Manages an inventory of claims to evaluate compensability/liability.

Establishes action plans based on case facts, best practices, protocols, regulatory issues, and available resources.

Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages.

Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves as necessary, during the processing of the claims, and refers claims to the subrogation group or Special Investigations Unit as appropriate.

Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.

Performs other duties as assigned.

Effective interpersonal, analytical and negotiation abilities required Ability to provide information in a clear, concise manner with an appropriate level of detail Demonstrated ability to build and maintain effective relationships Demonstrated success in a professional environment; success in a customer service/retail environment preferred Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory Licensing may be required in some states