JOB REQUIREMENTS: Claim Representative III Job Locations US \| US-WI-Merrill \| US-WI-Milwaukee \| US-WI-Madison ID 20243470 Category Claim Type Regular Full-Time Introduction Looking to join a vibrant organization that makes a difference? At Church Mutual, our customers are at the heart of everything we do. For more than 125 years, we\'ve made it our business to protect those who serve and inspire others through our specialized insurance expertise and innovative solutions. Our customers do amazing things for the world - when we protect them, we Stand for Good. We foster a workplace where all employees are treated with dignity and respect; diversity, inclusion and belonging are woven into the fabric of our company through our customers, employees, leadership, business relationships and outreach programs. What you\'ll be doing: In accordance with application of state and federal laws and company best practices, handle higher exposure, complex claims within an assigned line of coverage. Gather and review claim information, determine coverage, and conduct investigation. Initiate and maintain customer contact to provide updates and resolve any issues with the claim. Update information in the claim system to document claim handling activities. Determine/set reserves and make payments within level of authority. Investigate and refer identified claims to Loss Recovery Services, as applicable. On any given day, you\'ll: I. Perform claim tasks timely and document claim files appropriately. Proactively manage claim activities to ensure fair claim resolution. Handle all claims in accordance with state and federal laws. II. Make complex coverage decisions by gathering information necessary to make an informed decision in a fair, equitable, and ethical manner. Deny losses within authority level, providing detailed explanation, citing facts, and policy language. III. Perform a thorough investigation based upon the type, complexity, and severity of the claim. Upon completion of the investigation, analyze and evaluate the potential exposure and damages, including potential full or partial liability and compensability denials. Formulate and document an action plan based on the covered damages and injuries. IV. Determine and set reserves based on the most probable outcome of the claim, within authority level. Evaluate and negotiate directly with insured, claimant, or claimant\'s attorney on all cases within authority level. Review claim facts and exposure with claims management, as appropriate, to guide claim strategy. Make complete, accurate, and timely payments within authority for covered losses. Refer claims above authority to appropriate team member... For full info follow application link. Church Mutual is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/5FAE91AA33F244E3