Claims Examiner - Auto TX

Job Description

Job Description

Job Profile

Job Title: Claims Examiner Auto

Location: Remote

Hire Type: Contingent

Pay Range: $56

Work Model: Remote

Work Shift: Monday-Friday 8 am – 4:30 pm

Recruiter Contact: Sean Craft I View email address on ziprecruiter.com I View phone number on ziprecruiter.com

Nature & Scope:

Positional Overview

We are seeking an experienced Claims Examiner – Commercial Auto Bodily Injury to join a high-performing claims team. This role is responsible for investigating, evaluating, and managing complex commercial auto bodily injury claims, including high-exposure litigation files. The ideal candidate has extensive experience handling commercial trucking losses, strong litigation management skills, and the ability to independently manage claims valued in excess of $1 million .

This position requires an experienced claims professional who thrives in a fast-paced environment and can effectively collaborate with clients, attorneys, vendors, and internal stakeholders to achieve timely and cost-effective claim resolutions.

Role & Responsibility:

Tasks That Will Lead to Your Success

• Investigate, evaluate, and manage complex commercial auto bodily injury claims from initial assignment through resolution.
• Review insurance coverage, determine liability, and evaluate damages based on policy provisions and applicable laws.
• Manage litigated bodily injury claims, partnering with defense counsel to develop effective litigation strategies.
• Handle high-severity commercial trucking claims, including losses exceeding $1 million .
• Develop strategic action plans to ensure timely claim resolution while meeting all state and client service requirements.
• Maintain accurate claim reserves and adjust reserves throughout the life of each claim.
• Communicate claim activity and settlement strategies with insureds, clients, brokers, attorneys, medical providers, and internal stakeholders.
• Ensure claim files are thoroughly documented and accurately coded.
• Negotiate settlements within designated authority levels.
• Monitor compliance with company policies, regulatory requirements, and client expectations.
• Participate in claim reviews and present complex cases to internal and external stakeholders.
• Coordinate with vendors, experts, and legal counsel as needed throughout the claims process.
• Perform additional duties and support quality initiatives as assigned.

Skills & Experience

Qualifications That Will Help You Thrive

• Minimum of 5 years of commercial auto claims management experience .
• Extensive experience handling commercial auto bodily injury claims .
• Experience managing commercial trucking claims with high-severity losses exceeding $1 million .
• Demonstrated litigation management experience involving bodily injury claims.
• Active adjuster's license with the ability to maintain licensing requirements; licensing in the contiguous 48 states is required.
• Strong understanding of commercial auto liability, coverage analysis, and claim investigation.
• Ability to independently manage complex, high-exposure claims from inception through resolution.
• Experience handling Amazon or transportation-related commercial auto claims.
• Expert knowledge of commercial auto insurance policies, coverages, and applicable regulations.
• Strong understanding of medical terminology, injury evaluation, and Medicare compliance.
• Knowledge of deductibles, self-insured retentions (SIRs), large deductible programs, and excess insurance structures.
• Excellent analytical, investigative, and problem-solving skills.
• Strong negotiation and settlement skills.
• Outstanding written and verbal communication abilities.
• Proficiency with Microsoft Office Suite and claims management systems.
• Excellent organizational and time management skills.
• Ability to manage multiple high-value claims in a fast-paced environment.
• Strong interpersonal skills with the ability to build relationships across clients, legal counsel, and internal teams.
• Ability to consistently meet or exceed service expectations and performance standards

Preferred Qualifications

• Bachelor's degree from an accredited college or university.
• Professional claims-related certifications.
• Third-Party Administrator (TPA) experience.