Casualty Specialist - Colorado Springs

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Job Title

Casualty Specialist – Colorado Springs

Requisition Number

R1321 Casualty Specialist – Colorado Springs (Open)

Location

Colorado Springs, Colorado

Additional Locations

Job Information

Job Summary

Handles 1st party injury cases without Liability injury (Medical Pay, Accidental Death Benefits, High Limits). Dependant upon level of proficiency, Handles Auto low to moderate complexity 1st and 3rd party injury cases reserved up to 25k. Potentially handles Personal Injury Protection claims. First Priority in First Notice Of Loss queue (approx. 95%). As applicable, may own claims of less complexity when supporting catastrophes. Handles claims in multiple states

Essential Functions / Principal Responsibilities

  • Works in call center environment. External communication completed in writing, by telephone and by electronic means (e.g., e-mail).
  • Assigned as Owning/Adjuster when injury exposure is identified.
  • Handles simple to moderate 1st and 3rd party auto cases involving injury.
  • Handles 1st party Medical payment and Uninsured Motorists claims including ADB (Auto Death Benefit) claims.
  • Handles liability injury claims.
  • Assists in catastrophes and/or injury phone queue.
  • Potentially handles Personal Injury Protection and Out of State claims.
  • 1st Priority in First Notice of Loss casualty queue.
  • Responsible for handling, managing, investigating, negotiating, settling and/or resolving complex claims with exposure valued less than $25,000, with minimal supervision.

Duties include, but are not limited to:

  • Making coverage determinations and advising customers as to proper course of action related to coverage issues.
  • Conducting investigative work of a complex nature (interviewing witnesses; obtaining and analyzing evidence, including medical records; deciding whether an independent medical examination is warranted; etc.).
  • Making liability determinations.
  • Evaluating potential for subrogation and initiating initial notice of subrogation request.
  • Developing negotiating strategies.
  • Negotiating with claimant or claimant’s attorneys.
  • Making final decisions to settle within settlement authority, without supervisory approval.
  • Presenting cases in Committee setting when seeking above settlement authority level; thereafter, independently negotiating and settling the claim.

Core – Customer Focus (Developing), Core – Innovation (Developing), Core – Knowing the Business (Developing), Core – Results Orientation (Developing), Core – Teamwork & Collaboration (Developing), Functional – Insurance Policy Understanding & Knowledge of Legal/Regulatory Requirements (Developing), Functional – Negotiation (Developing), Functional – Time Management (Developing), Knowledge, Skills and Abilities

Required:

Strong analytical, problem-solving and organizational skills.

Strong ability to work independently.

Strong decision making ability.

Strong customer service orientation.

Basic math and computer skills and ability to type 30 wpm.

Proficient oral and written communication skills and good command of the English language.

Ability to function in a team environment.

Ability to successfully complete training courses pertinent to job duties.

Developing understanding of statutory and regulatory requirements.

Developing understanding of AAA claims policies and procedures preferred.

Ability to travel on rare occasions.

Ability to work extended hours and/or weekends.

Education, Work Experience, Licenses & Certifications

Required:

BA/BS in business, insurance or related area, or equivalent combination of education and experience.

Preferred:

2-3 years of claims experience

Bilingual a plus

  • LI-JA1

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