BI Telephone Claims Representative II - (Ontario, CA)

JOB OVERVIEW PRIMARY PURPOSE: Examines claims data, investigates the facts of loss, determines coverage and liability, and adjusts claims within limit of authority. Claims involved frequently require analysis and may require research to resolve coverage and/or damage issues. There is periodic review of ongoing activities and results of work. There is more focused supervision on complex files (The CRII will handle complex files on a regular basis). ESSENTIAL DUTIES AND RESPONSIBILITIES: Following is a summary of the critical functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. * Receive claim assignments and verifies/investigates coverage and documents all appropriate details * Determine claim approval and or denial up to $7,500 per exposure or $10,000 per file