Job Details

Requisition Number 17-0261
Post Date 11/30/2017
Title Claims-Casualty Claims Rep III
City Macon
State GA
Description The employee must be able to organize and prioritize work; must have knowledge of office administration procedures and able to operate most standard office equipment. The employee must pay attention to detail in composing and proofing materials. Must be self motivated with initiative and ability to make decisions and accept responsibility. Be flexible to respond to unexpected situations that require immediate attention. A high level of confidentiality is to be maintained by the employee.
‘The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, or skills required of personnel so classified.”
The employee is expected gather information from both members and nonmembers, police agencies, medical record facilities and all other reasonable resources in an effort to make claims handling decisions included but not limited to coverage, liability, and loss settlement. The employee is also responsible for:
- Cycle time
- Severity
- Quality of claims file
- Customer Satisfaction level
- Professional development of self
Employee promotion, development, growth, and advancement is based on but not limited to job performance at the current level along with the ability and capacity to undertake additional responsibilities.

Evaluate, handle, and adjust automobile claims to include serious bodily injury claims, medical payments claims, UMBI losses, total losses, some fatality claims and other automobile casualty losses. Assure high customer satisfaction levels through professionalism, integrity, fairness and promptness. Maintain satisfactory levels of productivity / claims handling cycle time. Continue job development through training. The employee will be expected to handle numerous claims in above average complexity and maintain a healthy diary system at an advanced level. Must be self motivated with initiative and ability to make decisions, accept responsibility; to include being dependable, resourceful and a problem solver. Be flexible to respond to unexpected situations that require immediate attention. Adjust bodily injury and non-bodily injury claims by evaluating and negotiating claims settlement. This is handled using investigative and negotiating skills with clients, claimants, attorneys and medical professionals. Also determines reserves needed and ensures they are
adequately adjusted throughout the life of the file. Manage files through gathering of information through written or phone interactions and securing necessary documents such as police reports, death certificates, medical information, property repair estimates, and witness statements, as needed to settle claims. This includes proper documentation in the claims system. A high level of confidentiality is to be maintained by the employee. The employee may meet with multiple members of management at once to discuss and advise on claim actions in both written and verbal format. The employee may assist other key Claims units in times of need. Occasionally the employee may be asked to assist a supervisor/ manger in employee development, training, mentoring, and team development. The employee may be asked to work on special projects and or serve on committees.

Other duties as assigned by Manager or Supervisor

Requirements 4 year college degree plus at least 1 year of property casualty with bodily injury adjusting experience preferred, or 2 years of college and 3 years property and casualty with bodily injury adjusting experience preferred, or 5 years of property and casualty with bodily injury adjusting experience preferred. AIC, CPCU or other insurance certification strongly desired. The employee is expected to pass the introduction to INS Series within 6 months of the hiring date.
Language Skills:
Must be able to read, analyze and interpret procedures, regulations, instructions, manuals and other documents as required. Excellent telephone, public relations and oral/written communication skills are required.
Reasoning Skills:
Must be able to solve practical problems and deal with a variety of concrete variables. Ability to interpret a variety of instructions furnished in written, oral, or schedule form.
Computer Skills:
Must possess basic skills and be proficient or have demonstrated aptitude with computers including experience with Excel, Word, and web based systems.
While performing the duties of this job, the employee is required to operate in a normal office environment with occasional travel necessary to visit office locations, conduct investigations, attend conferences/training classes and meetings. The employee is required to sit, use hands to finger, handle controls and talk and hear. The employee frequently is required to reach with hands and arms. The employee is occasionally required to stoop, lift and move up to 30 pounds. Specific vision requirements by this job include close vision. Must maintain a valid Georgia drivers license.
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