Job Description
Job DescriptionWe are looking for a detail-oriented Claims Examiner to join our team in Greenville, New York. In this role, you will be responsible for thoroughly investigating and resolving Property and Casualty claims while ensuring compliance with applicable regulations and company policies. This position demands strong analytical skills, effective communication, and the ability to handle complex situations with fairness and integrity.
Responsibilities:
• Conduct detailed investigations and assessments of Property and Casualty claims, including analyzing coverage and policy terms.
• Oversee the claims process from initial notification through resolution, ensuring timely and accurate handling.
• Engage empathetically and effectively with policyholders, agents, attorneys, and vendors to address inquiries and concerns.
• Resolve disputes and conflicts with attention to detail while adhering to policy guidelines and regulations.
• Negotiate settlements within your authority, even in challenging or high-pressure scenarios.
• Review supporting documentation such as estimates, reports, and medical records to evaluate the validity of claims.
• Monitor compliance with New York State insurance regulations and company standards throughout the claims process.
• Maintain organized and accurate claim files, ensuring documentation is timely and thorough.
• Identify opportunities for fraud detection or subrogation and take appropriate action.
• Proven experience in handling Property and Casualty claims, demonstrating expertise in claims processing.
• Solid knowledge of New York State insurance regulations and compliance requirements.
NYS Adjuster License preferred or the ability to obtain
• Strong analytical and problem-solving skills to evaluate claims and make sound decisions.
• Excellent communication skills, both written and verbal, to interact effectively with stakeholders.
• Ability to negotiate settlements and resolve disputes while maintaining professionalism.
• Familiarity with reviewing and interpreting estimates, reports, and medical documentation.
• High level of organizational skills to manage multiple claims and ensure accurate record-keeping.
• Proficiency in identifying potential fraud or subrogation opportunities and taking action accordingly.