Claims Examiner-Professional Claims Position Available In Charleston, South Carolina
Tallo's Job Summary: As a Claims Examiner-Professional Claims, you will evaluate coverage, liability, and damages for claims, collaborating with teams and stakeholders to investigate and resolve claims effectively. Requirements include 2+ years of experience for an Associate Claims Examiner or 7+ years for a Claims Examiner, with expertise in insurance coverage and claim evaluation processes. The position offers full-time hours with remote work flexibility and benefits such as dental and health insurance.
Job Description
Claims Examiner-Professional Claims 4.3 4.3 out of 5 stars 4105 Faber Place Dr, North Charleston, SC 29405
Your Role:
You’ll play a critical role in evaluating coverage, liability, and damages for each unique claim. You’ll collaborate across teams and with external stakeholders to effectively investigate, negotiate, and resolve claims.
Key Responsibilities:
Coverage Evaluation:
Review the first notice of loss and policy details to determine coverage, and draft disclaimers and reservation of rights letters as needed.
Comprehensive Investigation:
Conduct in-depth claim investigations, including liability and damages assessments, witness interviews, scene inspections, and evidence collection.
Independent Adjuster Oversight:
Retain, direct, and manage independent adjusters throughout the investigation process.
Liability Assessment:
Analyze statutory and case law to evaluate liability exposure and ensure appropriate contribution from joint tortfeasors.
Reserve Management:
Maintain accurate reserves that reflect evolving liability and damages as claims progress.
File Administration:
Proactively manage claim files, negotiate settlements with claimants or attorneys, oversee defense counsel, and ensure effective litigation strategies.
Reporting & Documentation:
Prepare detailed reserve authority requests, reinsurance reports, serious loss reports, and coverage position letters.
Cross-Functional Collaboration:
Work closely with underwriting, compliance, and actuarial teams to ensure the integrity and effectiveness of insurance products.
What You’ll Bring:
Problem-Solving Expertise:
Strong analytical and creative problem-solving skills with a focus on liability and damage evaluation.
Effective Communication:
Excellent oral and written communication skills for engaging with internal teams and external stakeholders.
Negotiation & Decision-Making:
Assertive decision-making with strong negotiation and conflict resolution abilities.
Organizational Excellence:
Ability to efficiently manage multiple priorities with strong time management skills.
Technical Acumen:
Solid understanding of insurance coverage, negligence law, and claim evaluation processes.
Qualifications:
2+ years of relevant experience for Associate Claims Examiner 7+ years of relevant experience for Claims Examiner Experience as an examiner, adjuster, paralegal, attorney, or in a related role Specialized experience: Experience with Directors & Officers, Errors & Omissions, Cyber liability and/or other professional claims involving claims-made policies is a plus
Additional Qualifications:
Multi-jurisdictional knowledge, advanced degrees, and/or JD are a plus Passion and drive can be just as important as experience. If you’re excited about this opportunity, we’d love to hear from you! Position affords 5 days per month to work remotely.
Job Type:
Full-time Expected hours: 35 per week
Benefits:
401(k) Dental insurance Health insurance Paid time off Referral program Vision insurance
Schedule:
Monday to
Friday Work Location:
In person
