Senior Commercial Property Claims Examiner
Athens Administrators, Parsippany, New Jersey, United States
Position:
Senior Commercial Property Claims Examiner
Location:
Parsippany, NJ
Remote Status:
Remote
Job Id:
1505
# of Openings:
1
ATHENS POSITION DETAILS Position Title:
Department:
Property & Casualty
Reports To:
FLSA Status:
Exempt in all state but California
Job Grade:
13
Next step in progression could include Complex 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!
Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL 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 a state Athens operates in(includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). 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.
The Senior Claims Examiner is responsible for the review, analysis and processing of complex claims, with emphasis on commercial property and residential property, business interruption, and inland marine claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure, long term claims and will often entail litigation and coverage issues. The goal of this position is to ensure the delivery of quality service claims adjusting in full compliance with special claims handling obligations.
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
Within prescribed settlement authority, establish appropriate reserves for both indemnity and expense and conduct reviews on a regular basis to ensure reserve adequacy.In matters exceeding settlement authority, should have the ability to recommend a specific reserve range, based on industry experience and the specific evidence secured in a specific claim investigation.
Fully evaluate losses, including expense budgeting and all available property limits (including sub-limits) to make recommendations and set proper reserves at appropriate levels for claims within and outside of client authority level. Demonstrate credibility with clients and other business professionals by discussing and explaining these recommendations.
Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management.
Manage all processes requiring estimating, assessment, valuation, and applicable depreciation. Include interpretation and evaluation of applicable insurance contracts in the assessment process.
Possess familiarity with scoping, estimating and use of Xactimate and other valuation programs.
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 vendor services such as independent adjusting firms, contractors, consultants, forensic accountants, engineers, emergency repair, cleaning services and various replacement services to ensure prompt, equitable and appropriate resolution of all commercial property claims.
Large loss commercial claim handling and oversight experience. Facilitate communication between claimants, clients and brokers for resolution of claims.
Exchange information with clients, claimants, insurance brokers, inspectors, producers and account managers.
Superior customer service skills. Ability to recognize matters of urgency and act promptly and efficiently to address them.
Participate in client meetings, status conferences, file reviews and fully comply with client instructions for all levels of communication and notification.
Be aware of insurance fraud and the internal and external requirements of notification/reporting of potential fraudulent matters.
Keep the client involved in decision making as required and comply with escalation process for advance notification of serious losses.
Investigate, evaluate, and determine settlement value or denial of liability for severe to major-level 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 an 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.
Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment.
Ensure appropriateness of all payments
Capability to adjust large commercial property losses
Exchange information with clients, claimants, insurance brokers, inspectors producers and account managers
Assist in training of new employees
Provide training and daily guidance to other examiners
Some oversight of less experienced examiners and claims assistants
May fill-in for supervisor if necessary
Attend meetings and educational seminars for professional development and to maintain required licenses
Coordinate and work with a vendor services such as contractors, emergency repair, cleaning services and various replacement services.
Participate and/or conduct department meetings
Present company abilities in new client meetings
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
Relies on extensive experience and judgment to plan and accomplish goals with a minimum 8-10 years of complex/major property claims experience including proficiency in investigation and resolution of severe to major casualty claims
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
Additional State Adjuster License(s) may be required within 180 days
Maintain licenses and continuing education requirements in all states.
Experience with property and casualty insurance policies, insurance tort laws, codes and procedures
Knowledge of contractual/policy law and commercial property insurance policies. Experience in reviewing Condo By-Laws and Condo Rules and Regulations
Proficiency in investigation and resolution of moderate to major level property claims. Understands principals of co-insurance and replacement cost evaluations
Understanding of medical, legal terminology and liability concepts
Time Management and project management skills
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 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 http://www.athensadmin.com/careers/job-openings 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: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf .
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 www.athensadmin.com 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 at
https://www.athensadmin.com/careers/why-work-here
#J-18808-Ljbffr
Senior Commercial Property Claims Examiner
Location:
Parsippany, NJ
Remote Status:
Remote
Job Id:
1505
# of Openings:
1
ATHENS POSITION DETAILS Position Title:
Department:
Property & Casualty
Reports To:
FLSA Status:
Exempt in all state but California
Job Grade:
13
Next step in progression could include Complex 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!
Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL 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 a state Athens operates in(includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). 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.
The Senior Claims Examiner is responsible for the review, analysis and processing of complex claims, with emphasis on commercial property and residential property, business interruption, and inland marine claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure, long term claims and will often entail litigation and coverage issues. The goal of this position is to ensure the delivery of quality service claims adjusting in full compliance with special claims handling obligations.
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
Within prescribed settlement authority, establish appropriate reserves for both indemnity and expense and conduct reviews on a regular basis to ensure reserve adequacy.In matters exceeding settlement authority, should have the ability to recommend a specific reserve range, based on industry experience and the specific evidence secured in a specific claim investigation.
Fully evaluate losses, including expense budgeting and all available property limits (including sub-limits) to make recommendations and set proper reserves at appropriate levels for claims within and outside of client authority level. Demonstrate credibility with clients and other business professionals by discussing and explaining these recommendations.
Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management.
Manage all processes requiring estimating, assessment, valuation, and applicable depreciation. Include interpretation and evaluation of applicable insurance contracts in the assessment process.
Possess familiarity with scoping, estimating and use of Xactimate and other valuation programs.
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 vendor services such as independent adjusting firms, contractors, consultants, forensic accountants, engineers, emergency repair, cleaning services and various replacement services to ensure prompt, equitable and appropriate resolution of all commercial property claims.
Large loss commercial claim handling and oversight experience. Facilitate communication between claimants, clients and brokers for resolution of claims.
Exchange information with clients, claimants, insurance brokers, inspectors, producers and account managers.
Superior customer service skills. Ability to recognize matters of urgency and act promptly and efficiently to address them.
Participate in client meetings, status conferences, file reviews and fully comply with client instructions for all levels of communication and notification.
Be aware of insurance fraud and the internal and external requirements of notification/reporting of potential fraudulent matters.
Keep the client involved in decision making as required and comply with escalation process for advance notification of serious losses.
Investigate, evaluate, and determine settlement value or denial of liability for severe to major-level 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 an 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.
Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment.
Ensure appropriateness of all payments
Capability to adjust large commercial property losses
Exchange information with clients, claimants, insurance brokers, inspectors producers and account managers
Assist in training of new employees
Provide training and daily guidance to other examiners
Some oversight of less experienced examiners and claims assistants
May fill-in for supervisor if necessary
Attend meetings and educational seminars for professional development and to maintain required licenses
Coordinate and work with a vendor services such as contractors, emergency repair, cleaning services and various replacement services.
Participate and/or conduct department meetings
Present company abilities in new client meetings
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
Relies on extensive experience and judgment to plan and accomplish goals with a minimum 8-10 years of complex/major property claims experience including proficiency in investigation and resolution of severe to major casualty claims
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
Additional State Adjuster License(s) may be required within 180 days
Maintain licenses and continuing education requirements in all states.
Experience with property and casualty insurance policies, insurance tort laws, codes and procedures
Knowledge of contractual/policy law and commercial property insurance policies. Experience in reviewing Condo By-Laws and Condo Rules and Regulations
Proficiency in investigation and resolution of moderate to major level property claims. Understands principals of co-insurance and replacement cost evaluations
Understanding of medical, legal terminology and liability concepts
Time Management and project management skills
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 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 http://www.athensadmin.com/careers/job-openings 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: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf .
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 www.athensadmin.com 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 at
https://www.athensadmin.com/careers/why-work-here
#J-18808-Ljbffr