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Complex Claims Analyst
Career Insights for Claims Examiner (General)
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Based on New Hampshire data
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What they do
A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.
$83,778 / year median in New Hampshire
-1% projected decline
Job Description
Complex Claims Analyst Riverstone Resources - 3.5 Manchester, NH Job Details Full-time 2 hours ago Qualifications Liability assessment in motor vehicle insurance Contract management Risk transfer Commercial insurance knowledge Budget control Claims payment authorization Expense management Managing legal teams Filing Client file management Process improvement Mid-level Records management Bachelor's degree Insurance claims litigation Contracts Insurance policy review Settlement negotiation Damages evaluation Property damage claims Insurance claims status tracking General & commercial litigation Claims documentation management Insurance claims reserve management Task assignment 2 years Managing litigation projects Construction claims management Litigation response management Full Job Description Summary Reporting to the Unit Manager, this role will be responsible for direct handling of multi-line commercial claims including Auto, General Liability and Construction Defect claims. Duties include investigation and evaluation of coverage, liability and damages issues. The role will be responsible for claim evaluation, establishment/recommendation of adequate reserves, litigation management, case resolution and transaction processing in alignment with the Company's and Client's Strategic Vision. Essential Functions Directly handles and/orassistsin monitoring, reviewing, and coordinating the activities involving multi-line commercial insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims. Reviews loss notices; confirms and interprets policy coverages;establishesadequate reserves; and investigates and handles claims involving primary,umbrellaand excess policies. Ensures proper file setup, reserving, generalhandlingand application of companyprocedure. Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures. Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language. Assigns and manages work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations. Participates in developing claims handlingstrategy, including defense coordination, litigation strategy and budgets, and expense control. Records specificclaimsinformation and reports asappropriate toa managerrelativeto pertinent financial and general statistical records. Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company's exposure and reports to our Reinsurance Department toassistin providing notice to reinsurers and the Reinsurance Department's recovery of specific amounts when payment exceeds the company's retention. Handles largevolumeof diverse and dynamic claims effectively. Empowered to make decisions within job description and authority. Seeks guidance whereappropriate. Develops creative ideas and solutions to real time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible. Seeks continuous development byidentifyingareas for growth improvement and works with team to implement process and technical improvements Experience Minimum of 2+ years' experience in claims or related field. Required Education Four-year college degree or equivalent work experience. Preferred Education or Certification Click here to enter text. Supervisory Role None Travel As required, based upon business needs. Work Environment / Physical Demands This position operates in a professional, collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions. The position uses standard equipment such as phones, computers, copiers/printers and filing cabinets. Noise level is moderate. Other Duties (Disclaimer Statement): RiverStone retains the right to change or assign other duties to this position as needed, or other duties or responsibilities may change or be assigned as needed. Diversity, Equity, Inclusion & Belonging RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law. Privacy Notice for California Residents https://www.trg.com/california-consumer-privacy-notice/