Sr. Claims Examiner

HICIX Hiscox Insurance Company Inc.; Atlanta (GA); Hybrid; USD 80,000 - 110,000; Full time

Benefits offered by this job

401(k) with competitive company matching

Comprehensive health insurance

Paid time off

Paid parental leave

$600 reimbursement for health club membership

Job summary

HICIX Hiscox Insurance Company Inc. is seeking a Senior Claims Examiner based in Atlanta, GA. This role involves adjudicating claims and providing operational support to the claims team.

The ideal candidate will bring 3-5 years of experience and advanced analytical skills, alongside an active insurance adjuster's license. Additionally, benefits include health insurance, 401(k) matching, and generous PTO.

Qualifications

• 3-5 years of claims handling experience in commercial general liability.
• Advanced knowledge of claims analysis and adjusting practices.
• Active insurance adjuster's license.

Responsibilities

• Adjust and resolve moderate to complex claims, including phases of litigation.
• Document claim files accurately in compliance with policies.
• Draft coverage letters and denies letters with minimal supervision.

Skills

Claims handling experience

Negotiation skills

Analytical skills

Communication skills

Education

B.A./B.S degree from an accredited College or University

Job description

Job Type: Permanent

The Role

The Senior Claims Examiner adjudicates assigned claims within given authority and provides operational support to the claims team.

Key responsibilities include:

• Adjusts and resolves moderate to complex claims, including all phases of litigation.
• Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities.
• With minimal supervision, drafts coverage letters, including reservation of rights and denial letters.
• Reviews and analyses claim documentation and legal filings to set timely and accurate reserves, and notify the manager if upward segmentation is needed.
• Identifies emerging exposures and claims trends.
• Drives litigation best practices to manage deployment and utilization of defense counsel.
• Identifies suspected fraudulent claims and tracks them with the special investigations unit.
• Participates in Claims Projects as needed.

The Team

The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise.

Requirements

• 3-5 years of claims handling experience in the area of commercial general liability with an insurance carrier.
• Advanced knowledge of claims analysis and adjusting practices.
• In depth knowledge of standards for claims documentation and legal filings.
• Proven ability to actively and effectively negotiate settlement of moderate to complex claims.
• Experience in mentoring and training other claims examiners.
• Advanced analytical skills.
• Strong verbal and written communication skills.
• Active insurance adjuster’s license.
• B.A./B.S degree from an accredited College or University (preferred).

Benefits

• 401(k) with competitive company matching.
• Comprehensive health insurance, vision, dental, and FSA plans.
• Company paid group term life, short‑term disability, and long‑term disability coverage.
• Paid time off: 24 days plus 2 Hiscox days, 10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days.
• Paid parental leave.
• 4‑week paid sabbatical after every 5 years of service.
• Financial Adoption Assistance and Medical Travel Reimbursement Programs.
• Annual reimbursement up to $600 for health club membership or related fitness program fees.
• Company paid subscription to Headspace for employee mental health and wellbeing support.
• 2024 Gold level recipient of Cigna’s Healthy Workforce Designation.

Location

Hybrid; requires working in office a minimum of two (2) days per week. Possible locations: Atlanta, GA; Boston, MA; Chicago, IL; Manhattan, NY; Scottsdale, AZ; West Hartford, CT.

Salary Range

$80,000 – $110,000, based on scope, complexity, location, qualifications, and other factors.

Other Details

This is a permanent position. The actual salary will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Equal Opportunity Employer.