SUMMARY DESCRIPTION: The Residential Claims Examiner is responsible for approving and settling residential property claims from the field where an estimate of damage has been prepared, or for preparing and settling estimates, or documenting claims decisions and settling those claims with the policyholder and claimants. The role’s primary duties include phone scoping, reviewing coverage, determining settlement amounts, communicating with the policyholder or their representative, and documenting the claim file as outlined by the client or RENFROE. They are also responsible for documenting all activity, submitting required claims documentation, issuing settlement payments, settling and closing the claim using fair claims settlement practices, and ensuring compliance with legal and contractual obligations.

REPORTS TO: Assigned RENFROE Manager

ESSENTIAL JOB FUNCTIONS:

· Follows RENFROE and clients’ policies and procedures to handle all assigned property claims
    · Works with the RENFROE Manager and other adjusters to share knowledge and experience and to gain new skills
    · Assigns task work for property inspections and interacts with field adjusters and estimators to determine the scope of     loss
    · Oversees claims files for assigned claims and updates claims as new information becomes available using the client’s     proprietary software
    · Manages the progression of claims/tasks and claim inventories assigned to them
    · Contacts and interacts with the policyholder or their representative to obtain documents such as purchase receipts, bills,     photographs, or other documents to establish the existence, ownership, and value of the items claimed damaged
    · Determines coverage and amounts for additional living expenses such as rental housing, travel, meals, etc.
    · Sets claim reserves following the client’s guidelines
    · Calculates settlement amounts and, within their settlement authority or after receiving requested authority from the     client’s designee, issues settlement checks with supporting claim documentation
    · Writes closing reports, including recommendations for the pursuit of subrogation or the disposal of salvage
    · Reviews the claim file to support and draft coverage decision letters
    · Maintains required jurisdictional adjusting licenses as required by the client and/or RENFROE
    · Does not handle claims for which they do not have client authorization or for which they are not licensed
    · Participates and communicates in client team meetings to discuss claim handling trends, team production, and any claim     handling concerns or changes
    · Makes suggestions on ways to improve process efficiency
    · Participates in special projects and completes other duties as assigned

Non-Authorized Activities:

Claims Examiners should not:
    · Communicate training requirements to client staff adjusters and non-affiliated firms
    · Communicate training requirements to any claim handler who is not deployed with RENFROE
    · Discuss Human Resource issues with any client staff adjusters in any segment or any claim handler that is not deployed with RENFROE
    · Discuss any of the following topics with a client staff adjuster or any claim handler that is not deployed with RENFROE: job openings, termination, prior work history, attendance, absence requests, daily work schedule, claim volume or workload, meal and rest break schedule, promotions, development, compensation, or mentoring of any kind

EXPERIENCE/QUALIFICATIONS:

    · Minimum of 1 year of property claims experience is preferred
    · Participation in technical insurance coursework is preferred, such as CPCU
    · Experience using various claims processing systems is preferred
    · Appropriate licenses, depending on state requirements, and successful completion of required/applicable claims     certification training classes
    · Effective problem resolution and decision-making skills to include analyzing insurance policies and information,     demonstrating sound judgment, and utilizing one's own experience and the experience of others
    · Strong analytical skills and consistent attention to detail
    · Knowledge of ISO forms, and client policy coverage, procedures, and systems
    · Communicates clearly and effectively, both verbally and in writing
    · Strong customer service orientation and good rapport with the insured
    · Well-organized and hard-working, with the ability to thrive in a fast-paced work environment
    · Strong interpersonal skills and proven ability to establish good relationships with clients, RENFROE management,     employees, and others with whom they interact
    · Computer skills, including but not limited to practical knowledge of Word and Excel

PHYSICAL DEMANDS:

    · Sitting in a chair for extended periods of time 
    · Ability to operate a telephone, computer, mouse, keyboard, and other similar equipment for extended periods of time
    · Extended and varying work schedules, which may include work from home or work from a centralized office
    · Regular attendance required, working up to 12 hours a day, 7 days a week, for extended periods of time, including     weekends and holidays
    · Ability to work in a fast-paced, changing, and multi-tasking environment