Sr Claims Examiner - MSI

The Baldwin Group

1d•Remote

About The Position

MSI is a leading Managing General Agent (MGA) that specializes in creating insurance solutions by combining deep underwriting expertise with insurer and reinsurer risk capacity. They offer a diverse range of products, from digital renters coverage to high-value homeowners and sophisticated commercial coverages like cyber liability, distributed through various partners. MSI is committed to providing exceptional service and simplifying the insurance experience through advanced technology. The company handles third-party claims involving bodily injury and property damage under homeowner's and renter's insurance policies nationwide. They are seeking an experienced individual to join their Liability Claims Team as a Sr. Claims Examiner. This role is for an expert in managing insurance claims, specifically handling high severity and complex cases, both pre-suit and in suit. The Sr. Claims Examiner needs strong experience and technical knowledge to manage a complex caseload from inception to resolution, while delivering superior customer service. Key to success are relationship development, effective communication, strategic vision, and tactical execution. The position requires working with 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.