Senior Claims Examiner

About the role

The Senior Claims Examiner adjudicates assigned claims within given authority and provides operational support to the claims team. This person also:

• Adjusts and resolves moderate to complex claims that includes all phases of litigation
• Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
• With minimal supervision, drafts coverage letters, including reservation of rights and denial letters
• Reviews and analyzes claim documentation and legal filings to set timely and accurate reserves and notify the manager if upward segmentation is needed
• Identifies emerging exposures and claims trends
• Drives litigation best practices to manage deployment and utilization of defense counsel
• Identifies suspected fraudulent claims and tracks with special investigations unit
• Participates in Claims Projects as needed

Responsibilities

The Senior Claims Examiner is responsible for:

• Adjusting and resolving moderate to complex claims that includes all phases of litigation
• Accurately documenting claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
• With minimal supervision, drafting coverage letters, including reservation of rights and denial letters
• Reviewing and analyzing claim documentation and legal filings to set timely and accurate reserves and notify the manager if upward segmentation is needed
• Identifying emerging exposures and claims trends
• Driving litigation best practices to manage deployment and utilization of defense counsel
• Identifying suspected fraudulent claims and tracking with special investigations unit
• Participating in Claims Projects as needed

Requirements

• 3-5 years of claims handling experience in the area of commercial general liability with an insurance carrier
• In-depth knowledge of claims analysis and adjusting practices
• In-depth knowledge of standards for claims documentation and legal filings
• Proven ability to actively and effectively negotiate settlement of moderate to complex claims
• Proven ability to mentor and train other claims examiners
• Advanced analytical skills
• Strong verbal and written communication skills
• Active insurance adjuster’s license
• B.A./B.S degree from an accredited College or University preferred

What Hiscox USA Offers

• 401(k) with competitive company matching
• Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
• Company paid group term life, short- term disability and long-term disability coverage
• 24 Paid time off days plus 2 Hiscox days, 10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days
• Paid parental leave
• Financial Adoption Assistance and Medical Travel Reimbursement Programs
• Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
• Company paid subscription to Headspace to support employees’ mental health and wellbeing
• 2024 Gold level recipient of Cigna’s Healthy Workforce Designation for having a best-in-class health and wellness program
• Dynamic, creative and values-driven culture
• Modern and open office spaces, complimentary drinks
• Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation

About Hiscox USA

Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of over 400 employees operating out of several major cities - New York, Atlanta, Chicago, Scottsdale, and West Hartford. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism.

Salary Range

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.