Answers claim-type specific incoming phone loss reports within a functional unit in the Call Center. Investigates assigned claims to determine coverage and provide benefits to insureds, according to Company Guidelines and DOI Regulations. Adjusts or denies claims within the scope of the company’s contractual and legal obligations, communicating those decisions to insureds and their agents as necessary. Enters and retrieves online data, establishing manual claim file folders. Types and logs all drafts into the computer database according to company procedures. Communicates orally, in writing, and face-to-face with Home Office, insureds, agents, experts and others associated with individual claims. Reviews and evaluates files for subrogation possibilities. Corresponds with third parties, negotiating payment plans when necessary.
Qualifications: Self-directed and superior work ethic. Must possess strong organizational and analytical skills with the ability to evaluate coverage, perform detailed investigations and effect settlement. Must possess excellent customer service skills with the ability to listen carefully and communicate effectively.
Education & Experience: Equivalent to completion of two years of college (or equivalent experience) and one year of claim-adjusting support or customer service related experience. Excellent communication skills, oral and written, within the English language. Superior customer service techniques. Basic computer knowledge of WINDOWS Operating Systems.
Capital Insurance Group
Human Resources Department
2300 Garden Road
Monterey, CA 93940
Fax: (831) 233-5900
Capital Insurance Group - 14 months ago