Commercial Claims Examiner

Jobgether; United States; Remote; USD 64,000 - 71,000; Full time

Benefits offered by this job

Remote work

Full-time position

Job summary

Jobgether, on behalf of a partner company, seeks a Commercial Claims Examiner III based in the United States. The role handles complex commercial property claims over $500,000, reviewing coverage, reserves, and authorizing settlements.

It requires a Bachelor's degree, 5+ years in property claims, and CEA certification, with strong communication and negotiation skills. This full-time remote position offers collaboration with adjusters, legal counsel, and internal teams, while ensuring regulatory

Qualifications

• Bachelor's degree or equivalent.
• At least 5 years of property claims adjusting experience.
• 2+ years in commercial property claims.
• 4 years of commercial claims experience, incl. handling >$500,000.
• CEA certification and knowledge of Fair Claims Settlement Practices.
• Strong communication, collaboration, and negotiation skills.

Responsibilities

• Manage a portfolio of commercial property claims, primarily >$500,000.
• Review adjuster investigations to assess coverage and validity.
• Adjust loss reserves and authorize payments and recommendations.
• Investigate and negotiate settlements with stakeholders and counsel.
• Collaborate with internal teams and external counsel on litigated claims.
• Ensure compliance with guidelines and claims handling standards.
• Identify potential fraud indicators and refer cases appropriately.
• Monitor files for regulatory and procedural compliance.

Skills

Communication skills

Analytical skills

Negotiation

Decision making

Collaboration

Education

Bachelor's degree

CEA certification

Fair Claims Settlement Practices

Tools

MS Office

Excel

Word

Job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Commercial Claims Examiner III based in the United States.

The Commercial Claims Examiner III is responsible for evaluating, investigating, and resolving complex commercial property insurance claims, with a primary focus on high-value losses exceeding $500,000. This role involves reviewing coverage, assessing claim validity, managing reserves, and authorizing payments and settlement recommendations. Working closely with independent adjusters, internal teams, and legal counsel, the examiner ensures claims are handled accurately, fairly, and efficiently. The position requires strong technical expertise in commercial property policies, claims procedures, and settlement practices. It also involves identifying potential fraud, maintaining regulatory compliance, and negotiating settlements that reflect covered losses while protecting the insurer’s interests. This is a full-time remote opportunity for an experienced claims professional based in the United States.

Accountabilities

• Manage a portfolio of commercial property claims from initial assignment through final resolution, primarily handling claims exceeding $500,000.
• Review claims investigated by independent adjusters to assess coverage, verify claim validity, and determine appropriate resolutions.
• Evaluate and adjust loss reserves, review correspondence and reports, verify policy coverage, and authorize payment requests and recommendations submitted by independent adjusters.
• Investigate, assess, and adjust claims using technical expertise and strong interpersonal skills to support fair and timely settlements.
• Collaborate with internal stakeholders and legal counsel on claims involving litigation.
• Monitor independent adjuster files to ensure compliance with applicable guidelines and claims-handling standards.
• Analyze settlement data and supporting documentation to confirm the accuracy and validity of claims and ensure settlements follow established procedures.
• Maintain compliance with Department of Insurance requirements and internal claims procedures.
• Identify potential indicators of fraud or illegal activity and refer cases through the appropriate internal processes.
• Negotiate settlements promptly, ensuring that payments reflect covered losses while protecting the insurer from invalid claims.

Requirements

• Bachelor's degree or equivalent.
• At least 5 years of property claims adjusting experience, including preferably 2 or more years in commercial property claims.
• Four years of commercial claims experience, including 2 years handling claims exceeding $500,000.
• Comprehensive understanding of insurance policy contracts, applicable statutes, and claims processes.
• Certification in CEA and Fair Claims Settlement Practices.
• Strong written and verbal communication skills, with the ability to collaborate effectively with adjusters, legal counsel, and internal stakeholders.
• Working knowledge of Microsoft Office, particularly Word and Excel.
• Strong analytical, investigative, negotiation, and decision-making skills, with the ability to evaluate complex claims and recommend appropriate settlements.

Benefits

• Compensation: $46.15-$51.28; the source does not specify the pay period or currency.
• Work arrangement: Remote.
• Employment type: Full-time.

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

We appreciate your interest and wish you the best!