Claims Examiner - Liability - Remote​/Telecommute

Job Description

Pay Range: $17.42hr - $21.42hr

• The Claims Examiner – Liability is responsible for analyzing, investigating, and resolving complex general liability claims.
• This role manages claims through timely resolution, ensures compliance with applicable laws and regulations, and maintains strong communication with claimants, clients, vendors, and internal stakeholders.

• Analyze and process complex or technically difficult general liability claims by investigating and gathering information to determine claim exposure.
• Manage claims through well-developed action plans to achieve appropriate and timely resolution.
• Assess liability and negotiate settlements within designated authority levels.
• Calculate, assign, and manage claim reserves throughout the life of the claim.
• Calculate and pay benefits due; approve and issue timely claim payments and adjustments.
• Prepare required state filings within statutory limits.
• Manage the litigation process to ensure timely and cost-effective resolution.
• Coordinate vendor referrals for investigations and litigation management.
• Apply cost containment techniques, including strategic vendor partnerships, to reduce claim costs.
• Manage claim recoveries including subrogation, excess recoveries, and Social Security and Medicare offsets.
• Report claims to excess carriers and respond to requests in a professional and timely manner.
• Communicate claim activity with claimants and clients while maintaining professional relationships.
• Ensure claim files are properly documented and claims coding is accurate.
• Refer cases to supervisors or management when appropriate.
• Support organizational quality programs and perform other duties as assigned.

• Minimum of five years of claims management experience or an equivalent combination of education and experience.
• Strong knowledge of insurance principles and applicable laws for general liability claims.
• Excellent negotiation skills with the ability to resolve claims within authority levels.
• Strong analytical, interpretive, and problem‑solving skills.
• Ability to manage multiple priorities and meet service expectations.

• Experience managing complex liability claims, including litigation and vendor coordination.
• Experience handling reserves, settlements, recoveries, and compliance-related filings.

• Subject matter expertise in insurance principles, recoveries, offsets, and cost containment practices.
• Excellent oral and written communication, including presentation skills.
• Proficiency in Microsoft Office applications.
• Strong organizational and interpersonal skills.
• Ability to work effectively in a team environment.

• Bachelor’s degree from an accredited college or university preferred.
• Professional certification related to the line of business preferred.