Claims Investigator

Position Summary :

This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. Responsibilities include researching and investigating EZ Claim Total Loss, GAP, CPI, and other claims as assigned. The role involves processing and investigating 20-40 claims daily, reviewing all claim documentation for coverage application, and utilizing databases such as Unitrac, insurance company websites, Lexis Nexis, ISO, and other automotive databases to assess insurance coverage before claims are assigned to a Claims Adjuster or Analyst.

The key responsibilities are both administrative and investigative, requiring an understanding of insurance policy coverage and securing necessary documentation for claim adjudication.

Associates must handle a high volume of claims, evaluate coverage using online tools and databases, and analyze insurance records within our tracking system. This is a detail-oriented, investigative role demanding strong analytical skills.

Job Duties and Responsibilities :

• Review claim documentation including security agreements, condition reports, loan histories, valuation databases, statements, ISO, Lexis Nexis, and other sources to match damage with insurance policies.
• Determine coverage and damage application, identify claims with recovery potential, and refer to senior staff for adjudication and collection.
• Adjudicate claims within carrier guidelines for GAP and CPI, then refer to licensed adjuster for final calculation and release.
• Utilize and understand programs related to auto valuation such as CCC, AUDATEX, ISO, NADA, Kelley Blue Book, and other tools.
• Meet and exceed recovery and claim service standards for a Claims Investigator.
• Respond promptly to carrier and lender inquiries professionally.
• Handle incoming calls and direct as necessary.
• Complete special projects and duties as assigned.
• Obtain necessary adjuster licenses.

Qualifications :

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