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Business Unit ClaimsPro
Region Western
Location Edmonton
Province Alberta [AB]
Position Title/Titre du poste Regional Service Manager (for a National Account)
Job ID/ID Travail 1478
Postion Reports to [Title] Technical Team Leader - Western Region
Role Summary

This position will be a Control Adjuster and will be involved all aspects of claims adjustment and direction of files, production hours and responding to client inquiries on assigned files in applicable region.

Competencies required to succeed  
  • Individual must demonstrate the ability to direct adjusters of all levels and work effectively in a team environment
  • Previously demonstrated ability to communicate effectively with both internal and external associates, written and oral techniques
  • Demonstrated ability to deliver excellent customer service
  • A positive, “can do” attitude and customer service approach ensuring all inquiries are effectively dealt with in a timely manner
  • Strong analytical, problem solving and organizational skills
  • Proven negotiation and settlement skills
  • Proven ability to consistently demonstrate high attention to detail with quality outcomes
  • Ability to follow instructions
  • Ability to learn new systems and technology
  • Resourcefulness to act in a situation without direction in the facilitation of delivery of claim requirements to maintain legal and client compliance
Responsibilities  
  • Adjust claims for one of the business lines: Property/Auto/Bodily Injury/Accident Benefits claims

 

    • Assemble information on new, transferred and ongoing claims for the purposes of evaluating the loss and determining appropriate coverage and indemnification to effectively manage loss and expense costs
    • Where applicable, complete detailed field investigations including scene investigations, scope of the loss, and collection of photos
    • Complete estimates using Xactimate (for Property only)
    • Meet with or contact all relevant parties, obtaining appropriate reports and statements from appraisers/preferred contractors/claimants, insureds, insurers, witnesses
    • Responsible for applying and explaining applicable coverage to all relevant parties and documenting claims files
    • Analyze information gathered on coverage, liability and quantum to verify authenticity and appropriateness of claims submitted
    • Manage/negotiate & settle claims directly with insureds/claimants or their representatives
    • Maintain productivity & quality targets and ensure all client KPI’s are adhered to

 

  • Act as the primary point of contact for the policy holder/customer and any service issues
  • Interpret policy wordings, determine policy coverages, reserves, and process payment within established authority levels
  • Delegate field activity and direct Field Adjusters on task assignment investigations
  • Liaise with all stakeholders including client to assure that needs are met
Education, knowledge and experience required  
  • University degree/College diploma or combination of education and equivalent business
  • Chartered Insurance Professional (CIP) Program in progress (within 1-2 courses of completion)
  • Must have or eligible to obtain appropriate level of adjuster's license
  • Minimum of 2 years of full handling adjusting experience in Property/Auto/Bodily Injury/Accident Benefits
  • Signing authority and ability to negotiate settlements in accordance with provincial licensing requirements
  • Mathematical aptitude to calculate benefits entitlements
Date Added 12/7/2012
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