Claim Examiner

18 hours ago

Webster, MA, United States Massachusetts Staffing Full time
Claim Examiner

As a Claim Examiner, you will provide technical leadership and oversight across all Claims Offices enterprise-wide. You will provide strategic oversight and direction to high-exposure, complex casesincluding high-value claims, bad faith allegations, discrimination matters, appeals, and class action lawsuitswhile granting settlement, reserve, and expense authority on cases exceeding regional office limits. You will play a critical role in litigation monitoring, analyzing changes in law and regulation, and ensuring consistent, high-quality claim handling. This position also involves developing review processes, identifying improvement opportunities, and collaborating with cross-functional teams to influence underwriting decisions and product strategies.

Key Responsibilities

Customer Service

  • Provide guidance on technical and legal issues, coaching and mentoring regional offices to meet claim handling expectations.
  • Assist in resolving customer service concerns when needed.
  • Foster teamwork aligned with MAPFRE's Vision, Mission, and Values.
  • Build strong relationships with agents, defense counsel, and vendors.
  • Recommend workflow improvements and assist in developing technical training materials.

Quality & Productivity

  • Maintain diary systems for monitored losses and conduct file reviews for compliance with quality standards.
  • Support severity, frequency, and profitability analysis; track incurred losses.
  • Monitor and manage high-risk suits, including bad faith and significant exposure cases.
  • Develop procedures to ensure quality outcomes and establish departmental goals.

Technical Knowledge

  • Grant settlement authority within assigned limits for claims exceeding regional discretion.
  • Report and update claims to reinsurers per treaty requirements.
  • Provide quarterly updates on monitored losses and oversee structured settlement programs.
  • Analyze court decisions and regulatory changes for impact on claims and underwriting.
  • Advise technical units on coverage issues.

Leadership

  • Lead claim roundtables and committees participate in company-sponsored initiatives.
  • Serve on committees such as Claims Discussion Meetings, Large Loss Committees, and Underwriting Product/State Strategy Committees.
  • Act as a role model for collaboration and technical excellence.

Miscellaneous

  • Flexible schedule to support multiple time zones.
  • Travel for training, reviews, and special projects.
  • Handle special assignments from senior claim management.
  • Adhere to company policies and departmental standards.
What We're Looking For

Bachelor's degree or equivalent professional experience. Minimum 10+ years of multi-line property and casualty claims and litigation experience, including commercial and personal auto liability, general liability, property (1st and 3rd party), homeowner's liability, no-fault, SIU, and subrogation. At least 6 years of litigation experience required. Strong multi-state claim investigation, negotiation, settlement, and litigation expertise. Excellent oral and written communication skills. Ability to build rapport across all organizational levels and with external partners. Adjuster licenses may be required based on state regulations. Experience with large loss first-party property coverages preferred.

Travel

Moderate, including out-of-state visits for training, reviews, mediations, arbitrations, and trials

Why Join Us?

Opportunity to influence enterprise-wide claims strategy and standards. Work on high-impact cases and collaborate with senior leadership. Hybrid work schedule. Be part of a company committed to excellence, innovation, and customer satisfaction. Pay Philosophy: The typical starting salary range for this role is determined by several factors including skills, experience, education, certifications, and location. Some roles at MAPFRE are eligible for commission and/or bonus earnings, in addition to salary, calculated based upon factors set forth in the compensation plan for the role. Salary Range $100,900 - $132,200

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