Selective Insurance Company of America

Subro Claims Representative

US-NC-Charlotte
Experience (Years)
3
Category
Claims
Status
Full-Time Regular
FLSA Status
Non-Exempt/Hourly
Job ID
5512
Travel %
0-5%
Relocation Cost
0
Auto Reimbursement
No

Overview

Evaluation of subrogation potential and negotiation on Worker's Compensation Claims. This individual reviews, negotiates and concludes by settlement or denial assigned claims through telephone, personal contact, and/or electronic or written correspondence. They are skilled to analyze investigative data and make prompt and sound decisions. They possess strong negotiation skills to obtain the highest settlements possible to impact the Company’s bottom line. The individual in this position will also ensure claims are processed within company policies, procedures, and individual's prescribed authority with exceptional standards of performance. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.

Responsibilities

  • Receives assigned claims (which can be complex in nature), reviews and verifies facts to determines course of action. 
  • Processes claims which includes the following activities: Analyze investigational data, explore subrogation potential, identify any additional investigation which may be necessary in support of subrogation ,settle non-litigated claims, secure appropriate releases, process recovery checks and return insured deductible when applicable 3. Documents claims files and maintain control of work through documentation or diary system.
  • Assigns litigated claims to staff or panel attorney who pursues subrogation on our behalf or files Intercompany Arbitration when a claim is disputed/denied in order to move file to settlement or closure. Evaluate range of potential recovery and give authority to attorney to settle both non-litigated and litigated claims within delegated authority. If over Claims Technical Specialist authority, provide case analysis to management for approval 
  • Process incoming calls and correspondence from insureds, claimants and agents regarding questions or problems associated with claims. Interact with underwriters and agents on claim issues. 
  • Assign experts to case and arrange for inspections when necessary.
  •  Prepare for and participate in claims review and settlement conferences as needed. 
  • Ensures compliance with company, state and federal regulations. 
  • Update MCS on a continual basis to accurately reflect status of each assigned file. 

 

Qualifications

  1. Advanced knowledge of claims handling and subrogation to assist co-workers and field personnel.
  2. Analyze (wc, auto, GL, HO, Property) policy language and endorsements pertaining to subrogation.
  3. Exceptional customer service skills
  4. Damage evaluation skills
  5. Excellent negotiation, analytical and organizational skills
  6. Well versed with rules and regulations of Intercompany Arbitrations, strong ability to formulate winning contentions and able to assist field personnel with questions.
  7. Understanding of Statute of Limitations and Statute of Repose and the importance of protecting them.

College degree preferred. 3 - 5 years claims experience preferred. 2 years appraisal experience preferred. 2 years data entry experience preferred. Must have valid State Licenses. Excellent negotiation, analytical and organizational skills

 

 

Selective is an Equal Employment Opportunity employer. Selective maintains a drug-free workplace.

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