Sr. Commercial Claims Examiner

Frontline Insurance Group, LLC; Town of Florida (NY); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading insurance company is seeking a Senior Commercial Claims Examiner to manage claims effectively while working remotely. This role requires expertise in commercial claims, proven negotiation skills, and the ability to mentor junior adjusters. The ideal candidate has at least 10 years of experience and a Florida insurance license. Enjoy a collaborative environment with competitive benefits.

Benefits

Company-sponsored Medical, Dental, Vision Insurance

401k Retirement Plan with a 9% match

Four weeks of PTO

Qualifications

• A minimum of 10 years of commercial claims experience preferred.
• In-depth professional knowledge of all aspects of claims operations.
• Florida 620/720 license is required.

Responsibilities

• Verify facts of loss and analyze coverage.
• Establish ultimate reserves and monitor them.
• Explain claims status to insureds and other parties.
• Draft denial letters for management approval.
• Close all files in a timely manner.

Skills

Commercial claims experience

Negotiation skills

Commercial coverage interpretation

Proficiency in Xactimate

Education

Bachelor's degree

Job description

Overview

Senior Commercial Claims Examiner — Remote

At Frontline Insurance, we are on a mission to Make Things Better, and our Senior Commercial Claims Examiner plays a pivotal role in achieving this vision. We strive to provide high quality service and proactive solutions to all our customers to ensure that we are making things better for each one.

Our core values — Integrity, Patriotism, Family, and Creativity — are at the heart of everything we do. If you’re looking for a role where you can make a meaningful impact and grow your career, your next adventure starts here!

Benefits

• Health & Wellness: Company-sponsored Medical, Dental, Vision, Life, and Disability Insurance (Short-Term and Long-Term).
• Financial Security: 401k Retirement Plan with a generous 9% match
• Work-Life Balance: Four weeks of PTO and Pet Insurance for your furry family members.

Responsibilities

• Verify facts of loss and pertinent information to analyze and confirm coverage.
• Establish ultimate reserves (anticipated cost to bring file to closure based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.
• Explain and appropriately respond to insureds, public adjusters, attorneys, and contractors during telephone contacts; contact the appropriate parties to obtain needed information, provide timely investigation status updates, and explain settlements and/or ultimate claim disposition.
• Timely submit reserve and payment approval requests, as appropriate.
• Identify claims requiring a Reservation of Rights and refer for management approval.
• Formulate and execute appropriate ADR strategy in compliance with statutory guidelines.
• Check emails and messages daily. Respond to all calls, emails, and questions daily.
• Apply advanced negotiation skills to effectuate resolution of disputed claims with insureds or their legal representatives.
• Coordinate appraisal process and maintain communication to ensure the appraisal process moves forward in a timely fashion.
• Draft denial letters for management approval.
• Identify and refer claims with subrogation potential to the subrogation department.
• Identify and refer cases with potential NICB fraud indicators.
• Virtually investigate and resolve claims, as appropriate, with the use of video technology.
• Close all files in a timely and complete manner.
• Serve as mentor and/or trainer, as needed, to junior adjusters.
• Strictly adhere to Best Practices and operational guidelines, as well as all statutory requirements.
• Interface with company clients, carriers, adjusters, or covered parties. Communicate with agents regarding the status of claims.
• Complete and/or review, approve, or elevate reservation of rights letters, payment explanation correspondence, denial letters, or partial denial letters, as applicable.
• Resolve disputes regarding claims resolution. Responsible for reopening and re-evaluating claims, as necessary.
• Participates in litigation when applicable.

Qualifications

• Bachelor's degree
• A minimum of 10 years of commercial claims experience preferred.
• In-depth professional knowledge of all aspects of claims operations.
• Florida 620/720 license is required.
• Ability to obtain AL, GA, NC and SC adjusters licenses.
• Strong commercial coverage interpretation and claims handling background is required.
• Must have commercial construction knowledge and be proficient in Xactimate.

Why work for Frontline Insurance?

At Frontline Insurance, we’re more than just a workplace – we’re a community of innovators, problem solvers, and dedicated professionals committed to our core values: Integrity, Patriotism, Family, and Creativity. We provide a collaborative, inclusive, and growth-oriented work environment where every team member can thrive.

Frontline Insurance is an equal-opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.