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.

• Confirm coverage and investigate claims by collecting relevant information to assess exposure.

• Develop action plans to ensure claims are resolved appropriately and in a timely manner, adhering to company policies and procedures.

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

• Calculate and assign timely and appropriate claim reserves while monitoring their adequacy.

• Perform thorough damage assessments and bill evaluations to manage claim costs effectively.

• Process and approve claims within established authority limits or deny claims when coverage, liability, or compensability is not applicable.

• Input claim payments and reserves into the computer system while maintaining concise and accurate file documentation.

• Clearly and professionally communicate decisions to relevant parties.

• Exhibit a customer-focused approach throughout the claims process.

• Engage in remote catastrophe claim responses, legal witness testimony, training sessions, work-related activities, and meetings as necessary.

⛳️ Requirements

• Minimum of 1 year of experience in examining Property & Casualty Residential Property.

• Associate degree or equivalent experience in place of a degree.

• Texas Adjuster License or demonstrated progress toward obtaining the license.

• Capability to sit, hear, converse on the telephone, and frequently use a computer for extended periods.

• May involve limited overnight travel.

• Preferred: Bachelor’s degree.

• Preferred: Cumulative GPA of 3.0 or higher.

• Preferred: AIC and/or CPCU designation.

• Preferred: Bilingual skills in English and preferably Spanish, Mandarin, or Vietnamese.

🏝️ Benefits

• Fully remote work setting, enabling you to work from home with no need for relocation.

• Comprehensive benefits package including medical, dental, vision, group life, AD&D, and dependent life insurance.

• 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.

• Continuous training and professional development opportunities funded by TWIA.

• Assistance in obtaining professional certifications.

• Tuition reimbursement program available.

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

• Flexible scheduling options to promote a healthy work-life balance.

• Collaborative and mission-driven organizational culture.

• Limited overnight travel opportunities, including remote catastrophe claim response efforts and legal witness testimony.