Claims Examiner I - Commercial Auto

Athens Administrators; San Antonio (TX); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Medical coverage

Vision plan

Dental plan

Life Insurance

401k plan

STD & LTD

Job summary

Athens Administrators is seeking a full-time Claims Examiner I to support our Property & Casualty department in San Antonio, TX. The role involves investigating coverage, evaluating settlements, and managing claims from start to finish.

The ideal candidate has a high school diploma, a state license, and at least three years of auto-claims experience, including commercial auto. The position offers a hybrid schedule with in-office and remote days.

Qualifications

• High School diploma required; higher education preferred.
• Licensed in your home state with at least one NY/TX/FL license.
• 3+ years auto-claims handling experience, 1+ year commercial auto.

Responsibilities

• Investigate coverage and disputes; evaluate issues and products.
• Determine settlement value or denial of liability for claims.
• Document claims and manage data from inception to closure.
• Negotiate settlements within authority ($15,000).
• Maintain licenses and participate in training and development.

Skills

Claims handling concepts

Negotiation skills

Verbal and written communication

Analytical decision making

Customer service mindset

Interpersonal skills

Education

High School Diploma or equivalent

AA/AS or BA/BS preferred

Tools

Microsoft Office Suite

Job description

Location: San Antonio, TX

Job Id:1570

# of Openings:1

Department: Property & Casualty

FLSA Status: Exempt in all state except California

Job Grade: 9

Position Summary

Athens Administrators has an immediate need for a full‑time Claims Examiner I to support our Property & Casualty department. Employees who live less than 26 miles from the San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. The Claims Examiner I is responsible for the timely investigation, evaluation and determination of settlement or denial of minor to moderate multi‑line auto property and casualty claims, handling claims from inception to closure.

Primary Responsibilities

• Knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated analytical, decision making and negotiation skills.
• Investigate coverage, including evaluate insurance coverage problems and/or disputes
• Investigate, evaluate and determine settlement value or denial of liability for all claims
• Develop a measure of damage for each loss, establish and maintain appropriate reserves
• Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure
• Ensure appropriateness of all payments
• Negotiate settlement of claim within individual authority ($15,000 unless otherwise noted)
• Maintain and update action plans for each claim
• May assign and coordinate with vendors, legal counsel, appraisers or experts as necessary
• Facilitate between claimants, clients, brokers and attorneys in resolution of liability claims
• Exchange information with clients, claimants, insurance brokers, inspectors, producers and account managers
• Provide customer service and support to insureds and claimants
• Assist in training of new employees
• Attend meetings and educational seminars for professional development
• Maintain required licenses

Essential Position Requirements

• High School Diploma or equivalent (GED) required for all positions
  • AA/AS or BA/BS preferred but not required
• Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL
  • Additional State Adjuster License(s) may be required within 180 days
  • Maintain licenses and continuing education requirements in all states
• Minimum of three years auto‑claims handling experience, at least one‑year commercial auto required
• Knowledge of property and casualty insurance policies
• Knowledge of auto insurance laws, codes, procedures, and liability concepts
• Proficiency in investigation and resolution of minor to medium level auto physical damage casualty claims
• Strong negotiation skills and ability to achieve optimal settlement results for clients.
• Well‑developed verbal and written communication skills with strong attention to detail
• Excellent organizational skills and ability to multi‑task
• Ability to type quickly, accurately and for prolonged periods
• Proficient in Microsoft Office Suite
  • Ability to learn additional computer programs
• Reasoning ability, including problem‑solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
• Ability to be trustworthy, dependable, and team‑oriented for fellow employees and the organization
• Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
• Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
• Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor.
• Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
• Must be able to reliably commute to meetings and events as required by this position

Benefits

Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company‑Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here.

Equal Employment Opportunity

Athens Administrators is an Equal Opportunity/Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.

The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf