Senior Casualty Claims Examiner

Utica First Insurance; Village of Oriskany (NY); On-site; USD 65,000 - 90,000; Full time

Job summary

Utica First Insurance is seeking a Claims Casualty Examiner to investigate, evaluate, negotiate, and resolve casualty claims per company policies and regulatory requirements. The role collaborates with policyholders, claimants, attorneys, and vendors to ensure fair, timely resolutions and exceptional service.

Positions vary by level with increasing responsibility, from routine to complex, high-exposure, and litigated losses.

Qualifications

• Knowledge of casualty insurance coverages and liability principles.
• Strong analytical, investigative, and problem-solving skills.
• Effective negotiation and conflict-resolution abilities.
• Excellent verbal and written communication skills.
• Strong organizational and time-management skills.
• Ability to interpret insurance policies, legal documents, medical records.
• Proficiency with claims management systems and Microsoft Office.

Responsibilities

• Investigate casualty claims by gathering and analyzing statements, reports, records, and other relevant documentation.
• Review policy language to determine coverage.
• Evaluate injuries and property damages, establish reserves, and develop resolution strategies.
• Negotiate settlements with claimants and attorneys.
• Maintain accurate, timely, and complete claim documentation.
• Communicate effectively with policyholders, claimants, agents, attorneys, medical providers, and other involved parties.
• Identify, investigate, and address potential fraud.
• Manage claims in compliance with company standards, state regulations, and industry best practices.
• Monitor claim inventories to ensure timely file progression and resolution.
• Participate in claim reviews, audits, training programs, and continuing education activities.
• Provide technical assistance and mentorship to less experienced examiners, as appropriate based on level.
• Assist with special projects, departmental initiatives, and catastrophe response efforts as assigned.

Skills

Analytical skills

Negotiation

Communication

Time management

Policy interpretation

Claims systems

Microsoft Office

Education

Bachelor's degree preferred

Licensing/certifications

Job description

Utica First Insurance is seeking a Claims Casualty Examiner to investigate, evaluate, negotiate, and resolve casualty claims per company policies and regulatory requirements. The role collaborates with policyholders, claimants, attorneys, and vendors to ensure fair, timely resolutions and exceptional service.

Positions vary by level with increasing responsibility, from routine to complex, high-exposure, and litigated losses.