, checking to ensure that coverages are not exceeded, that legal expenses are adequate, and confers with attorney about case direction and disposition. 

• Will participate in special projects or training programs. 

• Will assist in the training of Claims Service Specialists II and below. 

• Performs other related duties as required or requested. 

• Will keep management informed of activities and problems within assigned area of responsibility. 

• Provides information to all interested parties, including the local agents, by answering routine questions regarding the status of the claim. 

• Successfully completes all required training and applies. 

• Meets basic claim handling performance standards. 

• Manage and track all claims referred to Subrogation counsel. 

• Daily navigation and management of E-Subro Hub. 

• Prepare well written contentions for arbitration filings, including Special arbitrations, when coverage, liability and/or damages are in dispute. 

• Manage stretch assignments based on experience with oversight.

Requirements

• Success will be measured based on individual results compared to all established department standards in Customer Service, Teamwork, Loss and Expense Management, as well as Continuous Improvement.

• Excellent communication, customer service and collaboration skills

• 3-5 years of equivalent work related experience

• 2 or more years as a Claim Service Specialist II

• Demonstrated success in handling MD, PIP, BI in MA, CT, Commercial

• Where applicable pass the state licensing requirements

• Valid drivers license in good standing