Senior Claims Examiner (Insurance)

Senior Claims Examiner

Company

Arbol

Conditions

3 days agoLeadSalary: 100K - 115KAnywhere Remote Full Time Operations Jobs by Arbol

Skills

Ai Claims Contract Counsel Coverage Fraud Insurance Liability Litigation Negotiation Regulation Reserve Software Tort Vendor

Candidate Availability

Floridablanca · Required Louisiana · Required Texas · Required Remote · Required Required and preferred rules are kept separate and reflect the wording in the original posting.

About the Role

You will investigate, evaluate, negotiate, and resolve complex litigated property and liability claims. You will analyze coverage and liability, manage defense counsel and vendors, set and monitor reserves, participate in litigation proceedings, maintain claim files and reports, ensure regulatory compliance, detect fraud, and mentor less experienced examiners.

Requirements

• 4-year college degree plus 7+ years of property, liability, and litigation claims handling experience, or comparable education and experience
• Experience with first- and third-party litigation in Florida, Texas, and Louisiana
• Applicable state adjuster license where required
• Experience interpreting property damage estimates and policy coverages
• Experience evaluating liability exposures
• Technical expertise in claims management, coverage, forms, contracts, and tort law
• Negotiation experience with claimants and plaintiff attorneys
• Knowledge of insurance regulations across jurisdictions
• Experience adopting and using new software and tools
• Proficiency in Microsoft Word, Excel, and Outlook
• Insurance certifications, courses, or professional designations preferred
• Ability to work extended hours during weather-related events or litigation deadlines

Responsibilities

• Investigate, evaluate, and resolve complex litigated property and liability claims
• Investigate third-party liability claims from first notice of loss
• Contact insureds and claimants to gather facts
• Assess liability and determine claim evaluations
• Negotiate settlements with claimants and attorneys
• Develop litigation strategies with defense counsel
• Prepare claim files and follow up on cases
• Attend trials, mediations, arbitrations, and depositions
• Review policy information and analyze coverage issues
• Evaluate liability exposures using tort law, contracts, and coverage forms
• Recommend and monitor accurate reserves
• Maintain claim diaries using claims software
• Present files to internal claims committees
• Provide detailed reports for management
• Use AI-driven tools and claims software
• Ensure compliance with company guidelines, statutes, and Unfair Claims Practice Acts
• Identify fraud indicators and recovery opportunities
• Manage outside vendors, defense counsel, and experts
• Mentor less experienced examiners
• Support litigation and liability claims during high catastrophe volumes

Benefits

• Competitive compensation
• Equity
• Health insurance
• Dental insurance
• Vision insurance
• Flexible spending account
• 401(k) match
• Flexible paid time off

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