[Hiring] Claims Examiner II @The Baldwin Group

Role Description

The Claims Examiner II is considered an expert in managing insurance claims for our policyholders, handling claims with a higher level of complexity. The Claims Examiner II must have technical knowledge in insurance claims handling and the skills needed to provide superior service for our customers. The ability to develop relationships and effectively communicate with a diverse range of clients, carriers, and colleagues is a key success factor in this role. Strategic vision coupled with tactical execution to achieve results in accordance with goals and objectives is also critical to the overall success of this position.

• Analyzes insurance policies and other documents to determine insurance coverage.
• Investigates and analyzes claim information to determine extent of liability.
• Handles 1st Party Property Claims of a high level of complexity.
• Assists in suits, mediations, and arbitrations. Works with Counsel in the defense of litigation.
• Sets timely, adequate reserves in compliance with the company’s reserving philosophy.
• Engages experts to assist in the evaluation of the claim.
• Monitors vendor performance and controls expense costs.
• Evaluates, negotiates, and determines settlement values.
• Communicates with all interested parties throughout the life of the claim.
• Handles all claims in accordance with Best Practices.
• Responsible for monitoring and completing assigned claims inventory.
• Acquires and maintains a state adjuster’s license and meets state continuing education requirements.
• Provides Best-In-Class customer service for insureds and agents.
• Updates and maintains the claim file.
• Identifies opportunities for subrogation and ensures recovery interests are protected.
• Identifies fraud indicators and refers files to SIU for further investigation.
• Participates in claims audits, internal and external.
• Provides oversight of TPAs.

Qualifications

• High School/GED
• 5-9 years' experience in claims
• Must have Property & Casualty Insurance License

Company Description

As a leading MGA, MSI combines deep underwriting expertise with insurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers’ unique needs. We have a passion for crafting solutions for the important risks facing individuals and businesses. We offer an expanding suite of products – from fully-digital embedded renters coverage to high-value homeowners insurance to sophisticated commercial coverages, such as cyber liability and habitational property – delivered through agents, brokers, wholesalers, and other brand partners. Our partners and customers count on us to deliver exceptional service through a dedicated team that makes rapid resolutions a priority. We simplify the insurance experience through our advanced technology platform that supports every phase of the policy lifecycle.