HOCHHEIM PRAIRIE INSURANCE COMPANIES

Transcription

1 Page 1 06/01/2015 DEPARTMENT: Claims CLASSIFICATION: Exempt JOB DESCRIPTION SUMMARY: Accomplishes the plans, goals, and objectives established for the position; coordinates and manages all claims assigned; provides service to agents, insureds, and third party claimants. REPORTING RELATIONSHIPS: The Claims Representative reports directly to the Claims Manager. There are no positions reporting directly to the Claims Representative. REQUIREMENTS: Education: Required: Preferred: High school diploma or its equivalent; completion of AINS 21 and Ethics 311 required within one year of employment or transfer; A candidate is exempt from Ethics 311 if an Adjustors License is obtained prior to entering the position; A candidate is exempt from both Ethics 311 and the AINS21 if the candidate has an AIC-M, AIC, CPCU, or SCLA designation; AIC-M, AIC, SCLA, or CPCU Designation is recommended for advancement to Senior Claims Representative Bachelor s Degree from a four-year accredited college. Training and previous use of Xactimate. Licensing/Registration/Certification: Required: Valid driver s license with acceptable driving record. Texas property and casualty adjuster s license. Preferred: Insurance designations including Associate in Claims Management (AIC-M), Associate in Claims (AIC), Casualty-Property Claim Law Associate (CCLA/PCLA), and Senior Claim Law Associate (SCLA), and Chartered Property and Casualty Underwriter (CPCU). Skills, Knowledge, and Abilities: Must have strong skills involving the adjustment process of claims. Must possess computer skills; strong communication abilities, both verbal and written; ability to accomplish goals and objectives; possess effective human relations skills; ability to keep accurate documentation; excellent telephone skills and manners; excellent skills for planning and using time.

2 Page 2 06/01/2015 Physical: Body Positions: Sitting or standing in an office environment. Ability to spend time speaking to agents, insureds, and third parties on the telephone and working on the computer. Body Movements: Must have physical dexterity to move through office, talk on the telephone, and operate a computer. Body Senses: Must have full use of eyes, ears, and speech for communications with customers and management. Mental Requirements: Mathematics: Possess basic math skills or the ability to use calculator. Language: Must be able to communicate in English. Communications must be effective in both the verbal and written modes, interact with customers and business associates. Ability to read, analyze and interpret general insurance policies, expert opinions, and legal analysis. Effectively present information and respond to questions from agents, management, customers, and independent adjusting firms. Computer: Ability to work in a Windows environment, communicate via , research the Internet, and utilize industry software. Working Conditions: Primarily an office setting. Occasional overnight travel to corporate office seminars, regional meetings, agency visits, and training classes.

3 Page 3 06/01/2015 ESSENTIAL FUNCTIONS: Duties and Tasks: Accepts and responds to claim assignments. Investigates, evaluates, and negotiates settlements and dispositions on claims. Assign limited/full adjustment to an independent adjusting firm as received but not to exceed 24 hours of receiving a loss notice. Contact insured within 24 hours of receiving a loss notice. Establish reserves in system as received but not to exceed three (3) business days from reported date of claim. Evaluate all investigative work product requested within five (5) business days of receipt - the claim will either be denied or adjusted through a settlement. Review claims files and take appropriate actions. Comply with all time frames within Texas Insurance Code for claims handling. Submit all applicable claims and claimants to the ISO database. Document all claim files so that all directions, decisions, evaluations, and settlements (demands and offers), or denials will be evident. Review vendors quality of work, and provide constructive feedback to the vendor and management. Perform miscellaneous tasks assigned by the Claims Manager or Vice President of Claims, either verbally or in writing, substituting for absent workers, and performing any additional tasks necessary to provide products and services to customers during peak periods of business. The points addressed in this description outline the general duties of the position and are not meant to be all-inclusive. Additional duties may be assigned either on a temporary or permanent basis to an individual functioning in this position. The additional duties will be performed along with those addressed in this description.

4 Page 4 06/01/2015 OTHER JOB CRITERIA: Judgment and Decision Making: Seek guidance and direction as necessary for performance of duties. Demonstrate good judgment in investigating and solving problems. Respect the confidentiality of company and insureds information and not disclose that information. Relationship to Others: Maintain cooperative working relationship with Management and other employees. Demonstrate ability to tactfully handle difficult situations. Planning and Time Utilization: Manage time efficiently in order to meet deadlines. Consistently demonstrate ability to recognize and deal with priorities. Fully understand and responsibly utilize flextime and leave of absence. Provide proper notice of absence. Initiative: Perform all duties in an independent manner with little supervision. Recognize and perform duties that need to be performed although not directly assigned assist others as needed. Demonstrate through daily actions the application and use of training provided. Other: Maintain a neat and organized work area. Assume a responsibility for employee morale by supporting management and presenting a positive attitude. Represent the company in a professional and respectable manner with regard to personal appearance, written and verbal communication, and conduct.

5 Page 5 06/01/2015 This job description is given during the job interview process in order that applicants may carefully review the responsibilities, requirements and essential functions of the job for which they are applying. Do you understand the essential functions? Can you perform the essential functions of this job with or without reasonable accommodation? This is not an offer of employment nor does it comprise an employment contract. APPLICANT DATE