Claim Examiner - Auto Physical Damage

This role is based in Massachusetts, only candidates based in Massachusetts will be considered

Responsible for assisting claim professionals and the direct handling of  complex Auto Physical Damage claim files, including the monitoring and supervision of the Vermont Mutual Guaranteed Repair Network(GRN), independent appraisers, attorneys, vendors and claim personnel to ensure the timely, accurate and fair investigation, evaluation, repair and disposition of Auto Physical Damage claims. Employee should possess demonstrated expertise in handling significant higher value Auto Physical Damage repairable and total loss claims. Employee should be highly skilled in all relevant coverage’s written with an emphasis on the most difficult losses and exposures, and be capable of seeing a range of repairs from straightforward to our most difficult adjustments through final resolution. Claim outcomes must be consistent with policy terms and conditions, industry standards, best practices, actual damages and legal requirements. Directly interact with body shops and stakeholders and oversee the assigned adjusting and support personnel and assure prompt, accurate and fair repair of covered autos. Employee will work collaboratively with claim staff, auto appraisers, GRN shops, Glass suppliers/installers, towing interests, salvage companies, virtual appraisers and desk reviewers,  public safety agencies and independent agencies directly regarding accident related auto claims, repairs and processing. 

 DUTIES & RESPONSIBILITIES

• Direct, handle and monitor assigned claims to produce results consistent with policy language, damages and legal requirements.
• The Claim Examiner – Auto Physical Damage may also be responsible for the selection and oversight of Guaranteed Repair Network, independent adjusting firms, attorneys, experts and vendors.
• Review new losses and files on diary while providing appropriate file direction to the body shops, appraisal firms, experts, vendors, resources, etc.
• Monitor loss adjustment expense and take steps to avoid or mitigate expenses wherever reasonably feasible.
• Identify and assess cost saving methods, services and alternatives.
• Assist coworkers and others interested with advice and referrals to quality service providers. 
• Review causation questions and provide direction, interpretation and approval when needed regarding repair scope, pricing and methods.
• Refer appropriate coverage and damage matters to Claim Manager.
• Ensure appropriate file handling, documentation and expense control of all assigned files.
• Provide accurate, courteous and timely information to all external and internal customers concerning claim status, repair issues and other inquiries.
• This position is expected to directly and completely handle an array of auto property damage, liability, collision and comprehensive claims, especially those with higher complexity and exposure. Provide service calls and training for employees, policyholders and agencies as needed.
• Serve as a technical resource within the Department through mentoring and knowledge sharing.
• Must be highly responsive with staff and shops.
• Effective communicator verbally and written.
• Attend trials, depositions, EUO’s, arbitrations and mediations as needed or required by jurisdiction.
• Suggest improvements to processes within the department, or serve on committees, to increase the level and quality of service provided to internal and external customers, i.e. workflow changes, appraisal software and programs, systems upgrades, etc.
• Set repair direction on complicated or high-exposure vehicles within purview and recommend appropriate repair or disposal strategy.
• Confer with claim management, representatives, and other company personnel to plan, evaluate goals/objectives, resolve problems, and exchange information.
• Regulate referrals; produce reports analyzing performance results and territory performance.
• Monitor and maintain diaries and task counts.
• Nominate and qualify body shops eligible for inclusion in our repair network.
• Evaluate performance of GRN shops, address any issues and recognize high achievement.
• Evaluate, procure, coordinate and deliver technical training to repair facilities, agents, adjusters and clerical personnel.
• Respond to customer, agency and Insurance Department correspondence.
• This position is expected to directly handle certain claim repairs entirely
• Performs other duties or special projects as required or as assigned.

QUALIFICATIONS

• Bachelor's degree in business, insurance or a related field, or its equivalent.
• Ten or more years of relevant claim technical experience with demonstrated achievement and progressive responsibilities.
• Demonstrated commitment to professional development through continuing education related to the job through the attainment of recognized industry designations such as I-Car, ASE, AIC, AEI, RPA or CPCU programs, etc.
• Appropriate state Appraisal and Adjusters License(s) where required by law.
• Strong knowledge of the auto repair business, and the personnel and body shops in our states.
• Dedicated to technical lifelong learning, keeping informed of industry news, trends, issues, etc.
• This is a remote field based position, previous outside experience and valid driver’s license is required.
• Thorough understanding of the insurance industry and company operations.
• Superior analytical and negotiation skills.
• Excellent verbal and written communication skills.
• Proven planning, administrative and technical experience.
• Demonstrated ability to exercise good judgment in dealing with professional and personnel matters.
• Demonstrated ability to work effectively with a wide array of outside firms and organizations.
• Demonstrated ability to deal effectively with company management, peers and co-workers.
• Proficiency with technology and PC applications including CCC, Audatex, Microsoft Office (Word, Excel & Outlook), iNow and ImageRight.
• Ability to perform job responsibilities under stressful circumstances.

PHYSICAL DEMANDS/WORKING CONDITIONS

• Field positions require regular outside day travel of approximately 50% or more.
• The physical demands are typical of similar jobs in comparable organizations.
• The work environment is representative and typical of similar jobs in comparable organizations.
• Occasional overnight travel and travel to Home Office.
• Potentially subject to adverse weather and stressful situations with respect to claim disputes.