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Athens Administrators · 14 hours ago

Senior Claims Examiner P&C

California, United States

Full-time

Hybrid

Senior Level, Lead/Staff

8+ years exp

Athens Administrators is a leader in claims administration since 1976, known for fostering a supportive and inclusive culture. They are seeking a Senior Claims Examiner to review, analyze, and process complex commercial auto and trucking claims, ensuring quality service and compliance with policy and legal requirements.

ComplianceFinancial ServicesInsuranceProperty Insurance

Growth Opportunities

Responsibilities

Investigate, evaluate, and determine settlement value or denial of liability for severe to major-level commercial auto claims

Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews 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 large commercial property losses

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

Superior customer service skills

Participate and/or conduct department meetings

Present company abilities in new client meetings

Conduct quarterly file reviews with the client

Qualification

Commercial auto claims experienceBodily injury claims experienceClaims handling conceptsNegotiation skillsInsurance regulations knowledgeAnalytical skillsMicrosoft Office SuiteTime management skillsOrganizational skillsVerbal communication skillsWritten communication skillsTeam-oriented

Required

High School Diploma or equivalent (GED) required for all positions

Relies on extensive experience and judgment to plan and accomplish goals with a minimum 8-10 years of complex/major commercial auto claims experience including proficiency in investigation and resolution of severe to major casualty claims

Moderate to major Bodily Injury claims experience required

High exposure commercial trucking auto liability experience required

Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: 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

Negotiation skills

Well-developed verbal and written communication skills with strong attention to detail

Excellent organizational skills and ability to multi-task

Ability to type quickly, accurately and for prolonged periods

Proficient in Microsoft Office Suite

Ability to learn additional computer programs

Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution

Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization

Seeks to include innovative strategies and methods to provide a high level of commitment to service and results

Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner

Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor

Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company

Must be able to reliably commute to meetings and events as required by this position