Claims Examiner III

Job Description The incumbent is responsible for investigating, evaluating, negotiating, and resolving personal lines property claims. Adjusts major and complex losses, including high dollar claims, and may adjust standard losses. Responsibilities Complete coverage investigations and analysis and develop a detailed resolution plan. Provide exceptional customer service and handle claims in accordance with prescribed authority and best practices. Develop relationships with customers via telephone, investigate insurance policy coverage, determine cause of loss, and document activity on each claim to come to a resolution quickly and accurately. Identify, analyze, and resolve coverage issues according to established Company protocol, including thorough policy review and analysis of application to the individual claim. With supervisor approval, negotiate with policyholders to settle claims of limited monetary value. Develop and direct investigative plans. Conduct timely and detailed investigations that include scene investigation, statements, official reports, ownership documents, and identify alleged and actual damages, potential liable parties, potential fraud. Conduct thorough damage development, leading to timely and adequate evaluations, including appraisals, estimates, business records, invoices, detailed inventory, purchase records, receipts, credit card statements, and ALE documents. Develop appropriate methods of repair/replacement, verify ownership, and apply any special limitations. Establish voice-to-voice communication within 24 hours. Maintain effective communications with the customer at all times. Consistently work within specific time limits and authority. Maintain company reputation and integrity of insurance products by complying with federal and state regulations, Company protocol, and service standards. Maintain current knowledge of regulations, industry activity, and trends. Partner with SIU and Subrogation to identify questionable claims and subrogation opportunities. Assist or prepare files for suit, trial, or subrogation. Train and mentor lower‑level examiners as appropriate. May conduct quality audits. Handle authority requests during the absence of a supervisor. Qualifications Required Five years of related, applicable experience. Associate’s degree (A.A. or A.S.) or equivalent from a two‑year college, business school, or technical school. Adjusters License for states in which the Company conducts business. Preferred Eight years of related, applicable experience. Fluency in Spanish. Completion of a major insurance designation, or actively pursuing insurance related courses. Benefits Medical, dental, vision, life, disability, and AD&D insurance. Tax‑advantaged savings accounts. 401(k) plan with company match. Generous paid time off, including company holidays, vacation and sick days, new‑parent leave, and more. Eligible positions may qualify for restricted stock units and/or a deferred compensation plan. Equal Opportunity Employer Statement CRC Group is an Equal Opportunity Employer that does not discriminate based on race, gender, color, religion, citizenship, national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC Group is a Drug Free Workplace. EEO is the Law. Pay Transparency. Nondiscrimination. E‑Verify. #J-18808-Ljbffr 400 AmRisc LLC