Commercial Auto, Property Damage, Claims Examiner II _ Temp

Job Details: Level: Experienced, Job Location: Involuntary - Unit 3 - Remote - All States, PA, Position Type: Temporary, Education Level: High School Diploma or GED, Salary Range: $75000.00 - $83000.00Salary/year, Travel Percentage: None, Job Shift: Day, Job Category: Admin - Clerical, POSITION SUMMARY: Responsible for the prompt review and interpretation of policy information to determine coverage for automobile physical damage, property damage liability, and No-Fault/PIP claims, as assigned. Conduct thorough and efficient claim examinations and investigations through final resolution, including claims involving litigation.

The position requires frequent communication with claimants, insureds, legal representatives, clients, vendors, and other involved parties. Effectively communicate claim exposure, reserve recommendations, settlement strategies, and resolution plans to the client.

DUTIES AND RESPONSIBILITIES:

Review and interpret policy coverage and investigate, evaluate, process, negotiate, and resolve assigned automobile physical damage, and property damage liability claims.
Jurisdiction is NY & NJ claims.
Analyze coverage, liability, and damages and identify any issues requiring additional investigation or escalation.
Oversee and direct outside service providers, including appraisers and investigators, and work closely with clients, client counsel, and other involved parties to advance claims toward resolution.
Maintain an accurate and timely diary system and complete all required follow-up activities.
Continually evaluate claim exposure and establish or recommend accurate reserves and settlement strategies based on available information.
Prepare comprehensive loss reports that provide a thorough analysis of coverage, liability, damages, exposure, reserves, and recommended next steps.
Determine whether subrogation, contribution, or other risk-transfer opportunities exist and initiate recovery efforts in accordance with client instructions.
Accurately document all correspondence, reports, discussions, evaluations, and claim decisions in the claim file.
Independently conduct claim file reviews and ensure files are properly documented and handled in accordance with applicable requirements.
Provide timely, professional, and responsive service to clients, claimants, insureds, and other involved parties.
Engage TRISTAR Loss Control staff when appropriate. *
Comply with all company policies, procedures, client service instructions, and applicable regulatory requirements. *
Perform other duties and special projects as assigned.

* Essential job function.

EQUIPMENT OPERATED/USED: Computer, fax machine, copier, printer, and other office equipment.

SPECIAL EQUIPMENT OR CLOTHING: Appropriate business casual office attire

 
Qualifications: QUALIFICATIONS REQUIRED:

Education/Experience: High school diploma or GED required. Bachelor’s degree in business, insurance, risk management, or a related field preferred. A minimum of two years of experience handling automobile physical damage, property damage liability, general liability casualty, and/or No-Fault/PIP claims is required. An equivalent combination of relevant education, training, and experience may be considered.

KNOWLEDGE, SKILLS AND ABILITIES

Minimum of two years of automobile claims-handling experience.
Working knowledge of claim-handling principles, practices, and procedures, including policy interpretation, coverage analysis, liability assessment, damage evaluation, reserving, negotiation, and settlement.
Ability to investigate, evaluate, negotiate, and resolve assigned claims with minimal supervision.
Strong analytical, critical-thinking, decision-making, and problem-solving skills.
Ability to evaluate complex claim information, exercise sound judgment, and make well-supported recommendations.
Strong verbal and written communication skills.
Ability to communicate professionally and effectively with clients, claimants, insureds, attorneys, vendors, and other involved parties.
Strong customer-service and relationship-management skills.
Ability to manage competing priorities and maintain accuracy in a fast-paced environment.
Strong organizational, time-management, and follow-up skills.
Ability to understand and carry out detailed written and verbal instructions.
Ability to maintain complete, accurate, and timely claim documentation.
Proficiency with computers, claims-management systems, and standard business applications.
Ability to work independently while remaining flexible and responsive to changing client and business needs.
Ability to follow company guidelines, client service instructions, applicable regulations, and industry best practices.

LICENSES AND OTHER REQUIREMENTS:

Must possess a current and valid New York adjuster license.
Must be willing and able to obtain and maintain a California adjuster license within the timeframe established by the company.
Must obtain and maintain any additional licenses required to handle assigned claims.
Must be available to work on the company’s established Eastern Time core business hours.

Mental and Physical Requirements: [see separate attachment for a copy of checklist of mental and physical requirements]

                          MENTAL AND PHYSICAL REQUIREMENTS

1.  MENTAL EFFORT

a.      Reasoning development:

             Follow one- or two-step instructions; routine, repetitive task.

         Carry out detail but uninvolved written or verbal instructions; deal with a few concrete             variables.

         Follow written, verbal, or diagrammatic instructions; several concrete variables.

 X         Solve practical problems; variety of variables with limited standardization; interpret instructions.

         Logical or scientific thinking to solve problems; several abstract and concrete variables.

         Wide range of intellectual and practical problems; comprehend most obscure concepts.

b.      Mathematical development:

        Simple additional and subtraction; copying figures, counting, and recording.

        Add, subtract, multiply, and divide whole numbers.

 X    Arithmetic calculations involving fractions, decimals, and percentages.

        Arithmetic, algebraic, and geometric calculations.

        Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.

        Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination; requires theoretical application.

c.     Language development:

        Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.

        Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.

        Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.

 X    Ability to compose original correspondence, follow technical manuals, and have increased contact with people.

         Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.

2.  PHYSICAL EFFORT

a.      Physical activity required to perform the job:

         Sedentary work:  Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time.  Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

 X    Light work:

a.   Exerting up to 20 pounds of force occasionally

b.   Exerting up to 10 pounds frequently

c.   Exerting a negligible amount of force constantly to move objects

         (If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most of the time, the job is rated for Light Work).

        Medium work:

a.   Exerting up to 50 pounds of force occasionally

b.   Exerting up to 20 pounds of force frequently

c.   Exerting up to 10 pounds of force constantly to move objects

        Heavy work:

a.   Exerting up to 100 pounds of force occasionally

b.   Exerting up to 50 pounds of force frequently

c.   Exerting up to 20 pounds of force constantly to move objects

        Very heavy work:

a.   Exerting in excess of 100 pounds of force occasionally

b.   Exerting in excess of 50 pounds of force constantly to move objects

c.   Exerting in excess of 20 pounds of force constantly to move objects

Visual requirements necessary to perform the job:

         Far vision:  clarity of vision at 20 feet or more

 X         Near vision:  clarity of vision at 20 inches or less

 X        Mid-range vision:  clarity of vision at distances of more than 20 inches and less than 20 feet

         Depth perception:  the ability to judge distance and space relationships, so as to see objects where and as they actually are

         Color vision:  ability to identify and distinguish colors

         Field of vision:  ability to observe an area up or down or to the right or left while eyes are fixed on a given point

2.  PHYSICAL EFFORT (cont.)

  FREQUENCY

c.   Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally):

            Climbing:     Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms.  Body agility is  emphasized.  This factor is important if the amount and kind of climbing required exceeds that required for ordinary locomotion.

            Balancing:    Maintaining body equilibrium to prevent falling when walking, standing, or crouching on narrow, slippery, or erratically moving surfaces.  This factor is important if the amount and kind of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium.

 X Stooping:   Bending body downward and forward by bending spine at the waist.  This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.

 X        Kneeling:     Bending legs at knee to come to a rest on knee or knees.

 X Crouching: Bending the body downward and forward by bending legs and spine.

      Crawling:  Moving about on hands and knees or hands and feet.

 X Reaching:  Extending hand(s) and arm(s) in any direction.

 X        Standing:      Particularly for sustained periods of time.

 X Walking:   Moving about on foot to accomplish tasks, particularly for long distances.

 X Pushing:    Using upper extremities top press against something with steady force in order to thrust forward, downward, or outward.

 X        Pulling:        Using upper extremities to extent force in order to drag, haul, or tug objects in a sustained motion.

      Foot

       Motion:     Using feet to push pedals.

 X Lifting:      Raising objects from a lower to a higher position or moving objects horizontally from position to position.  This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.

 X Fingering:  Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.

 X Grasping:   Applying pressure to an object with the fingers and palm.

Occasionally

Occasionally

Occasionally

Occasionally

Occasionally

Occasionally

Occasionally

Occasionally

Frequently

Frequently

Occasionally

 
 
 
 

2.  PHYSICAL EFFORT (cont.)       

    FREQUENCY

 X        Talking:          Expressing or exchanging ideas by means of the spoken word.  Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.

 X        Hearing:          Perceiving the nature of sounds with or without correction.  Ability to receive detailed information through verbal communication, and to make fine discriminations in sound, such as when making find adjustments on machined parts.

      Feeling:     Perceiving attributes of objects, such as size, shape, temperature, or texture by touching with skin, particularly that of fingertips.

 X        Repetitive       Substantial movements (motions) of the wrists, hands,

      Motion:      and/or fingers.

Frequently

Frequently

Frequently

3.  WORKING CONDITIONS

Disagreeable job conditions to which the employee may be exposed and the frequency (e.g., continually, frequently, or occasionally) of this exposure. 

    WORKING CONDITION

       ENVIRONMENTAL

                 FACTOR

        NATURE/REASON

           OF EXPOSURE

            FREQUENCY

Dirt/Dust

Noise

Temperature extremes

Dampness

Vibrations

Equipment movement hazard

Chemicals/solvents

Electrical shock

Significant work pace/pressure

Odors/Fumes

Other (specify):