Senior Claims Examiner

Accountabilities: • Investigate and evaluate complex Employment Practices Liability claims, including coverage, liability, and damages, ensuring accurate and timely assessments.

• Establish, document, and execute appropriate claim strategies designed to achieve early, equitable, and cost-effective resolutions.

• Analyze initial claim reports, insurance contracts, legal information, and other technical materials to determine appropriate coverage and claim-handling approaches.

• Represent the organization in meetings with management and business partners and participate virtually in mediations.

• Build and maintain productive relationships with clients, insureds, underwriters, agents, defense counsel, and other internal and external stakeholders.

• Use claims technology and systems effectively to monitor, document, and manage caseloads.

• Maintain compliance with established claims-handling standards relating to investigation, coverage, loss assessment, documentation, and case management.

• Apply sound judgment and creative problem-solving to address complex claims and customer needs.

• Contribute to a collaborative team environment by sharing ideas, demonstrating initiative, and supporting collective goals.

• Assist with training new claims examiners and provide coaching and guidance as they develop their claims-handling capabilities.

• Participate in structured classroom and on-the-job training covering employment law, insurance products, coverage analysis, investigation techniques, legal processes, and settlement negotiation.

• Obtain and maintain applicable resident, designated home state, and potentially additional state adjuster licenses as required.

Requirements:

• Bachelor’s degree required; a Juris Doctor (JD) is preferred but not required.

• 2–4 years of experience handling claims of comparable complexity or working in a legal position.

• Previous Employment Practices Liability (EPL) or Financial Lines experience is preferred.

• Strong verbal and written communication skills, with the ability to clearly explain complex information.

• Strong interpersonal skills and the ability to establish productive relationships with stakeholders at all organizational levels.

• Strong aptitude for evaluating, analyzing, and interpreting technical and financial information.

• Sound decision-making skills and the ability to exercise appropriate judgment when handling complex claims.

• Proven ability to work independently while also contributing effectively within a collaborative team.

• Demonstrated initiative, leadership potential, and commitment to high-quality performance.

• Excellent time management, organizational, and problem-solving skills.

• Ability to adapt quickly to new ideas, situations, technologies, and processes.

• Creative and practical approach to overcoming obstacles and developing solutions to customer and claim-related challenges.

• Willingness to learn and apply employment law, insurance contracts, claims practices, and negotiation techniques.

• Ability to obtain required adjuster licensing if not already licensed.

Benefits:

• Collaborative professional environment with colleagues from diverse backgrounds across claims, legal, human resources, and related disciplines.

• Comprehensive classroom and on-the-job training led by managers, experienced claims examiners, and defense counsel.

• Opportunity to develop specialized expertise in Employment Practices Liability and employment-related legal issues.

• Exposure to complex and evolving workplace claims and insurance matters.

• Opportunities to develop coaching and leadership skills by supporting newer claims professionals.

• Technology-enabled, paperless claims environment.

• Non-remote position based in Pittsburgh, Pennsylvania.

• Opportunities to work with internal and external business partners across multiple functions.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether?

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