Sr. Commercial Claims Examiner

Frontline Insurance Managers Inc. • Remote, US,

2d • Remote

About The Position

At Frontline Insurance, we are on a mission to Make Things Better, and our Sr. Commercial Claims Examiner plays a pivotal role in achieving this vision. We strive to provide high quality service and proactive solutions to all our customers to ensure that we are making things better for each one. At Frontline Insurance, our core values – Integrity, Patriotism, Family, and Creativity – are at the heart of everything we do. We’re committed to making a difference and achieving remarkable things together. If you’re looking for a role, as a Sr. Commercial Claims Examiner, where you can make a meaningful impact and grow your career, your next adventure starts here!

Requirements

• Bachelor's degree
• A minimum of 10 years of Commercial claims experience preferred.
• In-depth professional knowledge of all aspects of claims operations.
• Florida 520/620 license is required.
• Ability to obtain AL, GA, NC and SC adjusters licenses.
• Strong commercial coverage interpretation and claims handling background is required.
• Must have commercial construction knowledge and be proficient in Xactimate.

Responsibilities

• Verify facts of loss and pertinent information to analyze and confirm coverage.
• Establish ultimate reserves (anticipated cost to bring file to closure based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.
• Explain and appropriately respond to insured’s, public adjusters, attorney’s and contractors during telephone contacts; as well as, contact the appropriate parties to obtain any needed information, provide timely investigation status updates, explain settlements and/or ultimate claim disposition.
• Timely submit reserve and payment approval requests, as appropriate.
• Identify claims requiring a Reservation of Rights and refer for management approval.
• Formulate and execute appropriate ADR strategy in compliance with statutory guidelines.
• Check e-mails and messages daily. Respond to all calls, emails, and questions daily.
• Apply advanced negotiation skills to effectuate resolution of disputed claims with insureds or their legal representative.
• Coordinate appraisal process, maintain communication necessary to ensure appraisal process is moving forward in timely fashion.
• Draft denial letters for management approval.
• Identify and refer claims with subrogation potential to the subrogation department.
• Identify and refer cases with potential NICB fraud indicators.
• Virtually investigate and resolve claims, as appropriate, with the use of video technology.
• Close all files as appropriate in a timely and complete manner.
• Serve as mentor and/or trainer, as needed, to junior adjusters.
• Strictly adhere to Best Practices and operational guidelines, as well as all statutory requirements.
• Interfaces with company clients, carrier, adjusters, or covered parties. Communicates with agents regarding status of claim.
• Completes and/or reviews, approves, or elevates reservation of rights letters, payment explanation correspondence, denial letters, or partial denial letters, as applicable.
• Resolves disputes regarding claims resolution. Responsible for reopening and re-evaluating claim, as necessary.
• Participates in litigation when applicable.

Benefits

• Remote work schedule!
• Company-sponsored Medical, Dental, Vision, Life, and Disability Insurance (Short-Term and Long-Term).
• 401k Retirement Plan with a generous 9% match
• Four weeks of PTO
• Pet Insurance for your furry family members.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior