Claims Examiner

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

📋 Description

• Investigate, assess, negotiate, and resolve property insurance claims of low to moderate complexity.

• Provide outstanding service to policyholders during the entire claims process.

• Analyze and manage claims by confirming coverage, conducting investigations, and collecting relevant information to ascertain exposure.

• Maintain action plans for timely and appropriate claim resolutions in accordance with established policies and procedures.

• Identify and tackle coverage issues, potential fraud, and subrogation opportunities.

• Calculate and assign timely and suitable claim reserves while monitoring the adequacy of those reserves.

• Perform thorough reviews of damages and bills while managing claim expenses.

• Process and pay claims within designated authority limits, or deny payments when coverage, liability, or compensability is not applicable.

• Input claim payments and reserves into the computer system with clear and precise documentation.

• Communicate decisions in a clear and professional manner.

• Collaborate with various departments in a transparent, innovative, and mission-driven environment.

⛳️ Requirements

• A minimum of 1 year of experience in examining Property & Casualty Residential Insurance.

• An Associate degree or equivalent experience can substitute for a degree.

• Texas Adjuster License or evidence of progress toward obtaining the license.

• Preferred: A Bachelor's degree.

• Preferred: A cumulative GPA of 3.0 or higher.

• Preferred: AIC and/or CPCU designation.

• Bilingual skills are preferred, specifically in English and ideally Spanish, Mandarin, or Vietnamese.

• Ability to sit, hear, engage in conversations over the phone, and frequently type on a computer for extended periods.

• Willingness to participate in limited overnight travel when necessary.

🏝️ Benefits

• Fully remote work environment, enabling contributions from home without the need for relocation.

• Comprehensive medical, dental, vision, group life, AD&D, and dependent life insurance coverage.

• Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) with a generous annual employer contribution to the HSA.

• 401(k) retirement plan with employer matching contributions of up to 6%.

• Pension plan that starts vesting after 5 years of employment.

• Ongoing training and professional development opportunities funded by TWIA.

• Support for obtaining professional certifications.

• Tuition reimbursement program.

• Generous paid time off, which includes vacation, sick leave, paid holidays, and personal days.

• Flexible scheduling to promote work-life balance.

• Limited overnight travel opportunities, including remote catastrophe claim response efforts, depositions, other legal witness testimonies, training sessions, work-related activities, and meetings.