Sr Claims Examiner - MSI

MSI, part of The Baldwin Group

1d•Remote

About The Position

MSI thrives on solving challenges, operating as a leading MGA that combines deep underwriting expertise with insurer and reinsurer risk capacity to create specialized insurance solutions. They empower distribution partners to meet customers’ unique needs, focusing on crafting solutions for important risks facing individuals and businesses. MSI offers an expanding suite of products, including fully-digital embedded renters coverage, high-value homeowners insurance, and sophisticated commercial coverages like cyber liability and habitational property, delivered through various partners. The company prides itself on delivering exceptional service through a dedicated team that prioritizes rapid resolutions and simplifies the insurance experience via an advanced technology platform supporting the entire policy lifecycle. MSI specifically handles third-party claims involving bodily injury and property damage under homeowner’s (HO3) and renter’s (HO4) insurance policies nationwide. The Sr. Claims Examiner role is for an experienced individual to join the Liability Claims Team, acting as an expert in managing high severity and complex insurance claims, both pre-suit and in suit. This role requires technical knowledge to manage a complex caseload from inception to resolution, providing superior service to customers and business partners. Key factors for success include developing relationships, effective communication, strategic vision, and tactical execution to achieve results. The Sr. Claims Examiner must be able to work with little to minimal supervision in a fast-paced environment.

Requirements

Ability to communicate clearly, professionally, and provide superior customer service over the phone and through written correspondence.
Comfortable managing claims across multiple platforms while maintaining accuracy and productivity standards.
Strong organizational and time management skills.
Strong writing skills.
Excellent analytical, investigative, and negotiation skills.
Proficient with Microsoft Office, Teams, Word, Excel and various other computer skills with the ability to learn and utilize new computer systems and other technologies.
Bachelor’s degree or equivalent work experience
8+ years of liability claims handling experience
Must have State Adjuster License(s) and be willing to obtain additional licenses as requested

Nice To Haves

Property experience is a plus
Insurance designations preferred

Responsibilities

Directly handles third-party (liability) claims involving complex and severe bodily injury or property damage from initial assignment through to resolution of claim, including negotiating settlements.
Evaluates and analyzes insurance policies in order to make coverage determinations.
Drafts Reservation of Rights letters and coverage disclaimers as warranted.
Makes prompt contact with policy holders, claimants and other appropriate parties to gather information, take recorded statements, and conduct thorough investigations.
Investigates claims to determine validity and the potential for liability against insureds.
Evaluates damages (both bodily injuries and property damages) to determine potential exposures and sets appropriate reserves.
Works a claim load efficiently and independently with little to no supervision.
Sets timely file reserves in compliance with company’s reserving philosophy and continues to evaluate pending reserves throughout the life of the claim.
Manage defense counsel which includes assisting in claim strategy, evaluating potential exposure, reviewing invoices, and attending mediations and settlement conferences as necessary.
Engages experts, as needed, to assist in the evaluation of the claim and monitors experts and vendors’ performance while controlling expense costs.
Drafts reports for large losses and reports to Leadership as required.
Evaluates, negotiates and determines settlement values in settlement of claims.
Communicates with all interested parties throughout the life of the claim including proactively discussing coverage decisions, the need for additional information, and settlement amounts with interested parties.
Establishes and maintains an organized diary system to ensure all claims are appropriately handled in a timely manner.
Adheres to all state/local regulations including the NJ/PA Unfair Claims Practices and Guidelines.
Handles all claims in accordance with Best Practices and provides exceptional customer service to insureds, agents, claimants, and business partners.
Responsible for monitoring and completing assigned claims inventory.
Acquires and maintains multiple state adjuster’s licenses and maintains continuing education requirements.
Develops and maintains relationships with external and internal stakeholders.
Identifies questionable risks, red flags and fraud indicators and alerts the Special Investigation Unit when applicable.
Identifies opportunities for subrogation and ensures recovery interests are protected.
Acts as a mentor for less experienced Claims Examiners.
Maintains well drafted claim file notes with proper documentation throughout the life of the file.
Assists with special projects when required.