Senior Claims Examiner (Commercial GL) - Remote or Hybrid

Senior Claims Examiner (Commercial GL) – Remote or Hybrid

Location: Lake Mary, FL

Job : 1585

# of Openings: 2

FLSA Status: Exempt in all states but California

Job Grade: 13

Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, , IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV).

Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday‑Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week.

The Senior Claims Examiner is responsible for the review, analysis and processing of complex general liability claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure and often entail litigation and coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests.

• Investigate, evaluate, and determine settlement value or denial of liability for severe to major‑level general liability claims
• Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and review on a regular basis to ensure adequacy. Make recommendations to set reserves at an appropriate level for claims outside of authority level
• Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management
• Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment
• Document and manage claims (i.e.: record statements, updated diaries, write reports) from inception through closure
• Ensure appropriateness of all payments
• Capability to adjust general liability property damage claims
• Exchange information with clients, claimants, insurance brokers, inspectors producers and account managers
• Assist in training of new employees
• Provide training and daily guidance to other examiners
• Some oversight of less experienced examiners and claims assistants
• May fill in for supervisor if necessary
• Attend meetings and educational seminars for professional development and to maintain required licenses
• Coordinate and work with vendor services such as contractors, emergency repair, cleaning services and various replacement services
• Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims
• Participate and/or conduct department meetings
• Present company abilities in new client meetings
• Conduct quarterly file reviews with the client

• High School Diploma or equivalent (GED) required for all positions
  • AA/AS or BA/BS preferred but not required
• 8-10 years of complex/major claims experience including proficiency in investigation and resolution of severe to major casualty and general liability claims
• High exposure general liability experience required
• Must possess a license from your domiciled state and a minimum of one license in NY, TX or FL
  • Additional State Adjuster License(s) may be required within 180 days
  • Maintain licenses and continuing education requirements in all states
• Experience with property and casualty insurance policies, insurance tort laws, codes and procedures
• Understanding of medical, legal terminology and liability concepts
• Proficiency in investigation and resolution of severe to major‑level casualty claims
• Time Management and project management skills
• Well‑developed verbal and written communication skills with strong attention to detail
• Exc…