Insurance Claims Specialist

2 weeks ago


West Palm Beach, Florida, United States Pathfinders Executive Search Full time

Insurance Claims Specialist

POSITION SUMMARY: Under minimal supervision, oversees all facets of automobile, general liability, and first-party property claims, managing them from initiation to resolution within established authority and guidelines.

  • Effectively handles a caseload of 150 to 180 auto and general liability files along with first-party property claims, including highly complex cases.
  • Initiates and performs investigations promptly.
  • May respond to on-site investigations, depending on the severity of the incident.
  • Determines liability and evaluates claims based on state law and in accordance with established company policies.
  • Refers cases to external defense counsel and manages them as necessary.
  • Communicates with claimants, service providers, and vendors regarding claims-related issues.
  • Calculates and sets reserves in line with company guidelines, with limits exceeding those for Claims Examiner I and II.
  • Finalizes and settles all claims, obtaining necessary authority as designated.
  • Maintains a diary system for case reviews and documents the status and work performed on each file.
  • Prepares and presents files for claim evaluations.

Conducts independent file reviews.

QUALIFICATIONS:

  • Bachelor's degree or equivalent experience; or a combination of education and experience. A minimum of four (4) years of experience in handling government claims matters, including Florida sovereign immunity and Statute 768.
  • Must possess an active Florida Adjuster's license.


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