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Senior Claim Representative I in Charlotte, NC at AF Group

Date Posted: 10/2/2018

Job Snapshot

Job Description

United Heartland - Southeastern Region



SUMMARY:

This position serves as a technical expert in the claim handler career path. Under limited supervision, handles claims with litigation, complex/catastrophic and/or coverage elements. Handles the most unique cases, where little precedence has been established. May handle the most complex, high touch or labor intensive customers. Serves as a department leader by developing other employees and may function as acting manager in the absence of department management.



RESPONSIBILITIES/TASKS:

  • Independently administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts.
  • Establishes timely and appropriate reserves based on claim profile and anticipated financial exposure.
  • Represents the Company by working closely with customers, agents and brokers to resolve the most complex claim issues.
  • Negotiates settlements with attorneys or injured and exercises independent judgment to settle cases prior to mediation or litigation.
  • Manages outside vendors to ensure cost containment efforts.
  • Establishes and maintains effective working relationships with all internal and external customers.
  • Stays abreast of changes in workers' compensation statutes, case law and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws.
  • Actively participates in agent/client relationship management.
  • Mentors team members.
  • May serve as department leader in the absence of management or act as manager designee.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

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