Claims Representative TPA

Summary:   Primarily responsible for the handling of Auto One claims in California. It will involve managing these claims on a separate claims operating system, while adhering to the Esurance Claims Handling Guidelines. Additional duties will include handling Esurance claims on an as needed basis.

 

Job Responsibilities:

 
Review new losses to examine coverage, initial contacts, and a course of action to follow
Clear up any coverage issues, reviewing the policy and all endorsements that could affect coverage
Make recommendations to underwriting as needed for correct policy rating where coverage cannot be found, the ability to obtain all the needed documentation from which to make a final decision on coverage
Initial contact with all involved parties in the claim to determine the exposures and needed steps in resolving the claim
Take the needed recorded statements, obtaining police reports, and outlining exactly what will be needed to come to a final liability determination 
Work with the approved list of Preferred Shops, Independent Adjusters, and Field Appraisers to resolve all property damage claims
Proper summary on any file needing referral to Subrogation for collection
Extensive knowledge of overall bodily injury handling
Ability to evaluate, negotiate and settle bodily injury claims
Work with Defense Counsel in all aspects of discovery to bring the file to closure
Complete all the necessary letters, forms and releases associated with cases that have been resolved or referred to Counsel
Document in the files, all key activities, contacts made, statements taken, including a full outline covering all aspects of the claim and what is needed for resolution
Understand all Department of Insurance Regulations and Insurance Codes that are applicable to claims handling



 

 

Qualifications:

 



?  Bachelor?s degree and/or equivalent work experience is required

?  Prior auto claims experience is required

?  Excellent verbal, written and interpersonal skills

?  Strong analytical skills

?  Organizational and multi-tasking abilities

?  Solid negotiation skills

?  Exceptional customer service skills

?  Team Player who can assist others as needed

?  Solid computer skills and use with MS Office Products

 

 

If you'd like to be a part of a team that is revolutionizing the way people think about insurance, please submit your resume to us by clicking on the following link: