Senior Claims Examiner - Claims Specialist
Company: James River Management Company
Location: Richmond
Posted on: October 22, 2024
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Job Description:
Senior Claims Examiner - Claims Specialist
Richmond, VA, USA * Virtual
Req #127
Wednesday, August 7, 2024
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
The Claims Examiner l will manage a caseload of low to moderate
severity/complexity property and casualty insurance claims under a
moderate level of supervision, depending on level of experience.
Job functions include the following: Analyzing insurance claims to
determine applicable coverage; Analyzing claims to determine the
extent of insured's or insurer's liability; Reviewing and
evaluating damages and determining strategies for resolution.
Settling claims in accordance with policy provisions and within an
authority level. The Claims Examiner l will engage in verbal and
written communication with claimants, attorneys, and policyholders.
The Claims Examiner l will ensure that all state claims handling
requirements are met and internal guidelines are followed. The
Claims examiner l will handle claims in accordance with established
James River Claims Best Practices.
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
Prepare correspondence to all required parties involved in claim
when necessary
May investigate allegations and determine facts based on evidence
and recorded interviews
May be required to complete actions to satisfy department of
insurance and/or state regulations
Draft disclaimers and reservation of rights letters when coverage
issues arise
Assign limited investigations and appraisals to licensed insurance
professionals
Negotiate settlements, mitigate losses, and control expenses
Maintain a high level of communication internally with claims
management team and externally with insureds, claimants, and
attorneys
May be called upon to assist in training existing and new Claims
Examiners
Knowledge, Skills and Abilities
Excellent written and verbal communication skills
Strong analytical skills
Strong negotiation skills
Ability to work independently with moderate level of
supervision
Excellent organizational skills
Proficiency in MS Office (Word, Excel, Outlook)
Ability to work in a team environment and take direction from
Claims Manager
Ability to train and provide technical guidance to less experienced
Claims Examiners
Functional knowledge and skills reflective of a fully competent
Claims Examiner
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
Adjuster license and/or certifications preferred
Senior Claims Examiner
High school diploma required
College degree preferred
Minimum of five years P&C claims handling experience
Experience and proven track record in managing complex coverage
issues and complex litigation
Multi-jurisdictional claims experience
Adjuster license and/or certifications preferred
Claims Specialist
High school diploma required
College degree preferred
Advanced degree or law degree preferred
Minimum of seven years claims handling experience
Extensive expertise in specific specialty area of claims (i.e. PL,
M&C, GL)
Experience working with complex coverage issues
Multi-jurisdictional claims and litigation experience
Adjuster license and/or certifications desired preferred
#LI-KS1
#LI-Remote
Other details
Job Family
Claims
Job Sub Family
Operations
Pay Type
Salary
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Keywords: James River Management Company, Suffolk , Senior Claims Examiner - Claims Specialist, Other , Richmond, Virginia
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