Claims Examiner Jobs

About The Position

Requirements

• 2–5 years of claims handling experience in property, casualty, or specialty lines
• Basic understanding of insurance coverage principles and policy interpretation
• Experience investigating and resolving claims, including exposure analysis and reserving
• Strong written and verbal communication skills
• Organizational skills with the ability to manage a caseload effectively
• Ability to work collaboratively with internal teams and external partners
• Proficiency in Microsoft Office applications (Excel, Word, Outlook)

Nice To Haves

• Experience working with TPAs or program business
• Exposure to litigated claims
• Professional designations in progress or interest in pursuing (AIC, ARM, CPCU, etc.)

Responsibilities

• Review claims submitted by TPAs and authorize reserves and payments where those amounts exceed the TPA’s authority
• Provide guidance to TPAs to ensure proper investigation and timely, equitable disposition of claims, including retention of experts and/or attorneys where needed
• Assist TPA with coverage analysis, seeking underwriting assistance where appropriate
• Review and approve reservation of rights and coverage denial letters to ensure accuracy and consistency in coverage analysis
• Review claims to ensure appropriate reserve levels and that changes are made on a timely basis
• Refer claims more than authority to supervisor
• Prepare notifications to underwriters and reinsurers for large or contentious claims
• Review and approve TPA funding requests within authority
• Participate in claim file audits to monitor TPA performance
• Assist with preparation of reports for underwriting, agents, insureds or state agencies as needed
• Provide clear and professional communication to TPAs/Claim Administrators, brokers, and program partners
• Issue timely claim correspondence, status updates, and regulatory notices
• Participate in claim reviews and provide updates to management as requested
• Escalate complex coverage or high-exposure matters to senior leadership
• Ensure claim handling complies with regulatory requirements and internal guidelines
• Maintain proper documentation in claim management systems
• Support data calls, audits, and reporting requests
• Assist with reinsurer reporting requirements when applicable
• Participate in training programs and technical development opportunities
• Seek feedback and coaching to continuously improve claim handling skills
• Contribute to team collaboration and knowledge sharing

Benefits

• Relocation Assistance
• Multiple medical plans to choose from
• 100% employer covered dental & vision plans for our team members and their families
• 401(k)-retirement plan
• Short & long-term disability
• Employer-paid life insurance
• Flexible Spending Accounts (FSA) for health and dependent care
• Employee Assistance Program (EAP)
• Equity compensation
• Training and internal career growth opportunities
• Flexible Time Off
• 12 weeks of parental leave for primary and secondary caregivers
• Snacks and drinks available
• Catered lunches for onsite employees