Claim Examiner (Commerical Insurance)

About the position

The primary role of the Claim Examiner is to investigate, evaluate, negotiate, and settle injury/damage claims in multiple jurisdictions, applying coverage, laws and regulations accordingly; reporting to management within necessary timelines and guidelines.

Responsibilities

• Promptly review new losses and determine initial plans of action.
• Analyze coverage as it relates to the facts and allegations of claims; prepare Reservation of Rights and Declination of Coverage letters, as applicable.
• Initiate contact with policyholder and claimant(s) to confirm notice of loss description and determine the scope of the investigation, as appropriate.
• When appropriate, assign and instruct independent adjusting firms to conduct needed investigative tasks; manage and direct activity of independent adjusting firms in any continued investigation of claims.
• Report losses timely to management and update as necessary.
• Evaluate claims as investigations develop and establish and adjust reserves as warranted.
• Review expense bills for appropriateness, accuracy and adherence to Company billing guidelines and process payments.
• Recognize, notify and pursue culpable parties and seek contributions from such parties.
• Identify and ensure subrogation efforts are undertaken against responsible parties.
• Negotiation of claims to settlement.
• Other duties as required.

Requirements

• Excellent written and oral communication skills.
• Exhibit negotiation, critical thinking, and problem-solving capabilities.
• Outstanding customer service, attention to detail, and multi-tasking skills.
• Strong computer skills, including the ability to work effectively in the claims management system and strong knowledge of Microsoft applications (e.g., Outlook, Word, Excel).
• Ability to exercise independent judgment with moderate supervision in handling claims within reserve and settlement authority.
• Bachelor's Degree from an accredited college/university.
• Minimum of 1+ years of property/casualty claims handling experience as a full-time exempt employee of a U.S. based property/casualty insurance company.
• A valid adjuster license in designated home state (or be able and willing to obtain one within 60 days after hire) and the ability to obtain additional non-residential adjuster licenses.

Nice-to-haves

• 3+ years of commercial general liability policy and/or garage policy experience.

Benefits

• Competitive compensation and benefits, including medical, dental, vision, 401(k), flexible spending, short-term and long-term disability insurance, life insurance, long-term care, paid parental leave, vacation and other paid time off.