Claims Examiner II - Commercial Auto BI

Athens Administrators; San Antonio (TX); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical benefits

Vision benefits

Dental benefits

Life & AD&D insurance

401k plan

Job summary

Athens Administrators is seeking a full-time Claims Examiner II to support our Property & Casualty department in San Antonio, TX. The role handles moderate to severe commercial auto claims with potential for other line work, ensuring quality service while protecting client interests.

The position requires licensure in the domicile state and experience with auto liability, coverage issues, and negotiation. Hybrid in-office/remote options, with weekly in-office attendance for this market area.

Qualifications

• High school diploma or GED required; higher degree preferred but not required.
• Current domiciled-state adjuster license and at least one license in NY/TX/FL; additional licenses may be required.
• Minimum 5 years of commercial auto handling experience.
• Knowledge of tort law, civil procedure, and contract law.
• Knowledge of auto insurance laws, codes, procedures, and liability concepts.
• Proficiency in Microsoft Office and strong written/spoken communication.

Responsibilities

• Investigate, evaluate, and determine settlement value or denial of liability for moderate to severe commercial auto claims.
• Establish appropriate reserves within prescribed authority and review adequacy regularly.
• Prepare comprehensive reports and identify claim trends for management.
• Manage litigation with counsel and adhere to litigation guidelines.
• Document and manage claims from inception to closure.
• Ensure appropriateness of all payments.
• Coordinate with vendors and field service providers.
• Facilitate communication between claimants, clients, brokers, and attorneys.
• Attend meetings and educational seminars for professional development.
• Maintain required licenses and conduct quarterly reviews with clients.

Skills

Verbal communication

Written communication

Analytical skills

Attention to detail

Multi-tasking

Education

High School Diploma or GED

AA/AS or BA/BS preferred

Tools

Microsoft Office Suite

Job description

Position:Claims Examiner II - Commercial Auto BI

Location: San Antonio, TX

Job Id:1661

# of Openings:2

ATHENS POSITION DETAILS

Position Title:

Department:

Property & Casualty

Reports To:

FLSA Status:

Exempt in all states but CA

Job Grade:

11

Next step in progression could include Senior Claims Examiner

ATHENS ADMINISTRATORS

Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!

POSITION SUMMARY

Athens Administrators has an immediate need for a full-time Claims Examiner II to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, 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.

As an Inside Property and Casualty Claims Examiner II, this candidate will be responsible for the review, analysis, and process of moderate to severe commercial auto claims with an opportunity to handle Commercial Property, Inland Marine, and General Liability claims. These claims are typically moderate exposure and may entail litigation and coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests.

PRIMARY RESPONSIBILITIES

Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:

Advanced 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 advanced analytical, decision making and negotiation skills.

• Investigate, evaluate, and determine settlement value or denial of liability for moderate to severe level commercial auto claims
• Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level
• Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management
• Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment
• Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure.
• Ensure appropriateness of all payments
• Coordinate and work with a vendor service such as appraiser, independent adjusting firms, contractors, social media and private investigation and various other field service vendors
• Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims
• Exchange information with clients, claimants, insurance brokers, inspectors, producers, and account managers
• Attend meetings and educational seminars for professional development
• Maintain required licenses
• Conduct quarterly claim reviews with the client

ESSENTIAL POSITION REQUIREMENTS

The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.

• 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 5 years of commercial auto handling experience
• Knowledge of tort law, civil procedure, and contract law
• Knowledge of auto insurance laws, codes, procedures, and liability concepts
• Knowledge of property and casualty insurance policies
• Proficiency in investigation and resolution of minor to medium level auto physical damage claims. Limited minor BI claims may be optional
• Relies on extensive experience and judgment to plan and accomplish goals in a fast-paced environment
• 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

This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.

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.

THANK YOU!

We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn , Glassdoor , and Facebook pages!

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