Senior Claims Examiner
About The Position
The Senior Claims Examiner adjudicates assigned claims within given authority and provides operational support to the claims team. This person also adjusts and resolves moderate to complex claims that includes all phases of litigation. They accurately document claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities. With minimal supervision, they draft coverage letters, including reservation of rights and denial letters. They review and analyze claim documentation and legal filings to set timely and accurate reserves and notify the manager if upward segmentation is needed. This role identifies emerging exposures and claims trends, drives litigation best practices to manage deployment and utilization of defense counsel, and identifies suspected fraudulent claims and tracks with the special investigations unit. They also participate in Claims Projects as needed.
Requirements
- 3-5 years of claims handling experience in the area of commercial general liability with an insurance carrier
- Advanced knowledge of claims analysis and adjusting practices
- In depth knowledge of standards for claims documentation and legal filings
- Proven ability to actively and effectively negotiate settlement of moderate to complex claims
- Experience in mentoring and training other claims examiners
- Advanced analytical skills
- Strong verbal and written communication skills
- Active insurance adjuster’s license
Nice To Haves
- B.A./B.S degree from an accredited College or University preferred
Responsibilities
- Adjusts and resolves moderate to complex claims that includes all phases of litigation
- Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
- With minimal supervision, drafts coverage letters, including reservation of rights and denial letters
- Reviews and analyses claim documentation and legal filings to set timely and accurate a reserves and notify the manager if upward segmentation is needed
- Identifies emerging exposures and claims trends
- Drives litigation best practices to manage deployment and utilization of defense counsel
- Identifies suspected fraudulent claims and tracks with special investigations unit
- Participates in Claims Projects as needed
Benefits
- 401(k) with competitive company matching
- Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
- Company paid group term life, short-term disability and long-term disability coverage
- 24 Paid time off days plus 2 Hiscox days
- 10 paid holidays plus 1 paid floating holiday
- Ability to purchase up to 5 PTO days
- Paid parental leave
- 4-week paid sabbatical after every 5 years of service
- Financial Adoption Assistance and Medical Travel Reimbursement Programs
- Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
- Company paid subscription to Headspace to support employees’ mental health and wellbeing
- Modern and open office spaces, complimentary drinks
- Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
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What This Job Offers
Job Type
Full-time
Career Level
Senior
