Senior Claims Examiner

Posted 3 Days Ago
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Hiring Remotely in US
Remote
Senior level
Insurance
The Role
The Senior Claims Examiner manages complex insurance claims, analyzes policies, negotiates settlement values, and provides superior customer service. They engage with various stakeholders, monitor claims inventory, mentor junior examiners, and ensure compliance with insurance regulations.
Summary Generated by Built In

Why MSI? We thrive on solving challenges. As a leading MGA, MSI combines deep underwriting expertise with insurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers’ unique needs. We have a passion for crafting solutions for the important risks facing individuals and businesses. We offer an expanding suite of products – from fully-digital embedded renters coverage to high-value homeowners insurance to sophisticated commercial coverages, such as cyber liability and habitational property – delivered through agents, brokers, wholesalers and other brand partners.

Our partners and customers count on us to deliver exceptional service through a dedicated team that makes rapid resolutions a priority. We simplify the insurance experience through our advanced technology platform that supports every phase of the policy lifecycle. Bring on your challenges and let us show you how we build insurance better.

The Sr Claims Examiner is considered an expert in managing insurance claims for our policyholders, handling claims with high severity and complexity.  The Sr Claims Examiner must have technical knowledge in insurance claims handling and the skills needed to provide superior service for our customers.  The ability to develop relationships and effectively communicate with a diverse range of clients, carriers and colleagues is a key success factor in this role. Strategic vision coupled with tactical execution to achieve results in accordance with goals and objectives is also critical to the overall success of this position. The Sr Claims Examiner must be able to work with little to minimal supervision.

PRIMARY RESPONSIBILITIES:

  • Analyzes insurance policies and other documents to determine insurance coverage.
  • Investigates and analyzes claim information to determine extent of liability.
  • Handles claims 1st Party Property Claims with complex to major severity.
  • Assist in suits, mediations and arbitrations. Works with Counsel in the defense of litigation.
  • Sets timely, adequate reserves in compliance with the company’s reserving philosophy.
  • Engages experts to assist in the evaluation of the claim.
  • Monitors vendor performance and controls expense costs.
  • Evaluates, negotiates and determines settlement values.
  • Communicates with all interested parties throughout the life of the claim.
  • Proactively discusses coverage decisions, the need for additional information, and settlement amounts with interested parties.
  • Handles all claims in accordance with Best Practices.
  • Responsible for monitoring and completing assigned claims inventory.
  • Acquire and maintain a state adjuster’s license and meet state continuing education requirements.
  • Provides Best-In-Class customer service for insureds and agents.
  • Develops and maintains relationships with external and internal stakeholders.
  • Acts as a mentor for less experienced Claims Examiners.
  • Updates and maintains the claim file.
  • Identifies opportunities for subrogation and ensures recovery interests are protected.
  • Identifies fraud indicators and refers files to SIU for further investigation.
  • Participates in claims audits, internal and external.
  • Provides oversight of TPAs
  • Assists with special projects

KNOWLEDGE, SKILLS & ABILITIES:

  • 10+ year's experience in claims
  • Must have Property & Casualty Insurance License

#LI-JW1

#LI-REMOTE

Click here for some insight into our culture!

The Baldwin Group will not accept unsolicited resumes from any source other than directly from a candidate who applies on our career site. Any unsolicited resumes sent to The Baldwin Group, including unsolicited resumes sent via any source from an Agency, will not be considered and are not subject to any fees for any placement resulting from the receipt of an unsolicited resume.

Top Skills

Insurance
The Company
HQ: Tampa, Florida
3,080 Employees
On-site Workplace

What We Do

BRP is now The Baldwin Group! We’ve updated our name to reflect our unified group of talented teams across the country.

The Baldwin Group is a cohesive group of experts in business insurance, employee benefits, retirement planning, and all areas of private and personal insurance. Since our founding in 2011, we’ve evolved from a local business into a national firm with a vast network of specializations and industry practices for the benefit of our more than two million clients across the country.

In addition, we have built excellent relationships with a wide range of insurance company partners. These relationships, coupled with our entrepreneurial and family-oriented culture, and deep expertise enable us to seamlessly deliver a breadth of innovative solutions to clients.

At The Baldwin Group, we help provide the solutions our clients need to have confidence and gain peace of mind as they pursue what’s possible for themselves, their families, and their businesses. Whether they are renting their first apartment or buying a larger home, opening a small business or taking their company public, we offer solutions to support them on every step of their journey. This has been our story since the beginning—we provide the indispensable expertise and quality insights that give our clients peace of mind to pursue their purpose, passion, and dreams. And that’s what The Baldwin Group will continue to do for years to come: we Protect the Possible℠.

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