Senior Claims Examiner

Texas Windstorm Insurance AssociationAustin, TX
Remote

About The Position

Join a team where your expertise truly makes a difference. As a Senior Claims Examiner, you'll lead the investigation and resolution of complex commercial property claims, guiding customers through critical moments with confidence and professionalism. This role combines technical challenge, independent decision-making, and meaningful customer interaction, giving you the opportunity to leverage your claims expertise while influencing fair and timely claim resolutions. If you thrive in a fast-paced environment, enjoy solving complex problems, and value delivering outstanding customer service, this is an opportunity to take your claims career to the next level.

Requirements

  • Bachelor’s degree or 6+ years of relevant work experience
  • Texas Adjuster License
  • This position requires the Sr. Claims Examiner to obtain the Associate in Claims designation within two years of the date of hire/promotion, or the Chartered Property Casualty Underwriter designation within three years of the date of hire.

Nice To Haves

  • Bilingual, preferably Spanish and/or Asian Languages (such as Mandarin, Vietnamese, etc.)
  • Building contractor, roofing contractor, restoration contractor background
  • Residential/Commercial Property estimating software

Responsibilities

  • Demonstrates a customer centric attitude
  • Analyzes and manages claims by verifying coverage and investigating and gathering pertinent information to determine the exposure on the claim
  • Maintains well-developed action plans for an appropriate and timely resolution in accordance with established policies and procedures
  • Recognizes and properly addresses coverage issues, potential fraud, and subrogation potential
  • Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim
  • Conducts detailed damage and bill reviews and controls claim expenses
  • Pays and processes claims within designated authority level or denies payments where no coverage, liability, or compensability exists
  • Enters claim payments and reserves on claims on computer system, inputting concise and accurate file documentation
  • Communicates decisions in a clear and professional manner
  • May provide training, coordination, and investigation of potential fraudulent activity for the Association.

Benefits

  • Comprehensive medical, dental, vision, group life, AD&D, and dependent life insurance coverage
  • Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) with a generous annual HSA employer contribution
  • A 401(k) retirement plan with employer matching contributions up to 6%, in addition to a pension plan that begins vesting at 5 years of employment
  • Active support for professional growth, including ongoing training and professional development opportunities sponsored by TWIA, support to obtain professional certifications, and a tuition reimbursement program
  • Generous paid time off, including vacation, sick leave, paid holidays, and personal days
  • Flexible scheduling to support work-life balance
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