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The Baldwin Group · 1 month ago

Sr Claims Examiner, Liability - MSI

United States

Full-time

Remote

Senior Level, Lead/Staff

10+ years exp

The Baldwin Group is a leading MGA that specializes in providing insurance solutions. They are seeking a Sr Claims Examiner to manage complex insurance claims involving bodily injury and property damage, ensuring superior service and effective communication with all parties involved.

CreditEmployee BenefitsFinancial ServicesInsuranceRisk Management

Work & Life Balance

Responsibilities

Directly handles third-party claims involving complex and severe bodily injury or property damage from initial assignment through to resolution of claim, including negotiating settlements

Evaluates and analyzes insurance policies in order to make coverage determinations

Drafts Reservation of Rights letters and coverage disclaimers as warranted

Makes prompt contact with policy holders, claimants and other appropriate parties to gather information, take recorded statements, and conduct thorough investigations

Investigates claims to determine validity and the potential for liability against insureds

Evaluates damages (both bodily injuries and property damages) to determine potential exposures and sets appropriate reserves

Works a claim load efficiently and independently with little to no supervision

Sets timely file reserves in compliance with company’s reserving philosophy and continues to evaluate pending reserves throughout the life of the claim

Manage defense counsel which includes assisting in claim strategy, evaluating potential exposure, reviewing invoices, and attending mediations and settlement conferences as necessary

Engages experts, as needed, to assist in the evaluation of the claim and monitors experts and vendors’ performance while controlling expense costs

Drafts reports for large losses and reports to Leadership as required

Evaluates, negotiates and determines settlement values in settlement of claims

Communicates with all interested parties throughout the life of the claim including proactively discussing coverage decisions, the need for additional information, and settlement amounts with interested parties

Establishes and maintains an organized diary system to ensure all claims are appropriately handled in a timely manner

Adheres to all state/local regulations including the NJ/PA Unfair Claims Practices and Guidelines

Handles all claims in accordance with Best Practices and provides Best-In-Class customer service to insureds, agents, claimants, and business partners

Responsible for monitoring and completing assigned claims inventory

Acquires and maintains multiple state adjuster’s licenses and maintains continuing education requirements

Develops and maintains relationships with external and internal stakeholders

Identifies questionable risks, red flags and fraud indicators and alerts the Special Investigation Unit when applicable

Identifies opportunities for subrogation and ensures recovery interests are protected

Acts as a mentor for less experienced Claims Examiners

Updates and maintains well drafted claim file notes with proper documentation throughout the life of the file

Assists with special projects when required

Qualification

Casualty claims adjustingState Adjuster LicenseInsurance designationsAnalytical skillsNegotiation skillsCustomer serviceMicrosoft OfficeOrganizational skillsTime managementWriting skills

Required

Bachelor's degree or equivalent work experience

10+ years of casualty claims adjusting experience

Must have a State Adjuster License(s) (California, Florida licenses are desirable) with a willingness to expand licenses as needed

Ability to communicate clearly, professionally, and provide superior customer service over the phone and through written correspondence

Strong organizational and time management skills

Strong writing skills

Excellent analytical, investigative, and negotiation skills

Proficient with Microsoft Office, Teams, Word, Excel and various other computer skills with the ability to learn and utilize new computer systems and other technologies

Preferred

First-Party Property experience is a plus

Insurance designations preferred

Company

The Baldwin Group

The Baldwin Group is an advisory firm that delivers insurance, risk mitigation, and wealth management solutions for businesses. It is a sub-organization of The Baldwin Group.

Founded in 2011

Tampa, Florida, USA

1001-5000 employees