Senior Claims Examiner - Cheshire, CT

Position Overview · The Senior Claims Examiner is responsible for investigation, evaluation, reserving, negotiation, and resolution of the companies' liability claims in multiple jurisdictions. The position is required to follow established claims management standards and exercis ...

Job description

Position Overview
The Senior Claims Examiner is responsible for investigation, evaluation, reserving, negotiation, and resolution of the companies' liability claims in multiple jurisdictions. The position is required to follow established claims management standards and exercise solid judgment when solving business problems as well as using critical thinking, decision-making skills, and judgment within their assigned authority levels. The Senior Claims Examiner continually explores ways to apply claim's best practices to business challenges. Individuals in this role are expected to mentor and coach team members to increase their technical expertise and business contributions.

Essential Functions

• Timely and effectively investigate and evaluate claims while managing outside adjusters and legal counsel
• Directs settlement activity using investigative and problem-solving skills in direct negotiations
• Handle all assigned cases efficiently and cost-effectively through conclusion
• Analyze and recommend appropriate reserves; periodically reviewing and adjusting these reserves based on the assessment of probable liability, financial responsibility and exposure
• Handle all assigned cases efficiently and cost-effectively through conclusion, identifying and thoroughly investigating all available risk transfer options (subrogation and third-party recoveries and re-insurance)
• Review, analyze and interpret coverage in accordance with applicable policies
• Prepare coverage evaluations, document files and draft letters for management review in a timely manner
• Concentration on larger cases with reinsurance involvement requiring ability to track aggregates, and prepare more complex reports
• Reviews invoices, estimates, legal fees, and other documents to ensure accuracy and legitimacy prior to payment
• Prepare clear and concise reports with little or no guidance that can be presented for review and require little or no edits by management
• Mentors' examiners, as well as coordinators, by providing guidance, sharing expertise, and overseeing work product
• Serve as Subject Matter Expert for certain venues and/or coverage line

Knowledge, Skills, Abilities:

• Create and manage positive working relationships with internal and external business partners
• Presents a positive and professional image of companies
• Knowledge and commitment to company mission, vision, and organizational values
• Ability to quickly assimilate and practically utilize new information
• Possess written and verbal communications skills to review, understand, interpret, and convey data including medical records, legal documents, and coverage interpretation
• Strong customer service skills including interacting with internal and external customers
• Team player; works effectively as part of a team

Job Requirements
Required

• High School Diploma
• Bachelor's degree in business management, insurance, or related field required, or equivalent work experience
• Minimum 5 years progressive liability claims handling experience for property/casualty insurance company or third-party administrator
• All lines property/casualty adjuster's license
• Experience analyzing and interpret coverage at a level commensurate with complexity of assigned claims
• Experience preparing and communicating written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers
• Understands the litigation process, current relevant case law and statutory law in multiple jurisdictions
• Experience implementing compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements
• Maintains adjusting licenses in all required states

Preferred

• AIC designation
• Knows the Public and Affordable Housing business

Work environment & Physical Demands

• Inside climate-controlled office building
• Prolonged sitting and using a PC

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Department Overview
The HAI Group [1] , Claims Department provides expertise and guidance to HAI Group members and insureds. We partner with our constituents to solve complex problems and facilitate favorable solutions. The team has deep subject matter expertise on the claims process and its financial impact to the insurance business and our insureds' business. Our goal is to achieve excellence using conceptual and critical thinking to serve the customer and add value to the partnership. We collaborate with our members and insureds to make the most appropriate business decisions that assure timely, fair and favorable resolution of claims. The team works closely with all other departments within HAI Group's insurance operation to coordinate a high level of service to our members and insureds.

Company Overview
HAI Group is the nation's leading property-casualty insurance company founded by and dedicated to affordable housing organizations. While we are recognized as a pioneer of affordable housing insurance programs, insurance is not our only strength. We protect, preserve, and promote the sustainability of affordable housing with an array of products and services that support the challenges housing organizations face. Besides insurance, we offer risk management services, online training, and consulting services used by more than 1,500 housing organizations nationwide. Headquartered in Cheshire, Connecticut, HAI Group was recognized as a Top Workplace in 2020, 2021, 2022, 2023 and 2024.

Cultural Objective
HAI Group contributes to a culture that creates a safe and healthy working environment and a space of inclusiveness and belonging for all by: exceeding our customers' expectations, working collaboratively across the organization, embracing diversity, and demonstrating mutual respect and empathy.

HAI Group Benefits And Perks

• Bonus program eligibility
• Annual merit program
• Outstanding 401(k) program and non-elective contribution
• Flexible work schedules
• Generous paid time off, paid volunteer days and paid holidays
• Medical, vision and dental Insurance
• Company paid life, AD&D, short-term disability, and long-term disability coverage
• HSA, FSA and dependent care options
• On-Site wellness: Full gym and locker rooms, wellness initiatives, outdoor basketball and tennis court, picnic pavilion area
• Tuition reimbursement and loan repayment
• Professional development
• Community outreach

HAI Group is an Equal Opportunity Employer.
HARRG Inc., reserves the right to fill this position at a level above or below the level included in this posting.

No agency submissions please. Resumes submitted to any HAI Group employee without a current, signed and valid contract in place with the HAI Group Recruiting team for this position will become the property of HAI Group and no agency fees will be paid.

[1] HAI Group is a marketing name used to refer to insurers, a producer, and related service providers affiliated through a common mission, management, and governance. Property-casualty insurance and related services are written or provided by Housing Authority Risk Retention Group, Inc.; Housing Authority Property Insurance, A Mutual Company; Housing Enterprise Insurance Company, Inc.; Housing Specialty Insurance Company, Inc.; Innovative Housing Insurance Company Inc.; Housing Investment Group, Inc.; and Housing Insurance Services, Inc. (DBA Housing Insurance Agency Services, Inc. in NY and MI).