Commercial Claims Specialist
|Position Number:||00418, 00072|
|# of openings:||2|
POSITION SUMMARY: The purpose of the position is to perform internal and external quality reviews to ensure compliance with company policies and procedures, provide training and support for our IA/GA/EGA resources and to provide oversight for the multiple claim workflows including claims with complex structural damages. During catastrophe response, the position will be responsible for providing supervision and direction to our IA Team Leads and their Field Adjusters. The position mandates successful completion requirements of Fundamental Claims School, which includes obtaining an overall passing score.
ESSENTIAL FUNCTIONS: THE FOLLOWING ARE THE USUAL, BASIC AND ESSENTIAL FUNCTIONS OF THE POSITION. THESE FUNCTIONS ARE NOT TO BE CONSTRUED AS AN EXHAUSTIVE LIST OF ALL RESPONSIBILITIES, DUTIES, AND SKILLS REQUIRED.
· Settles claims and manages the most complex structural losses to include; file action plans, agreements in scope/estimates, reserving, pending file strategies, negotiations, re-inspections and claims resolution utilizing all current claims models.
· Communicates with multiple parties until claim is resolved (such as contractors, public adjusters, attorneys, insured or representatives).
· Researches, analyzes and interprets policy language and state law as necessary.
· Performs open and closed claim file reviews to evaluate and document overall operational value.
· Identifies training opportunities based on Q/A reviews
· Trains, mentors, and guides external business partners and less experienced staff.
· Conducts audits of the claims process to include; coverage analysis, investigation, valuation, reserving and the accurate disposition of claims.
· Develops audit plans and measurement tools. Able to analyze audit results and trends with appropriate reporting to management.
· Provides feedback to Vendor Relations on vendor performance metrics.
· Oversees vendors working within the differing claims models.
· Assists in the development of the Commercial Property CAT Plan which includes:
· Working with Shared Services to establish workflows, identify and address support needs such commercial-specific orientation, QA assistance etc.
· Working with Vendor Relations to establish 3rd Party vendor teams comprised of IA/GA/EGAs who will assist in various Event Response capacities (Response Management, Reconnaissance, Reinspection, Phone Units etc.)
· Trains the IA/GA/EGAs who have been selected to fulfill an Event Response role.
EVENT RESPONSE FUNCTIONS:
· Implements the Commercial Property CAT Plan.
· Supervises all Event Response personnel (internal and 3rd party).
REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:
· Knowledge and experience in commercial construction to include repair methodology, understanding and application of building codes, and the ability to converse effectively with knowledgeable 3rd parties.
· Extensive knowledge and experience scoping and estimating commercial property losses.
· Working knowledge of estimating programs for evaluating and determining scope and repair costs.
· Practical experience across classes of business, types of risk, including residential and non-residential condominium associations, apartments or other commercial exposures.
· Knowledge of Florida property claim law and jurisdictional issues.
· Experience in managing large, diverse teams of experts and subordinate adjusters.
· Extensive catastrophe experience with an emphasis on response management.
· Technical expertise to conduct reinspection and file reviews based on company standards.
· Ability to plan and prioritize workload, organize and coordinate multiple tasks and projects.
· Strong communication, negotiation and organizational skills.
· Demonstrated leadership skills during response to catastrophic event(s)
· Computer literacy in Microsoft Word, Excel, Access and Outlook.
· Ability to travel frequently overnight and for long periods of time.
REQUIRED EDUCATION AND EXPERIENCE:
· Associate’s degree in field with skills transferable to insurance OR two years of experience relevant to position.
· Minimum of eight (8) years of commercial property loss adjusting experience
· Active Florida Adjuster license (620 for all lines) appointment required within 90 days of employment.
· Within 90 days of employment, must successfully complete all requirements of Citizens Fundamental Claims School which includes obtaining an overall passing score.
PREFERRED EDUCATION AND EXPERIENCE:
· 4 year college degree, preferably in an industry related field of study (e.g. Insurance, Construction, Business Administration)
· Professional designation such as Chartered Property Casualty Underwriter Professional (CPCU) or Commercial Lines Coverage Specialist (CLCS).
· Construction Experience
· Field claims experience adjusting commercial losses in excess of $1 million.
· Demonstrated proficiency using Xact Suite of products.
· Previous supervisory experience
· Two years training experience in property claims.
· Two years quality review experience in property claims.
This position requires the ability to sit or stand for long periods of time, hear and converse over the telephone, to speak to large groups both with and without microphone, and key frequently on a computer (2 or more hours per day). Position also requires the ability to be mobile, operate a motor vehicle, climb a ladder and ability to inspect roofs, inspect homes including attics, crawl spaces, navigating through debris, and activities associated with measuring and taking photos. Position requires overnight travel, often for extended periods of time, as well as participation in CAT Events and hours associated with CAT activity.
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