BI Telephone Claims Representative I, II, Sr - (Ontario, CA)

JOB SUMMARY PRIMARY PURPOSE: Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. ESSENTIAL DUTIES AND RESPONSIBILITIES: Following is a summary of the key 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. * Establish an investigative plan; initiate investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves and adjust or opens hidden exposures as necessary * Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to manager for approval * Evaluate settlement alternatives by reviewing regulatory compliance and fair claims practices; make decisions on best option