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    Senior Claims Examiner - Richmond, United States - James River Management Company

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    Description
    Senior Claims Examiner - Claims Specialist - Construction Defect

    Alpharetta, GA, USA * Chapel Hill, NC, USA * Raleigh, NC, USA * Richmond, VA, USA * Scottsdale, AZ, USA * Virtual
    Req #92

    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

    Strong negotiation 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

    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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