Senior Claims Examiner - MSI

About the role

The Sr Claims Examiner is responsible for managing insurance claims with high severity and complexity. This role requires technical knowledge in insurance claims handling and the skills to provide superior service to customers. Key responsibilities include analyzing policies, investigating claim information, setting reserves, communicating with all parties involved, and maintaining relationships with external and internal stakeholders.

Responsibilities

• Analyzes insurance policies and other documents to determine insurance coverage.
• Investigates and analyzes claim information to determine extent of liability.
• Handles first-party property claims with complex to major severity.
• Assists in suits, mediations, and arbitrations.
• Works with counsel in the defense of litigation.
• Sets timely, adequate reserves in compliance with the company's reserving philosophy.
• Engages experts to assist in the evaluation of the claim.
• Maintains vendor performance and controls expense costs.
• Determines settlement values and communicates with all interested parties.
• Handles claims in accordance with best practices.
• Makes sure all assigned claims are monitored and completed on time.
• Acquires and maintains a state adjuster's license and meets state continuing education requirements.
• Provides excellent customer service for insureds and agents.
• Develops and maintains relationships with external and internal stakeholders.
• Acts as a mentor for less experienced Claims Examiners.
• Updates and maintains the claim file.
• Identifies opportunities for subrogation and ensures recovery interests are protected.
• Identifies fraud indicators and refers files to Special Investigation Unit (SIU) for further investigation.
• Participates in claims audits, both internal and external.
• Assists with special projects.
• Acts as a Subject Matter Expert (SME) for a developing Claims Department.

Requirements

• Bachelor’s degree or equivalent work experience.
• At least 10 years of claims adjusting experience, including at least 5 years handling both commercial and residential property claims.
• Emphasis on Florida claims, including involvement in Assignment of Benefits, Public Adjusters, and Attorneys.
• Florida resident preferred.
• Insurance designations preferred.
• State adjuster licenses preferred.

Qualifications

• Strategic vision coupled with tactical execution to achieve results in accordance with goals and objectives.
• Ability to work with little to minimal supervision.
• Proactive approach to handling coverage decisions, gathering necessary information, and determining settlement amounts.
• Excellent communication skills to interact with a diverse range of clients, carriers, and colleagues.

Skills

• Technical knowledge in insurance claims handling.
• Strong analytical and problem-solving skills.
• Effective communication and interpersonal skills.
• Ability to manage multiple tasks and prioritize effectively.
• Knowledge of Florida insurance laws and regulations.

Benefits

MSI offers a competitive benefits package that includes health insurance, retirement plans, paid time off, and more. We believe in fostering a positive work environment where employees can thrive and grow professionally.

Pay

Compensation is commensurate with experience and qualifications.

Schedule

The schedule is flexible and designed to accommodate the needs of the employee and the business.