Senior Claims Examiner

Company Overview
One of the nation’s leading property-casualty insurance company founded by and dedicated to affordable housing organizations. While we are recognized as a pioneer of affordable housing insurance programs, insurance is not our only strength. We protect, preserve, and promote the sustainability of affordable housing with an array of products and services that support the challenges housing organizations face. Besides insurance, we offer risk management services, online training, and consulting services used by more than 1,500 housing organizations nationwide. Was recognized as a Top Workplace in 2020, 2021 and 2022.

Group Benefits and Perks

• Bonus program eligibility
• Annual merit program
• Outstanding 401(k) program and non-elective contribution
• Flexible work schedules
• Generous paid time off, paid volunteer days and paid holidays
• Medical, vision and dental Insurance
• Company paid life, AD&D, short-term disability, and long-term disability coverage
• HSA, FSA and dependent care options

On-Site wellness: Full gym and locker rooms, wellness initiatives, outdoor basketball and tennis court, picnic pavilion area

• Tuition reimbursement and loan repayment
• Professional development
• Community outreach

(Reasonable accommodations may be made

Job Requirements:

Required:

• Bachelor’s degree in business management, insurance, or related field required, or equivalent work experience
• Minimum 5 years progressive claims handling experience for property/casualty insurance company or third-party administrator
• Progressive liability claims handling experience
• All lines property/casualty adjuster’s license
• Ability to analyze and interpret coverage at a level commensurate with complexity of assigned claims
• Ability to prepare and communicate written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers
• Understands the litigation process, current relevant case law and statutory law in multiple jurisdictions
• Ability to implement compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements
• Ability to review invoices, estimates, legal fees, and other documents to ensure accuracy and legitimacy prior to payment
• Maintains adjusting licenses in all required states

Preferred:

• AIC designation
• Knows the Public and Affordable Housing business

Essential Functions:

• Timely and effectively investigate and evaluate claims while managing outside adjusters and legal counsel
• Directs settlement activity using investigative and problem-solving skills in direct negotiations
• Handle all assigned cases efficiently and cost-effectively through conclusion
• Analyze and recommend appropriate reserves; periodically reviewing and adjusting these reserves based on the assessment of probable liability, financial responsibility and exposure
• Handle all assigned cases efficiently and cost-effectively through conclusion, identifying and thoroughly investigating all available risk transfer options (subrogation and third-party recoveries and re-insurance)
• Review, analyze and interpret coverage in accordance with applicable policies
• Prepare coverage evaluations, document files and draft letters for management review in a timely manner
• Concentration on larger cases with reinsurance involvement requiring ability to track aggregates, and prepare more complex reports
• Prepare clear and concise reports with little or no guidance that can be presented for review and require little or no edits by management
• Mentors’ examiners, as well as coordinators, by providing guidance, sharing expertise, and overseeing work product
• Serve as Subject Matter Expert for certain venues and/or coverage lines

Knowledge, Skills, Abilities:

• Create and manage positive working relationships with internal and external business partners
• Presents a positive and professional image of companies
• Knowledge and commitment to company mission, vision, and organizational values
• Ability to quickly assimilate and practically utilize new information
• Possess written and verbal communications skills to review, understand, interpret, and convey data including medical records, legal documents, and coverage interpretation
• Strong customer service skills including interacting with internal and external customers
• Team player; works effectively as part of a team