SUMMARY: Responsiblefortheassignmentandhandling of complexpropertyor autoinsuranceclaims,whichincludecoverageanalysis,investigation,evaluation,negotiation,settlement,salvage, andsubrogation.Adjudicatesclaimswithinassignedsettlementauthorityand adheres to applicablelaws,regulations,and companyguidelines.Conductsfieldinvestigations todocumentfindings,estimateloss,andconcludeclaims bypaymentorcoveragedenial.
ESSENTIAL DUTIES: The following duties are representative of those required for this position. All of the duties may not be required, and additional duties may be assigned.
Performscomplexclaimhandlingdutiesasassignedwithin the property or auto discipline.
Conductson-sitefieldinvestigation and assessment of reportedclaims as needed and assigned.
SupportsworkloadsurgesandcatastropheresponseoperationsthroughouttheState of Missouriasneeded,includingroutineavailability for traditionalstormperiods,potentialevening,weekend,and/orholiday work outsideofnormalworking hours.
Documentstheclaimfile in a prompt,clear,andconcisemanner,withthefactsgathered in the investigation.
Evaluatescoverage,gathersevidence and documentation, and determineswhethercoverage is applicable for assignedlosses.
Establishes,evaluates, and maintainsindividualcasereserves in accordancewith the ClaimsDepartmentReservingPhilosophy.
Conductsdetailedanalysis whilepreparingpropertylossestimates,and/orscopingstormdamage to automobiles.
Negotiatesfaultand/ordamageswithinsureds,claimants,adversecarriers,attorneys, or otherinvolvedparties.
Determinesvalueofcovereddamages, and adjudicates the claimwithintheirauthoritylevel,orpresentsvaluationevidence to the ClaimsSupervisor for additionalauthority as needed,whilemaintainingcompliancewithapplicable laws, regulations,andcompanyguidelines.
Coordinateswithoutsidevendors and expertsforattorneyservices,firecauseandorigin,professionalengineeringservices(structural,mechanical, and electrical),estimatereviews,andofficialreports.
Performsandassistswithsubrogationandsalvagerecoveryefforts, to includeidentifyingrecoverypotential,and/orpursuingliabletortfeasororotherinsurancecarriers,aswarranted.
Assists in the handling of claimsatotherclaimlevelsandclaimdisciplines as necessary and withinauthority.
Preparesdetailed,technical,writtencorrespondence to communicateinvestigation,findings,policyapplication,orotheractivitiesinvolved in theadjudicationof a claim.
Attendsandparticipates in AlternativeDisputeResolution,ExaminationsUnderOath,oranylegalproceedings up to and includingtrial.
Assists in the handling of claimsatotherclaimhandlinglevels as necessaryandwithinauthority.
Assistswithtrainingpersonnelasneeded.
Providesexcellentcustomerservice to allexternalandinternal customers and maintainsgoodworkingrelationshipswithfield and HomeOfficepersonnel.
Performsotherduties as assigned.
EDUCATION and/or EXPERIENCE
Storm Claims Representative – Bachelor’s Degree required, except that additional related work experience may be substituted on a year-for-year basis for the formal education requirement.
QUALIFICATIONS
Ability to operate a personal computer and standard office equipment.
Ability to learn and operate claims-related software.
Consistently delivers accurate, clear and concise messages orally and/or in writing
Ability to handle a high volume of detailed work accurately and completely.
Ability to research and compile information and exercise good judgment.
Engages in continuous learning opportunities to further develop skills and capabilities in procedures and principles
Consistently presents a calm, competent, and professional image to the public and other MOFB employees
Takes responsibilities seriously and consistently meets MOFB’s expectations for quality, service, and professionalism
Co-operate with team members to contribute to the achievement of MOFB’s goals and mission
CERTIFICATES, LICENSES, REGISTRATIONS
Valid Missouri Driver License required.
PHYSICAL DEMANDS:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The employee is regularly required to stand, walk, sit, see, talk, and hear. The employee is frequently required to climb or balance, reach with hands and arms, and stoop, kneel, crouch, or crawl. The employee must regularly lift and/or move up to 20 pounds, and occasionally life and/or move up to 50 pounds.
WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The employee is frequently exposed to wet and/or humid conditions; moving mechanical parts; high, precarious places; fumes or airborne particles; toxic or caustic chemicals; outside weather conditions; and risk of electrical shock. The noise level in the work environment is usually moderate.