Commercial Claims Examiner III

Job not on LinkedIn

🔥 8 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $46 - $51 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 1%

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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

• Manage a caseload of commercial property claims from assignment through resolution. • Examine commercial claims investigated by independent adjusters to determine the extent of insurance coverage and validity of the claims. • Review and adjust commercial loss reserves, correspondence, reports, verify coverage and authorize payments submitted by independent adjusters. • Collaborate with internal personnel and/or legal counsel on claims involving litigation. • Investigate, evaluate, and adjust claims, applying technical knowledge and human relations skills to promote fair and prompt settlement of claims. • Oversee independent adjuster files to ensure they have followed CFP IA Guidelines. • Verify and analyze data used in settling claims to ensure validity and that settlement is in accordance with company practices and procedures. • Maintain compliance with the Department of Insurance and Company procedures. • Identify fraud or illegal activity indicators and follow internal processes to refer the claims to the appropriate personnel for follow up. • Promptly negotiates settlements ensuring the settlement reflects the insured losses while confirming the insurer is protected from invalid claims. • Focus on claims over $500,000, while receiving smaller claims as needed.

🎯 Requirements

• Bachelor’s degree or equivalent. • 5+ years of property claims adjusting experience, including 2+ years commercial property claims preferred. • Excellent oral and written communication skills. • Working experience with MS-Office (especially Word and Excel). • Comprehensive understanding of policy contract/statutes and claims processes. • Certified in CEA and Fair Claims Settlement Practices. • 4 years Commercial Experience, 2 years claims over $500k