Professional Liability Claims Examiner III

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

📋 Description

• Oversee every facet of Professional Liability claims from initiation to resolution in accordance with established authority and company policies.

• Analyze policy details, endorsements, and vehicle schedules to assess coverage for losses, damages, or injuries.

• Investigate and evaluate claims, including those in litigation, until final resolution is achieved.

• Regularly communicate with claimants and their legal representatives.

• Articulate loss exposure, reserves, and provide recommendations for settlement strategies to clients.

• Review, manage, and finalize assigned claims effectively.

• Interpret insurance policies and make determinations regarding coverage.

• Supervise and guide external investigative service providers.

• Collaborate with clients, client counsel, and investigation services to facilitate claims progress.

• Maintain a continuous claim diary to track developments.

• Evaluate exposure and assess reserves along with settlement recommendations.

• Create comprehensive Loss Reports detailing liability and damages.

• Identify and initiate subrogation or risk-transfer recovery efforts when relevant.

• Record all correspondence, reports, discussions, and decisions in claims files meticulously.

• Deliver exceptional client service consistently.

• Support supervisors and the Claims Department with assigned tasks and special projects.

• Carry out additional duties as directed.

• Work remotely from home under the supervision of the Area Manager, reporting to the Claim Supervisor and/or Area Manager.

⛳️ Requirements

• Bachelor's degree in a relevant field is preferred.

• A minimum of five (5) years of related experience is required.

• An equivalent combination of education and experience will be considered.

• Possess technical knowledge of coverage, statutory regulations, and medical terminology.

• Strong analytical skills are essential.

• Excellent written and verbal communication skills, with the ability to explain technical details to claimants, clients, and team members.

• Capable of interacting effectively with individuals at all levels within the business environment.

• Ability to independently and proficiently manage highly complex claims.

• Proficiency in Microsoft Word and Excel is preferred.

• Must hold an active Independent Adjuster License in New York State.

• Ability to perform sedentary or light work, along with required mental, visual, physical, and communication activities.

🏝️ Benefits

• Comprehensive benefits package including health, dental, and vision insurance.

• Opportunities for professional development and continuing education.

• Flexible work arrangements to promote work-life balance.

• Supportive team environment with a focus on career growth.