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Claims Representative

Role overview

Qualifications

  • Associate degree or equivalent relevant experience
  • One year of claims handling or insurance experience or related experience
  • Basic knowledge of the claims adjusting process
  • Good knowledge of computers, including claims systems

Responsibilities

  • Investigate and evaluate low-complexity third-party auto, casualty, and premises liability claims
  • Initiate timely contact with insureds, claimants, witnesses, clients, and other involved parties
  • Negotiate and resolve claims within assigned authority
  • Maintain active claim diaries and prepare claim summaries and reports

Key facts

Other skills

  • Negotiation
  • Customer Service
  • Communication
  • Problem Solving
  • Analytical Skills

About the company

EMC Insurance Companies logo

EMC Insurance Companies

Insurance

EMC Insurance Companies is among the top 60 insurance organizations in the country based on net written premium, and we have more than 2,500 employees. The company was organized in 1911 to write workers’ compensation protection in Iowa. Today, EMC provides property and casualty insurance products and services throughout the United States and writes reinsurance contracts worldwide. Operating under the trade name EMC Insurance Companies, Employers Mutual Casualty Company and one or more of its affiliated companies is licensed in all 50 states and the District of Columbia. Privacy Policy - https://www.emcins.com/misc/privacypolicy.aspx

Company details

Company typeLarge
IndustryInsurance
Company size1001 - 5000

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Job description

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.

  

**This position is eligible to work from home anywhere in the US**

As a Claims Representative, you'll play a key role in helping clients navigate the claims process by investigating, evaluating, and resolving low-complexity third-party auto, casualty, and premises liability claims. You'll be the primary point of contact for insureds, claimants, and clients, gathering facts, assessing coverage and liability, and delivering fair, timely claim resolutions. Working closely with experienced claims professionals, you'll develop your expertise in claim investigations, negotiations, and customer service while helping EMC deliver exceptional outcomes for its clients. Your ability to build relationships, communicate effectively, and make sound decisions will have a direct impact on customer satisfaction, claim resolution, and overall business results.

Essential Functions:

  • Investigate and evaluate low-complexity third-party auto, casualty, and premises liability claims, including coverage analysis and liability assessment.

  • Initiate timely contact with insureds, claimants, witnesses, clients, and other involved parties, typically within 24 hours of claim assignment.

  • Obtain statements, gather documentation, review police/fire reports, and identify subrogation or recovery opportunities.

  • Establish and maintain appropriate claim reserves based on exposure and claim developments.

  • Secure and review medical records, bills, invoices, receipts, and other supporting documentation for accuracy and claim evaluation.

  • Prepare excess carrier notifications and escalate complex claims to leadership when additional expertise is required.

  • Respond to inquiries from clients, agents, claimants, attorneys, and coworkers regarding claim status, coverage, liability, and damages.

  • Draft reservation of rights and denial letters, with appropriate management approval.

  • Negotiate and resolve claims within assigned authority, recommend settlements exceeding authority limits, and issue payments accordingly.

  • Prepare bodily injury and property damage evaluations, settlement documentation, and ensure proper execution of releases and agreements.

  • Maintain active claim diaries, adhere to client-specific handling instructions, prepare claim summaries and reports, participate in file reviews, and stay current on industry and jurisdictional developments through ongoing training.

Education & Experience:

  • Associate degree or equivalent relevant experience

  • One year of claims handling or insurance experience or related experience

  • Low-complexity third-party auto, casualty, and premises liability claims handling experience strongly preferred

  • Bachelor’s degree may be considered in lieu of the claim handling or insurance experience requirement

  • AIC, INS or other insurance related certifications preferred

Knowledge, Skills & Abilities:

  • Basic knowledge of the claims adjusting process 

  • Basic knowledge of insurance contracts, medical terminology and legal aspects of court procedures affecting legal liability for all lines of insurance

  • Good knowledge of computers, including claims systems

  • Strong organizational and written and verbal communication skills, including documentation

  • Good investigative and problem-solving abilities

The hiring salary range for this position will vary based on geographic location, falling within either of the following:

$46,990 - $64,911 or $51,927 - $71,385

A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.

 

 

For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers.

Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.

All of our locations are tobacco free including in company vehicles.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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