ESIS Claims Representative
Location: Wilmington, Delaware
Description: Ace Group is at present looking to employ ESIS Claims Representative right now, this career will be situated in Delaware. More details about this career opportunity kindly see the descriptions. Claims Representative
Under the direction of the Claims Team Leader investigates and settles claims promptly, equitably and within established best practices guidelines.
C.MAJO! R DUTIES & RESPONSIBILITIES:
Duties may include but are not limited to:
Receive assignments.
Reviews claim and policy information to provide background for investigation and may determine the extent of the policys obligation to the insured depending on the line of business.
Contacts, interviews and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
Depending on line of business may inspect and appraise damage for property losses or arranges for such appraisal.
Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the companys obligation to the insured under the policy contract.
Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
Sets reserves within authority limits and re! commends reserve changes to Team Leader.
Reviews prog! ress and status of claims with Team Leader and discusses problems and suggested remedial actions.
Prepares and submits to Team Leader unusual or possible undesirable exposures.
Assists Team Leader in developing methods and improvements for handling claims.
Settles claims promptly and equitably.
Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
Informs claimants, insureds/customers or attorney of denial of claim when applicable.
May assist Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements. Continues efforts to settle claims before trial.
Refers claims to subrogation as appropriate. May arrange for salvage disposition or other recovery proceedings as necessary by line of business.
May participate in claim file reviews and audits with customer/insured and broker.
! Administers benefits timely and appropriately. Maintains control of claims resolution process to minimize current exposure and future risks
Establishes and maintains strong customer relations
Depending on line of business, other duties may include:
Maintaining system logs
Investigating compensability and benefit entitlement
Reviewing and approving medical bill payments
Managing vocational rehabilitation
D.SCOPE INFORMATION: (include operating budget, revenue goals, reporting relationships, # of direct/indirect reports, etc.) The position reports directly to a Claims Team Leader or other member of claims management.
E.MINIMUM REQUIREMENTS:
F.DESIRED QUALIFICATIONS:
2-5 years experience handling claims in a relevant line of business.
Basic knowledge of claims handling and familiarity with claims terminologies
Effective negotiation skills
Strong com! munication and interpersonal skills to be capable of dealing with claim! ants, customers, insureds, brokers, attorneys etc in a positive manner concerning losses.
Ability to self motivate and work independently
Knowledge of ACE products, services, coverages and policy limits, along with awareness of ACE claims best practices
Knowledge of applicable state and local laws related t
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to Ace Group.
Interested on this career, just click on the Apply button, you will be redirected to the official website
This career will be opened on: Mon, 29 Apr 2013 09:25:45 GMT
Apply ESIS Claims Representative Here