Telephone Claim Representative Trainee
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POST DATE 9/18/2016
END DATE 11/19/2016
National General Insurance Company
Winston Salem, NC
* Investigates the facts of loss, determines and verifies coverage and liability, evaluates settlement value and settlement options and negotiates material damage claims at the direction of manager and/or mentor. Claims involved are subject to standardized procedures which lead to a settlement with limited exercise of discretion.
* Responsible for maintaining and growing a relationship between NGIC and current policyholders. Also responsible for focusing on the needs of loss participants. Identifies customer needs and works to meet those needs using appropriate customer service skills.
* For all duties and responsibilities, incumbent will take ownership of any issue, problem, or error that could potentially impact the policyholder and/or loss participant.
* Develop a basic understanding and knowledge of state laws and regulations applicable to claims handled, including state unfair claim practice laws, and exhibit the basic ability to apply these laws and regulations as it relates to handling of material damage claims assigned.
* Develops a basic understanding of the insurance industry and the organizational relationships of the company such as Policy Ops and Marketing.
* Develop an understanding of the types of policies written by the company.
* Receives initial claim assignments and verifies/investigates coverage, liability and damages and documents all appropriate information. Supervisor is involved with review of all claims to ensure they are commensurate with ability. Establishes an investigative plan; initiates investigation by gathering facts and evidence from all witnesses and interested parties; takes recorded statements when necessary; reviews loss reserves and adjusts or opens hidden exposures as necessary.
* Evaluates settlement value and settlement options and summarizes findings and action plan and submits to manager for approval.
* Makes appropriate contacts to discuss a settlement or disposition of PIP and / or Med Pay claims; extends an offer to appropriate party; documents all file activity and payments. Payment information in file notes clearly outlining basis for settlement.
* Determines subrogation or fraud potential and makes referral to appropriate claim unit for further handling.
* Performs other projects and assignments as directed by manager.
* High school diploma or general education degree (GED) required
* Bachelors degree or 2-3 years of relevant work experience
* Relevant experience includes Claims or Customer Service experience that required the ability to think critically, problem solve, and effectively communicate verbally and in writing.
* Obtaining/Maintaining appropriate licensing or educational requirements.
* Requires a degree of initiative, independent judgment, and discretion. Ability to resolve conflicts and empathize with customers is critical. Negotiation skills are important for resolving claims.
* Demonstrates professional oral and written communication skills. Organization, customer service, and time management skills are critical for this position.
* Demonstrated proficiency with basic computer skills with word processing, spreadsheets, email and internet.
* Studies and successfully completes the Claims Training Program.
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.