Claim Examiner

Insurance Information Institute, Inc.; Chapel Hill (NC); Hybrid; USD 80,000 - 100,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k)

Flexible spending account

Short-term disability insurance

Long-term disability insurance

Life insurance

Paid parental leave

Paid time off

Job summary

IFG Companies in the United States is seeking a Claim Examiner to investigate, evaluate, negotiate and settle injury and damage claims across multiple jurisdictions. You will handle complex claims, maintain accurate files and keep management informed of status.

The CE will manage claim files, coordinate with adjusters, review coverage, reserves and settlements while ensuring timely action under guidelines. This role blends independent judgment with collaborative problem-solving in a hybrid work

Qualifications

• A bachelor's degree from an accredited U.S. college/university, with a major or coursework in insurance, economics, or related fields.
• At least two (2) years of property/casualty claims handling experience as a full-time exempt employee, preferably with a U.S. commercial insurer.
• A valid adjuster license in designated home state (or be able and willing to obtain one within sixty (60) days after hire) and the ability to obtain additional non-residential adjuster licenses.
• Preferred: At least three (3) years of commercial general liability policy and/or garage policy experience, preferably with a U.S. commercial insurer.

Responsibilities

• Prompt reviewing of new losses and determining initial plans of action.
• Analyzing coverage as it relates to the facts and allegations of claims and preparing Reservation of Rights and Declination of Coverage letters, as applicable.
• Initiating contact with policyholder and claimant(s) to confirm notice of loss description and determine the scope of the investigation, as appropriate.
• When appropriate, assigning and instructing independent adjusting firms to conduct needed investigative tasks and managing and directing activity of independent adjusting firms in any continuous investigation of claims.
• Reporting losses timely to management and updating as necessary.
• Evaluating claims as investigations develop and establishing and adjusting reserves, as warranted.
• Reviewing expense bills for appropriateness, accuracy and adherence to IFG Companies’ billing guidelines and process payments.
• Recognizing, notifying and pursuing culpable parties and seeking contributions from such parties.
• Identifying and ensuring subrogation efforts are undertaken against responsible parties.
• Negotiating claims to settlement.
• Other duties, as requested.

Skills

Communication skills

Negotiation

Customer service

MS Office

Independent judgment

Education

Bachelor's degree in insurance/economics

2 years property/casualty claims experience

Valid adjuster license

Commercial liability experience (preferred)

Tools

Claims management system

Microsoft Office

Job description

Salary Range: $80,000.00 To $100,000.00 Annually

Draft

POSITION SUMMARY

The primary role of the Claim Examiner ("CE") is to investigate, evaluate, negotiate and settle injury/damage claims in a fair and timely manner across multiple jurisdictions while applying policy coverage considerations and applicable laws and regulations. The CE will handle potentially difficult and adversarial situations professionally, maintain accurate and supporting claim files and participate in quality reviews, as required. This role will keep Claims Management apprised of the status of difficult cases and be consultative with respect to their resolution, when appropriate, and within necessary timeliness and guidelines.

POSITION RESPONSIBILITIES INCLUDING

• Prompt reviewing of new losses and determining initial plans of action.
• Analyzing coverage as it relates to the facts and allegations of claims and preparing Reservation of Rights and Declination of Coverage letters, as applicable.
• Initiating contact with policyholder and claimant(s) to confirm notice of loss description and determine the scope of the investigation, as appropriate.
• When appropriate, assigning and instructing independent adjusting firms to conduct needed investigative tasks and managing and directing activity of independent adjusting firms in any continuous investigation of claims.
• Reporting losses timely to management and updating as necessary.
• Evaluating claims as investigations develop and establishing and adjusting reserves, as warranted.
• Reviewing expense bills for appropriateness, accuracy and adherence to IFG Companies’ billing guidelines and process payments.
• Recognizing, notifying and pursuing culpable parties and seeking contributions from such parties.
• Identifying and ensuring subrogation efforts are undertaken against responsible parties.
• Negotiating claims to settlement.
• Other duties, as requested.

KNOWLEDGE, SKILLS AND ABILITIES

• Excellent written and oral communication skills.
• Exhibit negotiation, critical thinking and problem-solving capabilities.
• Outstanding customer service, attention to detail and multi-tasking skills.
• Strong computer skills, including the ability to work effectively in the claims management system and strong knowledge of Microsoft applications (e.g., Outlook, Word, Excel).
• Ability to exercise independent judgement with moderate supervision in handling claims within reserve and settlement authority.

EDUCATION, EXPERIENCE AND CERTIFICATIONS

• Required: A bachelor's degree from an accredited U.S. college/university, with a major or coursework in insurance, economics, or related fields.
• Required: At least two (2) years of property/casualty claims handling experience as a full-time exempt employee, preferably with a U.S. commercial insurer.
• Required: A valid adjuster license in designated home state (or be able and willing to obtain one within sixty (60) days after hire) and the ability to obtain additional non-residential adjuster licenses.
• Preferred: At least three (3) years of commercial general liability policy and/or garage policy experience, preferably with a U.S. commercial insurer.

PHYSICAL DEMANDS

• Position is hybrid and requires the ability and the willingness to work in an IFG Companies office at least three (3) days per week if residing within a one-hour commuting distance.
• Physical demands are considered those of a climate-controlled office environment with minimal physical exertion.
• Position requires prolonged sitting, extensive utilization of computers and interactions with others in person and via phone.
• Position requires the ability and the willingness to travel when required to meet business needs.

SALARY AND BENEFITS

The salary range for this position is $80,000 to $100,000. Additionally, the position may be eligible to earn incentive compensation.

IFG Companies offers competitive compensation and benefits, currently including medical, dental, vision, 401(k), flexible spending, short-term and long-term disability insurance, life insurance, paid parental leave, vacation and other paid time off.

WHY IFG COMPANIES

Founded in 1985, IFG Companies is one of the oldest privately held insurance groups in the United States. It combines a specialty-carrier focus with long-term stability and thinking, while promoting a culture of underwriting rigor, collaboration, strategic thinking, superior technology and strong producer partnerships.

EQUAL OPPORTUNITY

IFG Companies is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status or any other protected characteristic under applicable law.