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Job Status:
Full Time
Work Experience Required:
Up to 2 Years
Hours/Shifts:
Day (First Shift)
Education Required:
High School Diploma
Certification Required:
Unspecified
Weekends:
Not Required
Authorized to work in US:
Yes
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| Pay and Benefits |
Salary Range:
Unspecified
Benefits:
Full Benefits
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No-Fault Specialist
Kentucky Farm Bureau
No-Fault Specialist Claims |
| Location: Louisville, KY |
Reference Code: |
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Responsibilities
Job Title: No-Fault Specialist Reports to: PIP Unit Supervisor Department: Claims Section: PIP Unit Job Status: Non-Exempt
JOB SUMMARY The No-Fault Specialist handles small first party claims and most no fault claims within a claim district. This person works with the district claims manager and provides support service when the field adjuster is away from assigned territory.
ESSENTIAL FUNCTIONS • Accept assignment of Pip claims from claim adjusters. • Accept assignment of small claims as claim volume and staffing dictate. • Monitor continuing eligibility of Pip claimants. • Receive, coordinate, and pay appropriate Pip benefits. • Receive loss reports from agents and verify coverage, code, setup, and handle small claims to conclusion. • Maintain proper reserves. • Perform necessary clerical functions. • Assist and cooperate with all company personnel. • Monitor the claim inventory report. • Pursue professional development. • Report claims as required by claims manual or by district claims manager. • Serve as a catastrophe team member or assist in other claim offices or locations as required. • Regular, predictable attendance. • This list of Essential Functions is non-exhaustive and may be supplemented as necessary.
OTHER RESPONSIBILITIES • Receive assignment and Pip worksheet from claim adjusters. • Establish companion Pip work file. • Secure appropriate Pip documents, i.e., medical reports, wage verifications, Pip applications. • Obtain initial claim payment authority on each claimant from claim adjusters. • Diary all companion claim files. • Furnish copy of Pip application, medical reports and wage verification to claim adjusters. • Keep Pip worksheet of claim adjusters current. • Receive and pay medical bills, wage loss benefits, survivor's economic benefits, replacement service benefits and funeral expense benefits. • Maintain appropriate reserves for both basic and added reparation benefits. • Perform claim file maintenance transactions via terminal entry. • Receive and review loss reports on a regular basis from agents, claim adjusters and senior adjusters. • Make contact with agent's office and provide support service when the field adjuster is away from assigned territory. • Keep district claims manager informed when providing support service while adjuster is away from assigned territory. • Confirm coverage and conduct investigation to determine merits of claim and its values. • Promptly dispose of claims by negotiations, settlement or denial. • Establish claim files using data from loss reports. • Document claim files with records of all maintenance transactions. • Type letters and forms required to process assigned work. • Transmit salvage and subrogation recoveries to the Accounting Department on a timely basis. • Report claims as required by Claim Manual or by district claim manager. • Promptly respond to complaints as requested. • Report immediately the receipt of all summonses to district claim manger and handle as directed. • Report to the Underwriting Department all incorrectly rated policies and poor risks. • Review claim inventory reports monthly and make needed adjustments. • Make corrections on claim files as recommended by district claim manger following review. • Document claim files to support actions taken. (See claim manual) • Attend and participate in company meetings, seminars and other company sponsored educational activities at the request of the company. • Attain the Certificate in General Insurance from Insurance Institute of America. • Maintain current knowledge of policy contracts.
JOB SPECIFICATIONS • Physical demands: Sitting, Normal vision/hearing with or without correction • Mental demands: Analytic reasoning • Environmental factors: Standard office lighting, temperature, and noise. • Equipment: Keyboard Telephone Calculator Copier
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Experience and Education:
QUALIFICATIONS • High School Diploma • Average typing skill (minimum 35 wpm) • Knowledge of claims handling procedures and insurance contracts. • Experience in the use of dictaphone/transcriber, photocopier, computer terminal or word processor and other office equipment is desirable. • Ability to communicate effectively orally and in writing. • Ability to make timely decisions. • Previous experience in a claims or insurance office required. • Excellent human relation skills and self-motivation required. • Ability to act in a confidential manner. • Knowledge of word processing software. • Required to obtain an Adjuster License within one year of hire date.
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