Commercial Claims Examiner III (Remote)
California FAIR Plan Association•Los Angeles, CA
•$46 - $51•Remote
About The Position
The Commercial Claims Examiner III reviews, evaluates, and processes complex commercial insurance claims and makes recommendations for resolution. The role examines and authorizes commercial claims investigated by independent adjusters, reviews claim forms and records to determine insurance coverage, and confirms that payment recommendations and settlements are correct. The position focuses on claims over $500,000, but may handle smaller claims as needed.
Requirements
- Bachelor’s degree or equivalent.
- At least 5 years of property claims adjusting experience.
- At least 4 years of commercial experience.
- At least 2 years of experience handling claims over $500,000.
- Excellent oral and written communication skills.
- Working experience with Microsoft Office, especially Word and Excel.
- Comprehensive understanding of policy contracts, statutes, and claims processes.
- Certification in CEA and Fair Claims Settlement Practices.
Nice To Haves
- At least 2 years of commercial property claims experience preferred.
Responsibilities
- Manage a caseload of commercial property claims from assignment through resolution.
- Examine claims investigated by independent adjusters to determine coverage and claim validity.
- Review and adjust commercial loss reserves and correspondence; verify coverage; and authorize payments submitted by independent adjusters.
- Collaborate with internal personnel and legal counsel on claims involving litigation.
- Investigate, evaluate, and adjust claims, applying technical knowledge and interpersonal skills to promote fair and prompt settlements.
- Oversee independent adjuster files to ensure compliance with CFP IA Guidelines.
- Verify and analyze settlement data to ensure its validity and compliance with company practices and procedures.
- Maintain compliance with Department of Insurance requirements and company procedures.
- Identify indicators of fraud or illegal activity and refer claims through internal processes for follow-up.
- Negotiate settlements promptly, reflecting insured losses while protecting the insurer from invalid claims.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
