Senior Claims Examiner P&C

About the role

Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV).

Responsibilities

• Advanced knowledge in the following areas: claims handling concepts, practices, and techniques, to include but not limited to coverage issues, and product line knowledge
• Functional knowledge of law and insurance regulations in various jurisdictions
• Demonstrated advanced verbal and written communications skills
• Demonstrated advanced analytical, decision making and negotiation skills
• Investigate, evaluate, and determine settlement value or denial of liability for severe to major-level commercial auto claims
• Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy
• Make recommendations to set reserves at an appropriate level for claims outside of authority level
• Prepare comprehensive reports as required
• Identify and communicate specific claim trends and account and/or policy issues to management
• Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment
• Document and manage claims (i.e.: record statements, updated diaries, write reports) from inception through closure
• Ensure appropriateness of all payments
• Capability to adjust large commercial property losses
• Exchange information with clients, claimants, insurance brokers, inspectors producers and account managers
• Assist in training of new employees
• Provide training and daily guidance to other examiners
• Some oversight of less experienced examiners and claims assistants
• May fill-in for supervisor if necessary
• Attend meetings and educational seminars for professional development and to maintain required licenses
• Coordinate and work with vendor-services such as contractors, emergency repair, cleaning services and various replacement services
• Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims
• Superior customer service skills
• Participate and/or conduct department meetings
• Present company abilities in new client meetings
• Conduct quarterly file reviews with the client

Requirements

• High School Diploma or equivalent (GED) required for all positions
• AA/AS or BA/BS preferred but not required
• Moderate to major Bodily Injury claims experience required
• High exposure commercial trucking auto liability experience required
• High exposure general liability experience preferred
• Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX or FL
• Additional State Adjuster License(s) may be required within 180 days
• Maintain licenses and continuing education requirements in all states
• Experience with property and casualty insurance policies, insurance tort laws, codes and procedures
• Understanding of medical, legal terminology and liability concepts
• Proficiency in investigation and resolution of severe to major-level casualty claims
• Time Management and project management skills
• Negotiation skills
• Well-developed verbal and written communication skills with strong attention to detail
• Excellent organizational skills and ability to multi-task
• Proficient in Microsoft Office Suite
• Ability to learn additional computer programs
• Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
• Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
• Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor

Qualifications

Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.

Skills

Must be able to reliably commute to meetings and events as required by this position

Benefits

We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more!