Casualty Claims Representative

Job Description

Job Description

Title: Casualty Claims Representative

Reports To: Claims Manager

Location: East Lansing, MI

Department: Property/Casualty and Workers’ Compensation (PC/WC)

SET SEG is looking for a Casualty Claims Representative who will be responsible for the investigation, negotiation, adjustment, and resolution of designated PC claims. This position reports to the Claims Manager.

WHO WE ARE

School Employers Trust (SET) is a non-profit company that was created after a monumental shift in school funding happened in 1965. SET, which began in 1971, served as an employee benefits association focused on offering comprehensive and affordable employee benefit solutions to Michigan public schools and their employees. Two years later, its partner organization School Employers Group (SEG) was formed to administer compensation and fringe benefits for SET. As schools were faced with more challenges related to insurance, SEG evolved and grew into a company that provides workers’ compensation and property/casualty services for Michigan public schools.
Today, SET SEG continues to expand and find creative ways to meet the specialized needs of its members. This, coupled with a superior member experience, is why SET SEG has maintained its position as an industry leader in the school insurance market.
We value those who proactively solve challenges, simplify the complex, thrive in a fast-paced setting, have a customer-first mentality, and seek a collaborative and inclusive work environment. We are also listed on the Business Insurance Best Places to Work. We offer 100% employer paid insurance (medical, dental, and vision), Paid Time off (PTO), and paid parental leave.
Our passion is delivering peace of mind to Michigan public schools and we look for team members who are motivated by our cause. To learn more, visit:

WHO YOU ARE

You are energized by working with a collaborative team and industry peers to support Michigan public schools through their challenges. You seek understanding and are motivated to tackle projects and problems with the customer in mind. You anticipate needs and preempt challenges and concerns, delivering increasingly relevant customer experiences over time. You value a culture that is rooted in mutual respect, where you can learn from different perspectives and roles.

Primary Responsibilities:

• Manages, investigates, evaluates, negotiates, and adjusts assigned claims in adherence to guidelines within authority
• Ensures adequacy of reserves and recommends reserve increases on cases in excess of authority
• Monitors outside investigators and performs outside investigations when assigned.
• Provides oversight of medical, legal damage estimates, and miscellaneous invoices to determine if they are reasonable and related to designated claims
• Negotiates any disputed bills or invoices for resolution
• Assigns litigated claims to approved law firms and/or individual attorneys and monitors progress
• Follows a uniform system of reserving by reviewing incoming litigation, establishing initial reserves and completing reserve reports
• Negotiates settlements in accordance with claim handling standards while also considering member preferences when appropriate
• Attends facilitations/mediations as assigned
• Manages diary system to move losses to conclusion in a timely manner
• Participates in strategy sessions with internal business units such as Underwriting and Loss Control
• Other duties as assigned by the Claims Manager
  
  

Required Qualifications:

• Bachelor’s Degree plus two years of experience adjusting general liability and professional liability claims or an equivalent combination of education and experience
• Must have knowledge of coverage, liability, and complex claims handling procedures
• Ability to handle complex case-related tasks in a fast-paced and changing environment
• Excellent interpersonal skills and the ability to work in a strong team environment
• Must be highly organized and detail oriented
• Must be dependable, reliable, and able to achieve high levels of professionalism when handling cases and interacting with school district representatives and their employees, attorneys, families of injured and fellow employees
• Must be able to create and maintain high levels of confidentiality when dealing with proprietary information and sensitive situations
• Must have strong cognitive and analytical skills
• Ability to initiate, receive, understand, and reply to written and oral communication (verbal, written, telephone, e-mail, etc.)
• Ability to travel and work remotely on a periodic basis
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Physical Demands / Work Environment

Several hours per day at a sit/stand desk, average mobility to move around an office environment; able to spend several hours per day at a computer. Occasional in-state travel may be required. Punctual, regular, and consistent attendance is required.
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.

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