Commercial Auto & General Liability Claims Examiner III

TRISTAR Insurance Group; United States; Remote; USD 85,000 - 95,000; Full time

Job summary

A leading insurance provider is seeking a remote Insurance Claims Examiner to manage and resolve liability claims. This role involves reviewing policy information, conducting investigations, and interacting with clients to ensure effective claims resolution. The ideal candidate has significant experience in automobile and general liability claims, excellent analytical skills, and is able to work within Pacific Time core hours.

Benefits

Medical, Dental, Vision Insurance

401(k) Plan

Paid Time Off

Qualifications

• Two years of experience in automobile and general liability claims.
• Knowledge of claims handling concepts and techniques.
• Strong verbal and written communication skills.

Responsibilities

• Review coverage, process and conclude assigned claims.
• Maintain an ongoing diary for claims.
• Prepare Loss Reports with thorough analysis.

Skills

Automobile claims experience

General Liability claims experience

Analytical skills

Decision-making skills

Communication skills

Education

High School Diploma or GED

Bachelor’s degree in related field

Job description

Overview

Job Details Level: Experienced Job Location: Involuntary Remote - Remote, CA Position Type: Full Time Salary Range: $85000.00 - $95000.00 Salary/year Job Shift: Day Job Category: Insurance Commercial Auto & GL Claims Examiner, III

Please make sure that you complete all the questions and navigate to the end of the application to sign the application. Must work PST core hours. Must pass the NYS Adjuster license exam within 60 days of hire.

Position Summary

Responsible for the prompt review of policy information to determine coverage for loss/damage/injury. Conduct an efficient claim examination and investigation leading to the final resolution of liability claims, including matters in litigation. Frequent contact and interaction with involved parties including claimants and their legal representatives will be required. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client.

Duties and Responsibilities

• Review and interpret coverage, process, and conclude assigned claims including investigation and evaluation of Auto, Auto Med Pay, and/or General Liability Casualty Claims.
• Oversee and direct outside investigative service providers and work closely with the client and client counsel, and investigative services to advance the claim to conclusion.
• Maintain an ongoing diary.
• Continually assess exposure and evaluate for accurate reserves and settlement recommendations.
• Prepare Loss Reports providing a thorough analysis of coverage, liability, and damages.
• Where applicable, determine if subrogation and/or risk transfer exists and initiate recovery efforts at the direction of the client.
• Document all correspondence, reports, discussions, and decisions in the claim file record.
• Provide outstanding service to the client.

Position is remote/working from home.

Qualifications

Education/Experience: High School Diploma or GED required; bachelor’s degree in related field (preferred) and two years auto and general liability casualty and/or No Fault/PIP related experience; or equivalent combination of advanced education and experience.

Special Requirements:

• At least two years of Automobile and General Liability claims experience required.
• Knowledge of claims handling concepts, practices, and techniques, including but not limited to coverage issues, litigation management and product line knowledge.
• Demonstrated verbal and written communications skills.
• Demonstrated advanced analytical, decision-making and negotiation skills.
• Computer proficiency.

Preferred Skills:

• Ability to communicate effectively and clearly, both orally and in writing.
• Ability to manage relationships in a fast-paced environment, while demonstrating problem solving and decision-making skills to work with customers.
• Good analytical abilities to review, exercise judgment and evaluate claims to make sound decisions with a minimal amount of supervision.
• Excellent customer service skills.
• An understanding of the litigation process and case valuation in multiple jurisdictions.
• Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense.
• An ability to handle assigned claims following company guidelines and industry best practices with a minimal amount of supervision.
• Time management skills, organizational skills, and ability to prioritize issues and tasks.
• Ability to effectively operate computer equipment and applications.
• Independence, flexibility, and creativity.

Other Qualifications:

• Candidate must have adjuster licenses and be willing to obtain the NY license if they do not already have one.
• Candidate must be willing to work Pacific Time core hours.

Benefits

• Medical, Dental, Vision Insurance.
• Life and Disability Insurance.
• 401(k) Plan
• Paid Holidays
• Paid Time Off.
• Referral bonus.

Mental and Physical Requirements

See separate attachment for the checklist of mental and physical requirements.

Mental and Physical Requirements Details

1. Mental Effort

Follow one- or two-step instructions; routine, repetitive task. Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables. Follow written, verbal, or diagrammatic instructions; several concrete variables. Solve practical problems; variety of variables with limited standardization; interpret instructions. Logical or scientific thinking to solve problems; several abstract and concrete variables. Wide range of intellectual and practical problems; comprehend most obscure concepts.

2. Physical Effort

a. Physical activity required to perform the job: Sedentary work; lifting up to 10 pounds occasionally. Light to heavy work ranges described with varying exertion levels. Note: The full checklist includes various lifting, carrying, and dexterity requirements; refer to the attached document for complete details.

Visual requirements: Far, near, mid-range, depth, color, and field of vision.

3. Working Conditions

Environmental factors and frequency of exposure are as described in the attached checklist, including potential exposure to dirt/dust, noise, temperature extremes, dampness, vibrations, chemicals/solvents, electrical shock, significant work pace/pressure, and odors/fumes.