Responsible for confirming coverage, investigating, negotiating, setting reserves and settling covered claims of moderate exposure within their personal settlement authority. Perform duties in accordance with the Claim Handling Guidelines and managerial direction. This is a field based position and will cover the Los Angeles (Van Nuys), CA territory.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
- Provide the best possible claim service to both internal and external customers
- Promote teamwork and proactively seek opportunities to assist fellow associates with common challenges, i.e. systems use, file quality, etc.
- Perform thorough investigation, confirm and interpret coverage issues and draft the appropriate reservation of rights or disclaimer letters as needed for manager approval; refer files to SIU when qualifying issues arise
- Complete an inspection of the property damage including completion of a Xactimate Report package
- Solicit estimates and photographs on smaller losses utilizing MyClaimPics to desk adjust claims
- Retain cause and origin experts, engineers, building consultants and any other necessary experts as warranted with manager approval; obtain police, fire, weather reports, etc., as needed
- Responsible for proper and timely reserving in accordance with our reserving philosophy
- Update the claim database system with proper and adequate coding and documentation
- Utilize and maintain diary on all open claims
- Review all bills, estimates and Proofs of Loss prior to making settlement and payment of claim
- Make recommendations to manager on damages exceeding adjuster’s authority
- Review vendors’ bills for accuracy and resolve any billing issues or inconsistencies with the vendor
- Determine subrogation/salvage potential on all claims; refer claim to subrogation when warranted
- Handle or oversee CAT claims as necessary