Claims Examiner - Auto

Jobgether; United States; Remote; USD 64,000 - 85,000; Full time

Benefits offered by this job

Remote/telecommuter (Canada)

Full-time employment

Career growth

Collaborative culture

Work-life balance

Job summary

Jobgether is seeking an experienced Claims Manager to handle complex auto claims across personal and commercial lines. You will document files meticulously and ensure correct coding while coordinating with attorneys and vendors.

You’ll review coverage, investigate claims, determine liability, and oversee litigation when necessary. This role emphasizes regulatory compliance, timely resolutions, and clear communication with insureds, clients, and brokers.

Qualifications

• 5+ years of claims management experience.
• In-depth knowledge of auto policies and claims principles.
• Bachelor's degree preferred.
• Licensing requirements must be met.
• Strong written and verbal communication.
• Knowledge of medical terminology in claim evaluation.

Responsibilities

• Manage complex auto claims, including bodily injury cases, documenting files accurately.
• Review coverage, investigate claims, determine liability, and assess damages.
• Oversee litigation for claims proceeding to court.
• Coordinate vendor activity, including independent adjusters.
• Report significant claims to excess insurers when required.
• Develop action plans to meet regulatory deadlines and resolve claims timely.
• Identify subrogation and risk transfer opportunities, including salvage.
• Communicate decisions and progress to insured parties, clients, and brokers.

Skills

Claims management

Auto insurance

Regulatory compliance

Communication skills

Negotiation abilities

Documentation

Education

Bachelor's degree preferred

Professional certification preferred

Tools

Microsoft Office

Claims software

Job description

Accountabilities

• Manage complex personal and commercial auto claims, including bodily injury cases, ensuring files are accurately documented and correctly coded.
• Review insurance coverage, investigate claims, determine liability, and evaluate the extent of damages.
• Oversee the litigation process for claims that proceed to legal action.
• Coordinate vendor activity, including engaging independent adjusters to support claim investigations.
• Report significant claims to excess insurers when required.
• Develop and maintain action plans to meet regulatory contact deadlines and move claims toward timely, appropriate resolution.
• Identify and pursue subrogation and risk transfer opportunities, including securing and disposing of salvage.
• Communicate claim decisions, actions, and progress to insured parties, clients, agents, and brokers as appropriate.
• Support quality assurance programs and perform additional duties as assigned.
• Travel when required.

Requirements

• At least five years of claims management experience, or an equivalent combination of education and experience.
• In-depth knowledge of personal and commercial auto insurance policies, coverage, claims principles, and applicable laws.
• Bachelor's degree from an accredited college or university preferred.
• Relevant professional certification preferred, depending on the line of business.
• Ability to obtain and maintain the adjusting licenses required for the position.
• Knowledge of medical terminology relevant to claim evaluation and Medicare compliance.
• Understanding of deductibles, sub-limits, self-insured retentions (SIRs), carrier programs, and large-deductible programs.
• Strong written and verbal communication skills, including presentation and negotiation abilities.
• Proficiency with computers and Microsoft Office applications.
• Excellent organizational and interpersonal skills, with strong attention to detail.
• Ability to collaborate effectively within a team and manage complex claims independently.
• Commitment to meeting or exceeding service expectations.

Benefits

• Remote/telecommuter work arrangement within Canada.
• Full-time employment.
• Opportunities for professional growth and career development.
• A collaborative, service-oriented workplace culture.
• Work-life balance and an environment that supports colleagues in developing their skills and careers.