Claims Examiner-Construction Defect

Analyzes coverage and settles moderately complex claims in one or more of Client's specialty claims areas. Essential Duties & Responsibilities:

• Able to manage the full-life cycle of all assigned claims files.
• Analyzes coverage and determines defense obligations.
• Independently conducts thorough analysis and investigations necessary to determine claims exposure, recommend appropriate settlement strategies, and action plans.
• Creates reservation of rights and coverage denial letters.
• Negotiates settlements with clients, client attorneys, and Public Adjusters.
• Interacts extensively with various parties involved in the claims process and may recommend retaining the advice of outside experts as necessary.
• Prepares reserve and settlement authority requests for client and carrier approval.
• May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.
• Has a solid understanding of claims processing and the insurance brokerage business.
• Has an in-depth understanding of the terminology and case law associated with their specialized claims niche/industry.
• Handles claims consistent with clients' and corporate policies, procedures and "best practices" and in accordance with any statutory, regulatory, and ethical requirements.
• Provides guidance and/or supervision to lower-level adjusters. Incumbents at this level should be able to work at full case load capacity

Additional Considerations: Investigate, evaluate, and resolve construction defect claims while engaging with our clients Required:

• 5 or more years related claims experience required.
• Demonstrated ability to handle unique/challenging claims issues at a senior adjuster level.
• Appropriately licensed and/or certified in all states in which claims are being handled.
• Knowledge of accepted industry standards and practices.
• Computer experience with related claims and business software.

Desired:

• Bachelor's Degree: JD preferred
• 10 or more years of prior experience adjusting claims in applicable specialty area preferred.
• Insurance carrier or TPA experience with the ability to interpret construction liability policies and conduct claim and litigation management

Work Traits:

• Ability to think critically, solve problems, plan, and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
• Analytical skills necessary to make decisions and resolve issues inherent in handling of claims.

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