Claims Examiner - Professional Claims

USLI; United States; Hybrid; USD 60,000 - 110,000; Full time

Benefits offered by this job

Performance-based bonuses

Medical benefits 100% for full-time

Profit-sharing program

Free lunch onsite

450+ development courses

Job summary

USLI is seeking an experienced claims professional to evaluate coverage, liability, and damages for each claim. You will collaborate with internal teams and external stakeholders to investigate, negotiate, and resolve claims effectively.

Key responsibilities include reviewing coverage, conducting thorough investigations, managing independent adjusters, applying liability law, maintaining reserves, and coordinating with underwriting and compliance for optimal outcomes.

Qualifications

• Analytical and creative problem-solving with focus on liability and damages evaluation.
• Strong oral and written communication with stakeholders.
• Assertive negotiation and conflict management skills.
• Excellent organization and time management for multiple priorities.
• Familiarity with insurance coverage, negligence law, and claim evaluation processes.

Responsibilities

• Review coverage by evaluating first notice of loss and policy details; draft disclosures and reservation of rights letters.
• Conduct thorough investigations including liability and damages assessment, interviews, scene inspections, and evidence collection.
• Retain and direct independent adjusters while managing all investigation aspects.
• Apply statutes and case law to evaluate liability exposure and ensure fair contribution by joint tortfeasors.
• Maintain reserves reflecting evolving liability and damages; manage claim files end-to-end.
• Negotiate settlements with claimants or attorneys and oversee defense counsel and litigation management.
• Prepare reserve authority requests, reinsurance reports, and serious loss reports; communicate with underwriting, compliance, and actuarial teams.

Skills

Problem-solving

Communication

Negotiation

Organization

Technical knowledge

Tools

Claims management systems

Legal research

Job description

About Us:

At USLI, we’re not just about insurance — we are committed to making a difference, both internally and externally. Our community is built upon five values: Caring, Attitude, Respect, Empathy and Energy. Our commitment to these values leads us to make better decisions and furthers our true sense of community. By joining our team, you'll be part of a vibrant organization that values innovation, collaboration, and growth. Here, you’ll have the opportunity to shape the future of insurance and make a meaningful impact.

Your Role:

You’ll play a critical role in evaluating coverage, liability, and damages for each unique claim. You’ll collaborate across teams and with external stakeholders to effectively investigate, negotiate, and resolve claims.

Key Responsibilities:

• Coverage review: Confirm coverage by reviewing the first notice of loss and policy details; prepare DISCLAIMERS and reservation of rights letters as necessary
• Thorough investigation: Conduct detailed investigations into claims, including liability and damages assessment, witness interviews, scene inspections, and evidence collection
• Independent adjusters: Retain and provide directions to independent adjusters while managing all aspects of the investigation process
• Liability analysis: Apply statutory and case law to evaluate liability exposure and ensure joint tortfeasors contribute their fair share
• Reserve maintenance: Maintain accurate reserves reflecting liability and damages as claims develop
• File management: Proactively manage claim files, negotiate settlements directly with claimants or attorneys, oversee defense counsel, and ensure effective litigation management
• Reporting: Prepare comprehensive reserve authority requests, reinsurance reports, serious loss reports, and coverage position letters
• Cross-team collaboration: Provide updates and collaborate with underwriting, compliance, and actuarial teams to maintain healthy products

What You’ll Bring:

• Problem-solving skills: Analytical and creative problem-solving capabilities with a focus on liability and damage evaluation
• Communication: Strong oral and written communication skills to effectively interact with all stakeholders
• Negotiation expertise: Assertive decision-making with effective negotiation and conflict management skills
• Organization: Strong organizational and time management skills to manage multiple priorities efficiently
• Technical knowledge: Familiarity with insurance coverage, negligence law, and claim evaluation processes

Qualifications:

• 2+ years of relevant experience for Associate Claims Examiner
• 7+ years of relevant experience for Claims Examiner
• Experience as an examiner, adjuster, paralegal, attorney, or in a related role
• Specialized experience: Experience with Directors & Officers, Errors & Omissions, Cyber liability and/or other professional claims involving claims-made policies is a plus
• Additional Qualifications: Multi-jurisdictional knowledge, advanced degrees, and/or JD are a plus

Position affords 5 days per month to work remotely.

What We Offer:

One of the advantages of working at USLI is the competitive salary and benefits program we offer full-time and eligible part-time employees.

• performance-based triannual bonuses
• medical benefits paid at 100% for full-time employees and 80% for eligible part-time employees
• profit-sharing program
• free lunch every day while onsite
• more than 450 annual personal and professional development courses

Explore more company benefits

Why USLI?

At USLI, we are committed to fostering a vibrant and inclusive community that celebrates the rich diversity of all ethnicities, nationalities, abilities, genders, gender identities, sexual orientations, ages, religions, socioeconomic backgrounds, and life experiences. We understand the importance of continuous learning, self-reflection, acknowledging our biases, and expanding our perspectives beyond our own. We actively encourage open dialogue on diversity, equity, inclusion, and belonging to support a workplace where every individual feels valued, respected, and empowered to contribute at their fullest potential. Join us in building a diverse and inclusive environment where our shared values drive us toward excellence.