Claims Examiner II

Job Responsibilities

Typically handles low to moderate low exposure claims.
Confirms coverage of claims by reviewing policies and documents submitted in support of claims.
Analyzes coverage and communicates coverage positions.
Ability to draft coverage position letters independently.
Utilizes acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records.
Conducts, coordinates, and directs investigation into loss facts and extent of damages.
Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure.
Sets reserves within authority or makes recommendations concerning reserve changes to manager.
Utilizes diary system to pro-actively resolve outstanding issues and to ensure timely processing and closure of the claim.
Negotiates and settles claims directly with claimant.
Prepares reports by collecting and summarizing information.
Participates in special projects or assists other team members as requested.
Provides timely service throughout the life cycle of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquiries according to company policy and procedures.
Identifies subrogation opportunities and fraud potential and makes appropriate referrals.

Qualifications

Strong emphasis on customer service to both internal and external customers.
Education: Bachelor’s degree or equivalent work experience, Advanced degree, or focused technical degree a plus.
Certification: Must have (preferred) or be eligible to receive claims adjuster license, Successful completion of basic insurance courses or achievement of industry designation (INS, IEA, AIC, ARM, SCLA, CPCU) preferred.
Work Experience: Minimum of two + years of claims handling experience or equivalent combination of education and experience, Knowledge of insurance industry or claims handling preferred, or Successful completion of two years as an Associate Claims Specialist preferred.

Skills

• Excellent written and oral communication skills
• Strong analytical and problem solving skills
• Strong organization and time management skills
• Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word)
• Ability to work in a team environment
• Strong desire for continuous improvement

Pay

N/A

Schedule

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Benefits

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