Claims Specialist

• Research and verify complex claims information for accurate and timely claims processing
• Enter coded and other required information into claims systems
• Review and correct scanned claims documents
• Check claims for completeness and accuracy before final entry
• Identify and resolve inconsistencies and request missing information
• Ensure contract benefits are applied correctly
• Research procedural questions using supporting documentation and training manuals
• Identify incomplete adjudication instructions and suggest procedure updates
• Identify training issues and consult management when necessary
• Record daily production information including edits processed, hours worked, downtime, and special projects
• Reject, redirect, or return incomplete or inaccurate claims
• Maintain contact with internal departments, staff, providers, members, lawyers, insurers, and other external entities
• Perform other job-related duties within the scope of responsibilities

Claims Processor I

• Conduct virtual and on-site investigations at policyholders’ residences
• Assess property damage, determine liability, evaluate the extent of loss, and negotiate fair settlements
• Use claims handling software, a company car, and a laptop to determine claims-related damage and write estimates in a paperless environment
• Evaluate and report potential subrogation opportunities
• Report theft, fraud, or arson incidents to appropriate state and industry agencies
• Perform duties independently with work directly impacting management outcomes
• Represent the company in public interactions while maintaining professional standards
• Engage with policyholders, claimants, agents, witnesses, contractors, law enforcement, fraud and arson investigators, attorneys, medical professionals, and other relevant parties
• Negotiate with policyholders to settle claims
• Perform additional duties as assigned
• Promote safety and comply with company safety and ergonomic standards
• Travel away from residence for catastrophe deployments, usually 23 days
• Commit to 1–3 catastrophe deployments per year
• Cover property damage claims across central Louisiana

Field Property Claims Adjuster

• Conduct virtual and on-site investigations at policyholders’ residences
• Assess property damage, determine liability, evaluate losses, and negotiate fair settlements
• Use claims handling software, a company car, and a laptop to determine damage and write paperless estimates
• Evaluate and report potential subrogation opportunities
• Report theft, fraud, and arson incidents to appropriate state and industry agencies
• Perform duties independently with work directly impacting management outcomes
• Represent the company professionally in public interactions
• Engage with policyholders, claimants, agents, witnesses, contractors, law enforcement, fraud and arson investigators, attorneys, medical professionals, and other stakeholders
• Negotiate with policyholders to settle claims
• Promote safety and comply with company safety and ergonomic standards
• Travel away from home for catastrophe deployments, usually for 23 days
• Cover property damage claims across central Louisiana