Senior Casualty Claims Examiner

Job description

We are seeking an experienced and detail-oriented Senior Casualty Claim Examiner to join our team. This role is responsible for handling complex personal and commercial auto, bodily injury, and general liability claims with a focus on thorough investigation, sound judgment, and timely resolution. The ideal candidate will bring strong technical claims expertise, excellent communication skills, and the ability to manage a diverse inventory of claims while delivering a high level of customer service.

We are hiring in Phoenix, AZ; O’Fallon, MO; and Alpharetta, GA.

Key Responsibilities

Analyze initial loss reports to determine the nature of loss, applicable coverage, and the scope of injury or damage in personal and commercial auto, bodily injury, and general liability claims. Conduct comprehensive investigations into all aspects of reported claims, including potential fraud, and secure appropriate supporting documentation. Verify the accuracy, relevance, and completeness of claim information and documentation.

Manage first- and third-party injury claims related to No-Fault/Med Pay and liability exposures. Apply knowledge of jurisdictional regulations and case law across all assigned territories. Negotiate liability and damages effectively when appropriate. Monitor and manage claim files to ensure timely development and resolution of claims inventory. Collaborate with department management to deliver presentations, conduct meetings, and serve as a technical resource.

Qualifications

5–7+ years of experience in liability insurance claims adjusting, including litigation. Bachelor’s degree or equivalent experience. Strong understanding of insurance contracts, investigation techniques, legal requirements, and insurance regulations. Ability to evaluate, analyze, and interpret policy language, contracts, and other complex information. Excellent verbal and written communication skills with the ability to clearly explain coverage positions, claim decisions, and recommendations.

Strong analytical and critical thinking skills with the ability to assess claim facts and determine appropriate next steps. Ability to manage multiple claims simultaneously while maintaining accuracy, organization, and attention to detail. Demonstrated negotiation skills and the ability to resolve liability and damages effectively. Sound judgment and decision-making skills in complex or sensitive claim situations. Ability to work independently and collaboratively with management, peers, and internal stakeholders.

Strong customer service orientation and the ability to handle challenging conversations professionally and tactfully. Ability to adapt to changing priorities, deadlines, and claim environments. Familiarity with litigation management and supporting claims through the litigation process. Proficiency in documenting claim activity thoroughly and maintaining clear, accurate file notes. Ability to identify potential fraud indicators and escalate concerns appropriately.

Strong presentation and facilitation skills with the ability to contribute in meetings and serve as a technical resource. Commitment to continuous learning and staying current on jurisdictional regulations, case law, and industry best practices. If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.