TRISTAR Insurance Group este un administrator național de servicii de asigurare pentru terți, care oferă angajatorilor, asigurătorilor și entităților publice servicii de administrare a asigurărilor și de gestionare a riscurilor. Compania sprijină programe pentru bunuri și răspundere civilă, compensații pentru accidente de muncă, răspundere civilă generală și auto, îngrijire medicală coordonată, gestionarea absențelor și dizabilităților, administrarea beneficiilor de grup pentru angajați și siguranța la locul de muncă. Capacitățile sale de îngrijire medicală coordonată includ verificarea facturilor, gestionarea cazurilor, evaluarea utilizării serviciilor, triajul efectuat de asistente medicale și administrarea beneficiilor farmaceutice. TRISTAR combină operațiunile susținute de tehnologie cu servicii adaptate pentru a ajuta clienții să gestioneze riscurile asociate unor nevoi complexe de asigurare și de beneficii pentru angajați.
Commercial Auto and General Liability Claims Examiner III - Remote
TRISTAR Insurance Group is seeking a remote, full-time Claims Examiner III to handle complex commercial auto and general liability claims across investigation, litigation, coverage, valuation, and settlement. The role also provides float coverage, client service, and coordinated claim resolution.
Descriere
- Investigate, assess, manage, and resolve complex commercial auto and general liability claims, including litigated matters.
- Interpret policies, endorsements, and vehicle schedules to determine coverage and flag coverage issues.
- Provide interim coverage for claims examiners during PTO, absences, and extended leave.
- Review transferred files, identify pending actions and deadlines, and preserve handling continuity.
- Maintain accurate claim diaries and complete timely follow-up on investigations, correspondence, litigation, and required actions.
- Assess liability, damages, and exposure while recommending and updating reserves.
- Create and communicate claim resolution and settlement approaches for clients.
- Negotiate settlements within delegated authority and secure additional approval when needed.
- Engage and oversee outside investigators and other service providers.
- Collaborate with clients and counsel to move claims toward resolution.
- Track litigation developments and assess recommendations from counsel.
- Produce loss reports covering coverage, liability, damages, reserves, and recommended next steps.
- Recognize subrogation and risk-transfer opportunities and begin recovery actions.
- Keep claim files complete, accurate, and current.
- Deliver responsive, professional service to clients and involved parties.
- Coordinate file transitions with supervisors and returning examiners.
- Support supervisors and the claims department with special projects and other assigned work.
- Prevent claim backlogs while meeting client service-level agreements.
Cerințe
- High school diploma or GED is required.
- At least seven years of commercial auto and general liability casualty experience is required.
- At least 10 years of commercial auto and general liability claims experience is required.
- An active Florida, New York, Georgia, or Texas license is required.
- Hold a resident or designated home-state adjuster license and required nonresident licenses, or be able to obtain them through reciprocity or applicable state examinations.
- Maintain required licenses and complete applicable continuing education.
- Demonstrate advanced knowledge of commercial auto and general liability claims handling.
- Understand claims-handling concepts, coverage issues, and relevant product lines.
- Understand litigation procedures and claim valuation across multiple jurisdictions.
- Apply advanced analytical, decision-making, and negotiation skills.
- Communicate effectively in writing and verbally.
- Manage complex claims independently with minimal supervision.
- Prepare clear, thorough claim reports and recommendations.
- Build and maintain relationships with clients, claimants, legal representatives, counsel, and service providers.
- Demonstrate strong organization and time-management skills.
- Adapt to unfamiliar claim inventories while maintaining service standards.
- Use claims-management systems, computer applications, and related technology proficiently.
- A bachelor’s degree in a related field is preferred.
- An Associate in Claims (AIC) or Chartered Property Casualty Underwriter (CPCU) designation is preferred.
- Experience providing float coverage or handling claims across multiple client accounts and jurisdictions is preferred.
Beneficii
- Fully remote work from home.
- Full-time employment.
- No travel required.