Claims Adjustor

Location : Location US-IL-Mattoon
ID
2024-22136
Category
Legal
Type
Regular Full-Time

About us

Rural King Farm and Home Store strives to create a positive and rewarding workplace for our associates. We offer opportunities for growth, competitive benefits, a people first environment, and an opportunity to work alongside dedicated associates who share a passion for providing an exceptional experience and service to our rural communities. Whether you are starting an entry-level position or joining with professional experience, Rural King encourages professional growth and provides the necessary resource to help you succeed and grow with us.

 

When you join the Rural King team, you become a contributing member in supporting the needs of and making a difference in the lives of those within the people and communities we serve. 

 

 

How we reward you

 

401(k) plan that provides a 100% match on the first 3% of your contributions and 50% of the next 2% * Healthcare plans to support your needs * Virtual doctor visits * Access to Centers of Excellence with Barnes Jewish Hospital and Mayo Clinic’s Complex Care Program * 15% Associate Discount * Dave Ramsey’s SmartDollar Program (no cost to you!) * Associate Assistance Program * RK Cares Associate Hardship Program * 24/7 Chaplaincy Services

What You’ll do

As a Claims Adjustor, you will be investigating and adjusting liability claims in accordance with established claims handling procedures and processes using Rural King guidelines.

 

  • Exercise proper judgment and decision making to analyze claim exposure and risk.
  • Analyze claim forms, policies, and endorsements.
  • Efficiently assess and prioritize incoming claims and related workloads to ensure proper turn around for all tasks such as processing new claims, coding claims, pending claims, customer service requests, claim documentation, and action plans.
  • Document and communicate all claim activity timely and effectively in a manner that supports the outcome of the claim file.
  • Maintain accurate documentation in the claim file and submit medical, legal, and miscellaneous invoices for supervisor and accounts payable approval through an online process.
  • Manage subrogation claims by identifying liable third parties, assessing their responsibility, and diligently pursuing recovery on behalf of the company through negotiation or legal action.
  • Provide courteous and professional assistance to claimants, addressing their concerns and questions.
  • Act as a liaison between the stores and claimants to ensure a smooth claims process.
  • Refer cases as appropriate to supervisor and management.
  • Use critical thinking in situational elements to work toward a resolution.
  • Gather and analyze incident evidence (i.e., recorded statements, video, pictures).
  • Make well-informed decisions regarding the denial or acceptance of claims based on the evidence and legal analysis.
  • Negotiate settlements considering factors such as medical expenses, pain and suffering, and other relevant damages.
  • Use discretion and independent judgment in daily decisions while maintaining a high level of confidentiality and professionalism.
  • Research and stay updated on relevant laws and regulations.
  • Identify areas for process improvement and contribute to the development of more efficient claims management procedures.
  • Work collaboratively with other departments, including Transportation, Risk Management, and Store Operations, to address broader issues related to claims and liability.
  • Adhere to the highest ethical standards in all aspects of claims handling, ensuring fairness and integrity throughout the process.
  • Use discretion and independent judgment in daily decisions while maintaining a high level of confidentiality and professionalism.
  • Actively participate in learning initiatives offered such as training programs, workshops, and webinars. Leverage these opportunities to acquire new knowledge, refine existing skills, and stay current on the latest developments.
  • Provide friendly, proactive, and professional internal and external support to others, assisting with inquiries, concerns, and issues promptly and effectively.
  • Demonstrate behaviors that exemplify Rural King’s Values: People First, Integrity, Attitude, Initiative, Teamwork, Accountability, and Continuous Improvement.
  • Perform other duties as assigned.

Essential Qualities for Success

 

  • At least 2 years of claims handling experience or equivalent combination of experience and education.
  • Active adjuster license.
  • Formal education/designations in insurance and claims preferred e.g., AIC and AINS.
  • Experience with Microsoft Office Suite and related software.
  • Highly proficient in Microsoft Excel.
  • Must possess the ability to quickly learn claim management systems.
  • Strong investigative skills to assess the validity of claims, including interviewing witnesses and gathering evidence.
  • Excellent verbal and written interpersonal and communication skills.
  • Superior customer service skills.
  • Understanding of retail store operations and potential risks, such as property damage and liability claims.
  • Highly skilled in negotiation and conflict resolution.
  • Demonstrated ability to adapt in a fast-paced environment.
  • Strong analytical and problem-solving skills.
  • Excellent organizational skills and attention to detail.
  • Commitment to staying updated on industry trends, regulations, and best practices through continuous learning and professional development.
  • Demonstrated behaviors must reflect integrity, professionalism, and confidentiality.

 

 

Physical Requirements 

 

  • Ability to maintain a seated or standing position for extended durations.
  • Capability to lift 15 pounds periodically.
  • Ability to navigate and access all facilities.
  • Skill to effectively communicate verbally with others, both in-person and via electronic devices.
  • Close vision for computer-related activities.

 

Supervisory Responsibilities

 

None

 

Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.

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