Professional liability claims examiner iii

Job Details:

• Job Location: Dallas - Irving, TX
• Position Type: Full Time
• Education Level: High School Diploma or GED
• Salary Range: $80000.00 - $95000.00 Salary/year
• Travel Percentage: None
• Job Shift: Day
• Job Category: Admin - Clerical

POSITION SUMMARY:

Under the oversight of the Area Manager, the Claims Examiner III reports to the Claim Supervisor and/or Area Manager and is responsible for managing all aspects of Professional Liability claims from inception through resolution, within established authority and company guidelines. Responsible for the prompt review of policy information including all relevant endorsements and vehicle schedules to determine coverage for loss/damage/injury. Conduct an efficient claim examination and investigation leading to the final resolution of liability claims, including matters in litigation. Frequent contact and interaction with involved parties including claimants and their legal representatives will be required. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client.

DUTIES AND RESPONSIBILITIES:

• Review, process and conclude assigned claims including investigation and evaluation of professional liability claims.
• Review and interpret policies, coverage determination.
• Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion.
• Maintain an ongoing diary.
• Continually assess exposure and evaluate accurate reserves and settlement recommendation.
• Prepare Loss Reports providing thorough analysis of liability and damages.
• Where applicable, determine if subrogation and/or risk transfer exists and initiate recovery efforts at the direction of the client.
• Document all correspondence, reports, discussions and decisions in the claim file record.
• Provide outstanding service to the client.
• Assist Supervisors and Claim Department with requested tasks or special projects.
• Other duties as assigned.

Position is remote/working from home.

EQUIPMENT OPERATED/USED:

Computer, and other office equipment.

SPECIAL EQUIPMENT OR CLOTHING:

Appropriate office attire when on video or attending client meetings.

Qualifications:

QUALIFICATIONS REQUIRED:

• Education/Experience: Bachelor’s degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience.
• Knowledge, Skills, and Abilities: Technical knowledge of coverage, statutory regulations, and medical terminology. Analytical skills. Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff. Ability to interact with people at all levels in the business environment. Ability to independently and effectively manage very complex claims. Proficient in Word and Excel (preferred).
• Other Qualifications: Active Independent Adjuster New York State License.

Mental and Physical Requirements:

[see separate attachment for a copy of checklist of mental and physical requirements]