Claims Specialist I - Auto Injury Adjuster hybrid

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Claims Specialist I - Auto Injury Adjuster
The candidate will be documenting 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 judgement 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 limits. Ensuring 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. Should have Juris Doctor degree and 1+ years of experience in the Claims Handling or Insurance area OR 1+ years in the Claims Foundational Training Program OR Bachelor’s Degree and 2+ years of experience in the Claims Handling or Insurance area OR Zurich Certified Insurance Apprentice including an Associate Degree with 2+ years of experience in the Claims Handling or Insurance area OR High School Diploma or Equivalent and 4+ years of experience in the Claims Handling or Insurance area. Customer service experience is required.

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