Claims Specialist I - Auto

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Claims Specialist I - Auto
Duties: The candidate will be documenting the claims file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate exposure and complexity personal or commercial line claims. Exercising judgment to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence. Exercising judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage. Working to have a timely resolution to claims by developing case strategy; developing a case evaluation; escalating issues as appropriate. Establishing timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims. Assessing damages by calculating applicable damages or range of damages allowed by law. Negotiating settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limit. sEnsuring customer service by proactively communicating information; responding to inquiries; following customer protocols and may participating in customer marketing efforts. Ensuring legal compliance by following state and federal laws and regulations and internal control requirements. Referring claims to subrogation and fraud teams by identifying potential subrogation and fraud. Responding to inter-company arbitrations through Arbitration Forums.

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