Claims Supervisor (Remote)

California FAIR Plan Association; Los Angeles (CA); Remote; USD 90,000 - 120,000; Full time

Job summary

California FAIR Plan Association in Los Angeles is seeking a seasoned Claims Supervisor to lead a team of claims examiners in investigating property losses, ensuring timely payments and adherence to Department of Insurance regulations.

You will coach staff, review reserves, coordinate with field adjusters, and drive settlements that reflect actual losses while protecting the insurer from fraud, in a fast-paced environment.

Qualifications

• Bachelor's degree or equivalent preferred.
• Excellent customer service, oral and written communication skills.
• 2 years of property claims supervisory experience preferred.
• Experience managing and settling dwelling or homeowners property losses.
• Experience with claims litigation, appraisal, and mediation.
• Working experience with MS-Office (Word and Excel) is required.

Responsibilities

• Supervises team of claims examiners, verifies coverage, and authorizes timely payments to policyholders.
• Reviews examiners correspondences to policyholders for accuracy and completeness.
• Review and ensure field adjuster work product is compliant with CFP Independent Adjuster guidelines.
• Reviews reserves and provides reserve recommendations to ensure reserving activities are consistent with company policies.
• Communicates to examiners and/or others involved to secure missing information.
• Promptsly assists examiners with negotiating difficult settlements, ensuring settlements reflect actual insured losses.
• Evaluates, coaches, and leads assigned examiners in accordance with HR and claims processes.
• Confer with Claims management and/or legal counsel on claims involving legal issues or litigation.
• Document claims activity clearly and concisely.
• Examine claims investigated by examiners for further investigation and payment authorization.
• Apply claims knowledge and human relations skills to promote fair and prompt settlement of claims.
• Conduct daily diary reviews on claim files to ensure status letters are sent timely and in accordance with regulations.
• Review and approve claims within designated authority level.

Skills

Customer service

Communication

Education

Bachelor's degree or equivalent

Tools

MS Office

Job description

POSITION SUMMARY:

Supervises a team of claims examiners in the investigation of property insurance claims for dwelling or commercial losses based on coverage, appraisal, and verifiable damage. Provides leadership to their assigned team to assure maximum quality, efficiency and adherence to Department of Insurance regulations and internal Claims practices and policies.

PRINCIPAL DUTIES & RESPONSIBILITIES:

• Supervises team of claims examiners, verifies coverage, and authorizes timely payments to policyholders.
• Reviews examiners correspondences to policyholders for accuracy and completeness.
• Review and ensure field adjuster work product is compliant with CFP Independent Adjuster guidelines.
• Reviews reserves and provides reserve recommendations to ensure reserving activities are consistent with company policies.
• Communicates to examiners and/or others involved to secure missing information.
• Promptly assists examiners with negotiating difficult settlements, making sure that the settlement reflects the actual insured losses while ascertaining that the insurer is protected from invalid claims in accordance with company practices and procedures.
• Evaluates, coaches, and leads assigned examiners in accordance with company human resources and claims processes and procedures.
• Confer with Claims management and/or legal counsel on claims involving legal issues or litigation.
• Document claims activity in a clear and concise manner.
• Examine claims investigated by examiners, including further investigation of questionable claims to determine payment authorization.
• Apply claims technical knowledge and human relations skills to promote fair and prompt settlement of claims.
• Conduct daily diary reviews on claim files to ensure status letters are sent to policyholders timely and in accordance with Department of Insurance regulations.
• Review and approve claims within designated authority level.
• Verify and analyze data used in settling claims to ensure validity and that settlement is in understanding of fraudulent and illegal practices.
• Leads and participates in special projects to improve department quality, efficiency, and customer service.

KNOWLEDGE AND SKILLS REQUIREMENTS

• Bachelor's degree or equivalent preferred.
• Excellent customer service, oral and written communication skills.
• 2 years of property claims supervisory experience preferred.
• Experience managing and settling dwelling or homeowners property losses.
• Experience with claims litigation, appraisal, and mediation
• Working experience with MS-Office (especially Word and Excel) is required.