Wyoming Association of Risk Management Claims Specialist
Under general supervision from the Executive Director, this position manages and coordinates the investigation of property and liability claims for customers and/or members. Incumbents have broad based accountability which includes: explaining coverage terms and conditions to customers; evaluating damages, determining coverage, setting loss cost estimates, engaging independent adjusters; and negotiating and controlling exposures and losses.
Works under the general supervision of the Executive Director.
Essential Duties and Responsibilities:
Duties/tasks may include but are not limited to:
- Coordinates, manages and administers claim settlement process which includes; conducting prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, cause, origin, and extent of loss; identifying and investigating losses; engaging and using third party information; analyzing and making recommendations;
- Monitors budget allocation for engaging consultants and independent adjusters;
- Negotiates settlement of claims of varying complexity and achieves a prompt, fair and equitable settlement of a claim where there is policy liability;
- Makes independent recommendations and self-supervises most files. Maintains a global view of the claim workflow in order to provide customers with appropriate, accurate and timely information throughout the life cycle of their claim;
- Develops information necessary to make advance, partial and final payments when appropriate which involves evaluating claim coverage based on the facts and policy terms and conditions;
- Keeps the appropriate parties informed about the claim’s status with clear, timely and accurate written/oral communications. Effectively communicates in writing on moderately complex coverage issues with minimal review and coaching;
- Documents a claim file with notes, evaluations and decision making process;
- Performs other duties as assigned.
Desired Minimum Qualifications:
Necessary Knowledge, Skills and Abilities:
- Demonstrated ability to efficiently and effectively handle simple to moderately complex property and liability claims.
- Knowledge of administrative and clerical procedures and systems including Microsoft Word, Excel, PowerPoint and Outlook.
- Demonstrated fundamental understanding of policies and endorsements related to property and liability coverages.
- Ability to plan, organize, direct, and coordinate the work as described above.
- Ability to prepare clear, concise, and accurate reports.
- Ability to communicate clearly and concisely, both orally and in writing.
- Ability to establish and maintain effective working relationships with those contacted in the course of work including member entities, employees and the general public.
- Ability to work independently and with limited supervision.
- Ability to exercise initiative and good judgment.
- Ability to travel up to 25%, with overnight stays.
- Valid driver’s license required plus an acceptable driving record.
- Ability to read and interpret documents such as insurance policies, procedure manuals, safety rules and operating and maintenance instructions.
- Initiative and ability to think logically and critically.
There is normal office environment when working inside the office. When in the field, travel is often required to visit with clients, claimants, vendors and others involved in gathering data and resolving claims. Weather might be inclement, may have to work in high, precarious places like roofs, subject to night duty and 24 hour emergency call. May have to lift or move up to 50 pounds.
Education and/or Experience:
Prior claims experience is preferred. Any equivalent combination of education, training or experience which provides the desirable knowledge, abilities and skills is acceptable. Experience in working with a public agency is desirable.