Sr Claim Examiner-Liability
About The Position
Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate-to-difficult claims. Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices. Evaluates and sets reserves using independent judgment. Assists supervisor and defense attorneys in preparing cases for litigations. Conducts training and mentors new hires. Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted. Manages all aspects of investigative activity on complex claims. Directs the discovery and litigation strategy with legal counsel. Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements. Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits. Develops subrogation and third party recovery potential and follows reclaim procedures. Analyzes claims activities and prepares reports for clients, carriers and/or management. Participates in claim reviews.
Requirements
- Bachelor's degree or equivalent experience required.
- Technical claims investigations/settling experience with 4-8 years experience in Claims or similar organization.
- Ability to work independently while assimilating various technical subjects.
- Strong written and oral communication, negotiation and presentation skills.
- Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.
- Effective advanced interpersonal skills to effectively interact with all levels of internal and external clients.
- License Requirements: Per State or Jurisdictional requirements.
Nice To Haves
- Industry Designations: Preferred: IIA, AIC, AEI, and/or CPCU.
Responsibilities
- Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision.
- Works within established authority on moderate-to-difficult claims.
- Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices.
- Evaluates and sets reserves using independent judgment.
- Assists supervisor and defense attorneys in preparing cases for litigations.
- Conducts training and mentors new hires.
- Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
- Manages all aspects of investigative activity on complex claims.
- Directs the discovery and litigation strategy with legal counsel.
- Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.
- Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits.
- Develops subrogation and third party recovery potential and follows reclaim procedures.
- Analyzes claims activities and prepares reports for clients, carriers and/or management.
- Participates in claim reviews.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
11-50 employees
