Remote Claims Examiner: Investigate, Negotiate & Resolve

USLI; Philadelphia (Philadelphia County); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Profit sharing

Medical benefits

Free lunch on site

Professional development

Remote work days (5/month)

Job summary

USLI in Philadelphia seeks a claims professional to evaluate coverage, liability, and damages for complex claims. You will collaborate with underwriting, compliance, and legal teams to investigate and resolve claims.

The role involves coordinating with independent adjusters, reviewing notices, and preparing reserve calculations, settlements, and coverage positions. JD or liability expertise preferred; remote work up to five days per month supported.

Qualifications

• Experience in third-party/liability claims.
• Strong negotiation and communication skills.
• Familiarity with insurance coverage and claim evaluation processes.
• Multi-jurisdictional liability knowledge is a plus.
• Ability to manage remote work up to five days per month.

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

Skills

Problem-solving

Communication

Negotiation

Organization

Insurance knowledge

Education

JD

Job description

USLI in Philadelphia seeks a claims professional to evaluate coverage, liability, and damages for complex claims. You will collaborate with underwriting, compliance, and legal teams to investigate and resolve claims.

The role involves coordinating with independent adjusters, reviewing notices, and preparing reserve calculations, settlements, and coverage positions. JD or liability expertise preferred; remote work up to five days per month supported.