Jobs

    Senior Claims Examiner - Alpharetta, United States - James River Group

    James River Group
    James River Group Alpharetta, United States

    3 weeks ago

    Default job background
    Description
    Monday, April 22, 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 Senior Claims Examiner will manage a caseload of insurance claims pending under a moderate to low level of supervision.


    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 Sr. Claims Examiner will engage in verbal and written communication with brokers, claimants and policyholders. The Sr. Claims Examiner will ensure that all state claims handling requirements are met and internal guidelines are followed. The Sr. Claims examiner 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
    Investigate allegations and determine facts based on evidence and interviews
    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
    Manage litigated files in accordance with Litigation Management Guidelines
    Provide technical guidance, assistance and training to co-workers
    Maintain a high level of communication internally with Claims Management team and externally with Insureds, claimants, attorneys and brokers.
    Frequently called upon to train new Claims Examiners
    Will be recognized as having extensive claims handling experience, including the handling of complex high exposure claims
    Knowledge, Skills and Abilities
    Excellent written and verbal communication skills
    Strong analytical skills
    Excellent organizational skills
    Proficiency in MS Office (Word, Excel, Outlook)
    Ability to take direction from Claims Manager
    Ability to work independently with limited supervision
    Ability to work on assignments that require a higher technical level of expertise due to complexity and exposure, under minimal supervision
    Ability to work successfully as an individual contributor and in a team environment
    Recognized as having a high level of expertise in claim handling and suit management
    Ability to provide technical guidance and assistance, and train less experienced Claims Examiners
    Possess demonstrated technical knowledge and skills, including product and industry, reflective of successful progress

    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
    High school diploma required
    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
    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

    #J-18808-Ljbffr
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