Commercial Auto, General Liability Claims Examiner III

Job not on LinkedIn

🔥 3 hours ago

🇺🇸 United States – Remote

💵 $80k - $90k / year

⏰ Full Time

🟠 Senior

🔴 Lead

📋 Claims Specialist

👻 Ghost score 0%

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TRISTAR Insurance Group

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1987

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

TRISTAR Insurance Group is a national third-party administrator (TPA) that provides insurance administration and risk management services to employers, insurers and public entities. Its solutions include property & casualty, workers' compensation, general and auto liability, managed care (bill review, case management, utilization review, nurse triage, pharmacy benefit management), absence and disability management, employee group benefits administration, and risk control and workplace safety services. TRISTAR emphasizes collaborative, technology-enabled and tailored services to transform risk into opportunity for its clients.

📋 Description

• Investigate, evaluate, manage, and resolve complex commercial automobile and general liability claims, including litigated claims • Review and interpret insurance policies, endorsements, and vehicle schedules to determine coverage and identify coverage issues • Provide temporary coverage for other claims examiners during PTO, absences, or extended leaves • Review transferred files, identify outstanding activities and deadlines, and maintain continuity of claim handling • Maintain accurate claim diaries and complete timely follow-up on investigations, correspondence, litigation activities, and required actions • Evaluate liability, damages, and potential exposure; recommend and update reserves • Develop and communicate claim resolution and settlement strategies to clients • Negotiate settlements within delegated authority and obtain approval when required • Coordinate and direct outside investigators and other service providers • Work with clients and counsel to advance claims toward resolution • Monitor litigation developments and evaluate counsel recommendations • Prepare loss reports analyzing coverage, liability, damages, reserves, and recommended next steps • Identify subrogation and risk transfer opportunities and initiate recovery efforts • Maintain complete, accurate, and timely claim file documentation • Provide responsive, professional service to clients and involved parties • Coordinate file handoffs with supervisors and returning examiners • Assist supervisors and the claims department with special projects and other assigned responsibilities • Prevent claim backlogs and meet client service level agreements

🎯 Requirements

• High School Diploma or GED required • Minimum of seven+ (7) years’ commercial auto and general liability casualty related experience • At least 10 years of Commercial Automobile and General Liability claims experience required • Must have an active FL, NY, GA or TX license • Holds an applicable resident or designated home state adjuster license and required nonresident licenses, or has the ability to obtain required licenses through reciprocity or applicable state examinations • Maintains required licenses and completes applicable continuing education requirements • Advanced knowledge of commercial automobile and general liability claims handling • Knowledge of claims handling concepts, coverage issues, and product line knowledge • Understanding of the litigation process and claim valuation across multiple jurisdictions • Advanced analytical, decision-making, and negotiation skills • Strong written and verbal communication skills • Ability to independently manage complex claims with minimal supervision • Ability to prepare clear, thorough claim reports and recommendations • Ability to develop and maintain relationships with clients, claimants, legal representatives, counsel, and service providers • Strong organizational and time management skills • Flexibility to assume unfamiliar claim inventories and maintain service standards • Proficiency with claims management systems, computer applications, and related technology • Bachelor’s degree in a related field preferred • Associate in Claims (AIC) and/or Chartered Property Casualty Underwriter (CPCU) designation preferred • Experience providing float coverage or managing claims across multiple client accounts and jurisdictions preferred

🏖️ Benefits

• Fully remote / working from home • Full-time position • No travel required