Claims Examiner II

Job not on LinkedIn

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

💵 $41 - $46 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 1%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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California FAIR Plan Association

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1968

🛡️ Insurance

Insurance

California FAIR Plan Association is an insurance organization that provides basic fire insurance coverage for high-risk properties in California when traditional insurance companies will not offer coverage. The FAIR Plan includes dwelling coverage for owner- or tenant-occupied dwellings with up to four family units, as well as commercial coverage for business-owned buildings. They also offer earthquake insurance through the California Earthquake Authority. The organization helps Californians access necessary fire insurance via licensed brokers and is essentially a temporary insurance solution when coverage is unavailable from traditional insurers.

📋 Description

• Process insurance claims for property losses based on coverage, appraisal, and verifiable damage. • Interact with independent adjusters and policy holders. • Review claim forms and other records to determine insurance coverage. • Make payment recommendations and settlements in accordance with company practices, procedures, and Fair Claims Settlement Practices regulations. • Investigate, evaluate, and resolve claims. • Adjust reserves and provide reserve recommendations. • Enter claim transactions clearly and concisely. • Examine claims inspected by independent adjusters, including further investigation of questionable claims and verification of coverage. • Conduct daily diary reviews on claim files and ensure status letters are sent in accordance with Department of Insurance regulations. • Pay and process claims within designated authority level. • Supervise independent adjusters to ensure adherence to CFP IA Guidelines. • Maintain compliance with Department of Insurance and company policies and procedures. • Create accurate and complete correspondence to policyholders and secure missing information. • Negotiate settlements reflecting actual insured losses while protecting the insurer from invalid claims. • Confer with Claims Management and legal counsel on claims involving litigation. • Handle the entire claim except inspection, or a specific coverage such as Personal Property or Fair Rental Value. • Handle claims generally ranging from $100,000 to $300,000 in damages, with larger or smaller claims as necessary.

🎯 Requirements

• Minimum bachelor’s degree or equivalent preferred. • Excellent oral and written communication skills. • Working experience with MS-Office (especially Word and Excel) is required. • 2+ years property claims experience and excellent customer service. • Certified in CEA and Fair Claims Settlement Practices. • 3 years total claims experience, 2 years handling HO claims up to $300,000. • 1 year Carrier Experience Required.