Senior Claim Examiner- NE

Essential Duties and Responsibilities

• Analyze, review and interpret policies to resolve coverage and assess liability.
• Independently handle more complex and high-exposure Commercial Garage claims.
• Resolve beginning to moderately complex claims by investigating losses, negotiating settlements, presenting evidence in legal proceedings while maintaining adequate production and quality levels.
• Investigate claims by interviewing shipper, consignee, witnesses, requesting and obtaining official reports, requesting and reviewing survey reports, and comparing claim information with evidence.
• Independently manage files in litigation.
• Establish and maintain proper loss and expense reserves.
• Determine what investigation is necessary in order to bring a claim to an equitable conclusion for all parties involved.
• Properly document information in the claim file.
• Review insurance policies for coverage and make recommendations. Make decisions regarding the liability of an insured.
• Maintain a working diary of assigned claims.
• Return phone calls promptly.
• Provide excellent customer service.
• Aid in the training of personnel within the unit.

Required Education/Experience

• Basic: A four-year degree from an accredited institution or equivalent experience.
• Advanced: Seven plus years successful handling of claims including advanced skills in coverage, investigation, litigation, negotiation, salvage and subrogation.
• Knowledge of medical terms and legal issues.
• Excellent computer skills.
• Excellent communication skills to understand, interpret and convey technical information.
• Excellent time management skills.

Licensing

• A valid resident adjuster license for the license state of the applicant.
• A non-resident adjuster’s license where required in the states where we do business.

Mental Requirements

• The position requires using and interpreting information and facts that may require refining and improving existing methods of analysis.
• The incumbent has considerable latitude for decision making and establishment of priorities.
• Significant planning is required to coordinate with other organizational units.

Physical Requirements

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• The noise level in the work environment is usually moderate.
• Works primarily indoors.

Travel

• 5%

Summary

Manages the settlement of complex, high-value claim and suit files independently. Cases will involve complex coverage, liability, damages and/or injuries. May give technical assistance to staff adjusters. Manages independent adjusters and attorneys assigned to the Examiner’s files. Has settlement authority in excess of adjusters. May extend settlement authority to staff adjusters. Does not administratively supervise staff adjusters.