Claims Examiner, Liability

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

📋 Description

• Manage third-party bodily injury and property damage claims that range from low to moderate complexity, overseeing the process from initial assignment to resolution, including settlement negotiations.

• Assess insurance policies and make determinations regarding coverage.

• Prepare Reservation of Rights letters and coverage disclaimers.

• Reach out to policyholders, claimants, and other relevant parties to collect information and conduct investigations.

• Investigate claims to ascertain their validity and potential liability.

• Analyze bodily injury and property damage, assess exposures, and establish appropriate reserves.

• Efficiently and independently manage claim loads.

• Ensure timely maintenance of file reserves and regularly reassess pending reserves throughout the claims process.

• Oversee defense counsel, which includes strategizing on claims, evaluating exposure, reviewing invoices, and participating in mediations and settlement conferences.

• Engage and supervise experts and vendors while controlling costs.

• Draft reports for large losses and leadership updates.

• Assess, negotiate, and establish settlement values.

• Relay coverage decisions, required information, and settlement amounts to relevant parties.

• Maintain an organized diary system and manage assigned claims inventory effectively.

• Obtain and keep multiple state adjuster licenses along with fulfilling continuing education requirements.

• Cultivate relationships with both internal and external stakeholders.

• Recognize questionable risks, red flags, and indicators of fraud, notifying the Special Investigation Unit as necessary.

• Identify subrogation opportunities and safeguard recovery interests.

• Mentor junior Claims Examiners.

• Keep well-documented claim file notes and records.

• Support special projects as needed.

⛳️ Requirements

• Bachelor’s degree or equivalent professional experience.

• A minimum of 5 years of experience in casualty claims adjusting.

• First-Party Property experience is advantageous.

• Preferred insurance designations.

• Must possess State Adjuster License(s); licenses from California, Florida, and Texas are particularly desirable.

• Openness to acquiring additional licenses as required.

• Ability to communicate clearly and professionally both over the phone and in writing.

• Strong organizational and time management capabilities.

• Excellent writing skills.

• Outstanding analytical, investigative, and negotiation abilities.

• Proficient in Microsoft Office, Teams, Word, Excel, and other relevant computer systems and technologies.

• Capability to work with minimal supervision in a fast-paced environment.

• Skill in managing a caseload from its inception through to resolution.

• Adherence to state and local regulations, including NJ/PA Unfair Claims Practices and Guidelines.

🏝️ Benefits

• A superior work environment focused on customer service.

• Opportunity for remote work.

• Support for continuing education requirements and maintenance for state adjuster licenses.

• Professional growth through mentoring of less experienced Claims Examiners.