[Hiring] Claims Examiner @MSI, part of The Baldwin Group

Role Description

As we expand our in-house renters claims handling capabilities, we’re seeking a Claims Examiner who is excited to be part of a growing team where renters claims experience is highly valued. The Claims Examiner will be managing insurance claims for our policyholders with low to moderate severity and complexity.

• Directly handles third-party bodily injury and property damage claims involving low to moderate complexity from initial assignment through to resolution of claim, including negotiating settlements.
• Evaluates and analyzes insurance policies to make coverage determinations.
• Drafts Reservation of Rights letters and coverage disclaimers as warranted.
• Makes prompt contact with policyholders, claimants, and other appropriate parties to gather information, take recorded statements, and conduct thorough investigations.
• Investigates claims to determine validity and the potential for liability against insureds.
• Evaluates damages (both bodily injuries and property damages) to determine potential exposures and sets appropriate reserves.
• Works a claim load efficiently and independently with little to no supervision.
• Sets timely file reserves in compliance with the company’s reserving philosophy and continues to evaluate pending reserves throughout the life of the claim.
• Manage defense counsel, which includes assisting in claim strategy, evaluating potential exposure, reviewing invoices, and attending mediations and settlement conferences as necessary.
• Engages experts, as needed, to assist in the evaluation of the claim and monitors experts and vendors’ performance while controlling expenses.
• Drafts reports for large losses and reports to leadership as required.
• Evaluates, negotiates, and determines settlement values in settlement of claims.
• Communicates with all interested parties throughout the life of the claim, including proactively discussing coverage decisions, the need for additional information, and settlement amounts with interested parties.
• Establishes and maintains an organized diary system to ensure all claims are appropriately handled in a timely manner.
• Adheres to all state/local regulations, including the NJ/PA Unfair Claims Practices and Guidelines.
• Handles all claims in accordance with best practices and provides best-in-class customer service to insureds, agents, claimants, and business partners.
• Responsible for monitoring and completing assigned claims inventory.
• Acquires and maintains multiple state adjuster’s licenses and maintains continuing education requirements.
• Develops and maintains relationships with external and internal stakeholders.
• Identifies questionable risks, red flags, and fraud indicators and alerts the Special Investigation Unit when applicable.
• Identifies opportunities for subrogation and ensures recovery interests are protected.
• Acts as a mentor for less experienced Claims Examiners.
• Updates and maintains well drafted claim file notes with proper documentation throughout the life of the file.
• Assists with special projects when required.

Qualifications

• Ability to communicate clearly, professionally, and provide superior customer service over the phone and through written correspondence.
• Strong organizational and time management skills.
• Strong writing skills.
• Excellent analytical, investigative, and negotiation skills.
• Proficient with Microsoft Office, Teams, Word, Excel, and various other computer skills with the ability to learn and utilize new computer systems and other technologies.

Requirements

• Bachelor’s degree or equivalent work experience.
• 5+ years of casualty claims adjusting experience.
• First-Party Property experience is a plus.
• Insurance designations preferred.
• Must have a State Adjuster License(s) (California, Florida, and Texas licenses are desirable) with willingness to expand licenses as needed.

Company Description

As a leading MGA, MSI combines deep underwriting expertise with insurer and reinsurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers’ unique needs. Since its founding in 2015, MSI has grown to offer a wide range of insurance products across commercial, specialty, and personal lines and has reached over $1 billion of in-force premium in its nationwide portfolio.