ESIS Claims Representative
Location: Wilmington, Delaware
Description: Ace Group is currently interviewing ESIS Claims Representative right now, this vacancy will be placed in Delaware. Detailed specification about this vacancy opportunity please give attention to these descriptions. Claims Representative
Under the direction of the Claims Team Leader investigates and settles claims promptly, equitably and within established best practices guidelines! .
C. MAJOR 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 policy’s 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 company’s obligation to the insured under the policy contract.
- Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
- Sets res! erves within authority limits and recommends reserve changes t! o Team Leader.
- Reviews progress 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 cu! stomer/insured and broker.
- Administers benefits timely and appropriately. Maintains control of claim’s resolution process to minimize current exposure and future risks
- Establishes and maintains strong customer relations
- Maintaining system logs
- Investigating compensability and benefit entitlement
- Reviewing and approving medical bill payments
- Managing vocational rehabilitation
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 termino! logies
- Effective negotiation skills
- Strong communicat! ion and interpersonal skills to be capable of dealing with claimants, 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 vacancy, please send us your resume, with salary requirements and a resume to Ace Group.
Interested on this vacancy, just click on the Apply button, you will be redirected to the official website
This vacancy will be opened on: Sat, 20 Apr 2013 12:55:41 GMT
Apply ESIS Claims Representative Here