Senior Casualty Claims Examiner

JOB DESCRIPTION

Key Responsibilities:


* Analyze initial reports to determine the nature of loss, coverage provided, and the scope of injury or damage in both personal and commercial auto, as well as general liability cases.


* Conduct comprehensive investigations into all aspects of reported claims, including potential fraud.

Secure appropriate supporting documentation and verify its accuracy, relevance, and completeness.


* Manage first and third-party injury claims related to No-Fault/Med Pay and liability exposures.


* Apply knowledge of jurisdictional regulations and case law applicable to all territories handled.


* Negotiate liability and damages effectively when appropriate.


* Demonstrate the ability to manage and monitor cases to ensure timely development and resolution of claims inventory.


* Collaborate with department management to deliver presentations, conduct meetings, and serve as a technical resource.

QUALIFICATIONS



* 5-7+ years of experience in liability insurance claims adjusting, including litigation.


* Bachelor's Degree or equivalent experience.


* If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.

Desired Skills:


* Comprehensive understanding of insurance contracts, investigation techniques, legal requirements, and insurance regulations.


* Strong ability to evaluate, analyze, and interpret policy language, contracts, and other complex information.


* Excellent verbal and written communication skills, with the ability to clearly explain coverage positions, claim decisions, and recommendations.


* Strong analytical and critical thinking skills with the ability to assess claim facts, identify key issues, and determine appropriate next steps.


* Ability to manage multiple claims simultaneously while maintaining accuracy, organization, and attention to detail.


* Demonstrated negotiation skills with the ability to resolve liability and damages effectively when appropriate.


* Sound judgment and decision-making skills, particularly in complex or sensitive claim situations.


* Ability to work independently while also collaborating effectively with management, peers, and other internal stakeholders.


* Strong customer service orientation with the ability to handle challenging conversations professionally and tactfully.


* Ability to adapt to changing priorities, deadlines, and claim environments.


* Familiarity with litigation management and the ability to support claims through the litigation process.


* Proficiency in documenting claim activity thoroughly and maintaining clear, accurate file notes.


* Ability to identify potential fraud indicators and escalate concerns appropriately.


* Strong presentation and facilitation skills, with the ability to contribute in meetings and serve as a technical resource.
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