Claims Examiner II

ATHENS POSITION DETAILS

Position Title:

Claims Examiner II

Department:

Property & Casualty

Reports To:

Claims Supervisor P&C

FLSA Status:

Non-Exempt in California

Job Grade:

11

Career Ladder

Next step in progression could include Senior Claims Examiner

ATHENS ADMINISTRATORS

Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a "Best Place to Work." Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today

POSITION SUMMARY

Athens Administrators has an immediate need for a full-time Claims Examiner II to support public entity and special district accounts for our Property & Casualty department. This Examiner must reside in California in order to attend file reviews and meetings. Employees who live less than 26 miles from the Concord, or Orange offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in California. Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week.

As an Inside Property and Casualty Claims Examiner II, this candidate will be responsible for the review, analysis, and process of moderate to severe commercial general liability and commercial auto claims. These claims are typically moderate exposure and are associated with schools governed under Joint Power Authority regulation. Claims will entail multi-line claims with minor litigation and potential coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests.

PRIMARY RESPONSIBILITIES

Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:

Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills.

• Investigate, evaluate, and determine settlement value or denial of liability for moderate to severe level commercial general liability and commercial auto claims
• Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level
• Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management
• Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure.
• Ensure appropriateness of all payments
• Coordinate and work with a vendor service such as appraiser, independent adjusting firms, contractors, social media and private investigation and various other field service vendors
• Facilitate between claimants, clients, brokers, and attorneys when necessary in resolution of liability claims
• Exchange information with clients, claimants, insurance brokers, inspectors, producers, and account managers
• Attend meetings and educational seminars for professional development
• Maintain required licenses

ESSENTIAL POSITION REQUIREMENTS

The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.

• High School Diploma or equivalent (GED) required for all positions
• AA/AS or BA/BS preferred but not required
• Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX or FL preferred
• CA License required (CQ to add to all job descriptions)
• Additional State Adjuster License(s), may be required within 180 days
• Maintain licenses and continuing education requirements in all states.
• Minimum of 5 years of commercial general liability and commercial auto handling experience
• Experience with relevant CA insurance laws, codes, and procedures
• Familiarity and understanding of the handling standards and requirements of public entities and special districts, including but not limited to due process and procedure, such as Individual education Plans (IEP), abuse, molestation, assault, premise, educators/administrators, Director and Offices and school or public officials preferred
• Proficiency in investigation and resolution of low to mid-level public entity and special district claims preferred
• Knowledge of property and casualty insurance policies
• Knowledge of tort law, civil procedure, and contract law
• Knowledge of insurance laws, codes, procedures, and liability concepts
• Negotiation skills
• Relies on extensive experience and judgment to plan and accomplish goals in a fast-paced environment
• Well-developed verbal and written communication skills with strong attention to detail
• Excellent organizational skills and ability to multi-task
• Ability to type quickly, accurately and for prolonged periods
• Proficient in Microsoft Office Suite
• Ability to learn additional computer programs
• Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
• Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
• Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
• Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner
• Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor.
• Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
• Must be able to reliably commute to meetings and events as required by this position

APPLY WITH US

We look forward to learning about YOU If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link:

This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.

Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.

THANK YOU

We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at as well as our LinkedIn, Glassdoor, and Facebook pages

Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more Further information about our comprehensive benefits package may be found on our website