Claims Representative - Auto Physical Damage

Please note, employment offered to residents in the following states only: Connecticut, Delaware, Massachusetts, Maryland, Maine, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont.

At Preferred, we understand the importance of holistic health. To meet the diverse needs of our employees, we offer a comprehensive set of benefits:

Financial

• Short-term disability, long-term disability, and life insurance coverage are provided at no cost
• Optional benefits include enhanced life insurance and critical illness plans
• 401k plan with an employer contribution that you will receive regardless of your own contribution to the plan
• A cash-balance pension plan
• Student Loan Repayment Assistance
• A short-term incentive plan for all employees

Social

• Generous paid time off, offering of 25 days at hire (prorated based on start date for the first year)
• 7 days of paid sick leave
• 10 paid company holidays
• Personalized paid time off after 3 years!

Emotional

• Access to 26 sessions with a BetterHelp therapist each year for you and up to 5 dependents, as well as access to all of BetterHelp’s group and digital resources
• Access to Family First, a team of care experts who can provide you and your loved ones 1:1 assistance with a variety of caregiving solutions, from elder care to legal and financial challenges, insurance and Medicare navigation, and more!

Physical

• Medical, dental, and vision coverage options begin on the first day of employment
• Health Savings Accounts (with a generous employer contribution!)

YOUR PURPOSE AND FUNCTION IN OUR COMPANY:

Alleviate the impact of adversity during challenging life events by the prompt investigation and resolution of claims. Supports and contributes to the Claims Department and Company’s missions, visions, values, and goals.

KEY CAPABILITIES FOR SUCCESS:

• Evaluate files for the accurate and timely reserving of claims in accordance with the Preferred Mutual reserving philosophy.
• Appropriately manage indemnity and loss expenses.
• Conduct thorough and timely investigation to determine liability and claim valuation.
• Treat customers in a proactive and responsible manner
• Adjust schedule as needed to accommodate customer needs and/or fluctuations in work volume.
• Leverage technology as a critical component in achieving efficiencies and delivering superior customer service.
• Handle claims of moderate severity and complexity, with authority up to $45,000
• Display an understanding of avenues of contribution and recovery by third parties and takes appropriate action when necessary.
• Resolve claims promptly and fairly in a manner that is reflective of coverage, liability, and damages.
• Demonstrate an understanding of claim procedures and file administration for proper file documentation and claim reporting.
• Demonstrate an understanding of products and coverages offered by Preferred Mutual;
• Meet file quality standards as determined by internal and external audits.
• Maintain work load in accordance with Key Performance Driver standards.
• Develop an understanding of fraud indicators.
• Recognize Key data points within the claim management and other systems and utilizes the data to make informed decisions and reach better claim resolutions.

FUNCTIONAL AREA RESPONSIBILITIES:

• Handles low to moderately complex losses, including liability exposures, with a focus on soundness and promptness of coverage and liability investigation and verification
• Demonstrates independent and effective analysis and decision making when a scenario is not new
• Demonstrate a developed understanding of the policies with an ability to identify coverage concerns & red flags independently
• Researches then seeks help when a situation is new or complex
• Displays a high quality of damages verification and negotiation; subrogation investigation and preservation
• Demonstrates soundness and timeliness of liability and coverage denials
• Displays effective expense management and accurate file reserving
• Able to draft appropriate coverage letters/communications to customers with some intervention
• Demonstrates willingness to lead and direct their files with less oversight needed

QUALIFICATIONS:

• High School Diploma or Equivalent
• Bachelor's degree preferred
• 2 or more years of experience in claim processing, Auto Physical Damage strongly preferred