What are the responsibilities and job description for the Claims Examiner-Specialty Claims position at USLI?
The ideal claims team member will be an analytical and creative problem solver with the ability to hone in on key issues for coverage, liability and damage evaluation. Our claim examiners are assertive decision makers with a strong desire to persuade through negotiation and conflict management. The claims team offers on going challenges, even for the most experienced professional, as every claim is unique, providing new opportunities to learn and grow. We welcome our ongoing interaction with underwriting, compliance and actuarial to keep our products healthy.
Essential Functions:
Coverage is confirmed by reviewing the first notice of loss, checking all available systems, and interpreting policy language. Upon coverage analysis, the examiner prepares initial position letters to the policyholder such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim. Investigation includes securing all pertinent facts, statements & documents, identifying joint tortfeasors and witnesses as well as scene investigation. Initial reserves are posted, reviewed and maintained as file develops to properly reflect ultimate exposure based upon liability and damage evaluation. The examiner is responsible for proactive file management toward final disposition via an effective diary, direction to defense counsel & independent adjusters, analysis & strategy leading to negotiated settlement or trial. Substantive file documentation in claim notes should reflect file activity. While the claim is pending, communication includes delivery of comprehensive and concise authority requests, reinsurance reports, serious loss reports, coverage position letters and appropriate communication with underwriting and actuary.
Beyond core responsibilities, examiners play a key role in delivering exceptional customer service by responding to internal and external phone calls and emails within the same business day and adhering to established claim service standards. Examiners may also be assigned special projects as needed.
Additionally, ongoing professional development is expected, including participation in continuing education to maintain state licenses and support both personal and career growth, as outlined in the annual Individual Development Plan.
Some travel may be required to attend mediations and mandatory court hearings.
Key Skills & Qualifications
- Strong oral and written communication abilities.
- Analytical mindset with keen problem-solving skills.
- Effective negotiation and dispute-resolution skills.
- Excellent organizational and time management capabilities.
- Technical expertise in insurance coverage, negligence law, and claim evaluation.
Passion and drive can be just as important as experience. If you’re excited about this opportunity, we’d love to hear from you!
Position affords 5 days per month to work remotely.
At USLI, we are committed to fostering a vibrant and inclusive community that celebrates the rich diversity of all ethnicities, nationalities, abilities, genders, gender identities, sexual orientations, ages, religions, socioeconomic backgrounds, and life experiences. We understand the importance of continuous learning, self-reflection, acknowledging our biases, and expanding our perspectives beyond our own. We actively encourage open dialogue on diversity, equity, inclusion, and belonging to support a workplace where every individual feels valued, respected, and empowered to contribute at their fullest potential. Join us in building a diverse and inclusive environment where our shared values drive us toward excellence.
Job Type: Full-time
Expected hours: 35 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Referral program
- Vision insurance
Schedule:
- Monday to Friday
Work Location: In person
