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Public Entities Claims Examiner III

73% Flex
Remote: 
Full Remote
Contract: 
Full time
Salary: 
80 - 95K yearly
Experience: 
Mid-level (2-5 years)
Work from: 
United States

Offer summary

Qualifications:

High School Diploma or GED; Bachelor’s degree preferred, 3-5 years of Public Entity claim experience; Commercial Automobile and General Liability knowledge, Strong verbal and written communication skills; advanced analytical and negotiation abilities, Computer proficiency; California Adjuster License (a plus).

Key responsabilities:

  • Review, process, and conclude claims; investigate exposure levels
  • Communicate effectively with involved parties and recommend settlement strategies
  • Maintain accurate reserves; document all claim-related activities
  • Assist in special projects as assigned by Supervisors
TRISTAR Insurance Group logo
TRISTAR Insurance Group Insurance SME https://www.tristargroup.net/
501 - 1000 Employees
About TRISTAR Insurance Group
TRISTAR began as an insurance program manager and medical malpractice claims administrator in 1987. Workers compensation claims management services were added in our offerings in 1989, and the Company was renamed TRISTAR Risk Management in 1995. As managed care and benefits administration services were added to our offerings, the organization grew into TRISTAR. We are the largest privately held third party claims administrator in United States. We empower more than 1,000+ professionals in offices throughout the United States, focusing business operations in three divisions: property casualty claims management, benefits administration, and managed care services. We are true to our values of RESPECT, INTEGRITY, TRUST, and EXCELLENCE, making the right choices both financially and ethically. At TRISTAR we strive to create an environment of respect, wherein all of us are encouraged to learn and to grow, to provide exceptional service to our clients and in turn to enjoy the satisfaction that comes from a job well done. We believe that to provide real service, we must contribute something which cannot be bought or measured with money: sincerity and integrity. At TRISTAR, you help create a world in which together we "transform risk into opportunity".
See more TRISTAR Insurance Group offers

Job description

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Your missions

Job Details
Level:    Experienced
Job Location:    Chino Hills - Chino Hills, CA
Position Type:    Full Time
Education Level:    High School Diploma or GED
Salary Range:    $80,000.00 - $95,000.00 Salary
Travel Percentage:    None
Job Shift:    Day
Job Category:    Insurance
Public Entities Claims Examiner III

POSITION SUMMARY: Responsible for the prompt review of claims to determine coverage for loss/damage/injury. Conduct an efficient claim examination and investigation leading to the final resolution of liability claims, including matters in litigation. Frequent contact and interaction with involved parties including claimants and their legal representatives will be required along with Defense Counsel. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client.

 

DUTIES AND RESPONSIBILITIES:

 

  • Review, process and conclude assigned claims including investigation and evaluation mid-level exposure to complex Public Entity Auto and/or General Liability Casualty Claims.
  • Review and interpret Memorandum of Coverage.
  • Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion.
  • Maintain an ongoing diary.
  • Continually assess exposure and evaluate for accurate reserves and settlement recommendation.
  • Prepare Loss Reports providing thorough analysis of liability and damages.
  • Where applicable, determine if subrogation and/or risk transfer exists and initiate recovery efforts at the direction of the client.
  • Document all correspondence, reports, discussions and decisions in the claim file record.
  • Provide outstanding service to the client.
  • Assist Supervisors and Claim Department with requested tasks or special projects.
  • Other duties as assigned.

 

Position can be Hybrid or Full Time remote/working from home.

Qualifications

Education/Experience: High School Diploma or GED required; Bachelor’s degree in related field (preferred) and a minimum of three to five (3 to 5) years Public Entity Auto and General Liability Casualty related experience; or equivalent combination of advanced education and experience.

 

Special Requirements:

 

  • At least 3 years of Commercial Automobile and General Liability claims experience required.
  • Knowledge of claims handling concepts, practices and techniques, including but not limited to coverage issues and product line knowledge.
  • Demonstrated verbal and written communications skills.
  • Demonstrated advanced analytical, decision-making and negotiation skills.
  • Computer proficiency.

 

Preferred Skills:

 

  • Ability to communicate effectively and clearly, both orally and in writing.
  • Ability to manage relationships in a fast-paced environment, while demonstrating problem solving and decision-making skills to work with customers.
  • Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions with a minimal amount of supervision.
  • Excellent customer service skills.
  • An understanding of the litigation process and case valuation in multiple jurisdictions.
  • Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense.
  • An ability to handle assigned claims following company guidelines and industry best practices with a minimal amount of supervision.
  • Time management skills, organizational skills and ability to prioritize issues and tasks.
  • Ability to effectively operate computer equipment and applications.
  • Independence, flexibility, and creativity.

 

 

 

Other Qualifications:

 

  • California Adjuster License considered a plus.

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

Coverage DeterminationCustomer CareClaims ManagementSoftware Proficiency

Soft Skills

  • Analytical Thinking
  • Negotiation Techniques
  • Excellent Communication
  • Problem Solving
  • Business Decision Making
  • Time Management
  • Organizational Skills
  • Independence
  • Creativity
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