Claims Specialist

## Company Overview JOIN THE WEST COAST’S PREMIER SUSTAINABILITY-DRIVEN INFRASTRUCTURE COMPANY. OWN YOUR FUTURE AT PRS. Founded in 1989, PRS has grown from a pioneering force in cold in-place recycling to a full-service, sustainability-driven infrastructure company. With operations across the Western U.S., we’ve led the industry in reducing environmental impact while delivering unmatched pavement solutions in a variety of settings. These include roadways, major civic projects, and commercial real estate. Wherever there’s pavement, there’s PRS. ## Position Overview The Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; documenting activities; conveying information regarding claims and/or benefits; and providing testimony in benefit disputes while exercising discretion, independent judgment, critical thinking skills and demonstrate exemplary customer services skills. **Primary Responsibilities** - Effectively evaluates, and manages liability, property, auto, general liability claims, and employment claims in compliance with state regulations - Adjudicates auto and general liability claims for Pavement Recycling Systems and all associated entities (e.g. determining validity, reaching closure, etc.) to comply with legal requirements and state statutes - Analyzes liability exposure for branches (e.g. Claims, etc.) to ensure correct action will take place - Attends legal hearings, settlement conferences, mediations (e.g. meets with defense counselors, district defendants, settlement conferences, mediations, etc.) to provide testimony and monitoring proceedings - Evaluates auto and general liability claims to establish eligibility and course of action - Maintains claims files and records to document actions and ensuring compliance with participating policies and mandated legal requirements - Oversees the claims handling and third-party provider (e.g. litigation on complex cases etc.) to ensure the claims are being handled according to the legal regulations per state - Prepares statistical summaries, evaluations and reports, oral presentations to provide information and/or documenting activities - Responds to inquiries from claimant, participating district and/or and involved personnel (e.g. status of claim, subrogation activities, etc.) to resolve issues, facilitating communication among parties and/or providing information or directions - Provides timely, balanced, and accurate claims reviews, documentation, and decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations - Serve as the face of the company in providing frequent, proactive verbal communication with our claimants, customers and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits, and other pertinent policy provisions - Documents conversations within the claim files in a timely manner utilizing the appropriate level of detail and professional writing skills - Interacts and communicates effectively with claimants, customers, health care providers, attorneys, brokers, and family members during the Claim Specialist’s claim evaluation - Compiles file documentation and correspondence requiring extensive policy analysis and factual detail - Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available - Collaborates with both external and internal resources, such as physicians, attorneys, and vocational consultants to gather data such as medical/occupational information to ensure claim decisions are well-reasoned and thorough - Identifies, clarifies, and reconciles inconsistencies when gathering information during claim evaluations and collaborates with underwriting and…