Claims Examiner

Job Description

Job Description

Southern Mutual Church Insurance Company located in Columbia, SC is a leading provider of property and casualty insurance serving the church market in the southeast. We are seeking a detail-oriented and experienced Claims Examiner to join our team. The Claims Examiner is responsible for reviewing, evaluating, and resolving insurance claims in accordance with policy provisions, company guidelines, and applicable state regulations. This role requires strong analytical skills, sound judgment, and the ability to communicate effectively with policyholders, agents, adjusters, attorneys, and other stakeholders. 3-5 years property and casualty claims experience preferred.

About Southern Mutual Church Insurance

We are a respected property and casualty insurance organization dedicated to providing exceptional service, responsive claims handling, and trusted insurance solutions. Our success is built on strong relationships, integrity, and a commitment to doing the right thing for our policyholders, agents, and employees.

 

We believe that our employees are our greatest asset and people matter. When you join our team, you're more than just an employee. You'll be part of a company that values its people and demonstrates that commitment through a strong total rewards package, and a supportive workplace culture where employees feel respected and supported.

Job Title: Claims Examiner 

Reports to: Claims Manager

Status: Full Time

 

Job Summary:

The Claims Examiner reviews insurance claims to verify that due process was followed and ensure legal compliance, approve or deny insurance claims and provide customer service to policyholders and claims adjusters as necessary.

Supervisory Responsibilities:

No

Duties/Responsibilities:

1. Reviews reports to ensure that no errors have been made in the appraisal process.

2. Settles, authorizes or denies payments for routine property/casualty claims based on coverage, appraisal and verifiable damage.

3. Works with attorneys, reinsurers, adjusters, agents and policyholders in processing claims.

4. Keeps claims files organized and maintained ensuring accuracy and privacy.

5. Provides information to accounting to payout claims weekly.

6. Reviews each file for subrogation opportunities and develops facts to support the likeliness of successful recovery.

7. Prepare appropriate claim updates for management and excess carriers.

8. Maintains timely and professional communications with insured.

9. Reviews insurance policy and state requirements for coverage determination.

10. Establish appropriate reserves based upon competent analysis of coverage, liability and damages and adjust reserves as necessary in a timely manner upon receipt of additional relevant information.

11. Effectively communicates claim decisions verbally and in writing to policyholders, claimants, attorneys and agents.

12. Notifies Underwriting department of potential underwriting issues.

13. Maintains current diary, workplan and activities via Image Right to bring claims to timely resolution.

14. Complete necessary claim reporting to management including high exposure alert notifications.

15. Maintains current diary, workplan and activities via ImageRight.

16. Assists with training and acts as a mentor for new and existing Claims Technicians.

 

Required Skills/Abilities:

· 3+ years’ experience in Property and Casualty field.

· Adjusters license required in the states in which the position handles, including completing the requisite continuing education.

· Proficient in Microsoft Office Suite.

· Demonstrated knowledge of property insurance contract and the ability to analyze coverage questions.

· Insurance certificates, courses, or professional designations a plus.

· Demonstrated ability to handle complex and/ or litigated claims. Familiarity with state regulations, investigative practices, and coverage analysis.

Education and Experience:

Bachelor’s degree in business administration, Risk Management & Insurance or related field or an equivalent combination of education and property & casualty claims experience. Professional designations desirable, including but not limited to: Associate in Claims (AIC), Chartered Property Casualty Underwriter (CPCU), Associate in Insurance Services (AIS). 3-5 years of P&C claims adjusting or claims examination experience desirable.

 

Physical Requirements:

Prolonged periods of sitting at a desk and working on a computer.

Must be able to lift to 15 pounds at times.

 

Other duties

Duties, responsibilities and activities may change at any time with or without notice.

 

EEO statement:

We are committed to providing equal employment opportunities without regard to any statuses protected by federal, state or local law.

\nCompany Description

We take pride not only in delivering reliable protection for our policyholders, but also in cultivating a workplace where our employees feel valued, supported, and empowered to succeed.

Company Description

We take pride not only in delivering reliable protection for our policyholders, but also in cultivating a workplace where our employees feel valued, supported, and empowered to succeed.