Professional Liability Claims Examiner III – Team Leader

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

📋 Description

• Offer daily guidance, technical assistance, and work direction to the Claims Examiners on the NVA Team.

• Oversee an active caseload of roughly 150–165 Professional Liability claims.

• Perform prompt and comprehensive investigations of the claims assigned.

• Analyze and interpret policies, endorsements, coverage provisions, and relevant laws to ascertain coverage, liability, damages, and strategies for claim handling.

• Engage in communication with clients, claimants, legal representatives, service providers, vendors, and other stakeholders.

• Establish and uphold precise reserves in accordance with assigned authority and both company and client guidelines.

• Review and sanction authority requests submitted by Claims Examiners under your supervision.

• Negotiate, resolve, and conclude assigned claims within designated authority limits.

• Maintain an efficient diary system, conduct case reviews, and document claim activities, evaluations, decisions, communications, and action plans.

• Report significant claim developments, coverage issues, litigation matters, exposure changes, and recommended strategies to management and clients.

• Conduct independent reviews of claim files.

• Collaborate with the Supervisor on training, coaching, mentoring, technical development, workflow management, and performance-related matters.

• Identify and report workflow concerns, quality issues, client service matters, and operational risks.

• Adhere to pertinent laws, regulations, company policies, client directives, and claim handling procedures.

• Execute additional duties as assigned.

⛳️ Requirements

• Bachelor’s degree in a relevant field (preferred).

• A minimum of three (3) years of related experience, or a comparable combination of education and experience.

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

• Strong analytical abilities.

• Exceptional written and verbal communication skills, including the capacity to convey technical details to claimants, clients, and staff.

• Capability to interact with individuals at all levels within the business environment.

• Ability to independently and effectively manage highly complex claims.

• Proficient in Word and Excel (preferred).

• Active Independent Adjuster License from the State of New York.

🏝️ Benefits

• Competitive salary and performance-based bonuses.

• Comprehensive health and wellness benefits.

• Opportunities for professional development and career advancement.

• Flexible work arrangements and a supportive work environment.