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.
Performs complex claim handling duties as assigned within the property discipline.
Conducts on-site field investigation and assessment of reported claims as needed and assigned.
Documents the claim file in a prompt, clear, and concise manner, with the facts gathered in the investigation.
Evaluates coverage, gathers evidence and documentation, and determines whether coverage is applicable for assigned losses.
Establishes, evaluates, and maintains individual case reserves in accordance with the Claims Department Reserving Philosophy.
Conducts detailed analysis and applies proper legal theory in determining negligence, evaluating medical records and injury valuation, and/or preparing large property loss estimates.
Negotiates fault and damages with insureds, claimants, adverse carriers, attorneys, or other involved parties.
Determines value of covered damages, and adjudicates the claim within their authority level, or presents valuation evidence to the Claims Supervisor for additional authority as needed, while maintaining compliance with applicable laws, regulations, and company guidelines.
Coordinates with outside vendors and experts for attorney services, fire cause and origin, professional engineering services (structural, mechanical, and electrical), estimate reviews, accident reconstruction, medical bill reviews, appraisal services, and official reports.
Performs and assists with subrogation and salvage recovery efforts, to include identifying recovery potential, and/or pursuing liable tortfeasor or other insurance carriers, as warranted.
Assists in the handling of claims at other claim levels and claim disciplines as necessary and within authority.
Prepares detailed, technical, written correspondence to communicate investigation, findings, policy application, or other activities involved in the adjudication of a claim.
Attends and participates in Alternative Dispute Resolution, Examinations Under Oath, or any legal proceedings up to and including trial.
Directly handles and/or assists with storm and catastrophe losses as needed.
Remains on-call for storm/catastrophe claims, or other escalated claims as needed.
Assists in the handling of claims at other claim handling levels as necessary and within authority.
Assists with training personnel as needed.
Provides excellent customer service to all external and internal customers and maintains good working relationships with field and Home Office personnel.
Performs other duties as assigned.
EDUCATION and/or EXPERIENCE
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.
