Staff Claim Representative
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POST DATE 8/13/2019
END DATE 9/7/2019
Church Mutual insurance
JOB DESCRIPTIONTracking Code
Acquire the general and detailed knowledge and experience necessary to perform the duties and carry out the responsibilities of a workers' compensation claims service representative. Outline, investigate claims, determine coverage and damages or determine compensability and calculate benefits, and adjust claims in accordance with stated settlement practices. Direct outside experts, investigators, attorneys, engineers, and other vendors to the extent necessary to properly evaluate or investigate claims. Study, learn, and act in accordance with claims procedures, operations, and functions for each line of business. Master claims automation applications: maintenance functions and general insurance principles related to the successful handling and settlement of claims.
Duties and Responsibilities:
* Participate with management and supervisors in meetings that will enhance a general understanding of Church Mutual's claims handling philosophy.
* Participate in activities directly related to litigation management and allocated adjusting expense.
* Complete adjusting license exams as necessary.
* Claims handling techniques.
* Initiate prompt contact, and complete an initial investigation of the loss.
* Determine applicable coverage or compensability and take appropriate actions to handle or deny the claim.
* Conduct a thorough and accurate investigation to include insured, claimant, witness, police, fire department, vendor, and contractor statements/information.
* Follow all federal, state, and local claims handling regulations.
* Handle claims within specified authority and review claims outside of authority and claims specifically identified by line of business with the supervisor.
* Communicate with other departments (Underwriting, Sales, etc.) whenever information is developed which may be of concern to them.
* Automation and document control.
* Learn and be able to effectively use the Claims Processing System and all related AS/400 systems required to gather, read, or verify required claims information.
* Four-year college degree required.
* Ability to conduct oral or written communications effectively.
* Positive attitude toward the company and policyholders.
* Ability to work with limited supervision.
* Ability to obtain and maintain state adjusting license requirements and complete continuing education requirements.
Church Mutual Insurance Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
Merrill, Wisconsin, United States