Claims Examiner

Claim Examiner

The Claims Examiner Reviews, evaluates, and processes insurance claims and makes recommendations for resolution; Examines and authorizes insurance claims investigated by insurance adjusters; Studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim; Communicates with agents, claimants, and policy holders; Determines settlement according to organization practices and procedures.; Works on projects/matters of limited complexity in a support role.

This position manages general liability, bodily injury, property damage, personal/advertising injury, auto and other miscellaneous claims. The Claims Examiner will analyze, investigate and resolve complex claim issues, including coverage, liability and damages. The position requires familiarity with regulatory compliance requirements and tort law.

Responsibilities

• Ensure appropriate investigation of the underlying facts and circumstances is carried out in a timely manner, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, proper negotiation strategy is employed.

• Recognizing exposures and ensuring reserving is appropriate and timely.
• Evaluating coverage issues and risk transfer opportunities.
• Effectively communicate exposures both internally and externally.
• Overall responsibility for formulating proper resolution strategy to ensure best total outcome.
• Position may require periodic travel to attend meditations, trials and/or other related meetings.
• Perform other duties as assigned

Qualifications

Requirements

• Bachelor’s degree preferred
• CPCU or AIC Certification (Preferred)
• Experience handling large complex commercial casualty claims with 0-2 years of commercial casualty claim adjusting experience handling primary and excess general liability, auto and personal injury claims.
• Experience in claims coverage analysis.
• Ability to approach every task in a meticulous and thorough manner, documenting actions and communications, prioritizing, maintaining schedules; paying attention to detail and striving for accuracy at all times; identifying and meeting all deadlines.
• Understanding of legal procedures, regulatory compliance and states’ statutes.
• Strong oral and written communication skills with the ability to communicate professionally at all levels within and outside the organization.
• Insurance designations a plus.
• Strong computer skills including Microsoft Office Word, Outlook and Excel.

Salary : $50,000 - $80,000