Professional Liability Claims Examiner, III

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

📋 Description

• Oversee all facets of Professional Liability claims from initial filing to resolution, adhering to the established authority and company policies.

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

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

• Frequently engage with claimants and their legal representatives.

• Provide clients with insights on loss exposure, reserve assessments, and settlement strategies.

• Review, process, and finalize assigned professional liability claims.

• Interpret policy provisions and determine coverage eligibility.

• Supervise and guide external investigative service providers.

• Collaborate with clients, their legal counsel, and investigative services to expedite claims resolution.

• Maintain a continuous diary of claims activities.

• Evaluate exposure and assess reserve levels and settlement recommendations.

• Create comprehensive Loss Reports detailing liability and damages.

• Identify and initiate subrogation or recovery efforts when appropriate.

• Record correspondence, reports, discussions, and decisions in claim files.

• Deliver exceptional client service.

• Support supervisors and the Claim Department with requested tasks or special projects.

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

⛳️ Requirements

• A Bachelor’s degree in a relevant field is preferred; a minimum of five (5) years of related experience or an equivalent combination of education and experience is acceptable.

• Technical expertise in coverage, statutory regulations, and medical terminology.

• Strong analytical skills.

• Excellent written and verbal communication abilities, with the capacity to explain technical information to claimants, clients, and staff.

• Ability to interact effectively with individuals at all levels within the business setting.

• Capability to independently and efficiently manage highly complex claims.

• Proficiency in Word and Excel is preferred.

• Possession of an active Independent Adjuster New York State License.

• High School Diploma or GED is required as the minimum educational qualification.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with company matching.

• Opportunities for professional development and training.

• Flexible work arrangements.

• Paid time off and holidays.