Claims Examiner, Auto | Bodily Injury

PRIMARY PURPOSE OF THE ROLE

To analyze complex or technically difficult auto and general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

Essential Responsibilities

• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim;
• manages claims through well-developed action plans to an appropriate and timely resolution;
• assesses liability and resolves claims within evaluation;
• negotiates settlement of claims within designated authority;
• calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim;
• calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level;
• prepares necessary state filings within statutory limits;
• manages the litigation process; ensures timely and cost effective claims resolution;
• coordinates vendor referrals for additional investigation and/or litigation management.

Qualifications

• Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws;
• Bachelor's degree from an accredited college or university preferred;
• Professional certification as applicable to line of business preferred;
• strong oral and written communication, including presentation skills, PC literate including Microsoft Office products, and ability to work in a team environment;
• Secure and maintain the State adjusting licenses as required for the position.