Job Description

Senior Claims Examiner - CGL

Job Summary

Seeking a highly skilled and experienced Senior Claims Examiner specializing in Commercial General Liability (CGL) to join a team. This role involves efficiently and effectively managing intermediate-level commercial first-party property and third-party general liability claims. The ideal candidate will possess strong analytical skills, excellent communication abilities, and a proven track record in claims handling. This is a remote position, offering the flexibility to work from the comfort of your home while contributing to a dynamic and professional team.

Compensation Package

• Salary Range: $80,000 - $90,000+ annually

Responsibilities

As a Senior Claims Examiner, your primary responsibilities will include:

• Reviewing and setting up new loss assignments promptly in compliance with departmental guidelines and best practices.
• Establishing and regularly evaluating loss and expense reserves for adequacy and accuracy.
• Analyzing and interpreting policy language to make appropriate coverage decisions.
• Drafting complex coverage correspondence, including reservation of rights and coverage disclaimers, in compliance with state statutes and regulations.
• Managing claim files from inception to closure, including investigation, evaluation, and resolution of coverage, liability, and damage issues.
• Documenting all claim file activity, including strategies, plans of action, and exit plans.
• Demonstrating intermediate-level skills in coverage analysis, investigation, evaluation, and negotiation.
• Directing and controlling activities and costs of external vendors, such as independent adjusters and legal counsel.
• Preparing and presenting detailed reports, including Large Loss Reports, as required.
• Obtaining and maintaining all required state adjuster licenses and fulfilling continuing education requirements.
• Serving as a technical resource within the department by mentoring and sharing knowledge with peers and junior staff.
• Participating in internal and external training sessions and seminars to enhance skills and knowledge.

Qualifications/Requirements

To be considered for this role, candidates must meet the following qualifications:

• Experience: 3-5+ years of CGL claims handling experience with a carrier background.
• Stability: A consistent work history without frequent job changes.
• Skills:
  • Strong verbal and written communication skills.
  • Proficiency in coverage analysis, investigation, evaluation, and negotiation.
  • Ability to manage multiple claims and prioritize tasks effectively.
• Licensing: Must hold or be able to obtain all required state adjuster licenses and comply with continuing education requirements.
• Technical Expertise: Familiarity with policy language interpretation and drafting complex coverage correspondence.
• Professionalism: Demonstrated ability to work independently in a remote environment while maintaining a high level of professionalism and accountability.

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