Esurance Claims Non-Attorney Rep Adjuster in Richardson, Texas
Adjuster focuses on customer needs and closely works with the customer throughout the claims process. Handles first and third party bodily injury and assignment of property damage claims. Role will explore all settlement opportunities and tools for resolution, focuses on claim resolution without attorney involvement and with authority levels up to $12,500 handling claims in excess of this authority with manager supervision.
Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution. Focus will be on speed and quality of contacts, investigations, evaluations, and negotiations.
Documents files to include all key activities, contacts made, statements taken, outline covering all aspects of the claim and for resolution.
Determines liability exposures for moderate impact losses to include complex comparative negligence issues.
Analyzes facts of loss, injury, and possible exposure potential for proper reserving.
Makes appropriate material damage assignments and handles initial rental assignments including repair and/or rental questions from the customer.
Determines the utilization of outside investigators or experts to assist in the review or investigation of more complex claims.
Reviews, evaluates and negotiates bodily injury claims with unrepresented insureds/claimants; Evaluates soft tissue injuries will be primary focus.
Review medical records and bills to validate accuracy of services provided.
Completes bodily injury evaluation summary including liability, damages, causation, diagnosis, treatment, reserves, and general damages.
Utilizes expert systems to assist in the review and evaluation of claims.
Identifies referrals, completes proper summaries and forwards files to subrogation for collection in a timely manner.
Refers files for specialization such as SIU focus, minor damage focus and sends correspondences related to claim and department of insurance regulations.
Follow-ups with the customer are frequent and vary based upon the facts of the claim.
Negotiate liens with healthcare and workers’ compensation providers for first and third party injury claims.
Detail-oriented with strong organizational, negotiation, influential, and customer service skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently.
Demonstrated ability to work effectively independently and within a collaborative team oriented environment using sound judgment in decision-making.
Demonstrated ability to manage relationships with both internal and external customers.
Excellent communication skills both oral and written with strong presentation skills.
Strong analytical and problem solving skills.
Demonstrated knowledge with MS Office products (Outlook, Word, Excel, PowerPoint) and claims related software applications.
Demonstrated knowledge of medical treatments and understanding of the relationship between vehicle impact and claimed injuries.
Demonstrated knowledge with handling claims involving minor to moderate issues of coverage.
Experience / Education:
Bachelor’s degree in Business Administration, a related field, and/or education required.
Three to five years of claims adjuster experience.
Physical Demands and Work Environment: Representative of those that must be met by an employee to successfully perform the essential functions of this job. Must be able to operate a PC and sit for extended periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.