Claim Examiner

Job Title: Senior Claim Examiner Casualty
Location: Cherry Hill, NJ
Job Summary:
The senior claims examiner is responsible for investigating, negotiation, and conclusion by settlement or denial, casualty, construction defect, and litigated claims in the business area of commercial habitational, general mercantile, contractors and homeowners. We write policies on various homeowner’s policies, as well as business owners policies and commercial package policy’s. The senior claim examiner position will deal with commercial and homeowners casualty claim assignments. The candidate must understand commercial and homeowners casualty claim adjusting principals, such as coverage verification, liability analysis, and litigation management. Ensure claims are processed within company policies, procedures, and prescribed authority. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.
Reporting Relationships:
The position will report directly to the VP of claims.
Main Duties/Essential Job Functions:
    1. Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information.
    2. Analyze information in order to evaluate assigned claims to determine the extent of loss, taking into consideration coverage, damages, liability, and future investigation needs. Assign and manage independent adjusters, defense counsel, or other experts on a task assignment basis where necessary.
    3. Process incoming calls and correspondence from insureds, claimants and agents regarding questions or problems associated with claims. Interact with underwriters and agents on claim resolution.
    4. Evaluate, negotiate and settle both non-litigated and litigated claims within delegated authority. Handle litigation files from start to finish. Prepare for and participate in claims review and settlement conferences. Participate in mediation or mandatory settlement conferences; this could involve travel out of state.
    5. Document file with a thorough analysis on the facts, coverage, investigation liability, scope of damages, reserves and disposition. Ongoing file overviews expected at prescribed intervals.
    6. Draft reservation of rights and coverage declination letters.
    7. Receive and approve expenses incurred to investigate, process, and handle a claim. Prepare check requisitions for all loss and expense payments. Close claim by issuing check or denial and securing appropriate releases.
    8. Relies on experience and judgment to plan and accomplish goals. Sets reserves appropriate for the claim, monitors and adjusts reserve as needed. Considerable independent judgment is used to make decisions in carrying out assignments that have significant impact on services or programs.
    9. Interact with underwriters to include notification to underwriters of unusual risk characteristics. Communicate large losses, and participate in claim conferences.
    10. Execution on our company best practices as to claim handling.
    • College degree preferred.
    • Possess at least 7-10 years claim experience.
    • Professional claims designation such as an Associate in Claims (AIC) or a CPCU designation preferred.
    • Experience with standard claims concepts, practices and procedures in product lines of commercial insurance.
    • Excellent communication, customer service, and negotiation skills.
    • Experience with multiple jurisdictions.
    • Experience in coverage and the unique coverage forms used in commercial and homeowners.
    • Organized and able to work independently.
    • Able to handle complex claims involving coverage, litigation and/or high financial exposure.
    • Experience in construction defect litigation and coverage issues.