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Claims Examiner
3 weeks ago
Job Summary
The Claims Division is seeking a team member to join the Arch Canada Claims Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of first and third party low complexity claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence.
Responsibilities
Specifics duties include but not limited to the below:
Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level
Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution
Review and analyze supporting damage documentation
Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions
Establish appropriate loss and expense reserves with documented rationale
Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines
Communicate effectively and timely with internal (such as underwriting) and external customers on claims and account issues
Maintain and manage diary system to efficiently manage and resolve assigned pending
Identify and communicate trends with senior claims and underwriting management
Effectively draft written communications to Insureds and Claimants regarding status of claim i.e. request for information, confirmation of investigatory details and/or coverage position letters
Mitigate claim expenses as economically as possible
Summarize claims in excess of authority and submit rational to manager for approval
Negotiate settlements within approved authority level, issue settlement payments and document all activities
Identify potential subrogation and fraud opportunities and make appropriate referrals
Support claims workflow efficiency by accurately documenting claim progress, referring high risk exposures outside authority levels and seeking opportunities that enhance operational knowledge
Use multiple systems to gather, enter and analyze claim metric data to ensure targets are achieved
Education and Experience
1-3 years’ experience handling the process of commercial insurance claims
Hands-on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint, and Word
Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions
Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines
Ability to work well independently and in a team environment
Bachelor’s degree preferred
C.I.P. designation, or working towards same
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