Associate Claims Examiner

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct investigations and analyze fundamental claim details to assist in coverage and liability decisions under guidance.

• Manage low-complexity First Party Property and/or Renters Claims in accordance with established protocols and best practices.

• Provide assistance to senior examiners with lawsuits, mediations, arbitrations, and tasks related to litigation.

• Aid in establishing initial reserves with oversight from senior staff for review and approval.

• Engage experts or vendors as instructed, oversee vendor performance, and assist in controlling costs.

• Assess, negotiate, and suggest settlement amounts for uncomplicated claims under supervision.

• Maintain communication with policyholders, agents, and other involved parties throughout the claims process.

• Recognize and escalate requests for additional information, coverage inquiries, and settlement negotiations.

• Process claims in line with company Best Practices and established procedures.

• Track and work towards completing assigned low-complexity claims inventory.

• Provide customer service to insured individuals and agents through phone, email, and written communication.

• Update and keep precise claim files and documentation.

• Identify potential subrogation opportunities or fraud indicators and escalate them as necessary.

• Participate in claims training, audits, and quality assessments.

• Assist in overseeing TPAs and other vendors on basic matters under supervision.

⛳️ Requirements

• High school diploma or equivalent is required.

• An Associate’s or Bachelor’s degree is preferred.

• No previous claims handling experience is necessary.

• Relevant experience in customer service, insurance, claims, or administrative positions is advantageous.

• Must obtain a Property & Casualty Insurance Adjuster License within the first 90 days of employment and maintain it thereafter.

• Ability to communicate clearly and professionally both verbally and in writing.

• Strong organizational and time management skills.

• Excellent writing capabilities.

• Basic analytical and investigative skills.

• Developing negotiation abilities.

• Proficient in Microsoft Office, including Teams, Word, and Excel.

• Willingness to learn and adapt to new computer systems, technologies, and claims software.

• Must fulfill state continuing education requirements for the adjuster’s license.

🏝️ Benefits

• Company support offered, where applicable, for acquiring the Property & Casualty Insurance Adjuster License.

• Claims training, audits, and quality assessments.

• Remote work arrangement.