Senior Claims Examiner

• Interview and correspond with policyholders, public adjusters, and attorneys
• Examine claim forms and records to determine coverage
• Responsible for all phases of property claims adjusting
• Manage and direct field adjusters and vendors
• Review case reserves on all assigned claim files to cover probable costs
• Approve or deny adjuster and contractor estimates of damage and loss amounts
• Prepare written reports of investigation, coverage, and damages within the CMS
• Negotiate and settle claims within authority
• Draft denial letters for Claim Manager review
• Investigate and pursue subrogation opportunities
• Work with attorneys to defend the company’s claim position
• Maintain accurate and complete files
• Other tasks and projects as may be assigned

• Florida All Lines Adjuster (620) License required
• Associate’s degree minimum; Bachelor’s degree preferred; Or, an equivalent combination of education and significant directly related claims experience
• A customer service oriented focus
• Min. 5 years of personal and commercial lines property and casualty claims experience preferred
• Strong ability to research, conduct proactive investigations and negotiate successful resolutions
• Exceptional organizational skills with strong ability to pay attention to detail
• Spanish language skills, both written and verbal, preferred
• Strong independent work ethic with ability to develop preferred results, meet deadlines, and manage changing priorities effectively
• Effective problem solving and analytical skills
• Knowledge and experience with Xactware products preferred
• Excellent communication skills and ability to interact on a professional level with internal and external personnel and partners
• Operational proficiency with MS Office products required

• Ability to effectively manage Claims Systems to accurately maintain commercial files and diaries.
• Ability to deliver exceptional customer service through professional and timely communication including telephone, email, and written correspondence.
• Direct defense counsel on files and manage expenses
• Ability to think critically, evaluate coverages, interpret insurance policies, and determine appropriate settlement strategies
• Ability to research, stay up to date, and comply with state regulations pertaining to claims handling
• Ability to communicate effectively verbally and in writing with internal departments and direct reports, and external vendors, stakeholders, and policyholders
• Ability to identify and interpret complex, special, or large loss claims and determine the appropriate resolution strategy

• Market Competitive Wages 
• Prof. Development and Educational Assistance Programs
• Safe Harbor 401K Plan with Immediate Vesting and an Automatic Company Contribution
• Paid Time-Off (Discretionary, PTO, Parental Leave, and others)
• Company Paid Holidays
• Health Insurance
• Dental Insurance
• Vison Insurance
• Short and Long Term Disability Insurance (company paid premiums)
• Flexible Spending Accounts with Company Contribution
• Health Savings Accounts with Company Contribution
• Employee Life and AD&D Insurance
• Dependent Life and AD&D Insurance
• AAA Membership (company paid)
• Identity Theft Protection (company paid)
• Other Ancillary Insurance Benefit Programs
• And more…

Last updated on Nov 15, 2024