Claims Examiner - Senior Claims Examiner

Job Summary Under moderate supervision, the Claims Examiner manages a caseload of low to moderate complexity P&C insurance claims by reviewing claims to analyze and determine applicable coverage, facts, liability, damages, plan & strategy for resolution in accordance with state and company guidelines.  The focus of this role would be General Liability, Bodily Injury and Property Damage. Duties and Responsibilities Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service Perform coverage, liability, and damage analysis on all claims assignments May investigate allegations and determine facts based on evidence and recorded interviews Draft disclaimers and reservation of rights letters when coverage issues arise Assign limited investigations and appraisals to licensed insurance professionals Manage a caseload of low to moderate complexity claims with delegated authority Negotiate settlements, mitigate losses, and control expenses Assist in the management of litigated files Participate in and attend mediations to facilitate settlements Maintain accurate documentation in claim files Prepare correspondence to all required parties involved in a claim when necessary Provide exceptional customer service to insureds, claimants, and attorneys, addressing inquiries, concerns, and providing regular updates on claim status May assist in training existing and new Claims Associates Ensure compliance with state regulations, industry standards, and best practices in claims handling, maintaining a high level of professionalism and integrity Handle claims in accordance with established James River Claims Best Practices Other duties as required by management Knowledge, Skills and Abilities Beginner level of expertise in claim handling and suit management Moderate knowledge of P&C insurance industry Ability to effectively assess risk Proficiency in MS Office (Word, Excel, Outlook) Excellent written and verbal communication skills Excellent organizational skills Ability to take direction from management Ability to work independently and take initiative Ability to exercise sound judgement in making critical decisions Research, analysis and problem-solving skills Strong negotiation skills Ability to build effective relationships with business partners Ability to perform effectively as part of a team Ability to organize complex information and pay close attention to detail Ability to anticipate customer needs and take initiative to meet those needs Ability to train and provide technical guidance to less experienced Claims professionals Ability to successfully obtain the required state adjusters’ licenses within six (6) months following the completion of Company-provided licensure training courses and maintain appropriate licensure thereafter Experience and Education Claims Examiner High school diploma required Bachelor’s Degree preferred Minimum of one year of P&C claims handling experience including handling liability and coverage issues, bodily injury claims as well as claims involving property damage.  These are multi-jurisdictional claims, and you would need experience negotiating settlements with claimants and attorneys. Adjuster license and/or certifications preferred Senior Claims Examiner High school diploma required Bachelor’s Degree preferred Minimum of three years of P&C claims handling experience including handling liability and coverage issues, bodily injury claims as well as claims involving property damage.  These are multi-jurisdictional claims, and you would need experience negotiating settlements with claimants and attorneys. Adjuster license and/or certifications preferred