Claims Examiner 2

Since March 2020, TWIA/TFPA is operating as a "remote first" work environment. Our office is open and still based in the heart of the Live Music Capital. We do offer the ability for our employees to work hybrid should they choose. This opening can be worked fully remotely. However, we are seeking candidates located in Texas as this position does require deployment to our coast in the event of a storm. More below.

We value smart, energetic, and flexible people who want to make a daily contribution toward helping serve our policyholders and employees. If that’s you, we may have just the right opportunity for you.

The Claims Examiner is responsible for demonstrating an understanding of insurance principles, claims investigation, damage evaluation, and resolution of property claims, creating a positive customer experience. A Claims Examiner provides prompt, cost effective and efficient examination, investigation, evaluation, and payment of insurance claims by exercising independent decision-making skills and judgment within designated authority. This position will generally work with semi-medium to semi-high complexity claims.

ESSENTIAL FUNCTIONS: The following are the usual, basic and essential functions of the Claims Examiner position. However, this job description does not preclude the performance of other duties by the incumbent. These functions are not to be construed as an exhaustive list of all responsibilities, duties, and skills required:

• Demonstrates a customer centric attitude
• Analyzes and manages claims by verifying coverage and investigating and gathering pertinent information to determine the exposure on the claim
• Maintains well-developed action plans for an appropriate and timely resolution in accordance with established policies and procedures
• Recognizes and properly addresses coverage issues, potential fraud, and subrogation potential
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim
• Conducts detailed damage and bill reviews and controls claim expenses
• Pays and processes claims within designated authority level or denies payments where no coverage, liability, or compensability exists
• Enters claim payments and reserves on claims on computer system, inputting concise and accurate file documentation
• Communicates decisions in a clear and professional manner

REQUIRED EDUCATION AND EXPERIENCE:

• 2 years’ experience examining P&C Residential Property.
• Associate degree (or equivalent experience in lieu of a degree)
• Texas Adjuster License or demonstrated progress toward achieving the license

PREFERRED EDUCATION AND EXPERIENCE:

• Bachelor’s degree, 3.0 cumulative GPA or higher
• 3 years’ experience examining P&C Residential Property.
• AIC, and/or CPCU designation

PREFERRED KNOWLEDGE, SKILLS, AND ABILITIES:

• Bilingual, English and preferably Spanish/Mandarin/Vietnamese

PHYSICAL REQUIREMENTS:

• This position requires the ability to sit, hear, converse over the telephone, and key frequently on a computer for long periods of time.
• This position may require some limited overnight travel including participation in remote catastrophe claim response efforts, deposition and other legal witness testimony, completion of training programs, additional work-related activities, and meetings.

TWIA & TFPA are proud to present our Total Rewards & Compensation Program. The Association invests in its most valuable resource - Our Employees.
We offer an excellent Health & Welfare benefits package that includes medical, dental, vision, life, accident, and disability insurance, and a retirement savings package that includes a 401(k) plan with 6% matching contributions and an employer paid pension plan. We also offer competitive pay, performance incentives, Student loan forgiveness benefits, and career growth with our Training & Professional Development program.. The Association offers a holistic approach to employee well-being by providing employees with classes, tools and resources to help employees achieve physical, mental and financial wellness. In addition, we provide a healthy environment and work/life integration along with paid holidays, personal days, paid vacation, and sick leave.

TWIA & TFPA is not accepting unsolicited assistance from search firms for this employment opportunity.
All resumes submitted on behalf of an applicant by a third party to any employee at TWIA & TFPA via-email, the Internet or in any form and/or method will be deemed the sole property of TWIA & TFPA. No fee will be paid to any third party in the event the candidate is hired by TWIA & TFPA as a result of the referral or through other means, unless TWIA & TFPA have previously entered into a contract for placement assistance with such party.