Job Description
Position: Sr. Auto/General Liability Claims Examiner
Type: Direct Hire
Location: Onsite in West Palm Beach, Florida (Zip Code: 33406)POSITION SUMMARY: Under minimal supervision manages all aspects of automobile, general liability, and first-party property claims, handling from inception to conclusion within established authority and guidelines.
This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other COMPANY staff in the office; therefore, consistently being at work in the office, in a timely manner, is inherently required of this position.
DUTIES AND RESPONSIBILITIES: - Effectively manages a caseload of 150 to 180 auto and general liability files and first-party property claims including very complex claims. *
- Initiates and conducts investigation in a timely manner. *
- Occasional response to on-scene investigations, depending on the severity of the loss. *
- Determines liability and evaluation of claims based upon state law and in accordance with established Company guidelines. *
- Refers cases to outside defense counsel. Directs and manages as appropriate. *
- Communicates with claimants, providers, and vendors regarding claims issues. *
- Computes and set reserves within Company guidelines. Limits are larger than those allowed for Claims Examiner I and Claims Examiner II. *
- Settles and/or finalize all claims and obtains authority as designated. *
- Maintains diary system for case review and documents file to reflect the status and work being performed on the file. *
- Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns. *
- Involves [COMPANY] loss control staff when appropriate. *
- Adheres to all Company policies and procedures. *
- Preparation and presentation of files for claim reviews.
- Conducts file reviews independently. *
- Other duties as assigned.
* Essential job function.
EQUIPMENT OPERATED/USED: Computer, 10-key, fax machine, copier, printer, and other office equipment.
SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire
QUALIFICATIONS REQUIRED: - Education/Experience : Bachelor’s degree in related field (preferred); four (4) or more years related experience; or equivalent combination of education and experience. Four (4) or more years’ experience handling government claims matter, including FL sovereign immunity, Statute 768.
Knowledge, Skills and Abilities :
- Technical knowledge of statutory regulations and medical terminology.
- Analytical skills.
- Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff.
- Ability to interact with persons at all levels in the business environment.
- Ability to independently and effectively manage very complex claims.
- Proficient in Word and Excel (preferred).
Other Qualifications :
- Active Adjuster’s Florida License
- Criminal history records check
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