Senior Claims Examiner

Responsibilities

• Manages communication with client employees and designated points of contact throughout the life of each assignment, from initial intake through final resolution.
• Proactively works claims to ensure file quality meets Claim Handling Guidelines, Best Practices, and client requirements.
• Maintains a timely diary of claims and consistently achieves audit scores of 90% and above.
• Investigates claims, including field investigation where applicable, to gather facts and determine liability, coverage, and damages.
• Develops clear, focused strategies for claims resolution with file notes reflecting control, momentum, and sound judgment.
• Works effectively with partners, subcontractors, and vendors to achieve satisfactory results on both expense and indemnity costs.
• Manages litigation in coordination with assigned defense counsel, including setting strategy, reviewing invoices, and attending mediations or roundtables as needed.
• Presents reports for clients and prepares claims for presentation in roundtable settings or at formal claim reviews.
• Provides excellent customer service to internal and external stakeholders and maintains a high level of productivity measured against the age and complexity of the assigned caseload.

Qualifications

• 3+ years of handling litigated auto and/or general liability property damage and bodily injury claims.
• Proven ability to manage claims of moderate to high severity, including litigation oversight.
• Strong knowledge of claims processes, procedures, and applicable insurance principles.
• Excellent verbal and written communication skills with the ability to present clearly to clients and stakeholders.
• Proficiency in claims management systems and Microsoft Office applications (Outlook, Word, Excel, PowerPoint).
• Strong analytical and problem-solving skills with demonstrated ability to exercise sound judgment.
• Demonstrated capacity to read and interpret legal documents, coverage determinations, and medical records.
• Ability to manage a high-volume caseload in a fast-paced environment with competing priorities.

Required Skills

• Field investigation experience preferred.
• Public entity experience is a plus.
• College degree preferred; equivalent professional experience will be considered.
• Insurance designation (e.g., AIC, AIM, ARM, CPCU) and insurance-related coursework are a plus.