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Review and interpret policy language to determine applicable coverage.
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Investigate, evaluate, process, negotiate, and resolve automobile physical damage, property damage liability, and No-Fault/PIP claims.
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Analyze coverage, liability, damages, and potential exposure.
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Identify claims requiring additional investigation, specialized resources, or escalation.
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Manage claims involving litigation and collaborate with counsel when appropriate.
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Coordinate and direct outside service providers, including appraisers and investigators.
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Maintain an accurate diary system and complete all follow-up activities within required timeframes.
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Establish or recommend accurate reserves and update them as claim information develops.
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Develop appropriate settlement and resolution strategies.
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Prepare detailed loss reports addressing coverage, liability, damages, exposure, reserves, and recommended next steps.
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Identify subrogation, contribution, and other risk-transfer opportunities and initiate recovery efforts.
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Document all correspondence, reports, evaluations, discussions, and claim decisions accurately and promptly.
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Conduct independent claim file reviews to ensure files are properly documented and handled.
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Provide timely, professional, and responsive service to clients, claimants, insureds, attorneys, vendors, and other involved parties.
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Engage internal loss-control resources when appropriate.
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Comply with company procedures, client service instructions, regulatory requirements, and industry best practices.
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Complete additional assignments and special projects as needed.
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Strong knowledge of claims-handling principles and procedures, including policy interpretation, coverage analysis, liability assessment, damage evaluation, reserving, negotiation, and settlement.
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Ability to investigate, evaluate, negotiate, and resolve claims with minimal supervision.
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Strong analytical, critical-thinking, decision-making, and problem-solving abilities.
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Sound judgment when evaluating complex claim information and developing recommendations.
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Excellent written and verbal communication skills.
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Ability to communicate effectively with clients, claimants, insureds, attorneys, vendors, and other stakeholders.
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Strong customer-service and relationship-management skills.
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Excellent organization, time management, documentation, and follow-up.
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Ability to manage competing priorities accurately in a fast-paced environment.
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Proficiency with claims-management systems, computers, and standard business applications.
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Ability to work independently while remaining flexible and responsive to changing client and business needs.