Accident Benefits Claims Representative - lll

Accident Benefits Claims Representative III

As an Accident Benefits Claims Representative III, you’ll investigate, evaluate, reserve, negotiate and resolve assigned automobile accident benefits claims by reviewing new losses, developing investigation plans, gathering statements, obtaining necessary documentation (medical records, authorizations, forms), and applying regulatory classifications accurately. You will communicate with policyholders, treatment providers, investigators, accountants, and medical professionals to assess injuries, financial losses, and determine claim eligibility. Application of systems like HCAI, dispute resolution techniques, structured settlements, and independent medical exams will ensure fair and timely claim outcomes.

Responsibilities

• Review new losses, prepare an investigation plan, and contact the insured to discuss loss details.
• Work with policyholders to explain claims process clearly to ensure an effic...