Property & Liability Claims Examiner

The candidate selected for this position must live within the state of Georgia. The employee's telecommuting work site location will contain a designated and approved workspace at the employee's home address.

General Definition of Work

Performs skilled technical work managing and resolving assigned property and liability claims on behalf of the Association's insurance programs to ensure prompt determination of compensability, litigation management and effective claim resolution, and related work as apparent or assigned. Work is performed under the supervision of the Claims Supervisor.

Claims Investigation and Administration

• Initiates initial investigation for newly assigned insurance claims; confirms coverage of claim, contacts member, member representative, non-represented claimants, claimant's attorney and/or claimants to obtain/provide information.
• Initiates compensability and/or liability determination through completion of statements, recorded statements, on-site investigations, and evaluation of property damage appraisal reports.
• Sets initial reserves for claims; performs proper and timely reserve evaluations and adjustments; reviews and approves bills for processing; reviews medical notes; reviews and signs off daily check sheet; prepares and submits reports to excess carriers when loss is greater than one-half retention level.
• Establishes and maintains proper claim diary requirements of existing caseloads with documentation of action plans; ensures action plans are adhered to in a timely manner.
• Receives and responds to inquiries and requests for information from members, injured claimants, vendors, case managers, legal representatives and medical providers.
• Occasional overnight travel required – less than 20 days per year – i.e. travel to mediations, hearings, field investigations, depositions, account/member visits, and seminars.

Knowledge, Skills and Abilities

• Thorough knowledge of business English, spelling and arithmetic;
• Thorough knowledge of standard office practices, procedures, equipment and administrative support techniques;
• Thorough knowledge of the principles, practices and process of liability claims handling and administration;
• General knowledge of the laws, legal codes, court procedures, precedents, government regulations and agency rules regulating the property and liability insurance industries;
• Thorough knowledge of ACCG organization and Insurance Division programs and policies;
• Skill in the use of standard office software equipment and applications, specifically Microsoft Office products, including Outlook, Word and Excel;
• Ability to communicate ideas effectively in both oral and written formats; ability to type accurately at a reasonable rate of speed;
• Ability to follow oral and written instructions; ability to read and understand detailed and complicated policies, procedures and materials that contain specialized words and phrases;
• Ability to make arithmetical calculations; ability to operate a variety of standard office equipment including personal computer and associated software;
• Ability to establish and maintain effective working relationships with associates, claimants, attorneys, Nurse Case Managers, physicians, local government officials, customers and the public.

Education and Experience

• Bachelor's degree with coursework in business administration, insurance, or related field and
• Moderate (1 – 3 years) of related experience in property liability claim handling requirements and administration, or
• Equivalent combination of education and experience.

Physical Requirements

• This work requires occasional exertion of up to 10 pounds of force;
• Work regularly requires sitting, speaking or hearing, using hands to finger, handle or feel and reaching with hands and arms and occasionally requires standing, walking, climbing or balancing, stooping, kneeling, crouching or crawling, pushing or pulling, lifting and repetitive motions;
• Work has standard vision requirements; vocal communication is required for expressing or exchanging ideas by means of the spoken word; hearing is required to perceive information at normal spoken word levels;
• Work requires preparing and analyzing written or computer data, operating motor vehicles or equipment and observing general surroundings and activities;
• Work is primarily performed in a home office environment. Noise levels are contingent upon environment, but work should be performed in an environment that is ergonomically sound, clean, safe, and free from obstructions and other hazardous conditions.

Special Requirements

• Employees are required to have and maintain a high-speed, broadband internet connection at their work site that is sufficient to enable fast, consistent service for the membership. A minimum download speed of 25 Mbps is required. To ensure a consistent speed at this level, 40MB internet connection is recommended. You may check your download speed at speedtest.net.
• Possession of or ability to acquire a Georgia Independent Adjusters License issued through the State of Georgia Insurance Department within one year of employment.
• Valid driver's license in the State of Georgia.