Senior Claims Examiner

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

📋 Description

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

• Exhibit a customer-focused mindset.

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

• Maintain action plans for appropriate and prompt resolution in line with established policies and procedures.

• Recognize and resolve coverage issues, potential fraud, and subrogation opportunities.

• Compute and assign timely and appropriate claim reserves while monitoring reserve sufficiency.

• Perform thorough damage and bill assessments and manage claim expenses effectively.

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

• Input 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 potential fraudulent activities for the Association.

⛳️ Requirements

• Bachelor’s degree or 6+ years of related work experience.

• Texas Adjuster License required.

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

• Ability to sit, hear, communicate over the phone, and frequently type on a computer for extended periods.

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

• Preferred: Bilingual, ideally in Spanish and/or Asian Languages (such as Mandarin, Vietnamese, etc.).

• Preferred: Background in building contracting, roofing contracting, or restoration contracting.

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

🏝️ Benefits

• Fully remote work environment with no relocation necessary.

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

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

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

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

• Continuous training and professional development opportunities funded by TWIA.

• Assistance in obtaining professional certifications.

• Tuition reimbursement program.

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

• Flexible scheduling to promote work-life balance.