Claims Examiner

Position Overview Senior DRC Claims Examiner responsible for managing and resolving claims with varying complexity, including Employment Practices Liability and other commercial lines. The role supports Shared Services initiatives and workflows, ensuring operational efficiency and collaboration across claims teams. Responsibilities Provide and maintain exceptional customer service and ongoing communication throughout the claim life cycle, including prompt contact and follow‑up to complete timely and accurate investigation, damage evaluation, and claim resolution in accordance with regulatory, company standards, and authority level. Conduct thorough investigation of coverage, liability and damages; document facts and maintain evidence to support claim resolution. Review and analyze supporting damage documentation. Comply with and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions. Establish appropriate loss and expense reserves with documented rationale. Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines. Communicate effectively and timely with internal (e.g., underwriting) and external customers on claims and account issues. Maintain and manage diary system to efficiently manage and resolve assigned pending claims. Identify and communicate trends with senior claims and underwriting management. Effectively draft written communications to insureds and claimants regarding status of claim (e.g., request for information, confirmation of investigatory details and/or coverage position letters). Mitigate claim expenses as economically as possible. Summarize claims in excess of authority and submit rationale to manager for approval. Negotiate settlements within approved authority level, issue settlement payments and document all activities. Identify potential subrogation and fraud opportunities and make appropriate referrals. Support claims workflow efficiency by accurately documenting claim progress, referring high‑risk exposures outside authority levels and seeking opportunities that enhance operational knowledge. Use multiple systems to gather, enter and analyze claim metric data to ensure targets are achieved. Qualifications Bachelor’s degree required. 5–7 years of experience handling commercial insurance claims, including Employment Practices Liability. Adjuster licensing in applicable states preferred; ability to obtain required licenses post‑hire. Exceptional communication, negotiation, and interpersonal skills. Strong analytical, organizational, and time‑management abilities. Proficiency in Microsoft Office (Excel, PowerPoint, Word); familiarity with claims systems (e.g., ImageRight) preferred. Ability to work independently and collaboratively in a team environment. Compensation Base salary range: $90,000 – $107,000 per year. Position is incentive eligible. Total individual compensation (base salary, short‑ and long‑term incentives) will be determined based on location, scope & responsibilities, qualifications, talent availability, and business needs. The pay range may be modified in the future. Benefits Comprehensive medical plans (including dental, vision, and prescription drug coverage). Competitive 401(k) with generous matching. Paid time off beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of volunteer time off. Basic life and AD&D insurance, plus short‑ and long‑term disability. Paid parental leave up to 10 weeks. Student loan assistance and tuition reimbursement. Backup child and elder care assistance. #J-18808-Ljbffr