Senior Claims Examiner, Complex Liability

Gallagher•Oakland, CA

48d•Remote

About The Position

The Senior Claims Examiner manages complex liability claims, including employment and civil rights claims, through conclusion in the most cost-effective manner for clients. The role also identifies claims involving coverage issues and refers them to the Claims and Coverage Committees for counsel referral. This is a remote position based in California; candidates must reside in the state. Keenan, part of Gallagher, serves hospitals, public agencies, and California school districts with insurance brokerage and consulting services. The examiner manages the full life cycle of complex general liability claims in accordance with PLCA guidelines and client expectations. The work includes analyzing coverage, directing investigations and defense counsel, evaluating damages, recommending and negotiating settlements, managing litigation costs, and ensuring compliance with statutory and ethical standards. The role also includes reporting, maintaining claim data, pursuing subrogation, adjusting reserves, supporting junior adjusters and client file reviews, and meeting a minimum daily billing productivity of 80%.

Requirements

High school diploma.
Seven years of related experience working within the applicable specialty claims area.
Demonstrated ability to handle unique or challenging claims issues at a senior adjuster level.
Appropriate licensure and/or certification in all states where claims are handled, or ability to obtain licenses or certification according to local requirements.
Knowledge of accepted industry standards and practices.
Computer experience with related claims and business software.
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, communicate effectively verbally and in writing, and embrace new challenges.
Analytical skill to make decisions and resolve issues involved in handling claims.
Ability to negotiate the settlement and disposition of claims, including interpreting related documentation.

Nice To Haves

Bachelor's degree highly preferred.
Ten or more years of prior experience adjusting claims in the applicable specialty area highly preferred.

Responsibilities

Manage the full life cycle of complex general liability claims in accordance with PLCA guidelines and client expectations.
Analyze coverage, assign and review investigations, evaluate damages, and recommend settlement strategies.
Prepare timely reports for reinsurers, JPAs, and Superpools, and maintain accurate statistical data.
Direct defense counsel, control litigation costs, and attend mediations or settlement conferences as needed.
Pursue subrogation opportunities and adjust reserves based on claim developments.
Draft coverage letters, negotiate settlements, and ensure compliance with statutory and ethical standards.
Provide guidance to junior adjusters and support client file reviews.
Maintain a minimum billing productivity of 80% daily and perform other duties as assigned.
Recognize claims involving coverage issues and bring them to the Claims and Coverage Committees for referral to counsel.