Claims Examiner II

Position Summary: The incumbent is responsible for investigating, evaluating, negotiating, and resolving personal lines property claims. They adjust major and complex losses and may also adjust standard losses. Shift and Language: Regular shift 1st Shift (USA). Language fluency: English (Required). Responsibilities Complete coverage investigations and coverage analysis and develop a detailed resolution plan. Provide exceptional customer service and handle claims in accordance with prescribed authority and best claims practices. Develop relationships with customers via telephone, investigate insurance policy coverage, determine cause of loss, and document activity on each claim to reach a quick and accurate resolution. Identify, analyze, and resolve coverage issues according to established company protocol, including thorough policy review and analysis of application to the individual claim. With supervisor approval, negotiate with policyholders to settle claims of limited monetary value. Develop and direct investigative plans. Conduct timely and detailed investigations that include scene investigation (photos, diagrams, blueprints, maps), statements, official reports (police, fire, weather, hail), and ownership documents (tax liens, judgments, encumbrances). Identify alleged and actual damages, potential liable parties, and possible fraud. Conduct thorough damage development, leading to timely and adequate evaluations, including appraisals/estimates, business records, invoices, detailed inventory, purchase records, receipts, credit card statements, and ALE documents. Develop appropriate methods of repair/replacement, verify ownership, and apply any special limitations. Establish voice-to-voice communication within 24 hours. Maintain effective communications with the customer at all times and consistently work within specific time limits and authority. Maintain company reputation and integrity of insurance products by complying with federal and state regulations, company protocol, and service standards. Maintain current knowledge of regulations and issues, industry activity, and trends. Partner with SIU and Subrogation to identify questionable claims and subrogation opportunities. Assist or prepare files for suit, trial, or subrogation. Required Qualifications Two years of related, applicable experience. Associate’s degree (A.A. or A.S.) or equivalent from a two‑year college, business school, or technical school. Adjuster’s License for states in which the company conducts business. Preferred Qualifications Two to five years of related, applicable experience. Fluency in Spanish preferred. Benefits Medical, dental, vision, life, disability, and AD&D insurance. Tax‑advantaged savings accounts and 401(k) plan with company match. Generous paid time off, company holidays, vacation, sick days, new parent leave, and more. Eligibility for restricted stock units and/or a deferred compensation plan. CRC Group is a diverse workforce and is an Equal Opportunity Employer that does not discriminate based on race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status, or any other classification protected by law. CRC Group is a Drug Free Workplace. EEO is the law. Pay transparency: nondiscrimination provision. E-Verify is required. #J-18808-Ljbffr 400 AmRisc LLC