Primary Responsibilities:
- Identifies and manages existing and emerging risks that stem from business activities and the job role.
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.
- Follows written risk and compliance policies and procedures for business activities.
- Manages assigned claims caseload comprised of claims with moderate to complex damages. Updates initial reserve levels dictated by complexity. Leverages digital platform(s) to prepare estimates.
- Partners with vendors and internal business partners to initiate inspections and facilitate moderately complex claims resolution.
- Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies resulting from unusual characteristics.
- Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate.
- Determines coverage through analyzing investigation information involving moderate to complex claim recommendation and resolution.
- Communicates with the insured about coverage and any issues that arise. Determines and negotiates settlement amounts for damages claimed.
