Defense Based Act Claims Representative

• Manage an inventory of low to moderate complexity commercial claims
• Verify policy coverage, gather information, maintain file documentation, and authorize disbursements within authority limits
• Interact with insureds, claimants, customers, and business partners to provide updates and respond to inquiries
• Establish reserves and estimate potential claim valuation by reviewing policy language
• Investigate claims, take recorded statements, and work with experts to determine liability and compensability
• Collaborate with internal and external partners, suppliers, and experts to achieve claim outcomes
• Negotiate settlements and elevate claims to management when appropriate
• Resolve claims accurately and timely while managing expenses and resources
• Identify subrogation, salvage, and potential fraud opportunities and make appropriate referrals
• Meet quality, cycle-time, documentation, regulatory, and claim-disbursement standards
• Stay current on commercial insurance laws, regulations, and trends

• High school Diploma required
• Associates or Bachelor's Degree preferred
• Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable
• Developing basic knowledge of the commercial insurance industry, products, and claim practices
• Good verbal and written communication skills with the ability to demonstrate empathy and provide exceptional customer servicelk
• Ability to develop collaborative business relationships with internal and external work partners
• Ability to exercise independent judgment, solve basic problems, and make sound business decisions
• Analytical mindset and critical thinking skills
• Strong work ethic, time management, and organizational skills
• Ability to manage multiple priorities in a fast-paced, collaborative environment
• Knowledge of Microsoft Office Suite and ability to learn business-related software
• Adaptability to a changing environment
• Ability to value diverse opinions and ideas
• Prior claim handling, insurance-industry business experience, and/or customer service preferred

Demonstrates expertise in managing commercial claims, including verifying policy coverage, investigating claims, and negotiating settlements. Proficient in maintaining documentation standards and staying current with insurance regulations and trends.

• Insurance Adjuster License
• Claims Investigation
• Negotiation Skills
• Commercial Insurance Knowledge
• Customer Service

• Claims Management
• Policy Coverage Verification
• Claim Valuation
• Documentation Maintenance
• Subrogation Identification
• Fraud Detection
• Analytical Skills
• Problem Solving
• Time Management
• Organizational Skills

• Verbal Communication
• Written Communication
• Empathy
• Collaboration
• Adaptability

• Insurance Adjuster License

• Commercial Claims
• Insurance Industry
• Claim Practices
• Regulatory Standards
• Customer Service Standards

• Microsoft Office Suite
• Business-Related Software