Senior Claims Examiner

Role Description

The Sr Claims Examiner is considered an expert in managing insurance claims for our policyholders, handling claims with high severity and complexity. The role requires:

• Technical knowledge in insurance claims handling.
• Skills needed to provide superior service for customers.
• Ability to develop relationships and effectively communicate with a diverse range of clients, carriers, and colleagues.
• Strategic vision coupled with tactical execution to achieve results in accordance with goals and objectives.
• Ability to work with little to minimal supervision.

Key responsibilities include:

• Analyzing insurance policies and other documents to determine insurance coverage.
• Investigating and analyzing claim information to determine extent of liability.
• Handling 1st Party Property Claims with complex to major severity.
• Assisting in suits, mediations, and arbitrations, working with Counsel in the defense of litigation.
• Setting timely, adequate reserves in compliance with the company’s reserving philosophy.
• Engaging experts to assist in the evaluation of the claim.
• Monitoring vendor performance and controlling expense costs.
• Evaluating, negotiating, and determining settlement values.
• Communicating with all interested parties throughout the life of the claim.
• Handling all claims in accordance with Best Practices.
• Monitoring and completing assigned claims inventory.
• Acquiring and maintaining a state adjuster’s license and meeting state continuing education requirements.
• Providing Best-In-Class customer service for insureds and agents.
• Developing and maintaining relationships with external and internal stakeholders.
• Acting as a mentor for less experienced Claims Examiners.
• Updating and maintaining the claim file.
• Identifying opportunities for subrogation and ensuring recovery interests are protected.
• Identifying fraud indicators and referring files to SIU for further investigation.
• Participating in claims audits, internal and external.
• Providing oversight of TPAs.
• Assisting with special projects.
• Serving as a Subject Matter Expert (SME) for a developing Claims Department.

Qualifications

• Bachelor’s degree or equivalent work experience.
• 10+ years of claims adjusting experience, including at least 5 years handling both commercial and residential property claims.
• Emphasis on Florida claims to include the involvement of Assignment of Benefits, Public Adjusters, and Attorneys.
• Florida resident preferred.
• Insurance designations preferred.
• State adjuster licenses preferred.

Company Description

Why MSI? We thrive on solving challenges. As a leading MGA, MSI combines deep underwriting expertise with insurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers’ unique needs. We have a passion for crafting solutions for the important risks facing individuals and businesses. We offer an expanding suite of products – from fully-digital embedded renters coverage to high-value homeowners insurance to sophisticated commercial coverages, such as cyber liability and habitational property – delivered through agents, brokers, wholesalers, and other brand partners.

Our partners and customers count on us to deliver exceptional service through a dedicated team that makes rapid resolutions a priority. We simplify the insurance experience through our advanced technology platform that supports every phase of the policy lifecycle. Bring on your challenges and let us show you how we build insurance better.