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Sr. Claims Examiner

Location: New York, USA
Salary: US$100000 - US$120000 per annum
Posted: 15 days ago
Contract Type: Permanent
Industry: Underwriting, Broking & Claims
Contact Name: Hoda Hilal
Contact Email: hoda.hilal@ojassociates.com

Sr. Claims Examiner

JOB SUMMARY: Investigates, evaluates, and negotiates claims to a successful resolution in support of Freedom Specialty lines of business which include: Errors and Omissions, Directors and Officers, EPLI, and other specialty lines/risks. Associates at this level have moderate monetary authority. File inventory includes litigated and non-litigated matters of moderate complexity and severity in terms of exposure and/or coverage. Responsible for managing the work and performance of vendors to achieve successful resolution of claims. Has contact with internal and external customers which involve maintaining, developing, and influencing relationships. Responsible for meeting the expectations and requirements of internal and external customers. Work is performed under general supervision and monitoring. Participates in determining objectives of assignment.

Job Description


REPORTING RELATIONSHIPS: Reports to Claims Director

CORE JOB DUTIES & RESPONSIBILITIES:

  1. Effectively investigates and evaluates coverage, liability and damages to set an appropriate claim strategy, settlement and file reserves.

  2. Provides timely and appropriate evaluation of claims to identify and manage reserves in compliance with Company standards.

  3. Delivers superior customer service and satisfaction through effective interactions with insured, agents, and legal counsel.

  4. May assist in the development, coaching, training and mentoring of individual team members. May act as a subject matter expert in a particular line of business or risk.
  5. Maintains current knowledge of applicable lines of insurance, court decisions which may impact the claims function; current guidelines in the claims function; and policy changes and modifications. This may require attendance at various seminars and training sessions.

  6. Contributes to a collaborative environment by consistently demonstrating teamwork, high motivation, positive behavior and effort to achieve goals and objectives.

  7. Performs other related duties as assigned.

MINIMUM JOB REQUIREMENTS:

Education: College degree required. Juris Doctorate preferred.

License/Certification/Designation: Associates must obtain the required Federal and/or state licenses/registrations within the time period designated by the business unit. Additional licenses/registrations may be required when new products and services are implemented. If an associate fails or is unable to obtain required licenses/registrations within the time period designated by the business unit, the associate will be ineligible to continue in the position.

Experience: Claims handling experience typically acquired through 3-5 years experience. Prior experience in directing defense counsel required. Specific experience in a particular line of business may be required by the hiring business unit.

Knowledge: Specific knowledge in a particular line of business and/or additional education may be required by the hiring business unit.

Skills/Competencies: Demonstrates aptitude in evaluating, analyzing and interpreting information; demonstrable expertise in particular line of business; excellent analytical skills; excellent written and verbal communication skills; the ability to multi-task; excellent time management and organizational skills; the ability to work independently; the ability to effectively and efficiently manage all responsibilities. The ability to direct attorneys in claims and litigation management.

Staffing Exceptions to the above Minimum Job Requirements must be approved by the: Vice President and Human Resources.

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