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Commercial Lines Claims Advocate III (R1)

Company: Houchens Insurance Group Inc.
Location: Bowling Green
Posted on: August 7, 2022

Job Description:

Description:

Work Location: All HIG Locations (Bowling Green, Owensboro, Elizabethtown, Crestview Hills, Lexington, Franklin TN)

Summary
The Claims Advocate III will service commercial client claims in an advocacy role. Three-way communication with the insured, adjuster, and producer will be facilitated so that the claim process moves quickly. This will include preparing the insured for each step of the process with education and direction so that they are not surprised with developments. Claims resolution to the insured's satisfaction as much as possible is the ultimate goal. Clerical and administrative work is a part of the responsibility and the Claims Advocate III must be prepared to handle the agency's most complex claims.

Essential Duties and Responsibilities
Disclaimer: the duties listed are intended to describe the general nature and level of work to be performed. This is not an exhaustive list of all responsibilities, duties and skills which may be required.

40%

Client Services

Responsibilities include:

- Maintaining direct communication and relationships with insureds.

- Processing initial information on claims over the telephone, including first reports of loss.

- Reporting losses to companies with diary follow-ups.

- Acting as intermediary to negotiate settlements between company and insured.

- Reviews loss scenarios and advises insureds on possible coverage and premium impact.

- Assisting in settling claims.

- Completing file audits as assigned.

- Visit the site of customer premises/loss locations when appropriate.

- Proactive foresight used to avoid misunderstandings on behalf of the insured.

- Prompting the insured to gather info that will be needed to the adjuster.

- Developing positive relationships with insured, adjuster, and producer to foster needed outcomes.

- Protecting the customer and agency's interests while balancing fairness to the carrier based on the policy terms.

- Involving other parties such as manager, producer, account manager and marketing when disputes cannot be resolved.

40%

Policy Services

Responsibilities include:

- Performing administrative functions, including but not limited to correspondence, reports, and other documents as needed.

- Maintaining conducive relationships with insurance carriers.

- Maintaining compliance with all Claims service standards and procedures.

- Maintaining Producer and Claims Manager confidence in job knowledge, judgment calls, and awareness of current industry trends and developments.

- Handling the most complex policy issues and finding resolution without Producer/Service Manager involvement.

- Mentoring others within the department with regard to client/policy service standards and procedures.

- Establishing and maintaining active claim files to include diary and suspense monitoring and follow-ups.

- Reviewing policies for coverage to anticipate problems.

- Involving Claims Counselor to review ROR's and denials.

- Involving Claims Counselor to research case law in the event of denial.

- Working with manager and producers for assistance on a proactive basis prior to coverage issues being relayed to customers.

10%

Teamwork

Works together with team and with other departments; this includes conferencing with Producer to discuss the execution of strategies. Acts as mentor to department team members. Volunteers to back up and/or assist others as needed. Manages PTO to work with departmental needs. Completes special projects that require extensive insurance knowledge and experience.

10%

Determination

Displays commitment and initiative to meet department and agency education goals as set forth in the organizations education program; continued pursuit of insurance education.

Requirements:

Competencies

To perform the job successfully, an individual should demonstrate the following competencies: Analytical - Synthesizes complex or diverse information; collects and researches data; uses intuition and experience to complement data. Continuous Learning - Assesses own strengths and weaknesses; seeks feedback to improve performance; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with others. Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires minimal supervision; displays understanding of how job relates to others; uses resources effectively. Use of Technology - Demonstrates required skills; adapts to new technologies; troubleshoots technological problems; uses technology to increase productivity; keeps technical skills up to date. Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics. Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; responds to requests for service and assistance; meets commitments. Communications - Expresses ideas and thoughts verbally; expresses ideas and thoughts in written form; exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods. Cooperation - Establishes and maintains effective relations; exhibits tact and consideration; offers assistance and support to co-workers; works cooperatively in group situations; works actively to resolve conflicts. Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings. Teamwork - Balances team and individual responsibilities; exhibits objectivity and openness to others' views; gives and welcomes feedback; contributes to building a positive team spirit; puts success of team above own interests; able to build morale and group commitments to goals and objectives; supports everyone's efforts to succeed. Written Communication - Writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet needs; presents numerical data effectively; able to read and interpret written information. Ethics - Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and principles; upholds organizational values. Organizational Support - Follows policies and procedures. Adaptability - Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events. Achievement Focus - Sets and achieves challenging goals; demonstrates persistence and overcomes obstacles; measures self against standard of excellence; recognizes and acts on opportunities. Personal Appearance - Dresses appropriately for position; keeps self well groomed. Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time. Dependability - Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals.; completes tasks on time or notifies appropriate person with an alternate plan. Initiative - Volunteers readily; undertakes self-development activities; seeks increased responsibilities; takes independent actions and calculated risks; looks for and takes advantage of opportunities; asks for and offers help when needed. Planning/Organizing - Prioritizes and plans work activities; uses time efficiently. Quality - Demonstrates accuracy and thoroughness; monitors own work to ensure quality.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

At least seven years related insurance experience and/or training, preferably handling multi-line, large commercial claims; or equivalent combination of education and experience.

Language Skills

Ability to read, analyze, and interpret the most complex documents, such as insurance policies. Ability to respond effectively to inquiries or service issues from company personnel and/or clients. Ability to speak and represent the company effectively before groups of customers.

Mathematical Skills

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages.

Reasoning Ability

Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to bring full resolution to issues without Producer/Service Manager involvement. Possess mature and experienced reasoning ability which maintains a high level of Producer and Service Manager confidence.

Computer Skills

To perform this job successfully, an individual should have knowledge of Database software; Internet software; Spreadsheet software and Word Processing software.

Certificates, Licenses, Registrations

Must hold applicable state insurance license or have the ability to obtain such within 90 days of employment. Must be able to obtain insurance designations as set forth by the organization's education plan.

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Competencies

To perform the job successfully, an individual should demonstrate the following competencies: Analytical - Synthesizes complex or diverse information; collects and researches data; uses intuition and experience to complement data. Continuous Learning - Assesses own strengths and weaknesses; seeks feedback to improve performance; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with others. Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires minimal supervision; displays understanding of how job relates to others; uses resources effectively. Use of Technology - Demonstrates required skills; adapts to new technologies; troubleshoots technological problems; uses technology to increase productivity; keeps technical skills up to date. Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics. Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; responds to requests for service and assistance; meets commitments. Communications - Expresses ideas and thoughts verbally; expresses ideas and thoughts in written form; exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods. Cooperation - Establishes and maintains effective relations; exhibits tact and consideration; offers assistance and support to co-workers; works cooperatively in group situations; works actively to resolve conflicts. Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings. Teamwork - Balances team and individual responsibilities; exhibits objectivity and openness to others' views; gives and welcomes feedback; contributes to building a positive team spirit; puts success of team above own interests; able to build morale and group commitments to goals and objectives; supports everyone's efforts to succeed. Written Communication - Writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet needs; presents numerical data effectively; able to read and interpret written information. Ethics - Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and principles; upholds organizational values. Organizational Support - Follows policies and procedures. Adaptability - Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events. Achievement Focus - Sets and achieves challenging goals; demonstrates persistence and overcomes obstacles; measures self against standard of excellence; recognizes and acts on opportunities. Personal Appearance - Dresses appropriately for position; keeps self well groomed. Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time. Dependability - Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals.; completes tasks on time or notifies appropriate person with an alternate plan. Initiative - Volunteers readily; undertakes self-development activities; seeks increased responsibilities; takes independent actions and calculated risks; looks for and takes advantage of opportunities; asks for and offers help when needed. Planning/Organizing - Prioritizes and plans work activities; uses time efficiently. Quality - Demonstrates accuracy and thoroughness; monitors own work to ensure quality.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

At least seven years related insurance experience and/or training, preferably handling multi-line, large commercial claims; or equivalent combination of education and experience.

Language Skills

Ability to read, analyze, and interpret the most complex documents, such as insurance policies. Ability to respond effectively to inquiries or service issues from company personnel and/or clients. Ability to speak and represent the company effectively before groups of customers.

Mathematical Skills

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages.

Reasoning Ability

Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to bring full resolution to issues without Producer/Service Manager involvement. Possess mature and experienced reasoning ability which maintains a high level of Producer and Service Manager confidence.

Computer Skills

To perform this job successfully, an individual should have knowledge of Database software; Internet software; Spreadsheet software and Word Processing software.

Certificates, Licenses, Registrations

Must hold applicable state insurance license or have the ability to obtain such within 90 days of employment. Must be able to obtain insurance designations as set forth by the organization's education plan.

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

PI184782006

Keywords: Houchens Insurance Group Inc., Bowling Green , Commercial Lines Claims Advocate III (R1), Other , Bowling Green, Kentucky

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