Property Claims Examiner II (Remote)

California FAIR Plan Association; Los Angeles (CA); Remote; USD 65,000 - 85,000; Full time

Job summary

A leading insurance company is seeking a Claims Examiner II to process and resolve property insurance claims. This role involves investigating claims, adjusting reserves, and negotiating settlements to ensure compliance with industry standards. Candidates should possess a Bachelor’s degree, relevant experience, and strong communication skills to provide excellent customer service.

Qualifications

• 2+ years of property claims experience required.
• Excellent oral and written communication skills.
• Certified in CEA and Fair Claims Settlement Practices.

Responsibilities

• Investigate, evaluate, and resolve claims, applying technical knowledge.
• Adjust reserves and ensure compliance with policies.
• Negotiate settlements and ensure timely payment to policyholders.

Skills

Communication

Negotiation

Problem Solving

Customer Service

Education

Bachelor’s degree or equivalent

Tools

MS-Office

Job description

POSITION SUMMARY
Process insurance claims for property losses based on coverage, appraisal, and verifiable damage. They will interact with independent adjusters and policy holders, review claim forms and other records to determine insurance coverage. This person will make payment recommendations and settlements in accordance with company practices, procedures, and Fair Claims Settlement Practices regulations.

PRINCIPAL DUTIES & RESPONSIBILITIES
• Investigate, evaluate, and resolve claims, applying technical knowledge and human relations skills to promote fair and prompt settlement of claims.
• Adjust reserves and provide reserve recommendations to ensure reserving activities are consistent with company policies.
• Enter claim transactions, in a clear and concise manner.
• Examine claims inspected by independent adjusters, including further investigation of questionable claims, verification of coverage, and timely issuance of payments to policyholders.
• Conduct daily diary reviews on claim files to ensure status letters are sent to policyholders in accordance with Department of Insurance regulations.
• Pay and process claims within designated authority level.
• Supervise independent adjusters to ensure adherence to CFP IA Guidelines.
• Maintain compliance with the Department of Insurance and Company policy and procedures.
• Create correspondence to policyholders that is accurate and complete. Communicate with insureds and/or others involved to secure missing information.
• Promptly negotiate settlements, making sure that the settlement reflects the actual insured losses while ensuring that the insurer is protected from invalid claims.
• Confer with Claims Management and legal counsel on claims involving litigation.

ADDITIONAL DUTIES & RESPONSIBILITIES
Claims Examiner II: This role may include handling the entire claim (except inspection), or may be responsible for a specific coverage, such as Personal Property or Fair Rental Value. This role will focus on claims ranging from $100,000 to $300,000 in damages, but the Claims Examiner II may receive larger or smaller claims when necessary.

EDUCATION & EXPERIENCE
• Minimum Bachelor’s degree or equivalent preferred.
• Excellent oral and written communication skills.
• Working experience with MS-Office (especially Word and Excel) is required.
• 2 + years property claims experience and excellent customer service.
• Certified in CEA and Fair Claims Settlement Practices.

ADDITIONAL REQUIREMENTS (PRIOR EXPERIENCE)

Claims Examiner II: 3 years total claims experience, 2 years handling HO claims up to $300,000
1 year Carrier Experience Required.