Claims Examiner

JOB TITLE: Claims Examiner – Inside Adjuster

STATUS: Full time, Exempt

DEPARTMENT: Claims

SUPERVISOR TITLE: Claims Supervisor

JOB SUMMARY

The Claims Examiner – Inside Desk Adjuster has direct responsibility for homeowners' property insurance claims, starting with contacting the insured upon the loss through claims resolution. The Claims Examiner provides world class customer service to our insurance policyholders by empathetically handling each claim and working as efficiently as possible to handle every claim fairly.

ESSENTIAL FUNCTIONS

• Conduct proper investigations, set adequate reserves, and perform expeditious adjustments of claims
• Recommend insurance claim payments to policyholders and claimants
• Handle a pending caseload of approximately 50-60 claims within policy and corporate guidelines for claims handling
• Engage and monitor the work of outside vendors contributing to the claims adjustment process
• Be adept in and use property and casualty insurance expertise and industry knowledge to recommend and implement change when needed
• Develop and employ creative resolution strategies
• Capable of negotiating disposition of claims with insureds and claimants or their legal representatives while recognizing and implementing alternative means of resolution
• Actively provide mentoring and coaching to less experienced claims professionals to increase the technical expertise and improve team strength
• Ensure compliance of all statutory regulations and Unfair Claim Practice Acts

REQUIRED SKILLS & EXPERIENCE

• Xactimate experience highly preferred
• Must be an out-of-the-box thinker who is not afraid of recommending and implementing sound, yet creative, claim-related business practices
• Possess proven negotiation skills for use with insureds and their representatives
• Have a positive attitude and the ability to embrace change
• Ability to work well in an open-concept, team-oriented environment
• Effectively communicate through oral and written communications with all internal and external customers of the claims department
• Diligent use and reliance upon a diary system for systematic tracking and processing of claims
• Proficiency with Microsoft Office products required (specifically Word, Excel, and Outlook)
• Able and willing to work extended hours due to weather-related events

EDUCATION & TRAINING

• Bachelor’s degree preferred, or a combination of equivalent experience and education

EXPERIENCE

• Minimum 4 years of Florida homeowners' property and casualty claims processing experience

LICENSES OR CERTIFICATIONS

• 5-20 or 6-20 Florida Adjuster’s license in good standing

HYBRID WORKING & COLLABORATION WEEKS

To foster HCI’s commitment to creating a collaborative work environment, remote workers will be required to report to a central office location for one week every quarter for collaboration, team building, and educational exercises. Attendance during collaboration weeks is a vital component of our team culture, and therefore mandatory unless exceptions are approved through Human Resources. Additionally, employees may be asked to report to the office outside of collaboration weeks as project requirements, team meetings, or other organizational needs that necessitate in-person collaboration occur.

WORK ENVIRONMENT

Work is primarily sedentary in nature. Job operates primarily in a hybrid/remote work environment. Hybrid/Remote employees will be provided with equipment that is essential to their job duties. The employee is required to have an internet speed of at least 20 Mbps download, 20 Mbps upload, and less than 20ms (milliseconds) for ping/latency for ideal phone call quality. Remote workers must be able to provide a quiet and distraction-free working space to ensure productivity and attentiveness.

PHYSICAL DEMANDS

The role requires sitting for long periods of time, as well as working with computer and other electronic screens under fluorescent lights.

PERFORMANCE OF JOB DUTIES AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Some requirements may exclude individuals who pose a threat or risk to the health and safety of themselves or other employees. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with HCI policy and applicable law. HCI cannot guarantee any particular accommodation requested by an employee and this job description does not constitute an agreement to do the same. Employees must review HCI’s policies regarding reasonable accommodation and notify the Human Resources Department regarding any accommodation request.

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