Senior Claims Examiner

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

📋 Description

• Oversee the examination and resolution of intricate commercial property claims.

• Exhibit a customer-focused approach.

• Evaluate and manage claims by confirming coverage, investigating, and collecting relevant information to assess claim exposure.

• Develop action plans for suitable and prompt resolution in line with established policies and procedures.

• Recognize and address coverage challenges, potential fraud, and subrogation opportunities.

• Calculate and allocate timely and appropriate claim reserves while monitoring reserve adequacy.

• Execute thorough damage and bill reviews and manage claim expenses effectively.

• Process and pay claims within authorized limits or deny payments when coverage, liability, or compensability is not established.

• Log claim payments and reserves into the computer system with clear and precise file documentation.

• Convey decisions in a clear and professional manner.

• May offer training, coordination, and investigation of suspected fraudulent activities for the Association.

⛳️ Requirements

• A Bachelor’s degree or over 6 years of relevant experience.

• Possession of a Texas Adjuster License.

• Must acquire the Associate in Claims designation within two years of hire or promotion, or the Chartered Property Casualty Underwriter designation within three years of hire.

• Ability to sit, hear, engage in conversations over the telephone, and frequently type on a computer for extended periods.

• May necessitate extended hours, overnight travel, and remote work outside the office during catastrophic storm events.

• Preferred: Bilingual skills, ideally in Spanish and/or Asian languages such as Mandarin or Vietnamese.

• Preferred: Background as a building contractor, roofing contractor, or restoration contractor.

• Preferred: Experience with residential/commercial property estimating software.

🏝️ Benefits

• Fully remote work environment, enabling contributions from home without the need for relocation.

• Extensive medical, dental, vision, group life, AD&D, and dependent life insurance coverage.

• Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) with a generous annual employer contribution to HSA.

• 401(k) retirement plan with employer matching contributions up to 6%.

• Pension plan that begins vesting after 5 years of employment.

• Continuous training and professional development opportunities provided by TWIA.

• Assistance in obtaining professional certifications.

• Tuition reimbursement program available.

• Generous paid time off, including vacation, sick leave, paid holidays, and personal days.

• Flexible scheduling options to promote work-life balance.