Claims Examiner

Orion180 is a leading provider of claim management and administration services tailored specifically for insurance companies. We pride ourselves on delivering efficient and innovative solutions that cater to the unique needs of each client. Our dedicated team of experts, equipped with cutting-edge technology, ensures seamless processes, accurate assessments, and prompt resolutions, providing unparalleled value and peace of mind to our clients.Nestled in a prime location, Orion180 enjoys a strong reputation for its excellent customer service and commitment to excellence. Our team is passionate about delivering world-class results and exceeding client expectations.As a proud subsidiary of Orion180 Group Inc., we specialize in Claims Administration, Management, and Investigation.

The Claims Examiner plays a crucial role in managing homeowners' property insurance claims, from the initial contact with the insured through to claims resolution. This position is dedicated to providing exceptional customer service to insurers, insureds, and agents by empathetically handling each claim and ensuring fair and efficient processing.Key responsibilities include demonstrating a solid understanding of insurance principles, conducting thorough claims investigations, evaluating damages, and resolving property claims to create a positive customer experience. The Claims Examiner is empowered to make independent decisions within designated authority, ensuring prompt and cost-effective examination, investigation, evaluation, and payment of claims.

To excel in this role, the Claims Examiner must effectively perform the following essential duties:

• Conduct prompt and thorough investigations of claims from initial contact to resolution, including research, analysis, and synthesis of findings.
• Provide exceptional customer service to Orion180 policyholders.
• Determine coverage and identify issues related to various claims, applying a comprehensive understanding of applicable insurance policies.
• Collaborate with Claims Management to resolve coverage issues.
• Assess subrogation potential and recommend files to subrogation examiners as appropriate.
• Negotiate settlements with insureds and third parties using an objective approach.
• Compose clear and professional correspondence to insureds, claimants, attorneys, agents, and regulatory agencies.
• Document all claim file activity meticulously, including current strategies and plans of action.
• Maintain effective communication with policyholders, field adjusters, and other parties to ensure timely processing of claims.
• Review adjuster reports and estimates for technical accuracy and compliance with industry guidelines.

• Experience: Minimum of 2 years in daily field or desk adjusting.
• Estimating Skills: 2+ years of experience with Xactimate/Xactanalysis.
• Licensing: Adjuster's license or the ability to obtain the required state license.
• Insurance Knowledge: Ability to read and interpret insurance policies.
• Communication Skills: Proficient in writing reports, business correspondence, and procedure manuals.
• Customer Service: Strong focus on customer experience and proactive claim handling.
• Technical Proficiency: Proficient in MS Word, Excel, and Outlook.

• Ability to work independently in a team-oriented environment.
• Self-directed with excellent time management and organizational skills.
• Strong interpersonal skills to work effectively with all levels of staff.
• Attention to detail and a commitment to accuracy.
• High standards of integrity, trustworthiness, and ethical behavior.

The office environment is typically quiet and temperature-controlled, with occasional noise or temperature fluctuations due to maintenance or weather conditions. Employees are expected to adhere to their assigned work schedules and may need to work extended hours based on departmental needs or project requirements.

Orion180 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status, and will not be discriminated against based on disability.