Hybrid Claims Examiner – Liability, GL & BI

Posted 21 hours ago

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About the role

  • Claims Examiner managing complex general liability claims for a global risk and claims administration partner. Analyzing claims and ensuring timely resolutions within service expectations in a hybrid work setting.

Responsibilities

  • To analyze complex or technically difficult general liability claims to determine benefits due.
  • To work with high exposure claims involving litigation and rehabilitation.
  • To ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements.
  • To identify subrogation of claims and negotiate settlements.
  • Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim.
  • Manages claims through well-developed action plans to an appropriate and timely resolution.
  • Assesses liability and resolves claims within evaluation.
  • Negotiates settlement of claims within designated authority.
  • Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
  • Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level.
  • Prepares necessary state fillings within statutory limits.
  • Manages the litigation process; ensures timely and cost effective claims resolution.
  • Coordinates vendor referrals for additional investigation and/or litigation management.
  • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
  • Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  • Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
  • Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
  • Ensures claim files are properly documented and claims coding is correct.
  • Refers cases as appropriate to supervisor and management.
  • Performs other duties as assigned.
  • Travels as required.

Requirements

  • 5 years of claims management experience or equivalent combination of education and experience required.
  • High School Diploma or GED required.
  • Bachelor's degree from an accredited college or university preferred.
  • Professional certification as applicable to line of business preferred.
  • General Liability and Bodily injury experience preferred.
  • Licensing: TX/FL preferred.
  • Jurisdiction Knowledge: 18 states within the eastern and south eastern region.

Benefits

  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Job title

Claims Examiner – Liability, GL & BI

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

High School Diploma

Location requirements

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