Senior Claims Examiner - Claims Specialist

Company: James River Management Company
Location: Richmond
Posted on: October 16, 2024

Job Description:

Senior Claims Examiner - Claims Specialist







Alpharetta, GA, USA * Raleigh, NC, USA * Richmond, VA, USA * Scottsdale, AZ, USA * Virtual
Req #127



Wednesday, August 7, 2024





Come grow with James River Insurance!
James River Insurance is an excess and surplus lines segment of James River Group Holdings, Ltd. and operates on an approved non-admitted basis in 50 states and Washington, DC. Since 2003, James River has provided thousands of commercial property and casualty customers with innovative and creative solutions for particular insurance needs.
At James River Insurance, we are committed to providing a stable and rewarding work environment supported by our Core Values and Guiding Principles: Integrity, Accountability, Innovation, Customer Service, Communication, and Teamwork. We are proud of our recent national recognition as a 2023, 2022, and 2021 Top Workplaces USA awards.
James River Group Holdings, Ltd. is a Bermuda-based insurance holding company which owns and operates a group of specialty insurance and reinsurance companies. The Company operates in two specialty property and casualty insurance segments: Excess and Surplus Lines and Specialty Admitted Insurance. The Company tends to focus on accounts associated with small or medium-sized businesses in each of its segments. Each of the Company's regulated insurance subsidiaries are rated "A-" (Excellent) by A.M. Best Company.






Job Summary
The Claims Examiner l will manage a caseload of low to moderate severity/complexity property and casualty insurance claims under a moderate level of supervision, depending on level of experience. Job functions include the following: Analyzing insurance claims to determine applicable coverage; Analyzing claims to determine the extent of insured's or insurer's liability; Reviewing and evaluating damages and determining strategies for resolution. Settling claims in accordance with policy provisions and within an authority level. The Claims Examiner l will engage in verbal and written communication with claimants, attorneys, and policyholders. The Claims Examiner l will ensure that all state claims handling requirements are met and internal guidelines are followed. The Claims examiner l will handle claims in accordance with established James River Claims Best Practices.
Duties and Responsibilities

Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service
Perform coverage, liability, and damage analysis on all claims assignments
Prepare correspondence to all required parties involved in claim when necessary
May investigate allegations and determine facts based on evidence and recorded interviews
May be required to complete actions to satisfy department of insurance and/or state regulations
Draft disclaimers and reservation of rights letters when coverage issues arise
Assign limited investigations and appraisals to licensed insurance professionals
Negotiate settlements, mitigate losses, and control expenses
Maintain a high level of communication internally with claims management team and externally with insureds, claimants, and attorneys
May be called upon to assist in training existing and new Claims Examiners

Knowledge, Skills and Abilities

Excellent written and verbal communication skills
Strong analytical skills
Strong negotiation skills
Ability to work independently with moderate level of supervision
Excellent organizational skills
Proficiency in MS Office (Word, Excel, Outlook)
Ability to work in a team environment and take direction from Claims Manager
Ability to train and provide technical guidance to less experienced Claims Examiners
Functional knowledge and skills reflective of a fully competent Claims Examiner
Ability to successfully obtain the required state adjusters' licenses within six (6) months following the completion of Company-provided licensure training courses and maintain appropriate licensure thereafter.

Experience and Education
Senior Claims Examiner

High school diploma required
College degree preferred
Minimum of five years P&C claims handling experience
Experience and proven track record in managing complex coverage issues and complex litigation
Multi-jurisdictional claims experience
Adjuster license and/or certifications preferred

Claims Specialist

High school diploma required
College degree preferred
Advanced degree or law degree preferred
Minimum of seven years claims handling experience
Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL)
Experience working with complex coverage issues
Multi-jurisdictional claims and litigation experience
Adjuster license and/or certifications desired preferred







Other details



Job Family
Claims

Job Sub Family
Operations

Pay Type
Salary






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Keywords: James River Management Company, Portsmouth , Senior Claims Examiner - Claims Specialist, Other , Richmond, Virginia