Liability Claims Examiner III

1 week ago

West Palm Beach, FL, United States Tristar Insurance Services LLC Full time
POSITION SUMMARY: Under minimal supervision, all aspects of indemnity claims are handled from inception to conclusion within established authority and guidelines. Responsible for the prompt review of policy information including all relevant endorsements and vehicle schedules to determine coverage for loss/damage/injury. Conduct and efficient claim examination and investigation lead to the final resolution of liability claims, including matters in litigation. Frequent contact and interaction with involved parties including claimants and their legal representatives will be required. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client.

This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore, consistently being at work in the office, promptly, is inherently required of this position.

DUTIES AND RESPONSIBILITIES:
• Review, process, and conclude assigned claims, including investigating and evaluating complex Commercial Auto and General Liability Casualty Claims.
• Review and interpret policies and coverage determination.
• Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion.
• Maintain an ongoing diary.
• Continually assess exposure and evaluate for accurate reserves and settlement recommendations.
• Prepare Loss Reports providing a thorough analysis of liability and damages.
• Where applicable, determine if subrogation and/or risk transfer exists and initiate recovery efforts at the client's direction.
• Document all correspondence, reports, discussions, and decisions in the claim file record.
• Provide outstanding service to the client.
• Assist Supervisors and Claim Department with requested tasks or special projects.
• Other duties as assigned.

EQUIPMENT OPERATED/USED: Computer, 10-key, fax machine, copier, printer, and other office equipment.

SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire

QUALIFICATIONS REQUIRED:

Education/Experience: Bachelor's degree in a related field (preferred); three (3) or more years of related experience; or equivalent combination of education and experience.

Knowledge, Skills and Abilities:

  • Technical knowledge of statutory regulations and medical terminology.
  • Analytical skills.
  • Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff.
  • Ability to interact with people at all levels in the business environment.
  • Ability to independently and effectively manage very complex claims.
  • Proficient in Word and Excel (preferred).
Other Qualifications:
  • Active Adjuster's Florida License

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