Claims Examiner 1

Job Description

Job Description

Join our Claims team as a Claims Examiner, where you will play a key role in delivering exceptional service to policyholders throughout the claims process. In this role, you will investigate, evaluate, negotiate, and resolve property insurance claims with a focus on accuracy, efficiency, and customer satisfaction. Leveraging your knowledge of insurance principles and claims handling practices, you will make sound, independent decisions within established authority levels. This position is responsible for managing low- to moderate-complexity property claims while ensuring timely resolutions, cost-effective outcomes, and a positive customer experience.

ESSENTIAL FUNCTIONS: The following are the usual, BASIC, and essential functions of the Claims Examiner position. However, this job description does not preclude the performance of other duties by the incumbent. These functions are not to be construed as an exhaustive list of all responsibilities, duties, and skills required:

• Demonstrates a customer centric attitude
• Analyzes and manages claims by verifying coverage and investigating and gathering pertinent information to determine the exposure on the claim
• Maintains well-developed action plans for an appropriate and timely resolution in accordance with established policies and procedures
• Recognizes and properly addresses coverage issues, potential fraud, and subrogation potential
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim
• Conducts detailed damage and bill reviews and controls claim expenses
• Pays and processes claims within designated authority level or denies payments where no coverage, liability, or compensability exists
• Enters claim payments and reserves on claims on computer system, inputting concise and accurate file documentation
• Communicates decisions in a clear and professional manner

REQUIRED EDUCATION AND EXPERIENCE:

• 1+ year experience examining P&C Residential Property.
• Associate degree (or equivalent experience in lieu of a degree)
• Texas Adjuster License or demonstrated progress toward achieving the license

PREFERRED EDUCATION AND EXPERIENCE:

• Bachelor’s degree, 3.0 cumulative GPA or higher
• AIC, and/or CPCU designation

PREFERRED KNOWLEDGE, SKILLS, AND ABILITIES:

• Bilingual, English and preferably Spanish/Mandarin/Vietnamese

PHYSICAL REQUIREMENTS:

• This position requires the ability to sit, hear, converse over the telephone, and key frequently on a computer for long periods of time.
• This position may require some limited overnight travel including participation in remote catastrophe claim response efforts, deposition and other legal witness testimony, completion of training programs, additional work-related activities, and meetings.

Why work with TWIA? 

The Association offers a comprehensive and competitive benefits package designed to support both your professional success and personal well-being. A key highlight of our offering is a fully remote work environment, allowing you to contribute from home with no relocation required.

In addition to our benefits, Texas Windstorm Insurance Association fosters a collaborative and mission-driven work environment where employees are valued, supported, and encouraged to grow. Our teams work closely across departments, promoting transparency, innovation, and a shared commitment to serving our policyholders and communities.

Employees also enjoy:

• Comprehensive medical, dental, vision, group life, AD&D, and dependent life insurance coverage
• Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) with a generous annual HSA employer contribution
• A 401(k) retirement plan with employer matching contributions up to 6%, in addition to a pension plan that begins vesting at 5 years of employment
• Active support for professional growth, including ongoing training and professional development opportunities sponsored by TWIA, support to obtain professional certifications, and a tuition reimbursement program
• Generous paid time off, including vacation, sick leave, paid holidays, and personal days
• Flexible scheduling to support work-life balance