Senior Claims Examiner – Claims Specialist – Commercial Bodily injury and Professional Liability Position Available In Wake, North Carolina

Senior Claims Examiner – Claims Specialist – Commercial Bodily injury and Professional Liability
Raleigh, NC, USA • Richmond, VA, USA • Virtual Req #221 Monday, April 28, 2025 Come grow with James River Insurance! James River Insurance is an excess and surplus lines segment of James River Group Holdings, Ltd. and operates on an approved non-admitted basis in 50 states and Washington, DC. Since 2003, James River has provided thousands of commercial property and casualty customers with innovative and creative solutions for particular insurance needs. At James River Insurance, we are committed to providing a stable and rewarding work environment supported by our

Core Values and Guiding Principles:

Integrity, Accountability, Innovation, Customer Service, Communication, and Teamwork. We are proud of our recent national recognition as a 2023, 2022, and 2021 Top Workplaces USA awards. James River Group Holdings, Ltd. is a Bermuda-based insurance holding company which owns and operates a group of specialty insurance and reinsurance companies. The Company operates in two specialty property and casualty insurance segments: Excess and Surplus Lines and Specialty Admitted Insurance. The Company tends to focus on accounts associated with small or medium-sized businesses in each of its segments. Each of the Company’s regulated insurance subsidiaries are rated “A-” (Excellent) by A.M. Best Company. Job Summary Under moderate supervision, the Claims Examiner manages a caseload of low to moderate complexity P&C insurance claims by reviewing claims to analyze and determine applicable coverage, facts, liability, damages, plan & strategy for resolution in accordance with state and company guidelines. Duties and Responsibilities Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service
Perform coverage, liability, and damage analysis on all claims assignments
May investigate allegations and determine facts based on evidence and recorded interviews
Draft disclaimers and reservation of rights letters when coverage issues arise
Assign limited investigations and appraisals to licensed insurance professionals
Manage a caseload of low to moderate complexity claims with delegated authority
Negotiate settlements, mitigate losses, and control expenses
Assist in the management of litigated files
Participate in and attend mediations to facilitate settlements
Maintain accurate documentation in claim files
Prepare correspondence to all required parties involved in a claim when necessary
Provide exceptional customer service to insureds, claimants, and attorneys, addressing inquiries, concerns, and providing regular updates on claim status
May assist in training existing and new Claims Associates
Ensure compliance with state regulations, industry standards, and best practices in claims handling, maintaining a high level of professionalism and integrity
Handle claims in accordance with established James River Claims Best Practices
Other duties as required by management Knowledge, Skills and Abilities Beginner level of expertise in claim handling and suit management
Moderate knowledge of P&C insurance industry
Ability to effectively assess risk
Proficiency in MS Office (Word, Excel, Outlook)
Excellent written and verbal communication skills
Excellent organizational skills
Ability to take direction from management
Ability to work independently and take initiative
Ability to exercise sound judgement in making critical decisions
Research, analysis and problem-solving skills
Strong negotiation skills
Ability to build effective relationships with business partners
Ability to perform effectively as part of a team
Ability to organize complex information and pay close attention to detail
Ability to anticipate customer needs and take initiative to meet those needs
Ability to train and provide technical guidance to less experienced Claims professionals
Ability to successfully obtain the required state adjusters’ licenses within six (6) months following the completion of Company-provided licensure training courses and maintain appropriate licensure thereafter Experience and Education Claims Examiner High school diploma required
Bachelor’s Degree preferred
Minimum of one year of P&C claims handling experience including handling liability and coverage issues, multi-jurisdictional claims, and negotiating settlements with claimants and attorneys required
Adjuster license and/or certifications preferred Senior Claims Examiner High school diploma required
Bachelor’s Degree preferred
Minimum of three years of P&C claims handling experience including working with complex coverage issues, handling liability and coverage issues, multi-jurisdictional claims, and negotiating settlements with claimants and attorney required
Adjuster license and/or certifications preferred Claims Specialist High school diploma required
Bachelor’s Degree preferred
Advanced Degree or Juris Doctorate Degree preferred
Minimum of seven years of P&C claims handling experience including working with complex coverage issues, handling liability and coverage issues, multi-jurisdictional claims, and negotiating settlements with claimants and attorneys required
Adjuster license and/or certifications desired preferred Other details
Job Family Claims Job Sub Family Operations Pay Type Salary