Claims Examiner

Orion180•Melbourne, FL

14d•Onsite

About The Position

CITON Claims Solutions is seeking a detail-oriented claims professional to work as a Desk Adjuster in its Melbourne, Florida office. The role involves investigating, evaluating, and resolving insurance claims while ensuring fair and efficient processing in accordance with policy terms, company guidelines, and applicable regulations. The office environment is fast-paced and collaborative. The employee must be able to work the regularly assigned schedule and, when needed, an extended schedule based on company or departmental needs, project requirements, or customer demands. The employee will review homeowners’ claims from first notice of loss through final settlement, assess coverage and liability, gather information from involved parties, document findings, prepare settlement recommendations, negotiate settlements, and resolve disputes. The role also involves communicating with policyholders and stakeholders, collaborating with internal teams such as underwriters and legal advisors, and supporting claims management during disaster events as needed.

Requirements

At least 3 years of experience handling homeowners’ insurance claims from first notice of loss through final settlement.
A bachelor’s degree, or relevant education and experience.
Ability to work the regularly assigned schedule and, when needed, an extended schedule based on company or departmental needs, project requirements, or customer demands.
Ability to sit, stand, and/or walk around, including using stairs.
Ability to communicate openly by talking, listening, comprehending, and reading.
Ability to lift light objects weighing less than 25 pounds.
Ability to use standard office equipment such as computers, printers, and phones.
Occasional ability to bend, twist, or squat and reach for files or other office objects.

Nice To Haves

Five or more years of experience.
Industry certifications such as CPCU or AIC.

Responsibilities

Review and analyze submitted claims documentation to determine claim validity and coverage.
Communicate with policyholders, witnesses, and other involved parties to gather information for claims evaluation.
Create detailed reports and maintain comprehensive notes supporting claims assessments.
Review insurance policies to determine applicable coverage and assess liability.
Submit reports containing findings and supported recommendations for claim settlements.
Negotiate settlements with policyholders and third parties to pursue fair outcomes.
Handle disputes professionally and efficiently.
Maintain transparent and professional communication with policyholders and stakeholders throughout the claims process.
Collaborate with internal teams, including underwriters and legal advisors, to resolve complex claims.
Comply with state and federal regulations and company policies in claims processes.
Support claims management efforts during disaster events as needed.