AMERIND is a federally chartered, tribally owned corporation, formed under Section 17 of the Indian Reorganization Act (25 U.S.C. § 5124) by its Members, the governmental units of federally recognized Tribal Nations that administer federally funded housing programs for American Indian and Alaska Native families. AMERIND has the operating authority to work with Tribal Governments, Enterprises, and Citizens for Property and Liability, Workers Compensation, Homeowners and Renters, Employee Benefits coverage, Fleet Auto coverage, and Critical Infrastructure development.
Position Characteristics and Competencies
- Excellent time and project management skills
- Meticulous attention to detail
- Advanced knowledge of industry-specific software applications
- Excellent customer relations skills
- Ability to provide transparent information and demonstrate high customer service
- Team collaboration
- Excellent fundamental understanding of insurance policy terminology
- Problem-solving and analytical thinking
- Strong verbal and written communication skills
- Strong negotiation skills
- Ability to speak and present in public
- Interest in discovering and developing new ideas.
- Service and people-oriented.
- Agile and adaptable decision-making
- Problem-solving approach that suggests trustworthiness
- Familiarity with technology infrastructure and user of technology tools
Job Summary
Evaluates high and mid-level claims using expertise to determine whether coverage will be provided. Understands insurance policies and regulations and possesses strong analytical and communication skills. Navigates complex situations and makes fair and accurate decisions, ensuring that both the insurance carrier and the claimant are treated with professionalism and respect. Collaborates with external parties and impartial entities to thoroughly investigate property and liability insurance claims. Performs meticulous on-site investigations and prepares comprehensive field reports using various third-party software tools such as Xactimate and Xactanalysis. Collaborates with experts. Possesses high-level experience and understanding of claims. Creates precise estimates of repair costs for both types of properties and generates comprehensive reports.
This job description does not represent an inclusive list of all duties encompassed in this position.
Job Responsibilities
Communicates with customers and associates virtually, over the telephone, in person, and in written correspondence.Takes initial calls and provides instructions on claim filing requirements.Investigates claims on-site, evaluates damages, completes coverage analysis, damage assessments, cause / origin determination, and submits a field report with a narrative, estimate, photos, and any other pertinent information for the damages.Utilizes policy and investigation reports to determine compliance and validity of claims for processing or denial.Interviews claimants, specialists, witnesses, physicians, or other professionals as necessary.Determines liability and total value of claim; negotiates settlements and makes recommendations regarding litigation.Issues denial notification regarding claim issues, i.e., claim not covered or does not meet deductible level.Obtains police reports, issue restitution notifications, requests deductible payments, and processes claim payments.Consults with attorneys regarding claims to control costs and assists in making decisions and actions.Negotiates directly with the claimants as necessary.Assists with workflow and the number of claims that are assigned to each examiner.Manages the daily task list of claims which are assigned to each examiner.Reviews and follows up on claims as needed and closes files as appropriate.Performs subrogation and recovery of property claims where there is another responsible party.Maintains claim files and other related documents pertinent to insurance claim activities.Acts as a resource to all other claims staff. Provides support, direction, advice, and mentoring.Assists in the development of claims staff policy, procedure, and protocol.Assist and develop training presentation material.Maintains confidentiality of all information.Participates in cross-functional team process improvement projects.Performs other duties as assigned.Supervision of Others
N / A
Minimum Qualifications
Bachelor’s degree in insurance, Economics, Business Administration, or related field and ten years’ experience in insurance, claims handling, or risk management required.Designations and certificates from accredited insurance institutions preferred.Minimum of five years of desk adjusting experience involving property claims required.Minimum of five years of field adjusting experience involving property + liability claims required.Minimum of five years of field adjusting experience using software applications such as Symbility, Xactimate, or Xactanalysis preferred.Minimum of three years of carrier risk information system experience such as Guidewire or Sapiens preferred.Must possess a valid driver’s licenseMust be able to successfully pass a background investigation; no felony, theft or fraud convictions.Must be able to travel 50% as needed.Additional Eligibility Requirements
New employees must complete the Associate in Insurance (AINS) designation within six months from the end of the 90-day evaluation period to be eligible for advancement and incentive compensation.For continued employment, employees must complete an elective course and six hours of professional development within 12 months after the end of the 90-day evaluation period.Knowledge / Skills / Abilities
Knowledge of applicable federal, state, Tribal, and local laws, regulations, and requirements.Knowledge of property, auto, liability insurance laws, policies, and regulations.Knowledge of medical and insurance terminology, and of claims processing practices.Knowledge of occupational safety theory, principles, and practices.Knowledge of modern office practices, procedures, and equipment.Ability to communicate effectively in the English language, both verbally and in writing.Ability to analyze situations and adopt appropriate courses of action.Ability to work effectively under stressful conditions.Ability to interact and maintain good working relationships with individuals of varying social and cultural backgrounds, employees and officials.Ability to develop and interpret policies, procedures, and regulations.Ability to maintain an accurate and organized filing system of complex insurance records and reports.Ability to handle multiple tasks and meet deadlines.Ability to exercise independent judgment.Ability to train and present information to others.Ability to follow oral and written instructions.Ability to collect and analyze data and prepare and present accurate reports and recommendations.Ability to act with integrity and maintain confidentiality.Skill in performing statistical and mathematical computations.Skill in preparing, presenting, reviewing, and analyzing insurance claims, forms, and reports.Skill in providing excellent customer service.Skill in operating business computers and office machines, including in a Windows environment, specifically Word, Excel, Access, and presentation software (such as PowerPoint).Database management skills.Excellent telephone communication skills.Working Conditions & Physical Demands
Typical business office setting with moderate noise level and outdoor settings with a high noise level.Non-office environment may be encountered for offsite presentations and support of company activities.While performing outdoor duties, one may be exposed to natural weather conditions and temperatures, various dusts, smoke, and mists, as well as normal debris and hazards.Must be able to sit for work at a computer and phone for more than 6 hours per day.Must be able to speak clearly.Must be able to use hands for dexterity of motion.Frequently required to stand, walk and reach with hands and arms.Must have ability to occasionally lift 20 + lbs.Must have ability to climb ladders for a property inspection.Must be willing to travel as necessary.Minimal business travel required.Physical Exam
Employee is required to successfully pass an annual physical exam to certify that the incumbent is capable of performing the physical demands of the job as described above.
Hiring of AMERIND employees is subject to Section 7(b) of the Indian Self-Determination Act (25 U.S.C. §5307(b)), which requires that, to the greatest extent feasible, preference and opportunities for training and employment shall be given to Native Americans and Alaska Natives.
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