Position Title: 

Insurance Claims Examiner

Reports To: 

Director of Ghertner Maintenance

Position Purpose:

Investigate, evaluate, and advocate for the company and the insured in Commercial Lines Insurance claims in order to achieve best practices settlements within legal statues, policy provisions, and Company or Client guidelines.

Position Requirements: 

  1. Ability to manage multiple projects and prioritize

  2. Minimum 5 years’ experience of insurance claims

  3. Provide strong customer service

  4. Work independently as well as with a team

  5. Communicate clearly, both oral and written

  6. Ability to negotiate

  7. Strong work ethic

  8. Good PC skills, including Google Docs, Google Drive, Microsoft Office

  9. Good planning and organization

  10. Maintain acceptable attendance and adhere to scheduled work hours

  11. Ability to read coverages and have a good understanding of terminology

Key Responsibilities and Accountabilities

  1. Proactively communicate and collaborate with external and internal customers, claims adjusting firms, and legal firms to assess and meet information needs

  2. Exercises discretion and independent judgment to investigate, evaluation, and settle insurance claims.

  3. Provide clerical/administrative support to department personnel

  4. Build relationships with the insured and property manager representative

  5. Process initial information on claims over the telephone and/or in person, including first reports of loss

  6. Act as intermediary between the company, the insured, and the carrier

  7. Establish and maintain active claim files to include correspondence, estimates, payments, and claim summary

  8. Audits files

  9. Perform administrative functions, including but not limited to correspondence, reports, and other documents as needed

  10. Coordinates complex policy issues and find resolution to include managing multiple tenants and/or owners, managing multiple agents and/or adjustors, insurance policy interpretation, reactive emergency services following first visit, enforcement of company policy

  11. Establishing own hours based on the needs of clients, adjuster and agents

  12. Exercises discretion and confidentiality with owner/tenant/and board information

  13. Acting in the best interest of the company to protect the company’s interests (e.g. choosing not to accept a higher risk claim)

  14. Selecting appropriate vendors for emergency services at the time of loss

  15. Maintain claims dead files

  16. Read and interpret governing documents and coverages

  17. Contact agent for clarification or to obtain missing information

  18. Generate, review, verify, and communicate quotes 

Physical Demand & Work Environment

  1. While performing the duties of this job, the employee is frequently exposed to fumes or airborne particles, moving mechanical parts and vibration. 

  2. The employee is occasionally exposed to a variety of extreme conditions at construction job sites. The noise level in the work environment and job sites can be loud.

  3. While performing the duties of this job, the employee is regularly required to talk or hear. 

  4. The employee is frequently required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. 

  5. The employee is occasionally required to sit; climb or balance; and stoop, kneel, crouch or crawl. 

  6. The employee must frequently lift and move up to 10 pounds and occasionally lift and move up to 25 pounds. 

  7. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.