Claims Examiner – Auto, General Liability, Bodily Injury

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

📋 Description

• Analyze and oversee complex or technically demanding general liability claims from initiation to resolution.

• Conduct investigations to establish liability, assess damages, and evaluate claim exposure.

• Formulate and implement strategic action plans for claims.

• Evaluate liability and negotiate settlements within assigned authority limits.

• Calculate, set, and manage claim reserves.

• Authorize and process claim payments and adjustments within designated authority.

• Ensure adherence to laws, regulations, and client-specific requirements.

• Prepare and submit necessary state filings within statutory deadlines.

• Report claims to excess carriers and respond to requests for information or directives.

• Manage litigated claims alongside defense counsel and external partners.

• Coordinate vendor referrals for investigations, medical reviews, surveillance, and litigation management.

• Employ cost-containment strategies and vendor partnerships to minimize claim expenses.

• Pursue and manage claim recoveries, including subrogation and applicable offsets.

• Communicate proactively with claimants, clients, attorneys, and stakeholders.

• Build and sustain client relationships through professional and responsive service.

• Accurately document and code claim files.

• Escalate complex issues and high-exposure cases to leadership.

• Perform additional duties as assigned.

⛳️ Requirements

• Five (5) years of experience in claims handling, or an equivalent combination of education and relevant experience.

• Preference for experience in handling complex general liability claims.

• Strong preference for litigation management experience.

• A bachelor's degree from an accredited college or university is preferred.

• Relevant industry certifications related to the line of business are preferred.

• In-depth knowledge of general liability claims practices, insurance principles, and applicable regulations.

• Understanding of recovery opportunities, subrogation, offsets, and cost containment strategies.

• Excellent verbal, written, and presentation communication skills.

• Strong analytical, investigative, and problem-solving skills.

• Effective negotiation and settlement management capabilities.

• Ability to prioritize tasks and manage multiple competing priorities.

• Capacity to work independently and collaboratively in a team environment.

• Proficiency with Microsoft Office applications and claims management systems.

• Commitment to delivering exceptional customer and client service.

• Computer keyboarding skills.

• Proficient in hearing, vision, and speaking.

• Clear and conceptual thinking ability; excellent judgment and discretion; capable of meeting deadlines.

• Knowledge and experience in New Jersey claims handling is required by the role title.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• 401k and matching.

• Paid Time Off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance programs.

• Flexible spending or health savings account options.

• Additional voluntary benefits.

• Commitment to work-life balance.

• Flexible work arrangements implied by telecommuting location.