Casualty Claims Examiner

Job Summary

This position is responsible for the oversight of complex and large exposure losses and will report to the National Casualty Claims Manager. The Casualty Claims Examiner will work alongside claims management, providing direction and oversight ensuring that compliance with best practices and state/local guidelines is achieved. In addition, this position will report findings and make recommendations on current practices including the claim department’s performance on meeting regulatory standards.

Job Responsibilities

• Review home office casualty files, provide direction as required to ensure that handling is within best practice guidelines and local jurisdiction regulations.
• Responsible for providing guidance and direction to claims staff in order to ensure proper handling and risk mitigation.
• Provide authority and guidance on all bodily injury claims regarding coverage, liability and damages, as required.
• Provide feedback to leadership and adjusting staff as required for continually improved file handling.
• Responsible for collaboration with claims staff, front line claims management, senior claims management and legal counsel.
• Available to answer questions and participate in roundtable discussions with claims staff and management to provide feedback and guidance on claim handling procedures.
• Complete research pertaining to complex coverage issues, industry trends, and related topics.
• May assist with targeted audits of a particular process or function (e.g. total loss handling, BI evaluations, cycle times, regulatory reviews, customer service skills, etc.) and/or management re-audits to verify calibration and accuracy of the first level reviews completed.
• Assist in designing and delivering casualty training as needed to ensure compliance and proper claim handling

Job Qualifications

• Formal Education & Certification: Bachelor’s degree or equivalent work experience
• Knowledge & Experience: A minimum of five years of adjusting claims. At least two years adjusting/overseeing casualty claims with high complexity. Prior claims management experience and/or auditing preferred.
• Skills & Competencies: Communication and analytical ability at a level to interact with associates, managers, agents and vendors. Demonstrated team building and coordination skills. Must possess strong interpersonal skills and the ability to present critical information to Senior Management. Ability to manage multiple priorities and work independently. Leadership abilities are necessary, with the ability to make autonomous decisions based on multiple facts. Must be able to work in a fast-paced automated production environment and possess solid planning and organizational skills including time management, prioritization, and attention to detail. Must meet company guidelines for attendance and punctuality and professional appearance/decorum.