Claims Examiner

Adventist Risk Management, Inc.•Silver Spring, MD

1d•$67,648 - $101,472•Hybrid

About The Position

As the official insurance and risk management company for the worldwide Seventh-day Adventist Church, Adventist Risk Management®, Inc. (ARM) is devoted to finding Adventist professionals who are committed to the success of our clients and our organization. Joining ARM allows you to be part of a team of professionals committed to extraordinary customer service, a culture of diversity and inclusion, while working in a Seventh-day Adventist Christian environment. We don’t view what we do as just a business; our ministry is to protect the ministries of the Seventh-day Adventist Church. We currently have a position for a full-time Claims Examiner to join our Claims team. This position works under general supervision to adjudicate assigned claims using the settlement authority granted by Adventist Risk Management, Inc. executive administration. This position is inclusive of our company benefits package which offers healthcare, employer matching 403(b), paid vacation, professional training, and other programs. This position is Hybrid.

Requirements

Bachelor’s degree in business related field required.
Ability to operate a PC, including knowledge of word processing, FCS software and spreadsheet, required.

Nice To Haves

AIC designation preferred.
Minimum of 3 years successful pertinent experience preferred.
AIC must be obtained within 2 years of hire.
Adjuster License must be obtained within 1 year of hire.
Self-starter and problem solver with the ability to work independently.
Ability to work in a fast-paced environment and ability to prioritize work.
Proven ability to take initiative in a constantly changing work environment.

Responsibilities

Apply insurance law to insurance policies and facts to arrive at accurate interpretation of coverage.
Analyze facts of case to determine investigation needs in order to arrive at cause and origin, as well as scope and cost of damage.
Set reserves to reflect the exposure to the insurance policy or coverage document, per established policy.
Prepare reports on selected files, in a timely manner and per established policy.
Communicate the status and progress of the case with the insured, ARM management, and others as requested per established internal policy.
Document all claim activity in claim file, in an accurate and timely manner, per established policy.
Exercise sound judgment: including ability to make appropriate decisions and recommendations.
Regularly monitor every file assigned through the diary system.
Manage and direct all activities of Field Adjusters.
Supervise and direct claim investigations.
Report to Reinsurance intermediaries or Excess carriers, as needed and per established policy.
Collect appropriate material in claim file to provide evidence constituting proof of claim.
Ensure data entry in claim files is correct and accurate and all departmental procedures in the handling of claims are followed.
Adjudicate claims in accordance with the coverage documents, ARM established policy and practice and the appropriate Fair Claims Settlement Practices Act.
Prepare Comparative Cost Analysis of contractors’ bids and Proof of Loss documents as needed and per established policy.
Coordinate with Claims Specialist/Coordinator as it relates to the Claims Assistant.
Any other duties may be assigned by the Lead Claims Examiner.