Claims Examiner - Complex

CITON Claims Solutions, LLC stands out as a leading provider of claim management and administration services tailored specifically for insurance companies. We pride ourselves on delivering efficient and innovative solutions that cater to the unique needs of each client. Our dedicated team of experts, equipped with cutting-edge technology, ensures seamless processes, accurate assessments, and prompt resolutions, providing unparalleled value and peace of mind to our clients.

CITON Claims Solutions is proud to call two vibrant cities home. Our headquarters on Florida's stunning Space Coast in Melbourne offers an exceptional quality of life, with affordable housing, excellent transportation, and close proximity to major cities like Orlando, Tampa, and Miami. Our Irving, Texas location places us in a dynamic center of culture, business, and entertainment, keeping us deeply connected to innovation and growth.

Join our team as a Claims Examiner - Complex!

ABOUT THE ROLE:

Are you a detail-oriented claims professional with a passion for helping others? We're looking for a Desk Adjuster to work in our office located in Melbourne, Florida or Dallas, Texas . In this role, you'll play a pivotal part in investigating, evaluating, and resolving insurance claims, ensuring fair and efficient processing in line with policy terms and company guidelines. In this role you will be handling complex litigated claims, mediations, appraisals, and claims involving other 3rd parties.

WHAT YOU'LL DO:

• Review Claims: Assess and analyze submitted claims documentation to determine validity and coverage.
• Gather Essential Information: Communicate with policyholders, witnesses, and other involved parties to collect relevant details for claims evaluation.
• Document Findings Thoroughly: Create detailed reports and maintain comprehensive notes to support claims assessments.
• Analyze Coverage: Review insurance policies to determine applicable coverage and assess liability.
• Prepare Reports: Submit thorough reports with findings and well-supported recommendations for claim settlements.
• Negotiate Settlements: Work with policyholders and third parties to negotiate settlements that ensure fair and just outcomes.
• Resolve Disputes: Handle disputes professionally and efficiently, ensuring favorable resolutions.
• Maintain Clear Communication: Foster transparent and professional communication with policyholders and all stakeholders throughout the claims process.
• Collaborate Across Teams: Partner with internal teams, including underwriters and legal advisors, to resolve complex claims.
• Ensure Compliance: In all claims processes, comply with state and federal regulations and company policies.
• Support Catastrophe Response: Provide critical support for claims management efforts during disaster events as needed.

WHAT WE'RE LOOKING FOR:

• Experience: Minimum of 7+ years in a claim adjusting role, with direct experience handling litigated claims, mediations, appraisals, and claims involving other 3rd parties. Experience handling Florida property claims is strongly preferred.
• Technical Skills: Proficiency with CMS, Microsoft Suite of products, strong analytical, investigative, and problem-solving skills; solid understanding of legal concepts surrounding liability claims.
• Licensing and Certifications: Valid adjuster's license in home state and Florida required.
• Insurance Knowledge: Strong understanding of insurance policies, coverage evaluation, claim investigation, and dispute resolution throughout the life of a file. Should be able to demonstrate advanced understanding of all issues related to liability claims including state regulations, case law, and statutes.
• Negotiation Skills: Excellent negotiation and communication skills, with proven ability to manage complex conversations and drive fair claim resolution with insureds, vendors, attorneys, and public adjusters.

WHAT'S IN IT FOR YOU:

• Dynamic Environment: Thrive in a fast-paced, collaborative, and results-driven office where your contributions make a real impact.
• Career Growth: Opportunities for professional development and advancement within a supportive company culture.

If you're excited to join a company that values innovation, teamwork, and your technical expertise, we'd love to hear from you. Take the next step in your IT career and help us keep our technology running smoothly!

The office environment is fast-paced and collaborative. An employee must be willing and able to work their regularly assigned work schedule onsite, and in times of need, be able to work an extended schedule depending on company or departmental needs, project requirements, or customer demands.


While performing general duties for this position, the employee is regularly required to sit, stand, and/or walk around (including the use of stairs). Other demands include the ability to openly communicate with others by talking, listening, comprehending, and reading; being able to lift light objects (<25 lbs); and using standard office equipment such as computers, printers, and phones. In addition, there is an occasional need to bend, twist, or squat down to open/close cabinets and reach for files or other standard office-type objects.


Orion180 is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.


Reasonable accommodations are available for qualified individuals with disabilities during the application process. Applicants who need accommodations may email View email address on click.appcast.io to request assistance.