To investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of non-attorney represented injury claims and to contribute to a reduced loss ratio
Essential Job Results :
% of Time
Results Expected and Duties Performed
Establishes proof of loss by studying documentation submitted; assembling additional information as required from outside sources such as claimant, witnesses, physician, employer, hospital, and other insurance companies; initiates investigation of claims involving complex coverage claims, complex liability, and/or bodily injury claims (non-attorney represented), as well as questionable claims.
Resolves claim by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter. Presents evidence at legal proceedings by testifying and producing reports and other documents as evidence
Ensure legal compliance by following guidelines, company policies, and state and federal insurance regulations
Required behaviors for all positions :
- Communicate with co-workers, management customers, vendors, and others in a courteous and professional manner
- Conform with and abide by all Company codes, regulations, policies, values, work procedures and instructions
- Adherence to company attendance policy
Education : Bachelor’s degree or higher (with two year’s work experience within field of major, is preferred).
Experience : Previous Claims and/or Customer Service experience within an Insurance environment is required. Prior experience interpreting policy language and state statutes is required. Ideal candidate will have a proven track record of making sound coverage and liability decisions based on facts presented by customers and/or through additional fact gathering and investigations. Experience in handling minor to moderate bodily injury claims is preferred (either attorney represented and/or non-attorney represented).
Skills and Abilities : Excellent verbal and written communications skills; ability to manage own time while prioritizing multiple tasks; ability to remain calm when dealing with difficult customers; effective negotiating skills; ability to gather and analyze information in order to evaluate results and choose the best solution to the problem.
Other : A valid State Adjuster License where required; Bilingual (English/Spanish) preferred; occasional weekend work may be required.
Compensation : Competitive salary based on experience. Excellent benefits package: medical, dental, vision insurance, life insurance, short term and long term disability insurance, 401K, Paid Vacation and Holidays. EOE
GAINSCO, INC. is a Dallas, Texas-based holding company established in 1978. The Company, through its insurance brand, GAINSCO Auto Insurance...