MMG Insurance
Property Claims Examiner
MMG Insurance, Presque Isle, ME
MMG INSURANCE COMPANY
Job Description
Job Title:Property Examiner
Department: Property Claims
Reports To:Manager
FLSA Status:Exempt
SUMMARY
Provides a high degree of expertisewith regard to the full life cycle of high value, complex claims.Responsible for investigating, evaluating, reserving, negotiating, and settling of high exposure and complex first party claims. Evaluates property-related damage estimates up to $1M+. Must routinely confer with defense attorneys and various experts; communicate technical information; manage relationships with independent adjusters; and verify investigative information.
ESSENTIAL DUTIES AND RESPONSIBILITIES
• Oversee and direct independent claims adjusters to ensure that adjusters have followed proper methods.
• Investigate, evaluate and settle claims valued up to $1M+, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
• Assists Management in training and mentoring adjusters
• Resolve complex, severe exposure claims, using high service-oriented file handling.
• Adjust reserves and provide reserve recommendations to ensure reserving activities consistent with corporate policies.
• Communicate with reinsurance brokers to obtain information necessary for processing claims.
• Conduct detailed bill reviews to implement sound litigation management and expense control.
• Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
• Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments with a focus on controlling adjusting expenses.
• Enter claim payments, reserves and new claims on computer system, inputting concise yetsufficientfile documentation.
• Prepares high level cases and represents the company's position at mediation and arbitration hearings.
• Serves as a technical and subject matter expert to assist Senior Adjuster, Adjusters and Associate Adjusters in processing challenging claims.
• Liaises across Marketing and Underwriting departments external partners to provide input relating to coverage questions on behalf of the Property Claims team.
• Present cases and participate in their discussion at claim committee meetings.
• Investigates and prepares files for Subrogation.
• Communicates verbally and through written reports, memoranda with insureds, claimants, attorneys, state and local police, fire departments, adjusters, other companies or contractors, insurance agents, and other individuals, as needed.
• Travels as required to perform the essential duties and responsibilities of the position and to fulfill educational requirements.Travels to home office for periodic meetings. (May include overnight stays.)
• Develops and maintains positive relationships with independent adjusting firms, agents, independent attorneys and other similar firms, as necessary, which may include travel, visitation and attendance at various conventions and meetings.(May include overnight stays.)
• Closely monitor and report overpayments, underpayments, and other irregularities.
• Other duties may be assigned.
OTHER SKILLS AND ABILITIES
• Demonstrates leadership by exhibiting confidence in self and others; Inspires and motivates others to perform well; Effectively influences actions and opinions of others; Accepts feedback from others; Gives appropriate recognition to others.
• Possesses above-average telephone skills.
• Possesses above-average interpersonal, relationship skills.
• Demonstrates excellent negotiating skills.
• Possesses the ability to professionally articulate a position/decision in an adversarial situation.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Demonstrates the ability to consistently maintain a positive attitude.
• Works cooperatively and productively with employees.
• Is self-motivated with strong organizational skills.
EDUCATION and/or EXPERIENCE
Bachelor's degree and 6-8 years of related experience and/or training; or equivalent combination of education and experience.
Job Description
Job Title:Property Examiner
Department: Property Claims
Reports To:Manager
FLSA Status:Exempt
SUMMARY
Provides a high degree of expertisewith regard to the full life cycle of high value, complex claims.Responsible for investigating, evaluating, reserving, negotiating, and settling of high exposure and complex first party claims. Evaluates property-related damage estimates up to $1M+. Must routinely confer with defense attorneys and various experts; communicate technical information; manage relationships with independent adjusters; and verify investigative information.
ESSENTIAL DUTIES AND RESPONSIBILITIES
• Oversee and direct independent claims adjusters to ensure that adjusters have followed proper methods.
• Investigate, evaluate and settle claims valued up to $1M+, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
• Assists Management in training and mentoring adjusters
• Resolve complex, severe exposure claims, using high service-oriented file handling.
• Adjust reserves and provide reserve recommendations to ensure reserving activities consistent with corporate policies.
• Communicate with reinsurance brokers to obtain information necessary for processing claims.
• Conduct detailed bill reviews to implement sound litigation management and expense control.
• Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
• Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments with a focus on controlling adjusting expenses.
• Enter claim payments, reserves and new claims on computer system, inputting concise yetsufficientfile documentation.
• Prepares high level cases and represents the company's position at mediation and arbitration hearings.
• Serves as a technical and subject matter expert to assist Senior Adjuster, Adjusters and Associate Adjusters in processing challenging claims.
• Liaises across Marketing and Underwriting departments external partners to provide input relating to coverage questions on behalf of the Property Claims team.
• Present cases and participate in their discussion at claim committee meetings.
• Investigates and prepares files for Subrogation.
• Communicates verbally and through written reports, memoranda with insureds, claimants, attorneys, state and local police, fire departments, adjusters, other companies or contractors, insurance agents, and other individuals, as needed.
• Travels as required to perform the essential duties and responsibilities of the position and to fulfill educational requirements.Travels to home office for periodic meetings. (May include overnight stays.)
• Develops and maintains positive relationships with independent adjusting firms, agents, independent attorneys and other similar firms, as necessary, which may include travel, visitation and attendance at various conventions and meetings.(May include overnight stays.)
• Closely monitor and report overpayments, underpayments, and other irregularities.
• Other duties may be assigned.
OTHER SKILLS AND ABILITIES
• Demonstrates leadership by exhibiting confidence in self and others; Inspires and motivates others to perform well; Effectively influences actions and opinions of others; Accepts feedback from others; Gives appropriate recognition to others.
• Possesses above-average telephone skills.
• Possesses above-average interpersonal, relationship skills.
• Demonstrates excellent negotiating skills.
• Possesses the ability to professionally articulate a position/decision in an adversarial situation.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Demonstrates the ability to consistently maintain a positive attitude.
• Works cooperatively and productively with employees.
• Is self-motivated with strong organizational skills.
EDUCATION and/or EXPERIENCE
Bachelor's degree and 6-8 years of related experience and/or training; or equivalent combination of education and experience.