Commercial Auto, Property Damage, Claims Examiner II _ Temp

Commercial Auto, Property Damage Claims Examiner IIPOSITION SUMMARY: Responsible for the prompt review and interpretation of policy information to determine coverage for automobile physical damage, property damage liability, and No-Fault/PIP claims, as assigned. Conduct thorough and efficient claim examinations and investigations through final resolution, including claims involving litigation.

The position requires frequent communication with claimants, insureds, legal representatives, clients, vendors, and other involved parties. Effectively communicate claim exposure, reserve recommendations, settlement strategies, and resolution plans to the client.

DUTIES AND RESPONSIBILITIES

Review and interpret policy coverage and investigate, evaluate, process, negotiate, and resolve assigned automobile physical damage, property damage liability, and/or No-Fault/PIP claims.

Jurisdiction is NY & NJ claims.

Analyze coverage, liability, and damages and identify any issues requiring additional investigation or escalation.

Oversee and direct outside service providers, including appraisers and investigators, and work closely with clients, client counsel, and other involved parties to advance claims toward resolution.

Maintain an accurate and timely diary system and complete all required follow-up activities.

Continually evaluate claim exposure and establish or recommend accurate reserves and settlement strategies based on available information.

Prepare comprehensive loss reports that provide a thorough analysis of coverage, liability, damages, exposure, reserves, and recommended next steps.

Determine whether subrogation, contribution, or other risk-transfer opportunities exist and initiate recovery efforts in accordance with client instructions.

Accurately document all correspondence, reports, discussions, evaluations, and claim decisions in the claim file.

Independently conduct claim file reviews and ensure files are properly documented and handled in accordance with applicable requirements.

Provide timely, professional, and responsive service to clients, claimants, insureds, and other involved parties.

Engage TRISTAR Loss Control staff when appropriate. *

Comply with all company policies, procedures, client service instructions, and applicable regulatory requirements. *

Perform other duties and special projects as assigned.

• Essential job function.

• EQUIPMENT OPERATED/USED: Computer, fax machine, copier, printer, and other office equipment.
• SPECIAL EQUIPMENT OR CLOTHING: Appropriate business casual office attire

QualificationsQUALIFICATIONS REQUIRED

Education/Experience: High school diploma or GED required. Bachelor’s degree in business, insurance, risk management, or a related field preferred. A minimum of two years of experience handling automobile physical damage, property damage liability, general liability casualty, and/or No-Fault/PIP claims is required. An equivalent combination of relevant education, training, and experience may be considered.

KNOWLEDGE, SKILLS AND ABILITIES

Minimum of two years of automobile claims-handling experience.

Working knowledge of claim-handling principles, practices, and procedures, including policy interpretation, coverage analysis, liability assessment, damage evaluation, reserving, negotiation, and settlement.

Ability to investigate, evaluate, negotiate, and resolve assigned claims with minimal supervision.

Strong analytical, critical-thinking, decision-making, and problem-solving skills.

Ability to evaluate complex claim information, exercise sound judgment, and make well-supported recommendations.

Strong verbal and written communication skills.

Ability to communicate professionally and effectively with clients, claimants, insureds, attorneys, vendors, and other involved parties.

Strong customer-service and relationship-management skills.

Ability to manage competing priorities and maintain accuracy in a fast-paced environment.

Strong organizational, time-management, and follow-up skills.

Ability to understand and carry out detailed written and verbal instructions.

Ability to maintain complete, accurate, and timely claim documentation.

Proficiency with computers, claims-management systems, and standard business applications.

Ability to work independently while remaining flexible and responsive to changing client and business needs.

Ability to follow company guidelines, client service instructions, applicable regulations, and industry best practices.

LICENSES AND OTHER REQUIREMENTS

• Must possess a current and valid New York adjuster license.
• Must be willing and able to obtain and maintain a California adjuster license within the timeframe established by the company.
• Must obtain and maintain any additional licenses required to handle assigned claims.
• Must be available to work on the company’s established Eastern Time core business hours.
• Mental and Physical Requirements: [see separate attachment for a copy of checklist of mental and physical requirements]

MENTAL AND PHYSICAL REQUIREMENTS

1. MENTAL EFFORT

a. Reasoning development

• Follow one- or two-step instructions; routine, repetitive task.
• Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables.
• Follow written, verbal, or diagrammatic instructions; several concrete variables.
• X Solve practical problems; variety of variables with limited standardization; interpret instructions.
• Logical or scientific thinking to solve problems; several abstract and concrete variables.
• Wide range of intellectual and practical problems; comprehend most obscure concepts.

b. Mathematical development

• Simple additional and subtraction; copying figures, counting, and recording.
• Add, subtract, multiply, and divide whole numbers.
• X Arithmetic calculations involving fractions, decimals, and percentages.
• Arithmetic, algebraic, and geometric calculations.
• Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.
• Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination; requires theoretical application.

c. Language development

Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.

Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.

Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.

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