Claims Examiner: Coverage, Negotiation & Resolution

Jobtailor; Town of Florida (NY); On-site; USD 60,000 - 90,000; Full time

Job summary

Jobtailor in New York seeks an experienced Claims Adjuster to handle low to moderate exposure claims, review policy coverage, and communicate coverage positions to insureds and claimants.

You’ll investigate, evaluate, negotiate, and settle claims, set reserves within authority, and coordinate with internal teams to ensure timely processing in line with SLAs and company policy. A valid adjuster license and 2+ years of claims handling are preferred.

Qualifications

• Bachelor’s degree or equivalent work experience.
• Must have or be eligible to receive claims adjuster license.
• Industry designations (INS, IEA, AIC, ARM, SCLA, CPCU) are preferred.
• Minimum of two years of claims handling experience.

Responsibilities

• Handle low to moderate exposure claims.
• Confirm claim coverage by reviewing policies and documents.
• Analyze coverage and communicate coverage positions.
• Investigate, evaluate, negotiate, and settle claims.
• Set reserves within authority or recommend reserve changes to the manager.
• Use the diary system to resolve outstanding issues and ensure timely claim processing and closure.
• Negotiate and settle claims directly with claimants.
• Provide timely service throughout the claim lifecycle in accordance with SLAs.

Skills

Claims Handling Experience

Analytical Skills

Written Communication

Oral Communication

Teamwork

Time Management

Education

Bachelor’s degree or equivalent work experience

Tools

Microsoft Excel

Microsoft Outlook

Microsoft PowerPoint

Microsoft Word

Diary System

Job description

Jobtailor in New York seeks an experienced Claims Adjuster to handle low to moderate exposure claims, review policy coverage, and communicate coverage positions to insureds and claimants.

You’ll investigate, evaluate, negotiate, and settle claims, set reserves within authority, and coordinate with internal teams to ensure timely processing in line with SLAs and company policy. A valid adjuster license and 2+ years of claims handling are preferred.