Claims Examiner - Auto

Job Title: Claims Examiner - Auto

Location: irving, TX

Duites:

• Auto casualty
• Must have commercial auto litigation experience, preferably in commercial trucking handling high severity/high value (in excess of (USD)1 million) losses.
• This is for bodily injury. Please do not send folks with PD experience only.
• TPA experience a plus
• Bodily injury handling experience to include demonstrable mid to high level injury handling.
• (USD) threshold handling up to 1 million.
• Licensed in the contiguous 48 states.
• **Litigation handling experience pertaining to BI
• Experience working in a fast paced environment, participating in and presenting cases to both internal and external stakeholders.

PRIMARY PURPOSE: To analyze and process commercial auto transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Processes commercial auto bodily injury claims and ensures claim files are properly documented and coded correctly.
• Responsible for litigation process on litigated claims.
• Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
• Communicates claim action/processing with insured, client, and agent or broker when appropriate.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.

QUALIFICATIONS

• Education & Licensing
• Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.
• Experience Five (5) years of commercial auto claims management experience or equivalent combination of education and experience required to include in-depth knowledge of commercial line auto policies, coverage's, principles, and laws.

Skills:

• In-depth knowledge of commercial line auto policies, coverage's, principles, and laws
• Knowledge of medical terminology for claim evaluation and Medicare compliance
• Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs.
• Strong oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Strong organizational skills
• Strong interpersonal skills
• Good negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Service Expectations

WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.


The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Education:
Education & Licensing
Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.
Experience Five (5) years of commercial auto claims management experience or equivalent combination of education and experience required to include in-depth knowledge of commercial line auto policies, coverage's, principles, and laws.