HAI Group
Senior Claims Examiner (General Liability)
The Senior Claims Examiner is responsible for investigation, evaluation, reserving, negotiation, and resolution of the companies’ liability claims in multiple jurisdictions. The position is required to follow established claims management standards and exercise solid judgment when solving business problems as well as using critical thinking, decision-making skills, and judgment within their assigned authority levels. The Senior Claims Examiner continually explores ways to apply claim’s best practices to business challenges. Individuals in this role are expected to mentor and coach team members to increase their technical expertise and business contributions. Essential Functions
Timely and effectively investigate and evaluate claims while managing outside adjusters and legal counsel Directs settlement activity using investigative and problem-solving skills in direct negotiations Handle all assigned cases efficiently and cost-effectively through conclusion Analyze and recommend appropriate reserves; periodically reviewing and adjusting these reserves based on the assessment of probable liability, financial responsibility and exposure Handle all assigned cases efficiently and cost-effectively through conclusion, identifying and thoroughly investigating all available risk transfer options (subrogation and third-party recoveries and re-insurance) Review, analyze and interpret coverage in accordance with applicable policies Prepare coverage evaluations, document files and draft letters for management review in a timely manner Concentration on larger cases with reinsurance involvement requiring ability to track aggregates, and prepare more complex reports Reviews invoices, estimates, legal fees, and other documents to ensure accuracy and legitimacy prior to payment Prepare clear and concise reports with little or no guidance that can be presented for review and require little or no edits by management Mentors’ examiners, as well as coordinators, by providing guidance, sharing expertise, and overseeing work product Serve as Subject Matter Expert for certain venues and/or coverage line Knowledge, Skills, Abilities:
Create and manage positive working relationships with internal and external business partners Presents a positive and professional image of companies Knowledge and commitment to company mission, vision, and organizational values Ability to quickly assimilate and practically utilize new information Possess written and verbal communications skills to review, understand, interpret, and convey data including medical records, legal documents, and coverage interpretation Strong customer service skills including interacting with internal and external customers Team player; works effectively as part of a team Job Requirements
Required
High School Diploma Bachelor’s degree in business management, insurance, or related field required, or equivalent work experience Minimum 5 years progressive liability claims handling experience for property/casualty insurance company or third-party administrator All lines property/casualty adjuster’s license Experience analyzing and interpret coverage at a level commensurate with complexity of assigned claims Experience preparing and communicating written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers Understands the litigation process, current relevant case law and statutory law in multiple jurisdictions Experience implementing compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements Maintains adjusting licenses in all required states Preferred
AIC designation Knows the Public and Affordable Housing business Work environment & Physical Demands
Inside climate-controlled office building Prolonged sitting and using a PC Company Overview
HAI Group is the nation’s leading property-casualty insurance company founded by and dedicated to affordable housing organizations. We protect, preserve, and promote the sustainability of affordable housing with an array of products and services that support the challenges housing organizations face. HAI Group Benefits And Perks
Bonus program eligibility Annual merit program Outstanding 401(k) program and non-elective contribution Flexible work schedules Generous paid time off, paid volunteer days and paid holidays Medical, vision and dental Insurance Company paid life, AD&D, short-term disability, and long-term disability coverage HSA, FSA and dependent care options On-Site wellness: Full gym and locker rooms, wellness initiatives, outdoor basketball and tennis court, picnic pavilion area Tuition reimbursement and loan repayment Professional development Community outreach HAI Group is an Equal Opportunity Employer.
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The Senior Claims Examiner is responsible for investigation, evaluation, reserving, negotiation, and resolution of the companies’ liability claims in multiple jurisdictions. The position is required to follow established claims management standards and exercise solid judgment when solving business problems as well as using critical thinking, decision-making skills, and judgment within their assigned authority levels. The Senior Claims Examiner continually explores ways to apply claim’s best practices to business challenges. Individuals in this role are expected to mentor and coach team members to increase their technical expertise and business contributions. Essential Functions
Timely and effectively investigate and evaluate claims while managing outside adjusters and legal counsel Directs settlement activity using investigative and problem-solving skills in direct negotiations Handle all assigned cases efficiently and cost-effectively through conclusion Analyze and recommend appropriate reserves; periodically reviewing and adjusting these reserves based on the assessment of probable liability, financial responsibility and exposure Handle all assigned cases efficiently and cost-effectively through conclusion, identifying and thoroughly investigating all available risk transfer options (subrogation and third-party recoveries and re-insurance) Review, analyze and interpret coverage in accordance with applicable policies Prepare coverage evaluations, document files and draft letters for management review in a timely manner Concentration on larger cases with reinsurance involvement requiring ability to track aggregates, and prepare more complex reports Reviews invoices, estimates, legal fees, and other documents to ensure accuracy and legitimacy prior to payment Prepare clear and concise reports with little or no guidance that can be presented for review and require little or no edits by management Mentors’ examiners, as well as coordinators, by providing guidance, sharing expertise, and overseeing work product Serve as Subject Matter Expert for certain venues and/or coverage line Knowledge, Skills, Abilities:
Create and manage positive working relationships with internal and external business partners Presents a positive and professional image of companies Knowledge and commitment to company mission, vision, and organizational values Ability to quickly assimilate and practically utilize new information Possess written and verbal communications skills to review, understand, interpret, and convey data including medical records, legal documents, and coverage interpretation Strong customer service skills including interacting with internal and external customers Team player; works effectively as part of a team Job Requirements
Required
High School Diploma Bachelor’s degree in business management, insurance, or related field required, or equivalent work experience Minimum 5 years progressive liability claims handling experience for property/casualty insurance company or third-party administrator All lines property/casualty adjuster’s license Experience analyzing and interpret coverage at a level commensurate with complexity of assigned claims Experience preparing and communicating written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers Understands the litigation process, current relevant case law and statutory law in multiple jurisdictions Experience implementing compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements Maintains adjusting licenses in all required states Preferred
AIC designation Knows the Public and Affordable Housing business Work environment & Physical Demands
Inside climate-controlled office building Prolonged sitting and using a PC Company Overview
HAI Group is the nation’s leading property-casualty insurance company founded by and dedicated to affordable housing organizations. We protect, preserve, and promote the sustainability of affordable housing with an array of products and services that support the challenges housing organizations face. HAI Group Benefits And Perks
Bonus program eligibility Annual merit program Outstanding 401(k) program and non-elective contribution Flexible work schedules Generous paid time off, paid volunteer days and paid holidays Medical, vision and dental Insurance Company paid life, AD&D, short-term disability, and long-term disability coverage HSA, FSA and dependent care options On-Site wellness: Full gym and locker rooms, wellness initiatives, outdoor basketball and tennis court, picnic pavilion area Tuition reimbursement and loan repayment Professional development Community outreach HAI Group is an Equal Opportunity Employer.
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