Claims Examiner II - MSI

The Baldwin Group; Northern (KY); Hybrid; USD 70,000 - 90,000; Full time

Job summary

MSI is seeking a Claims Examiner II to manage high-complexity insurance claims for policyholders remotely in the US. The role requires technical claims handling knowledge, strong communication with clients, carriers, and colleagues, and a strategic yet tactical approach to meeting goals.

The position emphasizes timely reserving, collaboration with counsel, and adherence to Best Practices while pursuing subrogation and fraud indicators. High school or GED and a P&C license are prerequisites.

Qualifications

• Analyses insurance policies to determine coverage.
• Investigates and analyzes claim information to determine liability.
• Handles high-complexity 1st Party Property Claims.
• Assists in suits, mediations and arbitrations.
• Communicates with all interested parties throughout the life of the claim.

Responsibilities

• Monitors vendor performance and controls costs.
• Evaluates, negotiates and determines settlement values.
• Identifies subrogation opportunities and ensures recovery.
• Identifies fraud indicators and refers files to SIU for investigation.
• Participates in claims audits, internal and external.
• Updates and maintains the claim file.

Skills

Claims handling

Customer service

Policy analysis

Communication

Fraud indicators

Education

High School / GED

Property & Casualty License

Job description

## Claims Examiner II - MSIApply: Remote US: Full time: Posted Yesterday: JR110224**Why MSI? We thrive on solving challenges.****As a leading MGA, MSI combines deep underwriting expertise with insurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers’ unique needs.****We have a passion for crafting solutions for the important risks facing individuals and businesses. We offer an expanding suite of products – from fully-digital embedded renters coverage to high-value homeowners insurance to sophisticated commercial coverages, such as cyber liability and habitational property – delivered through agents, brokers, wholesalers and other brand partners.****Our partners and customers count on us to deliver exceptional service through a dedicated team that makes rapid resolutions a priority. We simplify the insurance experience through our advanced technology platform that supports every phase of the policy lifecycle. Bring on your challenges and let us show you how we build insurance better.**The Claims Examiner II is considered an expert in managing insurance claims for our policyholders, handling claims with a higher level of complexity. The Claims Examiner II must have technical knowledge in insurance claims handling and the skills needed to provide superior service for our customers. The ability to develop relationships and effectively communicate with a diverse range of clients, carriers and colleagues is a key success factor in this role. Strategic vision coupled with tactical execution to achieve results in accordance with goals and objectives is also critical to the overall success of this position.**PRIMARY RESPONSIBILITIES:** • Analyzes insurance policies and other documents to determine insurance coverage. • Investigates and analyzes claim information to determine extent of liability. • Handles claims 1st Party Property Claims of a high level of complexity. • Assist in suits, mediations and arbitrations. Works with Counsel in the defense of litigation. • Sets timely, adequate reserves in compliance with the company’s reserving philosophy. • Engages experts to assist in the evaluation of the claim. • Monitors vendor performance and controls expense costs. • Evaluates, negotiates and determines settlement values. • Communicates with all interested parties throughout the life of the claim. Proactively discusses coverage decisions, the need for additional information, and settlement amounts with interested parties. • Handles all claims in accordance with Best Practices. • Responsible for monitoring and completing assigned claims inventory. • Acquire and maintain a state adjuster’s license and meet state continuing education requirements. • Provides Best-In-Class customer service for insureds and agents. • Updates and maintains the claim file. • Identifies opportunities for subrogation and ensures recovery interests are protected. • Identifies fraud indicators and refers files to SIU for further investigation. • Participates in claims audits, internal and external. • Provides oversight of TPAs **EDUCATION & EXPERIENCE:** High School/GED 5-9 years' experience in claims Must have Property & Casualty Insurance License