Claims Examiner I - Commercial Auto PD

Athens Administrators

Lake Mary, Florida

JOB DETAILS
SKILLS
Accidental Death and Dismemberment (AD&D), Analysis Skills, Brokerage, Business Intelligence, Claims Management, Claims Processing, Communication Skills, Compensation and Benefits, Construction, Contract Review, Critical Care, Customer Support/Service, Detail Oriented, Employee Orientation, Hospital, Identify Issues, Insurance, Insurance Regulations, Legal Support Skills, Liability Insurance, Long-Term Care, Managed Care, Materials Cost Analysis, Medical Records, Microsoft Exchange Server, Microsoft Office, Multitasking, Negotiation Skills, Organizational Skills, Presentation/Verbal Skills, Problem Solving Skills, Property and Casualty Insurance, Reporting Skills, Research Skills, Risk, Sales Management, Staff Training, Team Player, Time Management, Work From Home, Worker's Compensation, Writing Skills
LOCATION
Lake Mary, Florida
POSTED
13 days ago
 
 
Position Title:
Claims Examiner I
Department:
Property & Casualty
Reports To:
P&C Claims Supervisor
FLSA Status:
Exempt in all states but CA
Job Grade:
9
Career Ladder:
Next step in progression could include Claims Examiner II
 
ATHENS ADMINISTRATORS
Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!
 
POSITION SUMMARY
Athens Administrators has an immediate need for a full-time Claims Examiner I to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV).  Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines.   Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. 
 
The Claims Examiner I is responsible for the timely investigation, evaluation and determination of settlement or denial of minor to moderate multi-line property & casualty claims.  They will be handling claims from inception to closure.
 
Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation.  Additional duties may be assigned:
 
Knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated analytical, decision making and negotiation skills.
  • Investigate coverage, including evaluate insurance coverage problems and/or disputes
  • Investigate, evaluate, and determine settlement value or denial of liability for all claims
  • Develop a measure of damage for each loss, establish and maintain appropriate reserves
  • Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure
  • Ensure appropriateness of all payments
  • Negotiate settlement of claim within individual authority ($15,000 unless otherwise noted)
  • Maintain and update action plans for each claim.
  • May assign and coordinate with vendors, legal counsel, appraisers, or experts as necessary
  • Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims
 
ESSENTIAL POSITION REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required.  While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
 
  • High School Diploma or equivalent (GED) required for all positions
    • AA/AS or BA/BS preferred but not required
  • Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX or FL
    • Additional State Adjuster License(s) may be required within 180 days
    • Maintain licenses and continuing education requirements in all states.
  • Minimum of three years general claims handling experience
  • Knowledge of property and casualty insurance policies
  • Knowledge of insurance laws, codes, procedures, and liability concepts
  • Proficiency in investigation and resolution of minor to medium level casualty claims
  • Knowledge of general liability insurance principles, codes, procedures, and liability concepts
  • Knowledge of insurance laws, codes, procedures, and liability concepts
  • Familiarity with construction methods and building components preferred
  • Ability to evaluate contracts and review policies for coverage
  • Familiarity with labor and material costs to evaluate repair estimates
  • Understanding of premise liability and risk transfer concepts
  • Proficiency in investigation and resolution of minor to medium level BI and PD general liability damage claims
  • Strong negotiation skills and ability to achieve optimal settlement results for clients.
  • Well-developed verbal and written communication skills with strong attention to detail
  • Excellent organizational skills and ability to multi-task
  • Ability to type quickly, accurately and for prolonged periods
  • Proficient in Microsoft Office Suite
    • Ability to learn additional computer programs
  • Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
  • Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
  • Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
  • Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner
  • Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
  • Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
  • Must be able to reliably commute to meetings and events as required by this position
 
APPLY WITH US
We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings  Feel free to include a cover letter if you’d like to share any other details.   All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act.  Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf
 
This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.
 
Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
 
THANK YOU!
We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!
 
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more!  Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here

About the Company

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Athens Administrators