Casualty Claims Examiner

Job Summary

This position is responsible for the oversight of complex and large exposure losses and will report to the National Casualty Claims Manager. The Casualty Claims Examiner will work alongside claims management, providing direction and oversight to ensure compliance with best practices and state/local guidelines. In addition, this position will report findings and make recommendations on current practices, including the claim department’s performance on meeting regulatory standards.

• Review home office casualty files, provide direction as required to ensure that handling is within best practice guidelines and local jurisdiction regulations.
• Provide guidance and direction to claims staff in order to ensure proper handling and risk mitigation.
• Provide authority and guidance on all bodily injury claims regarding coverage, liability and damages, as required.
• Provide feedback to leadership and adjusting staff as required for continually improved file handling.
• Collaborate with claims staff, front line claims management, senior claims management and legal counsel.
• Available to answer questions and participate in roundtable discussions with claims staff and management to provide feedback and guidance on claim handling procedures.
• Complete research pertaining to complex coverage issues, industry trends, and related topics.
• Assist with targeted audits of particular processes or functions (e.g., total loss handling, BI evaluations, cycle times, regulatory reviews, customer service skills) and/or management re‑audits to verify calibration and accuracy of the first‑level reviews completed.
• Assist in designing and delivering casualty training as needed to ensure compliance and proper claim handling.

Bachelor’s degree or equivalent work experience.

• Minimum of five years of claim adjusting experience.
• At least two years of adjusting/overseeing casualty claims with high complexity.
• Prior claims management experience and/or auditing preferred.

• Communication and analytical ability at a level to interact with associates, managers, agents and vendors.
• Demonstrated team building and coordination skills.
• Strong interpersonal skills and the ability to present critical information to Senior Management.
• Ability to manage multiple priorities and work independently.
• Leadership abilities necessary, with the ability to make autonomous decisions based on multiple facts.
• Ability to work in a fast‑paced automated production environment and possess solid planning and organizational skills, including time management, prioritization, and attention to detail.
• Meet company guidelines for attendance and punctuality and professional appearance/decorum.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. Employment with Assurance America is at‑will. The at‑will relationship can be terminated at any time, with or without reason or notice by either the employer or the associate.