Alison Remington

- Investigates coverage and liability by reviewing and evaluating photos, recorded statements, medical records, police reports, and any other information related to the accident.
- Interviews or consults with claimants, witnesses, insureds, injured parties, agents/brokers, attorneys, police officers, and anyone with knowledge regarding the accident to confirm coverage.
- Investigates and evaluates damages by obtaining and reviewing current and prior claims history and experience, medical records, bills, and employment and wage records.
- Prepares claim status reports containing claim evaluation, reserving, negotiation, and legal consultation.
- As needed, conducts accident scene investigations and consults with accident reconstructionist or other experts.
- Conducts independent research in consultation with defense attorneys and/or corporate claims legal regarding coverage, liability, damages, litigation and/or venue.
- Consults with defense attorneys regarding experts, discovery demands, and litigation and case strategy.
- Participates in lawsuit status reviews by presenting files for discussion with defense attorneys, managers, and claims attorneys.
- Assembles and directs a defense team, including but not limited to defense attorneys, reconstruction experts, and doctors.
- Attends mediations, depositions, pre-trial and settlement conferences, and trials as required or necessary.
- Stays abreast of legal changes in assigned jurisdictions.

-Decides coverage and liability issues.
-Estimates the cost of treatment and/or compensation for injured parties.
-Sets accurate reserves.
-Identifies questionable aspects of claims and refers such claims for an independent medical examination or accident investigation.
-Evaluates personal injury claims and contractual exposures as locally defined.
-Interviews or consults with claimants, witnesses, insureds, injured parties, agents/brokers, attorneys, police, or other individuals with information about the accident.
-Interviews or corresponds with agents and claimants to confirm coverage.
-Obtains medical and wage authorizations in order to obtain medical records and bills to evaluate personal injury claims.
-Negotiates with claimants or their attorneys to settle claims and issues payment.

-Manages time and resources to make sound claims adjusting decisions.
-Investigates and determines insurance policy coverage and the extent of liability concerning loss or damages involving personal auto claims, using discretion and independent judgment.
-Determines the most effective and efficient sequence of activities to make timely contact with all relevant parties and ensures that conditions are set for a timely and accurate assessment of damages, including the movement of vehicles to the appropriate location for inspection and repair.
-Interviews, collects and documents information from customers, agents and witnesses. Reviews police reports, medical information, and other data when appropriate.
-Interprets personal auto policies and analyzes information gathered to determine course of action.
-Investigates facts of loss and ensures that coverage and liability decisions are consistent with the report of the accident.
-Recognizes applicable exposures and endorsements and refers if appropriate.
-Identifies potential fraud and refers for investigation.
-Proactively communicates, updates and responds timely to customer concerns.
-Collaborates on property damage with other claims adjuster(s) as to liability, coverage and damage resolution as needed.
-Makes decisions about subrogation referrals.
-Negotiates with customers and claimant carriers to ensure coverage and liability are assigned properly.
-Manages claims inventory workload, including claims paperwork, diaries, and communications (hard copy, electronic mail and phone communications); issues payments as appropriate.
-Monitors and makes decisions related to rental, including availability and length of rental period.
-Identifies, negotiates and resolves claims including total losses.
-Gathers information on the status and treatment needs of injured person(s), most commonly for soft tissue injuries and mild-to-serious sprain/strain, and minor scarring, fractures or concussions.
-Evaluates, settles and issues payments for unrepresented bodily injury claims.

-Manages time and resources to make sound claims adjusting decisions.
-Investigates and determines insurance policy coverage and the extent of liability concerning loss or damages involving personal auto claims, using discretion and independent judgment.
-Determines the most effective and efficient sequence of activities to make timely contact with all relevant parties and ensures that conditions are set for a timely and accurate assessment of damages, including the movement of vehicles to the appropriate location for inspection and repair.
-Interviews, collects and documents information from customers, agents and witnesses. Reviews police reports, medical information, and other data when appropriate.
-Interprets commercial policies and analyzes information gathered to determine course of action.
-Investigates facts of loss and ensures that coverage and liability decisions are consistent with the report of the accident.
-Recognizes applicable exposures and endorsements and refers if appropriate.
-Identifies potential fraud and refers for investigation.
-Proactively communicates, updates and responds timely to customer concerns.
-Collaborates on property damage with other claims adjuster(s) as to liability, coverage and damage resolution as needed.
-Makes decisions about subrogation referrals.
-Negotiates with customers and claimant carriers to ensure coverage and liability are assigned properly.
-Manages claims inventory workload, including claims paperwork, diaries, and communications (hard copy, electronic mail and phone communications); issues payments as appropriate.
-Monitors and makes decisions related to rental, including availability and length of rental period; may also negotiate loss of use.
-Identifies, negotiates and resolves claims including total losses.

- Utilizes bill adjudication software to accurately re-price medical billings.
- Identifies and promptly addresses wage exposures on medical claims.
- Reviews and researches wage loss expenses and documentation for payment consideration (when applicable).
- May review and interpret policy language upon receipt of a subrogation demand to determine if reimbursement is owed.
- Interprets medical records and understands medical terminology regarding injuries.
- Reads/conducts research to better understand medical records and establish any correlation to a motor vehicle accident could also research injuries or medical conditions.
- Injury causation may involve following up with a provider and/or securing medical records and ultimately recognizing the need for an IME/IMR.
- Investigates coverage, fraud, injury causation and subrogation issues on all claims assigned, interprets and applies policy and state laws in order to make accurate coverage decisions.
- Verifies and resolves Claims Verification Questions, sends underwriting memos, recognizes the need for fraud/Special Investigations Unit (SIU) involvement and opens/refers subrogation when appropriate.
- Develops and executes action plans around coverage, fraud, injury causation and subrogation issues.
- Maintains diaries and action items.
- Reviews and handles incoming mail, and electronic correspondence.
- Contacts insureds, attorneys and medical providers to follow up for current file status.

-Determines the most effective and efficient sequence of activities to make timely contact with all relevant parties. Ensures claims-related tasks are completed for timely resolution.
-Interacts with customers to answer questions, obtain information, and/or provide support throughout the claims cycle. Communicates coverage and liability decisions.
-Interviews, collects and documents information from customers, agents and witnesses. Reviews police reports and other data when appropriate.
-Investigates facts of loss and ensures that all damage is consistent with the report of the accident.
-Recognizes applicable exposures and endorsements and refers if appropriate.
-Identifies potential coverage issues that require further review/ investigation for transfer to appropriate claims groups.
-Proactively communicates, updates and responds timely to customer concerns.
-Collaborates on property damage with other claims adjuster(s) as to liability, coverage and damage resolution as needed.
-Makes decisions about subrogation referrals.
-Monitors and makes decisions related to rental, including availability and length of rental period.
-Coordinates resolution of, and documents activity on, each claim.

- Provides performance feedback and coaching to team members.
- Provides technical support and skill development to team members. Answers questions regarding phone etiquette, coverages, applications, endorsements, cancellations, renewals, return mail, correspondence, reports, overdue replies and Progressive systems.
- Performs quality audits of team members.
- Provides feedback to managers and trainers regarding team members' performance.
- Resolves escalated and/or complex customer issues.
- May assist with answering phones or processing during high call volume.
20% Administration
- May assist managers with call center operations, including scheduling, timecard reconciliation, interviewing, collecting and analyzing data, identifying training opportunities, implementing new processes and procedures and developing team members.
- May facilitate team meetings.
- May develop training materials to aid performance improvement.
- May develop meeting materials and handle administrative tasks as needed.
5% Continuous Learning
- Meets with coach or manager for feedback regarding phone etiquette, technical efficacy, and/or performance reviews.
- Stays abreast of changing procedures and processes.

The Processing Specialist Senior is a senior level position that provides service to customers and agents via written correspondence and/or transactional work items. Solves problems by understanding and questioning work processes and procedures to provide customers and agents with an experience that makes it easy and desirable for them to purchase, refer and renew business over the course of their policy lifetime. Serves as a peer resource.

- Handles transactions by processing through systems and/or correspondence via mail or online systems, while meeting performance goals.
- Uses multiple software applications to complete transactions.
- Partners with a resource specialist/coach or supervisor to continually develop skills and improve results.
- Communicates as needed with customers and agents via phone or email.
- Audit or assist with resource or coach others as needed.
- Assist customers in navigating Progressive systems.
- Identifies and understands the customers' needs.