Claims Examiner

About the role

The Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. This position examines and authorizes insurance claims investigated by insurance adjusters, studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim, and communicates with agents, claimants, and policy holders. The Claims Examiner determines settlement according to organization practices and procedures and works on projects/matters of limited complexity in a support role.

Responsibilities

• Manage general liability, bodily injury, property damage, personal/advertising injury, auto and other miscellaneous claims
• Analyze, investigate, and resolve complex claim issues, including coverage, liability, and damages
• Ensure appropriate investigation of the underlying facts and circumstances is carried out in a timely manner
• Retain and utilize proper experts where necessary
• Select and utilize counsel appropriately
• Employ proper negotiation strategy
• Recognize exposures and ensure reserving is appropriate and timely
• Evaluate coverage issues and risk transfer opportunities
• Communicate exposures effectively both internally and externally
• Formulate proper resolution strategy to ensure best total outcome
• Periodic travel may be required to attend mediations, trials, and/or other related meetings

Qualifications

• Bachelor’s degree preferred
• CPCU or AIC Certification (Preferred)
• 2–8 years of commercial casualty claim adjusting experience handling primary and excess general liability, auto, and personal injury claims
• Experience in claims coverage analysis
• Ability to approach every task in a meticulous and thorough manner, documenting actions and communications, prioritizing, maintaining schedules, paying attention to detail, and striving for accuracy at all times
• Understanding of legal procedures, regulatory compliance, and states’ statutes
• Strong oral and written communication skills with the ability to communicate professionally at all levels within and outside the organization
• Insurance designations a plus
• Strong computer skills including Microsoft Office Word, Outlook, and Excel

Work arrangement

Hybrid role requiring commuting to the office 2–3 days per week in the Manchester, NH or Boston, MA area.