Commercial Auto & General Liability Claims Examiner III (Floater)

Tristar Insurance•Long Beach, CA

3d•$80,000 - $90,000•Remote

About The Position

Under minimal supervision, investigates, evaluates, and resolves complex commercial automobile and general liability claims, including matters in litigation. Reviews policy provisions, endorsements, and applicable vehicle schedules to determine coverage and assess liability, damages, and potential exposure. Communicates reserve and settlement recommendations to clients and maintains effective working relationships with claimants, legal representatives, counsel, and other involved parties. Serves in a float capacity, providing claims handling coverage during planned paid time off, unexpected absences, and extended leaves of absence. Assumes responsibility for assigned files to maintain timely claim activity, prevent backlogs, and meet client service level agreements. The Claims Examiner (Float) is a versatile role designed to ensure continuity of operations within the claims department. This individual provides seamless coverage for permanent examiners during planned Paid Time Off (PTO), unexpected absences, or extended leaves of absence. The primary goal is to prevent backlogs claim and maintain service level agreements (SLAs) regardless of staffing fluctuations. Investigates, evaluates, manages, and resolves complex commercial automobile and general liability claims, including litigated claims, in accordance with applicable requirements, client instructions, company procedures, and industry best practices. Reviews and interprets insurance policies, endorsements, and vehicle schedules to determine applicable coverage and identify coverage issues. Provides temporary coverage for other claims examiners, reviewing transferred files, identifying outstanding activities and deadlines, and maintaining continuity of claim handling. Maintains an accurate claim diary and completes timely follow-up on investigations, correspondence, litigation activities, and other required actions. Evaluates liability, damages, and potential exposure; recommends appropriate reserves and updates recommendations as additional information becomes available. Develops and communicates claim resolution and settlement strategies to clients; negotiates settlements within delegated authority and obtains approval when required. Coordinates and directs outside investigators and other service providers; works with clients and counsel to advance claims toward resolution. Monitors litigation developments, evaluates counsel’s recommendations, and communicates material changes affecting claim exposure or resolution. Prepares loss reports containing a thorough analysis of coverage, liability, damages, reserves, and recommended next steps. Identifies potential subrogation and risk transfer opportunities and initiates recovery efforts at the client’s direction. Maintains complete, accurate, and timely claim file documentation, including correspondence, reports, discussions, decisions, and supporting rationale. Provides responsive, professional service to clients and other involved parties. Coordinates file handoffs with supervisors and returning examiners, documenting current claim status, pending actions, and upcoming deadlines. Assist supervisors and the claims department with special projects and other assigned responsibilities. Performs other duties as assigned. Position is remote/working from home.

Requirements

High School Diploma or GED required
Minimum of seven+ (7) years’ commercial auto and general liability casualty related experience
At least 10 years of Commercial Automobile and General Liability claims experience required
Knowledge of claims handling concepts, practices, and techniques, including but not limited to coverage issues and product line knowledge.
Demonstrated verbal and written communications skills.
Demonstrated advanced analytical, decision-making and negotiation skills.
Computer proficiency.
Advanced knowledge of commercial automobile and general liability claims handling, including coverage analysis, investigations, liability evaluation, damages assessment, reserving, and settlement practices.
Understanding of the litigation process and claim valuation across multiple jurisdictions.
Strong analytical, problem-solving, decision-making, and negotiation skills.
Ability to independently manage complex claims within established authority and with minimal supervision.
Strong written and verbal communication skills, including the ability to prepare clear, thorough claim reports and recommendations.
Ability to develop and maintain effective relationships with clients, claimants, legal representatives, counsel, and service providers.
Strong organizational and time management skills, with the ability to prioritize competing assignments and meet deadlines.
Flexibility to assume unfamiliar claim inventories, assess immediate priorities, and maintain service standards during staffing changes.
Proficiency with claims management systems, computer applications, and related technology.
Demonstrated commitment to responsive client service and accurate claim documentation.
Holds an applicable resident or designated home state adjuster license and required nonresident licenses, or has the ability to obtain required licenses through reciprocity or applicable state examinations.
Maintains required licenses and completes applicable continuing education requirements.
Logical or scientific thinking to solve problems; several abstract and concrete variables.
Arithmetic calculations involving fractions, decimals, and percentages.
Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.
Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time.
Near vision: clarity of vision at 20 inches or less
Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication and to make fine discriminations in sound, such as when making fine adjustments on machined parts.
Repetitive Motion: Substantial movements (motions) of the wrists, hands, and/or fingers.
Significant work pace/pressure

Nice To Haves

Bachelor's degree in a related field.
Associate in Claims (AIC) and/or Chartered Property Casualty Underwriter (CPCU) designation.
Experience providing float coverage or managing claims across multiple client accounts and jurisdictions.

Responsibilities

Investigates, evaluates, and resolves complex commercial automobile and general liability claims, including matters in litigation.
Reviews policy provisions, endorsements, and applicable vehicle schedules to determine coverage and assess liability, damages, and potential exposure.
Communicates reserve and settlement recommendations to clients.
Maintains effective working relationships with claimants, legal representatives, counsel, and other involved parties.
Provides claims handling coverage during planned paid time off, unexpected absences, and extended leaves of absence.
Assumes responsibility for assigned files to maintain timely claim activity, prevent backlogs, and meet client service level agreements.
Evaluates liability, damages, and potential exposure; recommends appropriate reserves and updates recommendations as additional information becomes available.
Develops and communicates claim resolution and settlement strategies to clients; negotiates settlements within delegated authority and obtains approval when required.
Coordinates and directs outside investigators and other service providers.
Works with clients and counsel to advance claims toward resolution.
Monitors litigation developments, evaluates counsel’s recommendations, and communicates material changes affecting claim exposure or resolution.
Prepares loss reports containing a thorough analysis of coverage, liability, damages, reserves, and recommended next steps.
Identifies potential subrogation and risk transfer opportunities and initiates recovery efforts at the client’s direction.
Maintains complete, accurate, and timely claim file documentation, including correspondence, reports, discussions, decisions, and supporting rationale.
Provides responsive, professional service to clients and other involved parties.
Coordinates file handoffs with supervisors and returning examiners, documenting current claim status, pending actions, and upcoming deadlines.
Assist supervisors and the claims department with special projects and other assigned responsibilities.
Performs other duties as assigned.